Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Ekzotropya Hastalarında Cerrahi Sonuçlar: Vaka Serisi
Outcomes of Strabismus Surgery in Exotropic Patients: Case Series
Cahid SHAHBAZOVa , Sariyya SHAHBAZOVAb , Aynura AKBAROVAa , Nigar RZAZADEa , Mehmet KAYc , Sayime AYDIN EROĞLUd
aCaspian International Hospital, Göz Hastalıkları Kliniği, Bakü, Azerbaycan
bAzerbaycan Tıp Üniversitesi Göz Hastalıkları Kliniği, Bakü, Azerbaycan
cBatıgöz Altunizade Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye
dİzmir Bakırçay Üniversitesi Çiğli Eğitim ve Araştırma Hastanesi, Göz Hastalıkları ABD, İzmir, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(2):81-6
doi: 10.5336/ophthal.2023-98969
Article Language: TR
Full Text
ÖZET
 Amaç: Ekzotropyalarda [exotropia (XT)] klasik cerrahi sıklıkla iki kas cerrahisi olmakla beraber kayma açısına göre tek kas cerrahisi, üç veya dört kas cerrahisi uygulanabilir. Bu çalışmada, temel tip intermittan XT olan hastalarda uygulanan cerrahi işlemleri ve postoperatif cerrahi başarıyı değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Temel tip intermittan XT nedeniyle cerrahi uygulanan hastaların dosyaları retrospektif olarak taranmıştır ve hasta dosyalarından uygulanan cerrahiler, preoperatif ve postoperatif kayma açıları, cerrahi ile elde edilen başarı oranı değerlendirilmiştir. Bulgular: Çalışmaya toplam 721 hasta dâhil edildi. Hastaların %60,5'inde kayma tek gözde idi ve preoperatif kayma açısı ortancası 40 prizm diyoptri (PD) idi. Hastaların %61'ine unilateral, %39'una ise bilateral cerrahi uygulandı. Dış rektus (DR) kasında medyan geriletme miktarı 8 mm, iç rektus (İR) kasında medyan rezeksiyon miktarı 8 mm idi. Tüm hastalar beraber değerlendirildiğinde; hastaların %7,1'ine tek kas, %71,6'sına iki kas, %16,1'ine üç kas, %5,3'üne dört kas cerrahisi uygulandı. Unilateral cerrahi uygulanan hastaların ise %88'ine DR geriletme ve İR rezeksiyon cerrahisi olmak üzere iki kas cerrahisi yapılırken, %12'sine unilateral DR geriletme olmak üzere tek kas cerrahisi yapıldı. Tek kas cerrahisi ile 25 PD, iki kas cerrahisi ile 40 PD, üç kas cerrahisi ile 60 PD ve dört kas cerrahisi ile 75 PD'lik kayma açısında düzelme miktarı elde edildi. Sonuç: Temel tip intermittan XT hastalarında en sık tercih edilen cerrahi yöntem bilateral DR geriletme veya unilateral DR geriletme ve İR rezeksiyon cerrahisi iken kayma açısı küçük olan hastalarda tek kas cerrahisi, yüksek kayma açısı olan hastalarda ise üç veya dört kas cerrahisi ile başarılı sonuçlar elde edilebilir.

Anahtar Kelimeler: Ekzotropya; intermittan ekzotropya; şaşılık cerrahisi
ABSTRACT
 Objective: Although two muscle surgeries are the classical surgery for exotropia (XT), one, three or four muscle surgeries can be performed according to the angle of deviation. The aim of this study is to evaluate the surgical procedures and postoperative surgical success of patients with basic type intermittant XT. Material and Methods: The records of patients with basic type intermittant XT were evaluated retrospectively and surgical procedures, preoperative and postoperative angle of deviations, surgical success rates were noted. Results: 721 patients were included. 60.5% had deviation in one eye and preoperative angle of deviation was 40 prism diopter (PD). 61% had unilateral surgery and 39% had bilateral surgery. Median amount of recession of lateral rectus (LR) muscle and resection of medial rectus (MR) muscle were 8 mm for both. While all patients were evaluated together, 7.1% had one muscle, 71.6% had two muscles, 16.1% had three muscles and 5.3% had four muscles surgeries. While 88% of patients with unilateral surgery, had LR recession and MR resection, 12% had unilateral LR recession. The correction of angle of deviation was 25 PD for one muscle, 40 PD for two muscles, 60 PD for three muscles, 75 PD for four muscles surgeries. Conclusion: While the most preferred surgeries for basic type intermittant XT are bilateral LR recession or unilateral LR recession and MR resection, the surgical success can be achieved with one muscle surgery in patients with small angle of deviation and with three or four muscles surgies in patients with large angle of deviations.

Keywords: Exotropia; intermittant exotropia; strabismus surgery
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