Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Tekrarlayan Penetran Keratoplasti Sonuçlarımız: Retrospektif Çalışma
Repeat Penetrating Keratoplasty Results: Retrospective Study
Rüveyde BOLAÇa, Yücel ÖZTÜRKa, Gizem YELb, Merve Beyza YILDIZa, Elvin YILDIZa, Ece TURAN VURALa
aSağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştıma Hastanesi, Göz Kliniği, İstanbul, Türkiye
bGazipaşa Devlet Hastanesi, Göz Hastalıkları Kliniği, Antalya, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(2):62-8
doi: 10.5336/ophthal.2021-85129
Article Language: TR
Full Text
ÖZET
 Amaç: Biz bu çalışmada, tekrarlayan penetran keratoplasti yapılan hastaları primer endikasyon, greft yetmezliği nedenleri, sonuç görme keskinliği ve greft saydamlığı açısından değerlendirmeyi amaçladık. Gereç ve Yöntemler: Birden fazla keratoplasti yapılan hastaların kayıtları retrospektif olarak incelendi. İki defa keratoplasti yapılanlar Grup 1, 3 veya daha fazla keratoplasti yapılanlar Grup 2 olarak sınıflandırıldı. Bulgular: Sağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Göz Kliniği'nde yapılan 979 keratoplastinin %12,5'i tekrarlayan penetran keratoplastiydi. Hastaların yaş ortalaması 57,76±17,59 idi. Grup 1, 95 (%78,5) hastadan, Grup 2 ise 26 (%21,5) hastadan oluşmaktaydı. Toplam ortalama takip süresi 43,6±21,7 aydı. Her iki grupta da tekrarlayan penetran keratoplasti için en sık endikasyonu büllöz keratopati oluşturmakta olup, iki grup arasında istatistiksel anlamlı fark yoktu (p=0,53). Grup 1'de geç endotelyal yetmezlik (%21,05), Grup 2'de ise allogreft rejeksiyon (%38,46) greft yetmezliğinin en sık nedenini oluşturmaktaydı. Son vizitte Grup 1'de hastaların %73,68'inde Grup 2'de ise hastaların %57,69'unda greft saydamdı. Grup 1'deki hastalarda görme keskinliği Grup 2'den istatistiksel olarak daha fazlaydı (p=0,02). Hastaların %29,75'inde görme keskinliği Snellen eşeline göre 0,05'ten yüksekti. Sonuç: Greft saydamlığı açısından iki grup arasında anlamlı fark olmamakla birlikte Grup 2'de görme keskinliği daha düşüktü. Bu nedenle tekrarlayan penetran keratoplasti hastalarında cerrahi kararı verilirken hastanın ihtiyaçları ve motivasyonu göz önünde bulundurulmalıdır.

Anahtar Kelimeler: Büllöz keratopati; greft yetmezliği; tekrarlayan penetran keratoplasti
ABSTRACT
 Objective: We aimed to evaluate patients who underwent repeat penetrating keratoplasty in terms of primary indication, cause of graft failure, final visual acuity and graft transparency. Material and Methods: Patient records were reviewed retrospectively. Those who had two keratoplasty were classified as Group 1, and those who had 3 or more keratoplasty were classified as Group 2. Results: Repeat penetrating keratoplasty was 12.5% of 979 keratoplasty performed in University of Health Sciences Haydarpasa Numune Training and Research Hospital Eye Clinic. The mean age of the patients was 57.76±17.59 years. Group 1, consisted of 95 (78.5%) patients, and Group 2, consisted of 26 (21.5%) patients. Total mean follow up time was 43.6±21.7 months. Bullous keratopathy was the most common indication in both groups and there was no significant difference between the groups (p=0.53). Late endothelial failure (21.05%) in Group 1 and allograft rejection (38.46%) in Group 2 were the most common causes of graft faiure. At the last visit, the corneal graft was clear in 73.68% of the patients in Group 1 and 57.69% in Group 2. The visual acuity of the patients in Group 1 was better than Group 2 (p=0.02). Visual acuity was higher than 0.05 in 29.75% of the patients according to the Snellen chart. Conclusion: Although there was no difference between the two groups in terms of graft transparency, visual acuity was significantly lower in Group 2. Therefore, in repeat penetrating keratoplasty, surgical decision should be made according to the needs and motivation of the patients.

Keywords: Bullous keratopathy; graft failure; repeat penetrating keratoplasty
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