Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Treatment Results, Factors Affecting the Success of Pneumatic Retinopexy in Rhegmatogenous Retinal Detachment, and the Importance of Other Eye Follow-Ups: Case Series
Yırtıklı Retina Dekolmanında Pnömatik Retinopeksinin Tedavi Sonuçları, Başarıyı Etkileyen Faktörler ve Diğer Göz Takiplerinin Önemi: Olgu Serisi
Yücel ÖZTÜRKa , Abdullah AĞINb , Aysun YÜCEL GENÇOĞLUa
aDepartment of Ophthalmology, University of Health Science Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye
bDepartment of Ophthalmology, University of Health Science Haseki Training and Research Hospital, İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2023;32(2):74-80
doi: 10.5336/ophthal.2022-92120
Article Language: EN
Full Text
ABSTRACT
 Objective: To reveal the factors affecting the surgical outcomes and pathological findings in the fellow eye in patients who underwent pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD). Material and Methods: Patients treated for RRD between 2014 and 2021 were evaluated retrospectively. The study included 43 eyes of 18 female and 25 male patients who underwent PR. Age, gender, best-corrected visual acuity (BCVA), lens status, number of preoperative tears, macular involvement, tamponade, intraocular pressure, and anatomic success were evaluated preoperatively and at the last visit. The fellow eye findings were also investigated. Results: Retinal reattachment was observed in 21/43 (48%) eyes. Macular involvement was present in 24 (55.8%) patients. The mean BCVA before surgery was 1.4±1.2 logarithms of minimum angle resolution (logMAR), and the mean BCVA at the final follow-up after surgery was 0.8±0.9 logMAR (p=0.003). Macular involvement, gas type (sulfur hexafluoride-perfluoropropane), lens status (phakic-pseudophakic), and the location of the tear quadrant (2 o'clock/10 o'clock) were not determined to affect the surgical success (p=0.43, p=0.37, p=0.15, p=0.73, respectively). Surgical success increased to 85% at the 1-year follow-up with secondary procedures. Lattice degeneration was found in 3 (7%) patients, retinal detachment in 4 (9%) patients, and retinal tear in 2 (4%) patients in the fellow eye of RRD. Conclusion: Although PR is a cost-effective method in RRD treatment, an additional surgical procedure may be required during follow-up. Detailed evaluation of the fellow eye pathologies is critical to prevent RRD development.

Keywords: Fellow eye; lattice degeneration; pneumatic retinopexy; retinal detachment; retinal tear
ÖZET
 Amaç: Yırtıklı retina dekolmanı [rhegmatogenous retinal detachment (RRD)] nedeniyle pnömatik retinopeksi (PR) uygulanan hastalarda cerrahi sonuçları etkileyen faktörleri ve diğer gözdeki patolojik bulguları ortaya çıkarmak. Gereç ve Yöntemler: RRD nedeniyle 2014- 2021 yılları arasında tedavi edilen hastalar geriye dönük değerlendirildi. Çalışmaya PR yapılan 18 kadın, 25 erkek hastanın 43 gözü dâhil edildi. Hastaların yaşı, cinsiyeti, en iyi düzeltilmiş görme keskinliği (EİDGK), lens durumu, ameliyat öncesi yırtık sayısı, makula tutulumu, tamponad, göz içi basıncı ve anatomik başarıları ameliyat öncesi ve son vizitte değerlendirildi. Ayrıca diğer göz bulguları da araştırıldı. Bulgular: Retinanın 21/43 (%48) gözde yatıştığı gözlendi. Yirmi dört (%55,8) hastada makula tutulumu mevcuttu. Ameliyat öncesi ortalama EİDGK 1,4±1,2 minimum çözünürlük açısının logaritması [logarithms of minimum angle resolution (logMAR)] ve ameliyat sonrası son takipte ortalama EİDGK 0,8±0,9 logMAR idi (p=0,003). Makula tutulumu, gaz tipi (sülfür hekzaflorit-perfloropropan), lens durumu (fakik-psödofakik) ve gözyaşı kadranının yerleşimi (saat 2 ve 10) cerrahi başarıyı etkilemedi (sırasıyla p=0,43, p=0,37, p=0,15, p=0,73). İkincil işlemlerle 1 yıllık takipte cerrahi başarı %85'e yükseldi. Ayrıca RRD'nin diğer gözünde 3 (%7) hastada latis dejenerasyonu, 4 (%9) hastada retina dekolmanı ve 2 (%4) hastada retina yırtılması saptandı. Sonuç: PR, RRD tedavisinde maliyet etkin bir yöntem olmasına rağmen takip sırasında ek bir cerrahi işlem gerekebilir. Diğer göz patolojilerinin ayrıntılı değerlendirilmesi, RRD gelişimini önlemek için kritik öneme sahiptir.

Anahtar Kelimeler: Diğer göz; latis dejenerasyonu; pnömatik retinopeksi; retina dekolmanı; retina yırtığı
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