PRİMER PSÖDOFAKİK RETİNA DEKOLMANI CERRAHİSİ SONUÇLARININ DEĞERLENDİRİLMESİ

Abstract

Amaç: Afakik veya psödofakik regmatojen retina dekolmanı (RRD) için tek başına pars plana vitrektomi (PPV) ve çevresel skleral çökertme (ÇSÇ) ile kombine ameliyatların sonuçlarını değerlendirmek. Gereç ve Yöntem: Psödofakik veya afakik primer RRD’ye nedeniyle tek başına veya ÇSÇ ile kombine PPV (20 ve 23 Gauge) uygulanan 37 hastanın 37 gözü çalışmaya dahil edildi. Postoperatif anatomik başarı (AB) ve fonksiyonel başarı (FB) değerlendirildi. AB, eğer kullanılmışsa silikon yağı tamponadının çıkarılmasından sonra hiç subretinal sıvının olmadığı tamamen yatışmış retina olarak tanımlandı. Ayrıca FB, Snellen görme keskinliğinin logMAR eşdeğerinde iki veya daha fazla ondalık artış olarak tanımlandı. Bulgular: Hastaların ortalama yaşı 62,43±11,40 (32-80) yıl, 21’i (%56,8) erkek, 16’sı (%43,2) kadındı. Ortalama takip süresi 21,35±16,86 (6-84) aydı. 23 hastaya ÇSÇ ile kombine PPV uygulandı. AB %86,5 (32/37), FB %49,9 (17/37) olarak bulundu. Hem AB ile hem de FB ile; preoperatif PVR varlığı (AB-p=0,61, FB-p=0,14), preoperartif maküla tutulumu (AB-p=0,98, FB-p=0,36), PPV’nin ÇSÇ ile kombine olup olmaması (AB-p=0,97, FB-p=0,29), ve kullanılan tamponad tipi (tümü p>0,05) gibi durumlara göre oluşturulan gruplar arasında istatistiksel olarak anlamlı bir fark gözlenmedi. Sonuç: Primer psödofakik retina dekolmanı olan olgularda PPV yalnız veya ÇSÇ ile kombine olarak uygulandığında, maküla tutulumundan veya PVR varlığından etkilenmeden iyi AB ulaşmak için etkili ve güvenlidir. Bununla birlikte, fonksiyonel başarı her zaman eşlik etmeyebilir.

EVALUATION OF OUTCOMES OF PRIMARY PSEUDOPHAKIC RETINAL DETACHMENT SURGERY

Abstract

Objective: To evaluate the results of pars plana vitrectomy (PPV) alone and combined with circumferential scleral buckling (CSB) surgeries for aphakic or pseudophakic rhegmatogenous retinal detachment (RRD). Materials and Methods: Thirty-seven eyes of 37 patients who underwent PPV (20 and 23 Gauge) alone or PPV combined with CSB due to pseudophakic or aphakic primary RRD were included in the study. Postoperative anatomical success (AS) and functional success (FS) were evaluated. The AS was defined as a completely flattened retina without any subretinal fluids after the removal of the silicone oil tamponade, if used. The FS was defined as two or more decimal improvements in the logMAR equivalent of Snellen visual acuity. Results: The mean age of the patients was 62.43±11.40 (32-80) years, 21 (56.8%) patients were male, and 16 (43.2%) were female. The mean follow-up time was 21.35±16.86 (6-84) months. PPV combined with CSB were performed in 23 patients. AS was found to be 86.5% (32/37), FS was 49.9% (17/37). No statistically significant difference was observed in both AS and FS between the groups according to preoperative PVR presence (AS-p=0.61, FS-p=0.14), preoperative macular involvement (AS-p=0.98, FS-p=0.36), whether PPV combined with CSB (AS-p=0.97, FSp= 0.29), and the type of tamponade (p>0.05 in all). Conclusion: PPV with or without CSB is safe and effective in cases with primary pseudophakic retinal detachment and achieves good AS without being affected by the presence of PVR or macular involvement. However, functional success may not always follow. Keywords: Pseudophakic retinal detachment, pars plana vitrectomy

Keywords

• Pseudophakic retinal detachment
• Pars plana vitrectomy
• Circumferential scleral buckling

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