Ezotropyalı hastalarda Faden ameliyatının uzun dönem sonuçları

Abstract

ÖZET Otuz dokuzu înfantil ezotropyalı, 97' si Akiz ezotropyalı toplam 136 olguda Faden Ameliyatı etkinliği araştırıldı. Operasyon yaşı ortalamaları; înfantil ezotropyalı olgularda 5.0±0.3 yıl, Akiz ezotropyalı olgularda 5.9±0.3 yıl olup olguların %61'i 4-5 yaş arasında öpere edildi. Postoperatif izlem süresi olguların tümünde ortalama 4.8±0.3 yıl olup 3 ay ile 14 yıl arasıdaydı. Olgularımızın tümünde kayma miktarı ortalama uzakta preoperatif +3 1. 1±1.3 PD iken postoperatif +3.7±0.6PD ile +2.0±0.6 PD ve yalanda preoperatif +35.8±1.2 PD iken postoperatif +3.7±0.6 PD ile +2.8±0.9 PD arasında bulundu. Olgularımızın tümünde postoperatif basan oranlan uzakta %82.5 ile %100 ve yakında %80.6 ile %100 arasında bulundu. Nonakomodatif konverjans fazlalığı olan 35 olguda preoperatif ortalama 13.3±0.7 PD olan yakın uzak farkı, postoperatif 1.8±0.6 PD ile 5.1±1.3 PD arasında bulundu (pO.001). Preoperatif olguların %30.9'nda varolan açı değişkenliği postoperatif %4.4'e indi (pO.001). Olgularımızın binoküler görme fonksiyonlarında preoperatif döneme göre anlamlı artış oldu. Preoperatif Bagolini testi uzakta %37.9'unda, yalanda %45.3'ünde pozitif iken postoperatif uzakta %77.9'unda, yakında %81.1 'inde pozitif oldu (p<0.01). Preoperatif yalnızca %1.9 olan Titmus testi pozitifliği postoperatif %28.7 oldu (p<0.001). Etkili bir teknik kullamldığmda Faden Ameliyatının kontrolü güç olan nonakomodatif konverjans fazlalığı ve açı değişkenliği de dahil olmak üzere infantil ve akiz ezotropyalarda başarılı olduğu görüldü. Anahtar kelimeler: înfantil ezotropya, nonakomodatif konverjans fazlalığı, açı değişkenliği, Faden Ameliyatı, binoküler görme. 65

LONG -TERM RESULTS OF FADEN OPERATIONS IN ESOTROPIA SUMMARY The effect of Faden Operation in 136 patients, 39 with infantile esotropia and 97 with acquired esotropia was examined. While mean age of operation was 5.0±0.3 in patients with infantile esotropia and 5.9±0.3 in patients with acquired esotropia and 61% of total patients were operated between 4-5 ages. Postoperative observation period was mean 4.8+0.3 years for all patients and it varied from 3 months to 14 years. In all cases, the mean far deviation was 3 1.1 ±1.3 preoperatively and it was found between +3.7±0.6 PD,and 2.0±0.6 PD postoperatively and the mean near deviation was +35.8 PD preoperatively and it was found between +3.7±0.6 PD and +2.8±0.9 PD postoperatively. In all cases, the postoperative success rate was 82.5% and 100% at distance and it was found between 80.6% and 100% nearby. In 35 cases with nonaccomodative convergence excess, preoperative mean of near-far deviation difference was 13.3±0.7 PD and it was found to be between 1.8+0.6 PD and 5.1±1.3 PD postoperatively (p<0.001). Variable angle deviation which was 30.9% in preoperative patients decreased to 4.4% in postoperative ones (p<0.001). Significant increase was found in binocular visional functions of our patients during postoperative period compared to preoperative period. While preoperative Bagolini test was positive in 37.9% of patients at distance and 45.3% nearby, postoperative test was positive in 77.9% of patients at distance and 81.1% nearby (p<0.01). While Titmus test was positive in just 1.9% preoperatively, it increased to 28.7% postoperatively (p < 0.001). 66We found that Faden Operation can be considered succesful when an effective technique is performed in infantile and acquired esotropias, involving nonaccomodative convergence excess and variable angle deviation which are hardly controlled. Key words: Infantile esotropia, nonaccomodative convergence excess, variable angle deviation, Faden Operation, binocular visional functions. 67