Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Pediatrik Açık Glob Yaralanmaları: Klinik Özellikler ve Uzun Dönem Sonuçlar
Pediatric Open Glob Injuries: Clinical Features and Long-Term Results
Burçin KEPEZ YILDIZa, İhsan ÇAKIRa, Nilay KANDEMİR BEŞEKa, Yusuf YILDIRIMa, Gökhan DEMİRa, Ceren GUREZa, Mevlüt CELAL ÖCALb, Alper AĞCAa
aSağlık Bilimleri Üniversitesi Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, TÜRKİYE
bŞanlıurfa Akçakale Devlet Hastanesi, Göz Hastalıkları Kliniği, Şanlıurfa, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(3):181-6
doi: 10.5336/ophthal.2019-70026
Article Language: TR
Full Text
ÖZET
 Amaç: Pediatrik gruptaki açık glob yaralanmalarında klinik ve demografik özellikleri, görsel ve anatomik sonuçları ve düşük görsel sonuç ve anatomik başarı ile ilişkili faktörleri değerlendirmek amaçlandı. Gereç ve Yöntemler: Ocak 2015-Haziran 2018 tarihleri arasında açık glob yaralanması nedeni ile primer saturasyon cerrahisi uygulanmış, 17 yaş ve daha genç hastaların kayıtları geriye dönük olarak incelendi. Yaş, cinsiyet dağılımı, takip süresi, yaralanma mekanizması, yaralanma tipi ve son muayenedeki görsel sonuçlar değerlendirildi. Bulgular: Çalışmaya 88 hastanın 88 gözü dâhil edildi. Gruba 30 (%34,1) kadın, 58 (%65,9) erkek katıldı ve yaş ortalaması 10,8±4,6 yıl idi. Oküler travmaya en çok neden olan nesneler kurşun kalem (%16) ve bıçak (%16) idi. Ortalama takip süresi 9,6±9,0 aydı. Hastaların %61'i zon 1 yaralanma geçirdi. Gözlerin %33'ünde aynı seansta açık glob yaralanmasıyla birlikte lens kapsülü perforasyonu vardı. Hastaların %15'inde primer saturasyon ile birlikte katarakt ameliyatı uygulandı. Retina dekolmanı saptanan 9 hastaya primer saturasyonun ardından pars plana vitrektomi cerrahisi uygulandı. Preoperatif dönemde hastaların %60'ında görme keskinliği bilgisi elde edilemememişti ancak postoperatif takip süresi sonunda gözlerin 1/3'ünden fazlasında (%36) 20/200 veya daha iyi bir son görme keskinliği mevcuttu. Sonuç: Açık glob yaralanmaları uygun müdahaleler ve düzenli postoperatif takiplerle umut verici sonuçlar vermektedir.

Anahtar Kelimeler: Açık glob yaralanması; travma; çocuk; prognoz
ABSTRACT
 Objective: To evaluate the clinical and demographic characteristics, visual and anatomical outcomes, and factors associated with poor visual outcome and anatomical success in pediatric open-globe injuries. Material and Methods: The records of patients aged 17 years and younger who had undergone surgical intervention after open globe injury between January 2015 and June 2018 were reviewed retrospectively. Various epidemiological parameters like age, sex distribution, follow up time, mechanism of injury, type of injury and final visual outcome were analyzed. Results: 88 eyes of 88 patients were enrolled in the study. 30 (34.1%) females, 58 (65.9%) males were participated in the group and the mean age was 10.84.6 years. Objects most often causing the ocular travma were pencil (16%) and knife (16%). The mean follow up time was 9.69 months. 61% of patients had zone 1 injury. 33% of the eyes had lens capsule perforation at the same session with open globe injury.15% of the patients had cataract surgery combined with primary suturation and 9 patients had retinal detachment and underwent pars plana vitrectomy following primary suturation. Visual acuity could not be obtained in 60% of the preoperative patients, but at the end of the postoperative follow-up period, more than one third of the eyes (36%) had a final visual acuity of 20/200 or better. Conclusion: The final outcomes of open globe injuries give promising results with appropriate interventions and regular postoperative visits.

Keywords: Open globe injuries; trauma; child; prognosis
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