Pterjiyum Cerrahisinin Nüks Dışı Komplikasyonları

Abstract

ÖzetAmaç: Klini¤imize yönlendirilmifl olgular› sunarak pterjiyumun nüks d›fl› komplikasyonlar›na dikkat çekmek. Gereç ve Yöntem: Klini¤imize yönlendirilen 18 hastan›n 20 gözüne ait veriler retrospektif olarak de¤erlendirildi. Olgular›n yafl, cinsiyet, efllik eden hastal›klar›, baflvuru an›ndaki ve sonuç en iyi düzeltilmifl görme keskinlikleri, primer cerrahiye ait bilgileri de¤erlendirildi. Uygulad›¤›m›z tedavi yöntemleri not edildi. Sonuçlar: Olgunun yafl ortalamas› 51,62±9,86 (37 ve 67 aras›nda) idi. Olgular›n tamam› primer pterjiyum nedeniyle opere edilmiflti. Dokuz gözde ç›plak sklera tekni¤i, 9 gözde intraoperatif Mitomisin C (MMC) uygulanm›flt›. Befl gözde kötü yara duda¤› sütürasyonu, 3 gözde ise afl›r› koter kullan›m›na ba¤l› komplikasyon geliflti¤i izlendi. Saptanan komplikasyonlar pyojenik granülom, inklüzyon kisti, Dellen, skleromalazi, limbal yetmezlik ve perforan yaralanma idi. Alt› gözde t›bbi tedavi yeterli olurken, geri kalan 14 göze cerrahi tedavi uyguland›. Tart›flma: Pterjiyum cerrahisi hafife al›nmamal›d›r. Cerrahinin her aflamas›nda azami dikkat gösterilmeli ve adjuvan ajanlara ba¤l› geliflebilecek komplikasyonlar unutulmamal›d›r. Peroperatuar antimitotik ajan kullan›m› seçilmifl vakalara saklanmal›, afl›r› koterizasyon ve skatrizasyonu tetikleyecek genifl cerrahi diseksiyonlardan kaç›n›lmal›d›r. (Turk J Ophthalmol 2011; 41: 151-5) Anahtar Kelimeler: Komplikasyon, mitomisin C, perforasyon, pterjiyum, skleromalazi Summary Purpose: To draw attention to non-recurrence complications of pterygium surgery by reporting the cases of patients who were referred to our clinic. Material and Method:The data of 20 eyes of 18 patients were evaluated retrospectively. Age, gender, accompanying diseases, best corrected visual acuities at the time of referral and at last visit, and data related to primary surgery were assessed. The treatment modalities we used were noted. Results: The mean age of the patients was 51.62±9.86 (range: 37-67) years. All cases had been operated for primary pterygium. Bare sclera technique had been used in 9 eyes and intraoperative mitomycin C (MMC) had been applied in 9 eyes. Complications related to poor suturing technique were observed in 5 eyes and to excessive cauterisation -in 3 eyes. The detected complications were pyogenic granuloma, inclusion cyst, dellen, scleromalacia, limbal insufficiency, and globe perforation. Medical therapy was sufficient in 6 cases, whereas the remaining 14 eyes had to undergo surgical treatment. Discussion: Pterygium surgery should not be underestimated. Maximum attention must be paid in every step of the surgery and complications that might develop related to adjuvant agents should not be neglected. Perioperative antimitotic agent use should be saved for selected cases, excessive cauterisation and wide surgical dissections that might trigger cicatrisation must be avoided. (Turk J Ophthalmol 2011; 41: 151-5)