COMPARISON OF CORNEAL PACHYMETRY CHANGES AND SURGICALLY INDUCED ASTIGMATISM OF MICROCOAXIAL PHACOEMULSIFICATION SURGERY AND COAXIAL PHACOEMULSIFICATION SURGERY

Year 2018, Volume: 81 Issue: 3, 77 - 83, 20.09.2018

Emre Altınkurt , Nilüfer Gözüm Zafer Cebeci Ayşe Yıldız Taş Ahmet Gücükoğlu

Abstract

DOI: 10.26650/IUITFD.396179

Objective: This study aimed to evaluate the
corneal pachymetry changes and surgically induced astigmatism (SIA) values in
microcoaxial phacoemulsification surgery with a 2.2 mm incison and to compare
those of the standard coaxial phacoemulsification surgery with a 2.75 mm and
3.2 mm incision.

Materials and Methods: The medical records
of 39 cases who underwent cataract surgery were retrospectively evaluated.
There were 15 eyes in the microcoaxial surgery group and 24 eyes in the
standard coaxial surgery group. The preoperative and postoperative 1-month
corneal topographies of the cases were analysed with a Pentacam Scheimpflug
camera (OCULUS Inc., Germany). The astigmatism and pachymetry values in the
Pentacam difference map were compared. Surgically induced astigmatism values
were calculated with a vectorial analysis programme.

Results: The SIA calculated with the
vectorial analysis programme on the postoperative at 1 month was 0.55±0.37 D in
the microcoaxial surgery group and 0.53±0.24 D in the coaxial surgery group
(p=0.743). The astigmatism in the Pentacam difference map is 0.41±0.62 D in the
microcoaxial surgery group and 0.44±0.40 D in the coaxial surgery group
(p=0.578). Postoperative visual acuity at 1 week was significantly higher in
the microcoaxial group (p=0.004). The corneal thickness decreased by/6.47±21.16
microns in the microcoaxial group and increased by/ 12.62±30.01 microns in the
coaxial group (p=0.004).

Conclusion: The postoperative 1 month SIAs
of the groups are similar to the values of previous studies but there isn’t any
significant difference between groups. Postoperative visual rehabilitation is
provided earlier in the microcoaxial surgery group.

Keywords

Astigmatism, cataract, corneal topography, phacoemulsification, treatment outcome

MİKROKOAKSİYAL FAKOEMÜLSİFİKASYON CERRAHİSİYLE KOAKSİYAL FAKOEMÜLSİFİKASYON CERRAHİSİNİN CERRAHİYE BAĞLI ASTİGMATİZMA VE KORNEAL PAKİMETRİ DEĞİŞİMLERİNİN KARŞILAŞTIRILMASI

Abstract

DOI: 10.26650/IUITFD.396179

Amaç: 2,2 mm’lik kesi ile yapılan
mikrokoaksiyal fakoemülsifikasyon cerrahisini, 2,75 ve 3,2 mm’lik kesi ile
yapılan standart koaksiyal fakoemülsifikasyon cerrahisi ile cerrahiye bağlı
astigmatizma (CBA) ve pakimetrik değişimler açısından karşılaştırmak.

Gereç ve Yöntem: Katarakt operasyonu
yapılan 39 olgunun kayıtları retrospektif olarak incelendi. Olguların hangi
büyüklükte kesi ile opere edilecekleri rastgele belirlendi. Mikrokoaksiyal
grupta 15 göz, standart koaksiyal grupta ise 24 göz bulunmaktaydı, Olgulara
preoperatif ve postoperatif 1. ayda Pentacam Scheimpflug kamera (OCULUS Inc.,
Almanya) ile kornea topografisi analizi yapıldı. Pentacam’ın iki topografi
arasındaki değişikliği hesaplayan fark haritasındaki astigmatizma ve pakimetri
değerleri karşılaştırıldı. Vektöryel analiz programı kullanarak cerrahiye bağlı
astigmatizma değerleri hesaplandı.

Bulgular: Postoperatif 1. aydaki vektöryel
analiz programı ile hesaplanan CBA değerleri mikrokoaksiyal cerrahi grubunda
0,55±0,37 D, koaksiyal cerrahi grubundaki 0,53±0,24 D olarak ölçüldü ve
aralarında anlamlı bir fark yoktu (p=0,743). Pentacam fark haritasında
ölçümlerde mikrokoaksiyal cerrrahi grubunda astigmatizma değişimi 0,41±0,62 D saptanırken
koaksiyal cerrahi grubunda 0,44 ± 0,40 D saptandı. Gruplar arasında anlamlı
farklılık yoktu (p=0,578 ). Postoperatif 1. haftadaki görme keskinliği anlamlı
bir şekilde mikrokoaksiyal grupta daha yüksek düzeydeydi.
(p=0,004).Mikrokoaksial kesi ile opere edilen grupta kornea kalınlığında
postoperatif 1. ayda ortalama 6,47 ± 21,16 mikron azalma saptanırken diğer
grupta ortalama 12,62 ±30,01 mikron artış saptandı. Aralarındaki fark anlamlı
bulundu (p=0,004).

Sonuç: Postoperatif 1. aydaki CBA değerleri,
literatürdeki CBA değerleri ile benzer sonuçlar vermiş ancak iki grup arasında
anlamlı bir farklılık saptanmamıştır. Mikrokoaksiyal cerrahi grubunda
postoperatif görsel rehabilitasyon daha erken sağlanmaktadır.

Keywords

Astigmatizma, fakoemülsifikasyon, katarakt, kornea topografisi, tedavi sonucu

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