Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Clinical Outcomes of Patients with Combined Penetrating Keratoplasty and Pars Plana Vitrectomy Surgery Using Eckardt Temporary Keratoprosthesis: Retrospective Study
Eckardt Geçici Keratoprotez Kullanılarak Kombine Penetran Keratoplasti ve Pars Plana Vitrektomi Cerrahisi Uygulanan Hastaların Klinik Sonuçları: Retrospektif Çalışma
Şerife ÇİLOĞLU HAYATa , Yusuf Cem YILMAZa , Emre ALTINKURTb , Gizem SAYAR BİLGİNc , Zafer CEBECİb , Nur KIRb
aBaşakşehir Çam and Sakura City Hospital, Clinic of Ophthalmology, İstanbul, Türkiye
bİstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Türkiye
cBursa Yüksek İhtisas Training and Research Hospital, Clinic of Ophthalmology, Bursa, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(2):102-10
doi: 10.5336/ophthal.2023-100914
Article Language: EN
Full Text
ABSTRACT
 Objective: To identify prognostic factors influencing the anatomical and functional outcomes of patients undergoing combined penetrating keratoplasty (PKP) and pars plana vitrectomy (PPV) with Eckardt temporary keratoprosthesis (TKP). Material and Methods: The study is a retrospective review of cases between 2015 and 2021 at the İstanbul University, Department of Ophthalmology, where combined PPV and PKP surgeries were performed using Eckardt TKP. Demographic data, etiologies, preoperative and postoperative ophthalmologic examination findings, as well as postoperative complications of the patients, were recorded. Corneal graft survival rates and preoperative factors that could affect survival, along with surgical methods, were analyzed. Results: In the study, 18 eyes were analyzed. The mean age of the cases was 42.4 years, and the average follow-up period was 26.9 months. Preoperatively, endophthalmitis was detected in 9 eyes (50%), retinal detachment in 8 eyes (44.4%), and choroidal detachment in one eye (9%). The total corneal allograft survival rate was 22.2%. The mean survival time of the grafts was 12.2 months, showing a significantly decreased corneal graft survival rate in the presence of endophthalmitis (p=0.029). Conclusion: The use of temporary keratoprostheses can contribute to anatomical and functional success in patients undergoing combined PKP and PPV. It has been observed that the presence of intense inflammation, such as endophthalmitis, adversely affects corneal graft survival. It is crucial for patients to be carefully monitored for signs of corneal graft rejection and graft failure during postoperative follow-ups.

Keywords: Cornea transplantation; endophthalmitis; keratoplasty; vitrectomy
ÖZET
 Amaç: Bu çalışmanın amacı, Eckardt geçici keratoprotezi (KP) ile kombine penetran keratoplasti (PKP) ve pars plana vitrektomi (PPV) yapılan hastaların, anatomik ve fonksiyonel sonuçlarını etkileyen prognostik faktörleri saptayabilmektir. Gereç ve Yöntemler: İstanbul Tıp Fakültesi Göz Hastalıkları Ana Bilim Dalında 2015-2021 yılları arasında Eckardt geçici KP kullanılarak, kombine PPV ve PKP cerrahisi yapılan vakaların dosyaları retrospektif olarak incelendi. Hastaların demografik bilgileri, etiyolojileri, ameliyat öncesi ve sonrası oftalmolojik muayene bulguları ile postoperatif komplikasyonları kaydedildi. Korneal greftlerin sağkalım oranları ve sağkalımı etkileyebilecek preoperatif faktörler ile cerrahi metodlar incelendi. Bulgular: Çalışmaya 18 göz dâhil edildi. Vakaların yaş ortalaması 42,4 yıl, takip süresi ortalaması ise 26,9 aydı. Gözlerin 9'unda (%50) endoftalmi, 8inde (%44,4) retina dekolmanı ve birinde (%9) koroidal dekolmanı saptandı. Total korneal allogreft sağkalım oranı %22,2 idi. Greft ortalama sağkalımı 12,2 aydı, endoftalmi varlığında korneal greftlerin sağkalım oranı önemli ölçüde azalmıştır (p=0,029). Sonuç: Geçici keratoprotez kullanımı, kombine PKP ve PPV'nin gerçekleştirildiği hastalarda anatomik ve fonksiyonel başarıyı sağlayabilmektedir. Endoftalmi gibi yoğun inflamasyon varlığının, korneal greft sağkalımı olumsuz yönde etkilediği görülmüştür. Hastaların, postoperatif kontroller sırasında, kornea greft red belirtileri ve greft yetersizliği açısından, dikkatli takip edilmesi son derece önemlidir.

Anahtar Kelimeler: Kornea nakli; endoftalmi; keratoplasti; vitrektomi
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