Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Penetran Keratoplasti Yapılan Hastalarda Rejeksiyon Risk Faktörlerinin ve Tedavi Sonuçlarının Değerlendirilmesi
Evaluation of Risk Factors and Treatment Results in Patients with Penetrating Keratoplasty
Emine Esra KARACAa, Dilay ÖZEKa, Gökhan ÇELİKa, Özlem EVREN KEMERa
aGöz Hastalıkları Kliniği, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(3):154-60
doi: 10.5336/ophthal.2018-63388
Article Language: TR
Full Text
ÖZET
 Amaç: Penetran keratoplasti (PK) yapılan hastalarda rejeksiyon risk faktörlerinin ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntemler: Ocak 2013-Ağustos 2018 tarihleri arasında PK yapılan hastalar retrospektif olarak incelendi. Greft rejeksiyonu gelişenler çalışmaya dâhil edildi. Hastalar rejeksiyon risk faktörleri, tedavi yöntemleri, görme keskinlikleri, takip süresi, klinik bulgular ve rejeksiyona olan yanıt açısından değerlendirildi. Bulgular: Penetran keratoplasti uygulanan 305 hastadan, akut greft rejeksiyonu gerçekleşen 22 hastanın 22 gözü çalışmaya dâhil edildi. PK sonrası gelişen akut greft rejeksiyon süresi ortalama 12,22±10,95 ay idi. Korneal vaskülarizasyon, önceden keratoplasti geçirmiş olmak, ön sineşi, glokom varlığı, çoklu cerrahi, sütür problemleri, enfeksiyon, kimyasal yanık ve herpetik keratit varlığı rejeksiyon risk faktörlerini oluşturmakta idi. Tedavi verilen hastaların 11 (%50)'inde rejeksiyon gerilemişken, 11 (%50)'inde gerileme izlenmedi. Akut greft rejeksiyonu sırasında ortalama en iyi görme keskinliği 2,45±0,74 logMAR iken, tedavi sonrası üçüncü ayda görme keskinliği 1,88±1,09 logMAR idi. Sonuç: Korneal vaskülarizasyon, ön sineşi, glokom varlığı ve çoklu cerrahi geçirmiş olmak en önemli risk faktörlerini oluşturmuştur.

Anahtar Kelimeler: Greft reddi; korneal vaskülarizasyon; penetran keratoplasti; rejeksiyon risk faktörleri; rejeksiyon tedavisi
ABSTRACT
 Objective: To evaluate the risk factors and treatment outcomes of rejection in patients undergoing penetrating keratoplasty (PK). Material and Methods: The patients who underwent PK between January 2013-August 2018 were retrospectively analyzed. Patients with graft rejection were included in the study. The cases were evaluated in terms of risk factors for rejection, treatment modalities, visual acuity, duration of follow-up, clinical findings, and response to rejection. Results: Twenty-two eyes of 22 patients who underwent acute graft rejection from 305 patients undergoing penetrating keratoplasty were included in the study. The mean duration of acute graft rejection after PC was 12.22±10.95 months. Corneal vascularization, pre-keratoplasty, anterior synechia, the presence of glaucoma, multiple surgery, suture problems, infection, the presence of chemical burns and herpetic keratitis were the risk factors for rejection. In 22 patients, rejection was observed in 11 (50%), and 11 (50%) did not. The mean best visual acuity during acute graft rejection was 2.45±0.74 logMAR and the mean visual acuity was 1.88±1.09 logMAR at the third month after the treatment. Conclusion: Corneal vascularization, anterior synechiae, presence of glaucoma and multiple surgery have been the most important risk factors.

Keywords: Graft rejection; corneal vascularization; penetrating keratoplasty; rejection risk factors; rejection treatment
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