Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Horizontal Rektus Geriletme ve Rezeksiyonlarında Minimal İnvaziv Şaşılık Cerrahisi
Minimally Invasive Strabismus Surgery for Horizontal Rectus Recession and Resections
Aslı İNALa, Birsen GÖKYİĞİTa, Osman Bulut OCAKa, Ebru DEMET AYGITa, Selcen ÇELİKa, Ceren GÜREZa, Zahit HÜSEYİNHANa, Ufuk ÜRDEMb, Muhittin TAŞKAPILIa
aSağlık Bilimleri Üniversitesi İstanbul Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, TÜRKİYE
bŞarkışla Devlet Hastanesi, Göz Hastalıkları Kliniği, Sivas, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(2):115-20
doi: 10.5336/ophthal.2019-66724
Article Language: TR
Full Text
ÖZET
 Amaç: Minimal invaziv şaşılık cerrahisi [minimally invasive strabismus surgery (MISS)] tekniği ile horizontal rektus geriletme ve rezeksiyonu uygulanan hastalarda erken postoperatif sonuçların değerlendirilmesi ve limbal konjonktival insizyon uygulanan hastalardan oluşturulan kontrol grubuyla karşılaştırılmasıdır. Gereç ve Yöntemler: 2014-2017 yılları arasında MISS uygulanan hastaların dosyaları geriye dönük olarak tarandı. Bu hastalarla aynı demografik özelliklere sahip olup, aynı tarihler arasında limbal konjonktival kesi ile operasyon uygulananlardan kontrol grubu oluşturuldu. Tüm bireylerde konjonktival hiperemi, kemozis ve kapak şişliği 0 ve 3 arasında derecelendirme yapılarak (0: yok, 1: hafif, 2: orta, 3: ağır) sınıflandırıldı. Ameliyat öncesi ve sonrası 1. gün, 1. hafta ve 1. ay sonuçları değerlendirildi. Bulgular: MISS uygulanan 30 hasta çalışma grubunu, limbal insizyon uygulanan 30 hasta kontrol grubunu oluşturdu. Ameliyat sonrası birinci günde MISS grubunda konjonktival hiperemi değeri 1,61±1, kemozis 1,12±1,0 ve kapak şişliği 1,5±1,2 olarak, yedinci günde sırasıyla 1,08±0,5, 1,00±0,3, 1,2±0,9 ve birinci ayda 0,1±0,02, 0,1±0,02 ve 0,1±0,3 olarak kaydedildi. Kontrol grubuyla karşılaştırıldığında; ameliyat sonrası birinci günde hiperemi, kemozis ve kapak şişliği değerleri arasındaki fark istatistiksel olarak anlamlı (p<0,05), yedinci günde hiperemi ve kemozis skorları arasındaki fark istatistiksel olarak anlamlı (p=0.00) idi. Ameliyat sonrası birinci ayda iki grup arasında hiçbir parametrede istatistiksel anlamlı fark saptanmadı (p>0,05). Sonuç: Erken postoperatif dönemde MISS tekniği ile uygulanan operasyonlar sonrasında daha az konjonktiva kızarıklığı, kemozis ve kapak şişliği saptanmıştır. Bu nedenle, MISS erken postoperatif dönemde hasta konforunun daha fazla olmasının istendiği seçilmiş hasta grubu için tercih edilebilir.

Anahtar Kelimeler: Minimal invaziv şaşılık cerrahisi; şaşılık; şaşılık cerrahisi
ABSTRACT
 Objective: To evaluate the early postoperative results in patients who underwent horizontal rectus recession and resection with minimally invasive strabismus surgery (MISS) technique and to compare the results with control group patients who underwent limbal conjunctival incision. Material and Methods: The data's of the patients who underwent MISS between 2014 and 2017 were retrospectively reviewed. A control group was formed from patients who had the same demographic characteristics and who underwent limbal incision between the same dates. In all cases, conjunctival hyperemia, chemosis and eyelid swelling were classified by scoring between 0 and 3 (0: none, 1: mild, 2: moderate, 3: severe). Preoperative and postoperative 1st day, 1st week and 1st month results were evaluated. Results: Thirty patients who underwent MISS made the MISS group and 30 patients who underwent limbal incision made the control group. On postoperative day 1, conjunctival hyperemia score was found to be 1.61±1, chemosis was 1.12±1.0 and eyelid swelling was 1.5±1.2. On postoperative 7th day, scoring was 1.08±0.5, 1.00±0.3, 1.2±0.9 respectively and postoperative month 1 it was recorded as 0.1±0.02, 0.1±0.02 and 0.1±0.3. The difference between hyperemia, chemosis and eyelid swelling scores on postoperative day 1 was statistically significant compared with the control group (p<0,05) and the difference between hyperemia and chemosis scores on day 7 was statistically significant (p=0.00). No statistically significant difference was found between the two groups in the first month. Conclusion: In the early postoperative period, fewer hyperemia and chemosis were detected after MISS technique. Therefore, it may be preferred for the selected patient group in which the patient comfort is desired to be more in the early postoperative period.

Keywords: Minimally invasive strabismus surgery; strabismus; strabismus surgery
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