ÖZET Amaç: Bu çalışmada alt göz kapağına ektropiyon nedeniyle cerrahi tedavi uyguladığımız hastalardaki sonuçlarımızı değerlendirmek amaçlandı. Yöntemler: Ağustos 2008 ve Haziran 2011 yılları arasında kliniğimizde ektropiyon operasyonu uygulanmış 28 hastanın kayıtları retrospektif olarak tarandı. Hastaların yaşı, cinsiyeti, cerrahi öncesi ve sonrası görme keskinliği, ektropiyonun derecesi kaydedildi. Uygulanan cerrahi teknik, cerrahi sonrası tedaviler ve cerrahiye bağlı oluşan komplikasyonlar not edildi. Bulgular: Çalışmaya Ankara Onkoloji Hastanesi Göz Hastalıkları Bölümünde ektropiyon cerrahisi uygulanmış 28 hasta alındı. Bu hastaların 18'i erkek, 10'u kadındı. Ortalama yaş 63,2 yıl olup 31 ile 81 arasında yaş dağılımı değişmekteydi. Hastaların ortalama takip süresi 14 (7-22) aydı. 28 Hastanın 10'u sağ alt göz kapağı, 11'i sol alt göz kapağı, 7'si bilateral alt göz kapağından opere edildi. Ektropiyon etyolojisinde sırasıyla involüsyonel (n=17), skatrisyel (n=7), mekanik (n=4) faktörler yer almaktaydı. İnvolüsyonel ektropiyon olgularında KuhntSzymanowski tekniğinin Smith modifikasyonu, skatrisiyel ektropiyon olgularında vertikal uzatma (cilt grefti veya lokal fleple ile), mekanik ektropiyon olgularımızda ise mukozal greft ve yanak veya alın rotasyon flebi ile kombine onarım yapıldı. Sonuç: Kliniğimizde ektropiyon cerrahisi genellikle involüsyonel sebeplerle uygulandı. İnvolüsyonel sebeplerle oluşan ektropiyon cerrhisinde Kuhnt-Szymanowski tekniğinin Smith modifikasyonu ile başarı oranının çok yüksek olduğu saptandı. Alt göz kapakları, fonksiyonel olarak göz küresini korumaları yanında, estetik olarak da önemli yapılardır bu yüzden deformitelerinin onarımları titiz bir çalışmayı gerektirdiği unutulmamalıdır. Anahtar Kelimeler: Ektropiyon; Alt göz kapağı; Kuhnt Szymanowski tekniğinin Smith modifikasyonu ABSTRACT Objective: We tried to evaluate the results of the patients that had inferior eye lid ectropium surgery. Methods: The records of 28 patients that had ectropium surgery in our clinic between August 2008 ve June 2011 were examined retrospectively. The age, gender, visual acuity before and after surgery and the grade of the ectropium were recorded. The performed surgical method, applied treatments after surgery and the complications due to surgery were all noted. Results: 28 patients that had ectropium surgery in Ankara Oncology Hospital Eye Clinic were included in the study. 18 of them were male, 10 of them were female. Average age was 63,2 years old and the distribution of the age was between 31 and 81years. The average follow up period of the patients were 14(7-22) months. The 10 of the 28 patients were operated from right inferior eye lid, 11 from left inferior eye lid and 7 from bilateral inferior eye lid. The etiology of the ectropium includes respectively involutional, (n=17), scatrical (n=7) and mechanical(n=4) factors. Kuhnt-Szymanowski technique with Smith modification, vertical elongation(skin greft or local fleb) and combinated repair with mucosal greft and cheek or forehead fleb was performed re...
The purpose of this study was to evaluate the efficacy and safety of the mini-nuc technique for the removal of brunescent and black cataracts. A prospective study was carried out in 33 eyes of 33 patients with cataract nigra operated with the mini-nuc technique between April 2002 and June 2003. Slit-lamp examinations, intraocular pressure (IOP) measurements, and best-corrected visual acuity (BCVA) were assessed pre- and postoperatively. Accompanying systemic diseases were noted. Intraoperative and postoperative complications were evaluated. Unilateral eyes of 33 patients (18 male [54.5%], 15 female [45.5%]) aged between 65 and 90 years (mean 72 years) were operated with the mini-nuc technique. Preoperative BCVA values varied between light perception and 0.2 in the Snellen chart. Intraocular lenses (IOL) were implanted into all of the patients (27 in-the-bag [81.8%], four to sulcus [12.1%], and two with scleral fixation [6.1%]). During the surgery, five patients (15.15%) had zonular dialysis and two (6.1%) had posterior capsule rupture and vitreous loss. Postoperatively, three (9.1%) rises in IOP, two (6.1%) hyphema, and one (3%) IOL subluxation were observed. At the first day visit, the mean of the uncorrected visual acuities (UCVA) was 0.5 in the Snellen chart. At the third month visit, the mean BCVA was observed to be 0.8. The residual mean astigmatism was 0.75 D against the rule. The mini-nuc technique was effective in removing brunescent and black cataracts with a low rate of serious complications. The mini-nuc technique, which is also performed with a small incision and without sutures, might be an alternative to phacoemulsification in cases of cataract nigra.
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