.: ORİJİNAL ARAŞTIRMA
Derin Anterior Lameller Keratoplastide Manuel Diseksiyon ve Büyük Kabarcık Yöntemlerinin Karşılaştırılması
Comparison of Manual Dissection and Big-Bubble Technique in Deep Anterior Lamellar Keratoplasty
Turkiye Klinikleri J Ophthalmol. 2020;29(2):143-9
doi: 10.5336/ophthal.2019-71114
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Derin anterior lameller keratoplasti (DALK) uygulanan hastalarda büyük kabarcık (BK-DALK) yöntemi ve manuel diseksiyon (M-DALK) yönteminin klinik sonuçları ve komplikasyon oranlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Nisan 2015-Mart 2017 tarihleri arasında DALK uygulanan 40 hastanın 42 gözüne ait kayıtlar retrospektif olarak incelendi. Manuel diseksiyon (M-DALK grubu, n=19) ve büyük kabarcık yöntemi (BK-DALK grubu, n=23) uygulanan hastalar iki grupta değerlendirildi. Gruplar, ameliyat öncesi ve sonrası en iyi düzeltilmiş görme keskinliği (EİDGK), merkezi kornea kalınlığı, korneal dansitometri değerleri, ameliyat ve takip komplikasyonları açısından karşılaştırıldı. Bulgular: Her iki grupta ameliyat sonrası EİDGK'de anlamlı artış saptanırken, gruplar arasında sonuç EİDGK açısından anlamlı fark bulunmadı (p=0,137). Sonuç merkezi santral kalınlık (M-DALK grubu: 573,8±52,4 μ, BK-DALK grubu: 556,2±65,5 μ; p=0,465) ve total korneal dansitometri değerleri (M-DALK grubu: 27,0±5,0, BK-DALK grubu: 23,2±5,9; p=0,069) gruplar arasında benzer bulundu. Ameliyat sırasında penetran keratoplastiye dönüş sayısı her iki grupta benzerdi (M-DALK grubu: 2/19, BK-DALK grubu: 5/23, p=0,293). Ameliyat sonrası takiplerde, oküler yüzey sorunları BK-DALK grubunda daha fazla görüldü (p=0,023) Sonuç: DALK'de manuel diseksiyon ve büyük kabarcık yöntemi uygulanan hastalarda benzer sonuçlar elde edilmiştir.
Anahtar Kelimeler: Derin anterior lameller keratoplasti; manuel diseksiyon; büyük kabarcık; keratoplasti
Amaç: Derin anterior lameller keratoplasti (DALK) uygulanan hastalarda büyük kabarcık (BK-DALK) yöntemi ve manuel diseksiyon (M-DALK) yönteminin klinik sonuçları ve komplikasyon oranlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Nisan 2015-Mart 2017 tarihleri arasında DALK uygulanan 40 hastanın 42 gözüne ait kayıtlar retrospektif olarak incelendi. Manuel diseksiyon (M-DALK grubu, n=19) ve büyük kabarcık yöntemi (BK-DALK grubu, n=23) uygulanan hastalar iki grupta değerlendirildi. Gruplar, ameliyat öncesi ve sonrası en iyi düzeltilmiş görme keskinliği (EİDGK), merkezi kornea kalınlığı, korneal dansitometri değerleri, ameliyat ve takip komplikasyonları açısından karşılaştırıldı. Bulgular: Her iki grupta ameliyat sonrası EİDGK'de anlamlı artış saptanırken, gruplar arasında sonuç EİDGK açısından anlamlı fark bulunmadı (p=0,137). Sonuç merkezi santral kalınlık (M-DALK grubu: 573,8±52,4 μ, BK-DALK grubu: 556,2±65,5 μ; p=0,465) ve total korneal dansitometri değerleri (M-DALK grubu: 27,0±5,0, BK-DALK grubu: 23,2±5,9; p=0,069) gruplar arasında benzer bulundu. Ameliyat sırasında penetran keratoplastiye dönüş sayısı her iki grupta benzerdi (M-DALK grubu: 2/19, BK-DALK grubu: 5/23, p=0,293). Ameliyat sonrası takiplerde, oküler yüzey sorunları BK-DALK grubunda daha fazla görüldü (p=0,023) Sonuç: DALK'de manuel diseksiyon ve büyük kabarcık yöntemi uygulanan hastalarda benzer sonuçlar elde edilmiştir.
Anahtar Kelimeler: Derin anterior lameller keratoplasti; manuel diseksiyon; büyük kabarcık; keratoplasti
ABSTRACT
Objective: To compare the clinical results and complication rates between manual dissection technique and big bubble technique in deep anterior lamellar keratoplasty (DALK). Material and Method: The records of 42 eyes of 40 patients who underwent DALK procedure between April 2015-March 2017 were retrospectively analyzed. The patients were divided into two groups in regard to the technique used in surgery (M-DALK: DALK with manual dissection, n=19 and BB-DALK: DALK using big bubble technique, n=23). Preoperative and postoperative best corrected visual acquity, central corneal thickness and corneal dansitometry values; intraoperative and follow-up complication rates were compared between groups. Results: Best corrected visual acuity was increased significantly in both groups. However, the difference was similar between two groups (p=0.137). At the last follow-up visit, central corneal thickness (M-DALK: 573.8±52.4 μ,vs. BB-DALK: 556.2±65.5 μ; p=0.465) and total corneal densitometry (M-DALK: 27.0±5.0 vs. BB-DALK: 23.2±5.9; p=0.069) were similar between groups. The number of patients in which the surgery was converted to penetrating keratoplasty was found to be similar (M-DALK:2/19 vs BB-DALK: 5/23, p=0.293). Ocular surface pathologies were found to be higher in BB-DALK group (p=0.023). Conclusion: Clinical outcomes and complication rates of manual dissection were found to be comparable to big bubble DALK.
Keywords: Deep anterior lamellar keratoplasty; manual dissection; big bubble; keratoplasty
Objective: To compare the clinical results and complication rates between manual dissection technique and big bubble technique in deep anterior lamellar keratoplasty (DALK). Material and Method: The records of 42 eyes of 40 patients who underwent DALK procedure between April 2015-March 2017 were retrospectively analyzed. The patients were divided into two groups in regard to the technique used in surgery (M-DALK: DALK with manual dissection, n=19 and BB-DALK: DALK using big bubble technique, n=23). Preoperative and postoperative best corrected visual acquity, central corneal thickness and corneal dansitometry values; intraoperative and follow-up complication rates were compared between groups. Results: Best corrected visual acuity was increased significantly in both groups. However, the difference was similar between two groups (p=0.137). At the last follow-up visit, central corneal thickness (M-DALK: 573.8±52.4 μ,vs. BB-DALK: 556.2±65.5 μ; p=0.465) and total corneal densitometry (M-DALK: 27.0±5.0 vs. BB-DALK: 23.2±5.9; p=0.069) were similar between groups. The number of patients in which the surgery was converted to penetrating keratoplasty was found to be similar (M-DALK:2/19 vs BB-DALK: 5/23, p=0.293). Ocular surface pathologies were found to be higher in BB-DALK group (p=0.023). Conclusion: Clinical outcomes and complication rates of manual dissection were found to be comparable to big bubble DALK.
Keywords: Deep anterior lamellar keratoplasty; manual dissection; big bubble; keratoplasty
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