Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Açık Glob Yaralanmalı Olgularda Epidemiyolojik Özellikler ve Prognostik Faktörlerin İncelenmesi
Investigation of Epidemiological Properties and Prognostic Factors in Patients with Open Glob Injuries
Ayşegül ÇÖMEZa, Bülent GÜRLERa
aGaziantep Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Gaziantep, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(4):278-87
doi: 10.5336/ophthal.2020-73523
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada amaç, açık glob yaralanmalı (AGY) olgularda epidemiyolojik özelliklerin, risk gruplarının ve sonuç görme keskinliği (SGK)ni etkileyen prognostik faktörlerin incelenmesidir. Gereç ve Yöntemler: Ocak 2009-Ocak 2012 tarihleri arasında Gaziantep Üniversitesi Tıp Fakültesi Göz Hastalıkları Ana Bilim Dalına AGY nedeni ile başvurmuş; primer onarımı, sekonder rekonstrüksiyon cerrahisi ve medikal tedavisi kliniğimizde yapılmış, en az 4 aylık takibi olan 237 hastanın 237 gözü retrospektif olarak incelenmiştir. Yaş, cinsiyet, travma neden ve tipleri, yara lokalizasyonları ile SGK'yi etkileyen prognostik faktörler değerlendirildi. Bulgular: Olguların, medyan yaş değeri 20 (1-84) yıl ve medyan takip süresi 12 (4-36) ay olarak saptanmıştır. Oküler travmanın, en sık erkeklerde (%74,7) geliştiği ve en sık 0-16 (%48,1) yaş grubunu etkilediği tespit edilmiştir. Oyun kazaları (%36,3), en sık travma nedeni olarak saptanmıştır. AGY'li olgularda, görsel prognoz üzerine olumsuz etki eden faktörlerin, travmanın tipi, globtaki yerleşimi, düşük başlangıç görme keskinliği, hifema, vitreus prolapsusu, vitreus içi hemorajisi, retina dekolmanı, proliferatif vitroretinopati olduğu saptanmıştır (her biri için p<0,001). Sonuç: AGY, teknolojik yenilikler ve gelişmiş cerrahi tekniklere rağmen özellikle çocuklarda ve işçilerde önlenebilir görme kayıplarının önemli bir kısmını oluşturmaktadır. Bu nedenle, koruyucu önlemlerin alınması ve riskli grubun bilgilendirilmesini içeren koruyucu hekimlik hizmetleri, AGY'nin azalmasında önemli katkı sağlayabilecektir.

Anahtar Kelimeler: Açık glob yaralanması; epidemiyolojik özellikler; prognostik faktörler
ABSTRACT
 Objective: The aim of this study was to investigate the epidemiological characteristics, risk groups and prognostic factors affecting final visual acuity (VA) in patients with open globe injury (OGI). Material and Methods: 237 eyes of 237 patients with at least 4 months of follow-up who applied to Gaziantep University School of Medicine, Department of Ophthalmology due to OGI between January 2009-January 2012 and underwent primary repair, secondary reconstruction surgery and medical treatment in our clinic were evaluated retrospectively. Age, sex, causes and types of trauma, wound localization and prognostic factors affecting final VA were evaluated. Results: The median age of the cases was 20 (1-84) years and the median follow-up duration was 12 (4-36) months. It was determined that ocular trauma was most common in males (74.7%) and most frequently affected the period between 0-16 (48.1%). Play accidents (36.3%) were found to be the most common cause of trauma. It was determined the factors that negatively affect visual prognosis in patients with OGI are type of trauma, globe localization, low initial visual acuity, hyphema, vitreous prolabsus, intravitreal hemorrhage, retinal detachment, proliferative vitroretinopathy (p<0,001 for each). Conclusion: Despite technological innovations and advanced surgical techniques, OGI is an important part of preventable vision loss especially in children and workers. Therefore, preventive medicine services, including taking preventive measures and making the risky group inform, can make a significant contribution to the reduction of OGI.

Keywords: Open globe injury; epidemiological features; prognostic factors
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