Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Penetran Keratoplastili Olgularda Endikasyon Dağılımları ve Klinik Sonuçlarımız
Indication Distributions and Clinical Results in Penetrating Keratoplasty Caces
Mehmet ÇUBUKa, Yusuf KOÇLUKa, Bahadır ÖZELBAYKALa
aGöz Hastalıkları Kliniği, Adana Şehir Eğitim ve Araştırma Hastanesi, Adana, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(4):273-80
doi: 10.5336/ophthal.2019-64724
Article Language: TR
Full Text
ÖZET
 Amaç: Kliniğimizde penetran keratoplasti yapılan hastalarımızın endikasyonlarını ve klinik sonuçlarını sunmaktır. Gereç ve Yöntemler: Haziran 2014-Aralık 2015 tarihleri arasında kliniğimizde penetran keratoplasti yapılan hastaların kayıtları retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, penetran keratoplasti endikasyonları ve operasyon tipi (tek başına keratoplasti veya kombine cerrahiler), preoperatif ve postoperatif birinci ay, üçüncü ay ve en son yapılan kontrol muayenesindeki (12. ay) düzeltilmiş en iyi görme keskinlikleri, göz içi basınç değişimleri ve ameliyat sonrası diğer bulguları detaylı olarak değerlendirildi. Bulgular: Toplam 151 [56 (%37,1)]'sı kadın, 95 (%62,9)'i erkek hastanın 151 gözü çalışma kapsamına alındı. Postoperatif ortalama takip süresi 12,08±5,02 (6-25) ay idi. Hastalarımızın ortalama yaşı 56,72±1,64 (13-87); donör kornea alınan hastaların yaş ortalaması ise 54,02±12,25 (16-81) yıl idi. Hastaların en çok sırasıyla greft yetmezliği (35 göz, %23,2), psödofakik büllöz keratopati (28 göz, %18,5) ve travmatik korneal skar (16 göz, %10,6) nedeni ile opere edildiği tespit edildi. On bir (%7,3) göze ekstrakapsüler katarakt ekstraksiyonu ve arka kamara göz içi lensi implantasyonu, 5 (%3,3) göze skleral fiksasyonlu göz içi lensi implantasyonu, 10 (%6,6) göze ön vitrektomi ve 3 (%2) göze ise sineşiotomi kombine cerrahileri uygulandı. Takip süresi sonunda hastaların %7,9 (12 göz)'unda greft yetmezliği saptandı. Hastalarımızın operasyon sonrası düzeltilmiş en iyi görme keskinliğindeki vizyon artışı istatistiksel olarak anlamlı bulundu. Sonuç: Literatürdeki çoğu çalışmadan farklı olarak çalışmamızda en sık penetran keratoplasti endikasyonunun, greft yetmezliği olduğu saptanmıştır. Lamellar keratoplasti tekniklerinin uygulama sıklığında artış ile penetran keratoplasti endikasyonlarında değişimler gözlemlenmiştir. Ancak, gereken hastalarda penetran keratoplasti ameliyatlarına olan ihtiyaç hâlâ devam etmektedir.

Anahtar Kelimeler: Penetran keratoplasti; kornea; greft yetmezliği
ABSTRACT
 Objective: To present the indications and clinical outcomes of our patients who underwent penetrating keratoplasty in our clinic. Material and Methods: The records of patients who underwent penetrating keratoplasty surgery between June 2014 and December 2015 were evaluated retrospectively. The age, gender, penetrating keratoplasty indications and operation type (keratoplasty or combined surgery), Best corrected visual acuity of preoperative and postoperative 1st month, 3rd month and final visual acuity of the recent examination (12 mounts), intraocular pressure changes and other postoperative findings evaluated. Results: 151 eyes of 151 patients were included in the study, 56 of them were female (37.1%) and 95 were male (62.9%). Postoperative mean follow-up period was 12.08±5.02 (6-25) months. The mean age of our patients was 56.72+/-1.64 (13-87) years. The mean age of the donor cornea was 54.02+/-12.25 (16-81). The patients mostlly operated for graft failure (35 eyes, 23.2%), pseudophakic bullous keratopathy (28 eyes, 18.5%) and traumatic corneal scar (16 eyes, 10.6%), respectively. In 11 (7.3%) eyes extracapsular cataract extraction and posterior chamber intraocular lens implantation, in five (3.3%) eyes scleral fixation intraocular lens implantation, in ten (6.6%) eyes anterior vitrectomy and in three (2%) eyes sinechotomy combined surgeries were performed. Graft failure was detected in 7.9% of the cases (12 eyes) at the end of the follow-up period. The increase in best corrected visual activity of our patients after the operation was found to be statistically significant. Conclusion: Unlike most studies in the literature, the most common indication for penetrating keratoplasty in our study was graft failure. Changes in the indications of penetrating keratoplasty have been observed because of the increased frequency of lamellar keratoplasty techniques. However, there is still a need for penetrating keratoplasty surgeries in required cases.

Keywords: Penetrating keratoplasty; cornea; graft failure
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