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

Öz

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.

Anahtar Kelimeler

• Astigmatism
• cataract
• corneal topography
• phacoemulsification
• treatment outcome

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

Öz

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.

Anahtar Kelimeler

• Astigmatizma
• fakoemülsifikasyon
• katarakt
• kornea topografisi
• tedavi sonucu

Kaynakça

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