Causes of Secondary Intraocular Lens Implantation and Surgical Outcomes

Öz

Objective: The aim of this study is to determine preoperative ocular risk factors and indications for secondary intraocular lens (IOL) implantation surgery and to compare the visual outcomes of this procedure.

Material and Methods: Nineteen patients who underwent secondary IOL implantation between January 2018 and February 2019 at Kırıkkale University Faculty of Medicine were included in the study. Preoperative causes of secondary IOL implantation, additional ocular pathologies such as pseudoexfoliation (PEX), uveitis, trauma, systemic syndromes, best corrected visual acuity (BCVA) before and after surgery, surgical procedures and possible postoperative complications were noted separately.

Results: Nineteen eyes of 19 patients were included in this study. Eleven (57.9%) of the patients were female and 8 (42.1%) were male. The mean age of all patients was 69.16 ± 6.92 (59-80) years. When the patients were evaluated preoperatively, the most common cause was surgical aphakia secondary to intraoperative complications due to primary surgery in 11 patients (52.6%). The second most common cause was IOL subluxation in 6 patients. IOL implantation with iris or scleral fixation was performed in patients who did not have sulcus support and the other IOLs were inserted to the sulcus. Preoperative mean BCVA was 0.223 ± 0.187, and postoperative mean BCVA was 0.702 ± 0.209. The difference between preoperative and postoperative mean BCVA was statistically significant (p <0.001).

Conclusion: IOL implantation in the sulcus is easier and the complication rate is lower than the iris and scleral fixation IOL implantation methods. The results of iris fixation or scleral fixation in cases without sulcus support are also promising.

Anahtar Kelimeler

• Secondary IOL implantation,cataract,IOL subluxation

SEKONDER GÖZ İÇİ LENS İMPLANTASYONU NEDENLERİ VE CERRAHİ SONUÇLARIMIZ

Öz

Amaç: Sekonder göz içi lens (GİL) implantasyonu yapılan hastalarda, preoperatif oküler risk faktörlerini ve ikincil GİL cerrahisi endikasyonlarını belirlemek ve bu işlemin görsel sonuçlarını karşılaştırmak amacıyla yapılacaktır.

Gereç ve Yöntemler: Kırıkkale Üniversitesi Tıp Fakültesi’nde, Ocak 2018 ve Şubat 2019 tarihleri arasında sekonder GİL implantasyonu yapılan ve postoperatif en az 3 ay takibi olan 19 hasta çalışmaya dâhil edildi. Ameliyat öncesinde hastaların sekonder GİL implantasyonu nedenleri; psödoeksfoliyasyon (PEKS), üveit gibi ek oküler patolojiler, travma, sistemik sendromlar, ameliyat öncesi ve sonrası düzeltilmiş en iyi görme keskinlikleri (DEGK), uygulanan cerrahi yöntem ve olası postoperatif komplikasyonlar ayrı ayrı not edildi.

Bulgular: Çalışmaya 19 hastanın 19 gözü dahil edildi. Hastaların 11 (%57.9)’i kadın, 8 (%42.1)’i erkekti. Tüm hastaların yaş ortalaması 69.16±6.92 (59-80) idi. Hastalar operasyon öncesi değerlendirildiğinde, en sık neden, primer cerrahi sonrası intraoperatif komplikasyonlara sekonder gelişen cerrahi afaki idi (%52.6, n=11). İkinci en sık neden ise 6 hastada görülen GİL subluksasyonu idi. Sulkus desteği olan hastalara sulkus yerleşimli GİL diğer hastalara ise, iris ya da skleral fiksasyonlu GİL implantasyonu yapıldı. Hastaların cerrahi öncesi DEGK 0.223±0.187 iken cerrahi sonrası DEGK 0.702±0.209 idi. Ameliyat öncesi ve sonrası görme düzeyleri değerlendirildiğinde aradaki fark istatistiksel olarak ileri düzeyde anlamlıydı (p <0.001).

Sonuç: Sulkus yerleşimli GİL implantasyonu, iris ve skleral fiksasyonlu GİL implantasyonu yöntemlerine göre daha kolay ve komplikasyon oranı daha düşük bir yöntemdir. Sulkus desteğinin olmadığı durumlarda iris fiksasyonu ya da skleral fiksasyon yönteminin sonuçları da yüz güldürücüdür.

Anahtar Kelimeler

• Sekonder GİL implantasyonu,katarakt,GİL subluksasyonu

Kaynakça

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