Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Evaluation of the Effects of Inferior Oblique MuscleWeakening Surgery on Macula by Optical Coherence Tomography
İnferior Oblik Kas Zayıflatma Cerrahisinin Makulaya Etkilerinin Optik Koherens Tomografi ile Değerlendirilmesi
Mehmet Erkan DOĞANa, Yaşar DURANOĞLUa, Abdulkadir ALIŞb
aDepartment of Opthalmology, Akdeniz University Faculty of Medicine, Antalya, TURKEY
bSehit Prof Dr. İlhan Varank Training and Research Hospital, İstanbul, TURKEY
Turkiye Klinikleri J Ophthalmol. 2019;28(3):174-80
doi: 10.5336/ophthal.2018-63935
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the success of the surgical procedure and investigate the impact of inferior oblique muscle traction on macula. To this end, evaluation of the possible macular changes by optical coherence tomography (OCT) due to disinsertion+distal muscle resection + tucking method used in inferior oblique muscle weakening procedure is planned. Material and Methods: 27 eyes of 20 patients who underwent surgery of inferior oblique muscle weakening procedure in the Akdeniz University Faculty of Medicine were included in this prospective study. The success rate of the procedure and complications were analyzed. In all cases, OCT examination was performed preoperatively and also postoperative second day, first week, first month, 3 months later and 6 months later and these results were evaluated. Results: 27 eyes of 20 cases were examined. The mean age at the time of presentation was 10.65±5.9 years (range 5-27). 11 (55%) cases had primary inferior oblique muscle overaction and 9 (45%) cases had secondary inferior oblique muscle overaction. Success rate of operation was 77.8%. There were no statistically significant differences between preoperative and postoperative (at the end of 2nd day, 1st week, 1st month, 3rd month and 6th month) macular thickness measurements. Conclusion:We have concluded that the inferior oblique muscle disinsertion + distal muscle resection and tucking process is a safe, simple and effective procedure which doesn't cause any morphological damage of the macula in patients with inferior oblique muscle overaction.

Keywords: Oculomotor muscles; optical coherence tomography; macula lutea; fourth cranial nerve palsy; strabismus
ÖZET
 Amaç: Bu çalışmadaki amacımız alt oblik kas traksiyonunun makula üzerindeki etkisini araştırmak ve uygulanan cerrahi prosedürün başarısını değerlendirmektir. Bu amaçla dezensersiyon + distal kas rezeksiyonu+tucking yöntemiyle uygulanan alt oblik kas zayıflatılması prosedürünün olası makula etkilerinin optik koherens tomografi (OKT) ile değerlendirilmesi planlanmaktadır. Gereç ve Yöntemler: Bu prospektif çalışmada Akdeniz Üniversitesi Tıp Fakültesi'nde alt oblik kas zayıflatılması prosedürü uygulanan 20 hastanın 27 gözü çalışmaya dahil edildi. Cerrahi başarı oranı ve komplikasyonlar analiz edildi. Tüm olgularda ameliyat öncesi ve sonrası postoperatif ikinci gün, birinci hafta, birinci ay, 3. ay ve 6. ay OKT incelemesi yapıldı ve bu sonuçlar değerlendirildi. Bulgular: 20 olgunun 27 gözü incelendi. İlk muayene sırasındaki yaş ortalaması 10,65±5,9 yıl (5-27) idi. Olguların 11 (%55)'inde primer alt oblik kas hiperfonksiyonu, 9 (%45)'unda sekonder alt oblik kas hiperfonksiyonu vardı. Operasyon başarısı %77,8 idi. Preoperatif ve postoperatif (2. gün, 1. hafta, 1. ay, 3. ay ve 6. ay sonunda) makula kalınlığı ölçümleri arasında istatistiksel olarak anlamlı bir farklılık yoktu. Sonuç: Alt oblik kas hiperfonksiyonu olan hastalarda uygulanan alt oblik kas dezensersiyonu + distal kas rezeksiyonu+ tucking prosedürünün güvenli, basit ve etkili bir yöntem olduğu ayrıca makulaya herhangi bir morfolojik zarar vermediği sonucuna varılmıştır.

Anahtar Kelimeler: Okülomotor kaslar; optik koherens tomografi; makula lutea; dördüncü kranial sinir felci; şaşılık
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