Katarakt Cerrahisini Takiben Erken Dönemde Göz İçi Basınç Değişiklikleri

Year 2019, Volume: 1 Issue: 1, 1 - 5, 29.10.2019

Muhammed Batur , Çağatay Çağlar , Habip Demir Eray Eser Tekin Yaşar

Abstract

Amaç: Katarakt cerrahisi sonrası göz içi basıncı (GİB) ve merkezi kornea kalınlığı (MKK)
değişimlerini incelemek.

Gereç ve Yöntem: Çalışmaya senil kataraktı bulunan 62 hastanın 62 gözü dahil edildi. Tüm
hastalar komplike olmamış fakoemülsifikasyon ve göz içi lensi (GİL) implantasyonu içeren
katarakt cerrahisi geçirdiler. GİB, nonkontakt tonometre ile katarakt ameliyatından önce ve
sonrasında 3. saatte, 1. günde, 1. haftada, 2. haftada ve 1. ayda ölçüldü. GİB ve MKK
ölçümleri tekrarlanan ölçümler için varyans analizleri (ANOVA) ile test edildi.

Bulgular: Çalışmaya ortalama yaşları 66±12.38 (40-84) olan 62 hasta dahil edildi.
Hastaların 35'i kadın (% 56.5), 27'si (% 43.5) erkekti. Preoperatif ortalama MKK 535,69 µ
idi. Preoperatif ortalama GİB 14.63 (10-21) mmHg idi. GİB, 3. saatte 19,95 (9-58), 1. günde
14.50 (8-29), 1. haftada 12.83 (8-19), 2. haftada 12.91 (7-18), 1. ayda 12.72 (8-18) idi.
Preoperatif GİB 14.63 mmHg iken 3. saatte istatiksel anlamlı olarak 19,95 mmHg'ya (%26)
yükseldi (p<0.001). 1. günde ise istatiksel olarak anlamlı şekilde 14.5 mmHg'ye düştü
(p<0.05). Preoperatif ve postoperatif 1. gün arasında istatiksel olarak anlamlı fark yoktu
(p>0.05). 1. gün ve 1. hafta arasında 1.67 mmHg düşüş görüldü. Bu fark istatiksel olarak
anlamlı idi (p<0.05). Gözlerin 7'sinde ciddi derecede GİB yüksekliği mevcuttu (>30 mmHg).
Bu gözlerde herhangi bir tedaviye gerek duyulmadan GİB normale döndü.

Sonuç: Katarakt cerrahisi sonrası ilk saatlerde anlamlı şekilde GİB yükselmekte. 1. günde
ise normale dönmektedir. GİB'teki yükselmeler sağlıklı gözlerde muhtemelen zararsızdır,
fakat riskli optik diskli hastalarda geçici yükselmeler dahi zararlı olabilir. Risk altındaki
hastalarda GİB yükselmesi için gerekli önlemler alınmalıdır. 

Keywords

Fakoemülsifikasyon, Göz içi basıncı, Merkezi kornea kalınlığı

Intraocular Pressure Changes In Early Period Following Cataract Surgery

Abstract

Objective: To analyze the changes of intraocular pressure (IOP) and central corneal
thickness (CCT) after cataract surgery.

Material and Method: The study was composed of 62 eyes of 62 patients with senile
cataract. All the patients had undergone uncomplicated phacoemulsification surgery and
intraocular lens implantation. IOP was measured by non-contact tonometer at baseline
before cataract surgery and on follow-upvisits 3 hours, 1 day, 1,2 and 4 weeks afterward.
IOP and CCT measurements were analyzed by analysis of variance (ANOVA) for repeated
measure.

Results: The study was composed of 62 patients with a mean age of 66±12.38 (range, 40 to
84) years. There were 35 females (56.5%) and 27 males (43.5%). The mean CCT was
535,69 before cataract surgery.The pre-operative mean IOP was 14.63 (10-21) mmHg at
baseline visit. IOP was 19,95 (9-58) at the third hours, 14.50 (8-29) at the first day, 12.83 (8-
19) at the first week, 12.91 (7-18) at the second week, 12.72 (8-18) at the first month. The
mean preoperative IOP was 14.63 mmHg, which statistical significant increased to 19,95
mmHg (26%) on the 3rd hours (p<0,001). The IOP decreased significantly to 14.5 mmHg at
1st day (p<0.05). The difference in IOP between pre-operative and post-operative first day
visit was no significantly different (p>0.05). The decrease in mean IOP between the
postoperative first day and the first week was 1.67 mmHg. This difference was significantly
different (p<0.05). Seven of eyes in this study had a considerable elevation (>30 mmHg) in
the pressure after the surgery. IOP was returned to normal values without antiglaucomatous
medication in these eyes.

Conclusion: The IOP increase significantly in the first hours following cataract surgery. It is
returned to normal values in the first day of surgery. It appears that IOP increasing in healthy
eyes are probably harmless, but the similar transient elevation of IOP may be detrimental in
cases with compromised optic discs. Necesarry measures should be taken to increase IOP
in patients at risk.  

Keywords

Central corneal thickness, Intraocular pressure, Phacoemulsification

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