Fakoemülsifikasyonla katarakt cerrahisinde paralimbal gevşetici kesilerin preoperatif korneal astigmatizma üzerine etkileri

Abstract

38 ÖZET Bu çalışmada, şeffaf korneal ve PGK uygulanarak fakoemülsifikasyon ve GİL implantasyonu cerrahisi uygulanmış, yaş ve cinsiyet özellikleri birbirine denk, kataraktlı iki hasta grubunda keşi telanğinin, preoperatif korneal astigmatizmaya olan etkilerini araştırdık. Süleyman Demirel Üniversitesi Tıp Fakültesi Göz Hastalıkları Kliniğinde, 15 kataraktlı göze şeffaf korneal keşi ile, 15 kataraktlı göze ise PGK ile, tek cerrah tarafından, fakoemülsifikasyon ve GİL implantasyonu uygulandı. Hastalar postoperatif 1. gün, 1. hafta ve 1. ay kontrole çağrıldı. Cerrahiye bağlı astigmatizma Ege Üniversitesi'nde hazırlanan Vektör Analiz Programı ile analiz edildi. Astigmatik ve pakimetrik değişimler Wilcoxon Signed-Rank, gruplar arası farkların anlamlılığı Mann- Whitney U testi ile değerlendirildi. Çalışmamızda 1. gün ve 1. hafta korneal astigmatizma değerleri arasmda anlamlı fark bulunmazken, 1. ay korneal astigmatizma değerleri PGK'li grupta anlamlı olarak düşüktü. Ancak cerrahinin indüklediği astigmatizmayı düzeltmede her iki grup arasmda anlamlı fark yoktu. Sonuç olarak PGK' ler preoperatif astigmatizmayı düzeltmede basit, etkin ve güvenilir bir yöntemdir.

39 SUMMARY In this study we investigated the effects of clear corneal and paralimbal relaxing incision (PRI) tecniques used during facoemulsification and intraocular lens (IOL) implantation surgery, on prepoperative corneal astigmatism. 30 patients were included in our study. These patients were comprised of 2 groups 15 patients each with similar age and sex distribution. All patients in both groups were operated by a single surgeon at opthalmology clinic of Süleyman Demirel University. In the first group clear corneal incisions were utilized during facoemulsification and intraocular lens (IOL) implantation surgery. Whereas in second group PRI were used during surgery. Patients in both study groups were seen 3 times after surgery; on 1st postoperative day, 1st postoperative week and 1st postoperative month. Surgically induced astigmatism was calculated by a vectorial analysis software developed by Ege University. Statistical analysis was done by using SPSS software. Wilcoxon Signed-Rank test was used for comparing the astigmatic and pakimetric data. Mann- Whitney U was used for comparing the parameters between groups. There was no statistically significant difference in values in the 1st postoperative day and week between first and second group. However, corneal astigmatisma values were significantly lower in the PRI group in 1st postoperative month. No significant difference was detected in corrected surgically induced astigmatism between two groups. As conclusion, we suggest that utilization of PRI' s is a simple, effective and safe method for correction of preoperative astigmatism.