Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Yüksek Miyopi Tedavisinde Yeni Nesil Arka Kamara Fakik İntraoküler Lens Uygulaması
New Generation Posterior Chamber Phakic Intraocular Lens Application in the Treatment of High Myopia
Kamil YAVUZERa, Yusuf EVCİMENb
aSağlık Bilimleri Üniversitesi Van Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, Van, TÜRKİYE b Urartu Göz Tıp Merkezi, Van, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2021;30(2):79-85
doi: 10.5336/ophthal.2020-76894
Article Language: TR
Full Text
ÖZET
 Amaç: Yeni nesil arka kamara fakik göz içi lens (GİL) implantasyonu yapılmış hastalarda, bu cerrahinin güvenilirlik ve etkinliğinin gösterilmesi amaçlanmıştır. Gereç ve Yöntemler: Ameliyat öncesi, hastaların manifest refraksiyonları ve Snellen eşeline göre görme keskinlikleri kaydedildi. Göz içi basıncı (GİB) Goldmann applanasyon tonometrisi ile ölçüldü. Hastaların ön segment yapılarını (limbus-limbus mesafesi 'LLM', ön kamara derinliği 'ÖKD', pakimetri, keratometri) değerlendirmek için korneal topografi (Sirius, CSO, Italy) ve optik biyometri (Lenstar LS 900, Haag-Streit AG, Switzerland) cihazları kullanıldı. Tüm hastalara, arka kamara fakik GİL (Eyecryl Phakic IOL, Biotech Vision Care, Hindistan) implante edildi. Ameliyat sonrası rutin oftalmik muayenenin ardından tüm hastaların ön segment yapılarını değerlendirmek için korneal topografi ve optik biyometri çekimleri tekrarlandı. Ön segment optik koherans tomografi (Optovue Inc, Fremont CA, United States) yardımıyla arka kamara fakik GİL vault mesafesi ölçüldü. Bulgular: Cerrahi uygulanan, 15 hastanın 29 gözünün ameliyat öncesi ve sonrası verileri karşılaştırıldığında, görme keskinliklerinin arttığı (p<0,001), GİB'lerinde değişiklik olmadığı (p=0,107), sferik değer ve sferik eş değerlerinin düştüğü gözlendi (p<0,001). Ön segment parametreleri karşılaştırıldığında, pakimetri ve LLM değerlerinin değişmediği (p=0,501, p=0,850 sırasıyla), ÖKD'nin ise daraldığı (p<0,001) gözlendi. Optik biyometri ile değerlendirilen keratometrik değerlerde (K1 için p=0,968, K2 için p=0,720), aksiyel uzunlukta (p=0,957) ve Sanders-Retzlaff-Kraff/Theoretical (SRK/T) formülüne göre GİL ölçümünde anlamlı bir farklılık saptanmadı (p=0,102). Ameliyat sonrası 1 gözde GİB artışı, 1 gözde katarakt gözlendi. Sonuç: Yüksek miyoplarda yeni nesil arka kamara fakik GİL uygulaması etkin, güvenilir, pratik ve sonuçları açısından öngörülebilir bir uygulamadır.

Anahtar Kelimeler: Arka kamara; fakik intraoküler lens; refraksiyon cerrahisi; yüksek miyopi
ABSTRACT
 Objective: To show the effectiveness and safety of new generation posterior chamber phakic intraocular lens (IOL) implantation in patients who have undergone this surgery. Material and Methods: Before surgery, manifest refractions and visual acuity of patients were recorded according to Snellen chart. IOP were measured by Goldmann applanation tonometry. Corneal topography (Sirius, CSO, Italy) and optical biometry (Lenstar LS 900, Haag-Streit AG, Switzerland) devices were used to evaluate the anterior segment structures of patients (limbus-limbus distance 'LLD', anterior chamber depth 'ACD', pachymetry, keratometry). All patients were implanted posterior chamber IOL (Eyecryl Phakic IOL, Biotech Vision Care, India). After surgery, following routine ophthalmic examination, corneal topography and optic biometry of all patients were repeated to evaluate the anterior segment structures. The posterior chamber phakic IOL vault distance was measured by anterior segment optical coherence tomography (Optovue Inc, Fremont CA, United States). Results: When the pre and postoperative data of the 29 eyes of 15 patients who underwent surgery were compared; it has been observed that visual acuities have improved (p<0.001), IOPs have not changed (p=0.107), spherical values and spherical equivalents have decreased (p<0.001). When the anterior segment parameters were compared; it has been observed that pachymetry and LLD values have not changed (p=0.501, p=0.850, respectively), and ACD has been narrowed (p<0.001). There have been no significant differences in keratometric values (p=0.968 for K1, p=0.720 for K2), axial length (p=0.957) and the IOL measurements according to the Sanders-Retzlaff-Kraff / Theoretical (SRK / T) formula (p=0.102). Postoperative IOP has been increased in 1 eye and cataract is seen in 1 eye. Conclusion: Posterior chamber phakic IOL implantation in high myopia is an effective, reliable, practical and predictable practice.

Keywords: High myopia; phakic intraocular lens; posterior chamber; refractive surgery
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