Saydam korneal fakoemülsifikasyonda postoperatif refraktif astigmatizma sonuçları

Özet

Amaç: Saydam korneal fakoemülsifikasyonda tek sütür konulan ve sütür konulmayan tek-niklerin, yara yeri kontrolü açısından karşılaştırılması ve postoperatif refraktif astigmatizma üzerindeki etkilerinin değerlendirilmesi. Metod: 61 hastanın 85 gözüne tek bir cerrah (YAA) tarafından AMO Diplomax Fakoemülsifikasyon (Allergari) cihazı ile saydam korneal fakoemülsifikasyon uygulandı. İnsizyon, 3.2 mm keratom (Network Medical Products, 80-8566, Ripon, England) kullanılarak yapıldı. 35 hastanın 50 gözüne İnsizyon yerinin daha iyi kontrolü için 10/0 naylon ile tek sütür konuldu (Grup 2). 26 hastanın 35 gözüne sütürsüz teknik uygulandı (Grup 1). İki grubun preoperatif ve postoperatif 4. haftada refraktif astigmatizma değerleri karşılaştırıldı. 0.75 D üzerinde astigmatizma oluşturan tek sütürler 3. haftalarda alındı. Cerrahi olarak indüklenen refraktif değişiklik sinüzoidal metod ile vektör analizi yapılarak tespit edildi. Sonuçlar: Tek sütür konulan grup 2'de preoperatif ortalama refraktif astigmatizma değeri 1.28 ± 1.30 dioptri olarak saptandı. Postoperatif ortalama refraktif astigmatizma değerinin bu grupta 0.54 ± 0.68 dioptri olduğu görüldü (p

Abstract

Purpose: To compare the effects of using single interrupted suture to better control the structure of the incision with the sutureless technique and to evaluate the effects on refractive astigmatism. Methods: Uncomplicated clear corneal phacoemulsification was performed on 85 eyes of 61 patients using AMO, Diplomax Phacoemulsification machine (Allergan) by one surgeon (YAA). The incision was created using a flatstock, angled, 3.2 mm keratome (Network Medical Products, 80-8566, Ripon, England). The study group compared 50 eyes of 35 patients where asingle 10/0 nylon interrupted suture was used to better control the corneal incision site, with 35 eyes of 26 patients where no sutures were used. Preoperative and postoperative 4th week refractive astigmatism was compared. Single suture was removed at 3-4th week postoperatively, if as-sociated with >0.75 diopters of astigmatism. Surgically induced refractive change was determined in both groups by using vector analysis of sinusoidal method. Results: Preoperatively, the average refractive astigmatism was 1.28 ± 1.30 diopters in the group where single interrupted suture was used and average postoperative astigmatism after re-moval of this single suture was reduced to 0.54 ± 0.68 diopters by refraction (p=0.50). In the group where no sutures were used, the pre and postoperative average refractive astigmatism we-re 0.79 ± 0.78, and 1.14 ± 0.57 diopters respectively (p=0.05). There was induced residual astigmatism in the technique where no sutures were used. Surgically induced refractive change was found as -1.52D in the group with one single interrupted suture and +1.91 in the sutureless group. Conclusion: Induced astigmatism may result in clear corneal phacoemulsification surgery depending on the structure of the incision. In our experience, using a single 10/0 nylon suture to better control the wound site reduces the residual refractive astigmatism compared to the sutureless technique.