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Öz

Objective: To evaluate the pars plana vitrectomy (PPV) surgery results of the patients with diabetic tractional retinal detachment (TRD).Methods: Two hundred ten eyes of 193 patients with diabetic TRD were enrolled to the study. Patients with TRD underwent 23-Gauge(G) PPV were reviewed retrospectively. All patients’ preoperative and postoperative visual acuity changes, intraocular pressure changes, biomicroscopy, indirect ophthalmoscopy fundus examination, intraoperative and postoperative complications, intraoperative use of tamponade and postoperative period surgical notes were evaluated.Results: Ninety-five males (49.2%), 98 female (50.8%) of 193 patients were included to the study. Mean age was 56.01 ± 10.91 years during the surgery. The average postoperative follow-up period was 18.47 ± 14.06 months. Ninety-seven eyes were performed preoperative intravitreal (IV) bevacizumab injection. Statistically significant increase in the final visual acuity compared to the controls were recorded at 1, 3, 6, 12, 24, 36. months. (p<0.001). Preoperative and postoperative 1st day, 1st month, 6th months, 12th months results were statistically significant according to intraocular pressure (p<0.001). While 201 (95%) cases achieved anatomical success, 165 (78.5%) cases were achieved functional success.Conclusion: PPV is very effective method in providing anatomical and functional outcomes in patients with diabetic TRD. Preoperative intravitreal bevacizumab application is an effective treatment method in reducing intraoperative and postoperative complications, and shorten the operation time. J Clin Exp Invest 2015; 6 (1): 27-32

Anahtar Kelimeler

• Tractional retinal detachment, pars plana vitrectomy, diabetic retinopathy

Diyabetik traksiyonel retina dekolmanlı olgularda 23-gauge pars plana vitrektomi cerrahisi sonuçları

Öz

Amaç: Diyabetik traksiyonel retina dekolman (TRD)’lı hastalara uygulanan pars plana vitrektomi (PPV) sonuçlarını ve komplikasyonlarını incelemek. Yöntemler: Diyabetik TRD’si bulunan 193 hastanın 210 gözü çalışmaya dahil edildi. TRD nedeniyle 23-Gauge (G) PPV yapılan hastalarımızın dosyaları geriye dönük olarak incelendi. Tüm hastaların preoperatif ve postoperatif görme keskinliği (GK), göz-içi basınç (GİB)’ları, biyomikroskopik muayeneleri, indirekt oftalmoskopla fundus muayeneleri, intraoperatif ve postoperatif komplikasyonları, intraoperatif endotamponad kullanımı, postoperatif dönemde geçirdikleri ameliyatlar kaydedildi. Bulgular: Çalışmaya alınan 193 hastanın 95’i erkek (%49,2), 98’i kadın (%50,8) olup cerrahi sırasındaki yaş ortalamaları 56,01 ±10,91 yıl idi. Hasta grubumuzun ortalama postoperatif takip süresi 18,47 ±14,06 (3-54) ay idi. 97 göze preoperatif intravitreal (İV) bevacizumab enjeksiyonu yapıldı. Hastaların preoperatif GK’leri ile postoperatif 1.,3.,6,12.,24.,36. ay ve son kontrollerdeki GK’leri karşılaştırıldığında istatistiksel olarak anlamlı bir artış görüldü (p≤0.001). Preoperatif GİB’ları ile postoperatif 1. gün, 1. ay, 6. ay, 12. ay ve hastaların en son takiplerindeki GİB’leri arasında istatistiksel olarak anlamlı fark görüldü (p < 0.001). Preoperatif İV bevacizumab enjeksiyonu uygulanan hastalarla uygulanmayan hastalar arasında postoperatif proliferatif diyabetik retinopati komplikasyonları, intraoperatif hemoraji ve iyatrojenik retina yırtığı gelişmesi açısından istatistiksel olarak anlamlı fark tespit edildi. Vakaların 201 (%95)’inde anatomik başarı, 165 (%78,5)’inde fonksiyonel başarı sağlandı. Sonuç: PPV diyabetik TRD’li hastalarda anatomik ve fonksiyonel başarı sağlamak açısından oldukça etkili bir cerrahidir. Preoperatif İV bevacizumab uygulaması da intraoperatif ve postoperatif komplikasyonları azaltarak ameliyat süresini kısaltmada faydalı bir tedavi yöntemi olarak görülmektedir.

Anahtar Kelimeler

• Traksiyonel retina dekolmanı, pars plana vitrektomi, diyabetik retinopati

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