Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Penetran Keratoplastili Hastalarda Korneal Topografi Kılavuzluğunda Sütür Alımının Astigmatizma Tedavisindeki Etkinliği
Effectiveness of Corneal Topography Guided Suture Removal of the Patients with Penetrating Keratoplasty in Astigmatism Treatment
Meryem ALTIN EKİNa, İclal YÜCELb, Mustafa ÜNALb
aGöz Hastalıkları Kliniği, İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi, İzmir, TÜRKİYE
bGöz Hastalıkları AD, Akdeniz Üniversitesi Tıp Fakültesi, Antalya, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(1):7-15
doi: 10.5336/ophthal.2017-59485
Article Language: TR
Full Text
ÖZET
 Amaç: Penetran keratoplastili hastalarda, erken postoperatif dönemde korneal topografi kılavuzluğunda sütür alımının astigmatizma tedavisindeki etkinliğini araştırmaktır. Gereç ve Yöntemler: Penetran keratoplasti operasyonu uygulanan saydam greftli 79 hastanın 80 gözü çalışmaya dâhil edildi. Geç postoperatif dönemde topografi kılavuzluğu olmaksızın sütürleri alınan 40 birey kontrol grubunu, erken postoperatif dönemde (3-10 ay) topografi kılavuzluğunda sütürleri alınan 40 birey de topografi grubunu oluşturdu. Sütür alımı öncesi ve sonrası düzeltilmiş görme keskinliği, astigmatizma dereceleri, yüzey asimetri indeksleri ve yüzey regülarite indeksleri hesaplandı. Sütür alımı sonrası kontrol ve topografi grupları düzeltilmiş görme keskinliği ve astigmatizma açısından karşılaştırıldı. Bulgular: Topografi grubunda (4,18±2,6 D) sütür alımı sonrası astigmatizma değerleri kontrol grubuna (7,89±4,67 D) göre istatistiksel olarak anlamlı derecede daha düşüktü. Sütür alımı sonrası görme keskinliği topografi grubunda 40 hastanın 31 (%77,5)'inde arttı, 7 (%17,5)'sinde değişmedi, 2 (%5)'sinde azaldı. Kontrol grubunda ise 40 bireyin 22 (%55)'sinde görme keskinliği artarken, 17 (%42,5)'sinde değişmedi ve 1 (%2,5)'inde azaldı. Topografi grubunda sütür alımı sonrası görme keskinliği kontrol grubuna göre istatistiksel olarak anlamlı derecede daha yüksek saptandı. Sonuç: Penetran keratoplastili hastalarda, erken postoperatif dönemde topografi kılavuzluğunda sütür alımı astigmatizma tedavisinde etkin bir yöntemdir ve görme kalitesinde artış sağlamaktadır.

Anahtar Kelimeler: Astigmatizma; görme keskinliği; korneal topografi; penetran keratoplasti; sütür alımı
ABSTRACT
 Objective: To investigate the effectiveness of corneal topography guided suture removal of the patients with penetrating keratoplasty in astigmatism treatment at early postoperative period. Material and Methods: Eighty eyes of 79 patients who had undergone penetrating keratoplasty and with clear grafts were included in the study. Forty cases whose sutures were removed without topography guidance at late postoperative period were formed the control group and other 40 cases whose sutures were removed with topography guidance at early postoperative period were formed the topography group. Corrected visual acuity, astigmatism degrees, surface asymmetry indices and surface regularity indices were calculated before and after suture removal. Control and topography groups were compared in terms of corrected visual acuity and astigmatism degrees after suture removal. Results: Astigmatism levels of topography group (4.18±2.6 D) after suture removal were statistically significantly lower than those of control group (7.89±4.67 D). In topography group, the visual acuity after suture removal was increased in 31 (77.5%) of 40 cases, not changed in 7 (17.5%) cases, decreased in 2 (5%) cases. In control group, while the visual acuity was increased in 22 (55%) of 40 cases, not changed in 17 (42.5%) cases and decreased in 1 (2,5%) case. Visual acuity of topography group after suture removal was significantly higher compared to control group. Conclusion: Topography guided suture removal at early postoperative period in patients with penetrating keratoplasty is an effective method in astigmatism treatment and provides increment in visual quality.

Keywords: Astigmatism; visual acuity; corneal topography; penetrating keratoplasty; suture removal
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