Ön lameller repozisyon yöntemi uygulanan trahomatöz skatrisyel entropiyonlu olgularda cerrahi sonuçlarımız Türkçe

Öz

Amaç: Hafif ve orta düzey entropiyonda anterior lameller repozisyon ve kısaltma ameliyatının sonuçlarını değerlendirmek amaçlandı.Materyal ve metot: Kırk hastanın trahomatöz skatrisyel üst kapak entropiyonlu 65 gözü çalışmaya alındı. Ameliyat sonrası 1. ve 7. gün, 1. ve 6. ay takip muayenelerinde hasta ve cerrahın memnuniyetleri değerlendirildi.Bulgular: Ortalama yaş 70 yıl olan 50 – 87 yaş arası 40 hastanın 15'i erkek, 25'i kadın 65 üst kapak ameliyatı değerlendirildi. Skatrisyel entropiyonun nedeni trahomdu. Hastalar ameliyat sonrası ortalama 6 ay kadar izlendi. Hastaların gözünün %89,2'sinde ameliyat sonrası semptomatik iyileşme not edildi. Hastalar 53 gözün %81,5 ameliyatından mumnundu. Cerrah 54 gözün %83 ameliyatından memnundu. Ameliyat sonrası 6. aydaki kontrol muayenesinde 5 gözde %9,2 rekürrens görüldü.Sonuçlar: Anterior lameller kısaltma ile birlikte anterior lameller repozisyon trahomatöz skatrisyel üst kapak entropiyonunda etkili olduğu görülmektedir

Anahtar Kelimeler

• Anterior lameller repozisyon,Entropiyon,Anterior lameller kısaltma

Surgical results from trahomatöz cicatricial entropion patients who underwent anterior lamellar repositioning

Öz

Background: To evaluate the outcomes of anterior lamellar repositioning and anterior lamellar shortening surgery for treatment of minimal and moderate trachomatous entropion.Materials and Methods: Sixty five eyes of 40 patients with cicatricial entropion that included upper lid trachoma were evaluated. Patient and surgeon satisfaction were evaluated on follow-up examinations performed on the 1 st and 7th day, 1st and 6th months. In a retrospective study, the technique and results were evaluated.Results: 65 upper eyelid operations were performed on 40 patients 15 male, 25 female , with a mean age of 70±12.1 years range 50–87 . The aetiology of the cicatricial entropion included trachoma. Patients were followed postoperatively for an average of 6 months. 89.2 % of patients' eyes noted symptomatic improvement. Postoperatively, patients were satisfied in 53 eyes 81.5 % operation. Ophthalmic surgeon was satisfied in 54 eyes 83 % operation. Recurrence was seen in 5 eyes 9.2 % operation on follow-up examinations performed on the 6th months Conclusion: Anterior lamellar repositioning with anterior lamella shortening appears to be effective in managing trachomatous cicatricial entropion of the upper lid

Anahtar Kelimeler

• Anterior lamellar repositioning,entropion,anterior lamellar shortening

Kaynakça

1. ) Cahill KV, Doxanas MT. Eyelid abnormalities: Ectropion, entropion, trichiasis. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology on CD-ROM. Lippincott: Williams&Wilkins; 2005. Chapter 73.
2. ) Frick KD, Melia BM, Buhrmann RR, West SK. Trichiasis and disability in a trachoma endemic area of Tanzania. Arch Ophthalmol. 2001; 119(12): 1839–44.
3. ) Millman AL, Katzen LB, Putterman AM. Cicatricial entropion:an analysis of its treatment with transverse blepharotomy and marginal rotation. Ophthalmic Surg. ; 20(8): 575–9. ) Kemp EG, Collin JR. Surgical management of upper lıd entropion. British Journal of Ophthalmology. 1986; (8): 575-9.
4. ) Kersten RC, Kulwin DR, Levartovsky S, Tiradellis H, Tse DT. Management of lower-lid retraction with hard- palate mucosa grafting. Arch Ophthalmol. 1990; 108(9): –43.
5. ) Baylis HI, Hamako C. Tarsal grafting for correction of cicatricial entropion. Ophthalmic Surg. 1979; 10(7): –8.
6. ) Leibovitch I, Malhotra R, Selva D. Hard palate and free tarsal grafts as posterior lamella substitutes in upper lid surgery. Ophthalmology. 2006; 113(3): 489–96.
7. ) Silver B. The use of mucous membrane from the hard palate in the treatment of trichiasis and cicatricial entropion. Ophthalmic Plast Reconstr Surg. 1986; 2(3): –31.
8. ) Swamy BN, Benger R, Taylor S. Cicatricial entropion repair with hard palate mucous. Clinical and Experimental Ophthalmology. 2008; 36(4): 348–52.

9. ) Dhaliwal U, Monga PK, Gupta VP. Comparison of three surgical procedures of differing complexity in the correction of trachomatous upper lid entropion: a prospective study. Orbit. 2004; 23(4): 227-36.
10. ) Hintschich CR. [“Anterior lamellar repositioning” for correction of entropion of the upper eyelid]. Ophthalmologe. 1997; 94(6): 436-40.
11. ) Didem S, Gürsoy A, Serdal Ç, Sahap K. Yaygın Trikiyaziste Ön Lamel Repozisyonunun Sonuçları. Turkiye Klinikleri J Ophthalmol. 2007; 16(1): 33.
12. ) Reacher MH, Munoz B, Alghassany A, Daar AS, Elbualy M, Taylor HR.. A controlled trial of surgery for trachomatous trichiasis of the upper lid. Arch Ophthalmol. ; 110(5): 667–74.