Konsekütif ekzotropya için medial rektus ilerletmesinin medial rektus rezeksiyonuna eşitliğinin değerlendirilmesi

Year 2022, Volume: 47 Issue: 2, 689 - 696, 30.06.2022

Abuzer Gündüz , Emrah Öztürk , Ercan Ozsoy

Abstract

Amaç: Bu çalışmada konsekütif ekzotropya tedavisinde medial rektus (MR) ilerletme miktarını sabit ekzotropyası olan hastalardaki MR rezeksiyonu ile karşılaştırarak incelemek ve konsekütif ekzotropya tedavisinde MR ilerletmesi ile birlikte lateral rektus (LR) geriletmesinin etkinliğinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Konsekütif veya sabit ekzotropya nedeniyle tek taraflı MR güçlendirilmesi ile birlikte LR zayıflatılması yapılmış hastaların kayıtları retrospektif olarak incelendi. Konsekütif ekzotropyalı hastalarda MR ilerletmesi ile birlikte LR geriletmesi ve sabit ekzotropyalı hastalarda MR rezeksiyonu ile birlikte LR geriletmesi yapılmıştı. Cerrahi dozlar standart bir tabloya göre belirlenmişti. 10 prizma dioptri ve daha az kayma başarılı sonuç olarak kabul edildi.
Bulgular: 18 konsekütif ekzotropyalı ve 18 sabit ekzotropyalı toplamda 36 hasta çalışmaya kabul edilme kriterlerini karşıladı. Başarılı hizalanma konsekütif ekzotropyalı hastaların %83.3’ ünde, sabit ekzotropyalı hastaların %88.9’unda elde edildi. Konsekütif ekzotropya olan hastalarda yapılan MR ilerletme miktarı ile sabit ekzotropya olan hastalarda yapılan MR rezeksiyonu miktarı arasında fark yoktu. Postoperatif dönemde, başarısız sonuç elde edilen konsekütif ekzotropyalı hastalarda fazla düzelme mevcut iken, başarısız sonuç elde edilen sabit ekzotropyalı hastalarda yetersiz düzelme vardı.
Sonuç: Bu çalışma daha önceden geriletilmiş MR’nin ilerletilme miktarı ile cerrahi olarak hiç dokunulmamış MR’nin rezeksiyon miktarı arasında bir fark olmadığını öne sürmektedir. Bu çalışma aynı zamanda MR ilerletmesi ile birlikte LR geriletmesinin sekonder ekzotropyayı düzeltmek için etkili bir yöntem olduğunu göstermiştir.

Keywords

İlerletme, lateral, medial, geriletme, rektus

Evaluation of the equality of medial rectus advancement to medial rectus resection for consecutive exotropia

Abstract

Purpose: The aim of this study was to analyze the amount of medial rectus (MR) advancement in the treatment of consecutive exotropia by comparing it with the amount of MR resection in a sample of patients with constant exotropia and evaluate the effectiveness of MR advancement with lateral rectus (LR) recession in the management of consecutive exotropia.
Materials and Methods: A retrospective chart review of patients who underwent unilateral MR strengthening with LR weakening due to consecutive or constant exotropia was performed. Patients with consecutive exotropia underwent MR advancement with LR recession, and those with constant exotropia underwent MR resection with LR recession. The surgical dosages were determined according to a standard table. A successful result was defined as alignment within 10 prism diopters of orthotropia.
Results: A total of 36 patients fulfilled the inclusion criteria: 18 had consecutive exotropia and 18 had constant exotropia. Successful alignment was obtained in 83.3% of patients with consecutive exotropia and 88.9% of patients with constant exotropia. There was no difference between the amount of MR advancement performed in consecutive patients with exotropia and the amount of MR resection performed in patients with constant exotropia. Postoperatively, while consecutive exotropes with a poor result showed overcorrection, constant exotropes with a poor result showed undercorrection.
Conclusion: This study suggests that there is no difference between the amount of previously recessed MR advancement and that of untouched MR resection. They also showed that MR advancement with LR recession is an effective means of correcting secondary exotropia.

Keywords

Advancement, lateral, medial, recession, rectus

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