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Çocukluk çağı edinsel komitan ezotropyalarda cerrahi sonuçlar

Year 2020, Volume: 45 Issue: 4, 1449 - 1458, 27.12.2020
https://doi.org/10.17826/cumj.734887

Abstract

Amaç: Bu çalışmanın amacı çocukluk çağında gözlenen edinsel komitan ezotropya hastalarında cerrahi sonuçları ve bunu etkileyen faktörleri değerlendirmektir..
Gereç ve Yöntem: Hastanemizde edinsel komitan ezotropya tanısı ile takip ve tedavisi yapılan 403 hastanın dosyası retrospektif olarak incelendi. Hastaların ayrıntılı anamnezleri, cinsiyetleri, ilk muayene ve operasyon yaşları, görme keskinlikleri, göz hareketleri, ambliyopi varlığı, kırma kusurları, binoküler görme ve stereopsis düzeyleri, uygulanan cerrahi işlem, cerrahi öncesi ve sonrası kayma miktarları kaydedildi. Cerrahi sonrası 10 PD altında kayması olanlar cerrahi başarılı kabul edildi.
Bulgular: Cerrahi yapılan 403 hastanın 191(%47,4) kız, 212’si (%52,6) erkekti. Hastaların başvuru yaş ortalaması 6,72±3,82 (2-18) yıl, kayma başlangıcı yaş ortalaması 2,88±2,14 (1-14) yıl, cerrahi uygulanma yaş ortalaması ise 7,57±3,68 (2-18) yıl idi. Cerrahi öncesi ortalama kayma miktarı 33,6±9,8 (16-70) PD idi. Cerrahi öncesi 205(%50,9) hastada ambliyopi, 82(%20,3) hastada anizometropi ve 108(%26,8) hastada anormal füzyon olduğu tespit edildi. Cinsiyet, cerrahi yaş, refraksiyon kusuru uygulanan cerrahi prosedür, cerrahi öncesi ambliyopi varlığı, cerrahi öncesi anizometropi varlığı, cerrahi öncesi anormal füzyon varlığının) cerrahi başarıyı etkilemediği bulundu. Kısmi refraktif ezotropya hastalarının cerrahi başarısının daha iyi olduğu tespit edildi. Cerrahi öncesi yüksek kayma miktarının ise cerrahi başarıyı olumsuz yönde etkilediği tespit edildi.
Tartışma: Cerrahi başarıyı etkileyen faktörler değerlendirildiğinde hastaların şaşılık türünün, cerrahi öncesi kayma miktarının ve etkin uygulanan kapama tedavisinin gelişiminin etkin olabileceği, bu nedenle hastaların cerrahi öncesi klinik özelliklerinin iyi belirlenmesinin ve cerrahi sonrası uygun tedavilerin devam edilmesinin önemli olduğu gözlenmiştir.

References

  • 1. Amy E, Greenberg BS, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia. Ophthalmology 2007; 114:170-174. 2. Sanaç AŞ. Şaşılık ve tedavisi: Muayene, Şaşılıkların cerrahi tedavisi. Ankara, Pelin Matbaası, 2001; 17-20, 43-7, 242-59. 3. Gunter K, Von Noorden G.K. Esodeviations. Binocular vision and ocular moti-lity. Saint Louis:1995;290-335. 4. Denny M, Daniel J. Pediatric opthalmology and strabismus. San Francis-co,CA:American Academy of Ophthalmology 2003,1:9-12. 5. Olitsky SE, Kelly C, Lee H, Nelson LB. Unilateral rectus resection in the treat-ment of undercorrected or recurrent strabismus. J Pediatr Ophthalmol Strabismus 2001; 38:349-53. 6. Şenerkek E, Önlü M.K. Konkomitan horizontal şaşılık olgularında cerrahi te-davi sonuçlarımız. T Klin Oftamoloji 1996; 5:293-297. 7. Erdöl H, İmamoğlu H.İ. Şaşılık cerrahisinde başarıyı etkileyen faktörler. Türk Oftalmoloji Gazetesi. 2000; 30:192-198. 8. Ozdemir S., Tugcu B., Konkomitan Ezotropyalarda Cerrahi Başarıyı Etkileyen Faktörler,T. Oft. Gaz. 2009; 39:453-461. 9. Mohan K, Sharma SK. Longterm motor and sensory outcomes after surgery for the nonaccommodative component of partial refractive accommodative esotropia. JAAPOS 2018; 22:356-360. 10. Kassem RR, Elhilali HM. Factors affecting sensory functions after succsesful postoperative ocular alignment of acquired esotrıopia. JAAPOS 2006; 10:112-116. 11. Arnoldi K. Long-term surgical outcome of partially refractive accommodative esotropia. Am Orthopt J 2002; 52:75-84. 12. Jacobs SM, Green-Simms A,Diehl NN, Mhney BG. Longterm follow-up of acquired nonaccommodative esotropia in a population-based cohort. Ophthalmology 2011 June:118(6):1170-1174. 13. Chan TYB, Mao AJ, Piggott JR, Makar I. Factors affecting postoperative ste-reopsis in acquired nonaccommodative esotropia. Can J Ophthalmol 2012;47:479-483. 14. Sezen F, Gezer A, Şerifoğlu İ. İnfantil esotropya tedavisinde simetrik cerrahi ve tek taraflı geriletme-kısaltma sonuçlarımız. TOD XXVI Ulusal Kongre Bülteni, Bur-sa,1992;61-4. 15. Şener CE, Abbasoğlu ÖE ve ark. Komityan Horizontal Kaymalarda Horizon-tal Kas Cerrahisi Etkinliği. Turk J Ophthalmol 1994,3:196-199. 16. Kushner BJ, Fischer MR. Factors influencing response to strabismus sur-gery. Arch Ophthalmol. 1993; 111:75-79. 17. Köse S, Akkın C, Eğrilmez S, Pamukçu K: Konkamitan Ezotropyalı Olgularda Cerrahi Başarıyı Etkileyen Preoperatif Faktörler. TOD XXVIII. Ulusal Kongre Bülteni 1994;528-30. 18. Yusufoglu EE, Cinar FGY, Somer D, Burcu A, Akkaya ZY, Ornek F. Infantil Ezotropyada Cerrahi Basariyi Etkileyen Faktorler. Turk J Ophthalmol. 2013; 43:413-8. 19. Keenan JM, Willshaw HE. The outcome of strabismus surgery in childhood ezotropia. Eye 1993; 7:341-345. 20. Jiang D Han D, Zhang J Pei T, Zhao QI. Clinical study of the influence of postoperative wearing time on postoperative effects in children with partially accom-modative esotropia. Medicine 2018; 97:19. 21. Fawcett SI, Wang YZ, Birch EE. The critical period of susceptibility of human stereopsis. Invest Opthalmol Vsi Sci 2005; 46:521-5. 22. Birch EE. Binocular sersory outcomes in accommodative esotropia. JAAPOS December 2003; 7:369-73. 23. Fawcett S, Leffler J, Birch EE. Factors influencing stereoacuity in accommo-dative esotropia. J AAPOS 2000;4(1):15-20. 24. Kurup SP, Barto HW, Myung G, Mets MB. Stereoacuity outcomes following surgical correction of the nonaccommodative component in partially accommodative esotropia. JAAPOS 2018; 22:92-96. 25. Lee HJ, Kim SJ,Yu YS. Stereopsis in patients with refractive accommodative esotropia. JAPOOS 2017;21:190-195. 26. Iordanous Y, Mao A. Preoperative Factors Affecting Stereopsis after Surgical Alignment of Acquired Partially Accommodative Esotropia. Strabismus 2015; 23(4): 151–158. 27. Leffler Ct, Vaziri K, Schwarts SG, Cavuoto KM, McKeown CA, Kishor KS, Ja-not AC. Rates of reoperation and abnormal binocularity following strabismus surgery in children. Am J Ophthalmol 2016 February,162:159-166.

Surgical results in childhood acquired comitant esotropia

Year 2020, Volume: 45 Issue: 4, 1449 - 1458, 27.12.2020
https://doi.org/10.17826/cumj.734887

Abstract

Purpose: The aim of this study was o evaluate the surgical outcomes and factors in patients with ac-quired comitant esotropia observed in childhood.
Materials and Methods: The files of 403 patients who had surgery with ac-quired comitant esotropia in our hospital were reviewed retrospectively. Detailed an-amnesis, gender, age of initial examination and operation, visual acuity, presence of amblyopia, refractive errors, binocular vision and stereopsis, surgical procedure, pre-and postoperative deviation were recorded.
Results: Of the 403 patients, 191 (47.4%) were girls and 212 (52.6%) were boys. The mean age of patients at the first visit was 6.72 ± 3.82 (2-18) years, the aver-age age of onset was 2.88 ± 2.14 (1-14) years, and the mean age at the time of surgery was 7.57 ± 3.68 (2 -18) years. The mean preoperative deviation before surgery was 33.6 ± 9.8 (16-70) PD. Amblyopia was found in 205 (50.9%) patients before sur-gery, anisometropia in 82 (20.3%) patients and abnormal fusion in 108 (26.8%) pa-tients. Gender, surgical age, refractive error surgical procedure performed, presence of amblyopia, anisometropia before surgery, and abnormal fusion before surgery was found not to affect surgical success. Surgical success was found to be better in patients with partial refractive esotropia. High amount of deviation before surgerynegatively affected surgical success.
Discussion: Strabismus type, amount of deviation before surgery and efficient amblyo-pia treatment could be affecting the success of surgery, so it was important to determine the clinical features of the patients preoperatively and to continue the appropriate treatments after surgery.

References

  • 1. Amy E, Greenberg BS, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia. Ophthalmology 2007; 114:170-174. 2. Sanaç AŞ. Şaşılık ve tedavisi: Muayene, Şaşılıkların cerrahi tedavisi. Ankara, Pelin Matbaası, 2001; 17-20, 43-7, 242-59. 3. Gunter K, Von Noorden G.K. Esodeviations. Binocular vision and ocular moti-lity. Saint Louis:1995;290-335. 4. Denny M, Daniel J. Pediatric opthalmology and strabismus. San Francis-co,CA:American Academy of Ophthalmology 2003,1:9-12. 5. Olitsky SE, Kelly C, Lee H, Nelson LB. Unilateral rectus resection in the treat-ment of undercorrected or recurrent strabismus. J Pediatr Ophthalmol Strabismus 2001; 38:349-53. 6. Şenerkek E, Önlü M.K. Konkomitan horizontal şaşılık olgularında cerrahi te-davi sonuçlarımız. T Klin Oftamoloji 1996; 5:293-297. 7. Erdöl H, İmamoğlu H.İ. Şaşılık cerrahisinde başarıyı etkileyen faktörler. Türk Oftalmoloji Gazetesi. 2000; 30:192-198. 8. Ozdemir S., Tugcu B., Konkomitan Ezotropyalarda Cerrahi Başarıyı Etkileyen Faktörler,T. Oft. Gaz. 2009; 39:453-461. 9. Mohan K, Sharma SK. Longterm motor and sensory outcomes after surgery for the nonaccommodative component of partial refractive accommodative esotropia. JAAPOS 2018; 22:356-360. 10. Kassem RR, Elhilali HM. Factors affecting sensory functions after succsesful postoperative ocular alignment of acquired esotrıopia. JAAPOS 2006; 10:112-116. 11. Arnoldi K. Long-term surgical outcome of partially refractive accommodative esotropia. Am Orthopt J 2002; 52:75-84. 12. Jacobs SM, Green-Simms A,Diehl NN, Mhney BG. Longterm follow-up of acquired nonaccommodative esotropia in a population-based cohort. Ophthalmology 2011 June:118(6):1170-1174. 13. Chan TYB, Mao AJ, Piggott JR, Makar I. Factors affecting postoperative ste-reopsis in acquired nonaccommodative esotropia. Can J Ophthalmol 2012;47:479-483. 14. Sezen F, Gezer A, Şerifoğlu İ. İnfantil esotropya tedavisinde simetrik cerrahi ve tek taraflı geriletme-kısaltma sonuçlarımız. TOD XXVI Ulusal Kongre Bülteni, Bur-sa,1992;61-4. 15. Şener CE, Abbasoğlu ÖE ve ark. Komityan Horizontal Kaymalarda Horizon-tal Kas Cerrahisi Etkinliği. Turk J Ophthalmol 1994,3:196-199. 16. Kushner BJ, Fischer MR. Factors influencing response to strabismus sur-gery. Arch Ophthalmol. 1993; 111:75-79. 17. Köse S, Akkın C, Eğrilmez S, Pamukçu K: Konkamitan Ezotropyalı Olgularda Cerrahi Başarıyı Etkileyen Preoperatif Faktörler. TOD XXVIII. Ulusal Kongre Bülteni 1994;528-30. 18. Yusufoglu EE, Cinar FGY, Somer D, Burcu A, Akkaya ZY, Ornek F. Infantil Ezotropyada Cerrahi Basariyi Etkileyen Faktorler. Turk J Ophthalmol. 2013; 43:413-8. 19. Keenan JM, Willshaw HE. The outcome of strabismus surgery in childhood ezotropia. Eye 1993; 7:341-345. 20. Jiang D Han D, Zhang J Pei T, Zhao QI. Clinical study of the influence of postoperative wearing time on postoperative effects in children with partially accom-modative esotropia. Medicine 2018; 97:19. 21. Fawcett SI, Wang YZ, Birch EE. The critical period of susceptibility of human stereopsis. Invest Opthalmol Vsi Sci 2005; 46:521-5. 22. Birch EE. Binocular sersory outcomes in accommodative esotropia. JAAPOS December 2003; 7:369-73. 23. Fawcett S, Leffler J, Birch EE. Factors influencing stereoacuity in accommo-dative esotropia. J AAPOS 2000;4(1):15-20. 24. Kurup SP, Barto HW, Myung G, Mets MB. Stereoacuity outcomes following surgical correction of the nonaccommodative component in partially accommodative esotropia. JAAPOS 2018; 22:92-96. 25. Lee HJ, Kim SJ,Yu YS. Stereopsis in patients with refractive accommodative esotropia. JAPOOS 2017;21:190-195. 26. Iordanous Y, Mao A. Preoperative Factors Affecting Stereopsis after Surgical Alignment of Acquired Partially Accommodative Esotropia. Strabismus 2015; 23(4): 151–158. 27. Leffler Ct, Vaziri K, Schwarts SG, Cavuoto KM, McKeown CA, Kishor KS, Ja-not AC. Rates of reoperation and abnormal binocularity following strabismus surgery in children. Am J Ophthalmol 2016 February,162:159-166.
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Details

Primary Language Turkish
Subjects Ophthalmology
Journal Section Research
Authors

Fatma Gül Yılmaz Çınar 0000-0001-8158-173X

Publication Date December 27, 2020
Acceptance Date September 24, 2020
Published in Issue Year 2020 Volume: 45 Issue: 4

Cite

MLA Yılmaz Çınar, Fatma Gül. “Çocukluk çağı Edinsel Komitan Ezotropyalarda Cerrahi sonuçlar”. Cukurova Medical Journal, vol. 45, no. 4, 2020, pp. 1449-58, doi:10.17826/cumj.734887.