Dirençli glokom olgularında transskleral diod lazer siklofotokoagülasyon
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Amaç: Medikal veya cerrahi tedavilerle kontrol edilemeyen ileri evre glokom olgularında transskleral diod lazer siklofotokoagülasyon (TSDLS) uygulamasının güvenilirliğinin ve etkinliğinin değerlendirilmesi. Gereç ve Yöntem: 2009-2011 yılları arasında TSDLS tedavisi uygulanan olgular retrospektif olarak incelendi. Tedavi öncesi ve sonrası göz içi basıncı (GİB) değerleri, görme keskinlikleri, kullanılan antiglokomatöz tedavi sayıları ve komplikasyonlar kaydedildi. TSDLS başarı kriteri, son kontrolde GİB ölçümünün 6-22 mmHg (ilaçlı ya da ilaçsız) olması olarak belirlendi. Sonuçlar: Çalışmaya 37 olgunun 37 gözü dahil edildi. Olguların yaş ortalaması 61,7317,13 yıl (19-80 yıl) ve ortalama takip süresi 8,065,81 ay (3-22 ay) idi. Tedavi öncesi ortalama GİB değerleri 38,688,94 mmHg, tedavi sonrası 2. haftada 26,4611,34 mmHg (p 0,01) ve son kontrolde 24,9710,84 mmHg (p0,01) idi. Olguların %40,5’inde son kontrolde ölçülen GİB değerleri 22 mmHg ve altındaydı. Göz başına ortalama diod lazer seans sayısı 1,480,73 olarak saptanırken birden fazla tedavi seansı gerektiren olgu sayısı 13 (%35,1) idi. Kullanılan antiglokomatöz tedavi etken madde sayısı tedavi öncesi 3,141,18 iken tedavi sonrası 2,761,23 olarak saptandı. Takip süresince olguların hiçbirinde fitizis bulbi ya da persistan hipotoni gelişmedi. Tart›flma: TSDLS uygulaması, dirençli glokom olgularında GİB düşürülmesinde etkin ve güvenilir bir tedavi yöntemidir. Aynı zamanda antiglokomatöz tedavi kullanımında azalma sağlayarak hastaların tedaviye uyumunu ve yaşam kalitesini artırmaktadır.
Purpose: To evaluate the safety and efficacy of transscleral diode laser cyclophotocoagulation (TSDLC) in advanced glaucoma refractory to medical or surgical treatment. Material and Method: The data of subjects who were treated with TSDLC between 2009 and 2011 were retrospectively reviewed. Intraocular pressure before and after treatment, visual acuity, the number of medications and complications were analysed. Success was defined as final IOP of 6-22 mmHg with or without antiglaucomatous medications. Results: Thirty seven eyes of 37 patients were included in the study. Mean age of patients and mean follow-up time were 61.73±17.13 years (range: 19-80 years) and 8.06±5.81 months (range: 3-22 months), respectively. Mean pretreatment IOP was 38.68±8.94 mmHg and IOP was 26.46±11.34 mmHg (p <0.01) at the second week, whereas it was 24.97±10.84 mmHg (p<0.01) at the last visit. IOP of less than 22 mmHg was achieved in 40.5% of eyes at the last visit. Mean treatment number per eye was 1.48±0.73, and more than one treatment was required in 13 (35.1%) eyes. Preoperative and postoperative mean total antiglaucomatous medications were 3.14±1.18 and 2.76±1.23, respectively. No phthisis bulbi or persistent hypotonia developed during the follow-up period. Discussion: TSDLC is an effective and safe method for the treatment of refractory glaucoma. It also served to reduce the number of antiglaucoma medications, thus improving both the quality of life of the patients and their compliance to therapy.
Purpose: To evaluate the safety and efficacy of transscleral diode laser cyclophotocoagulation (TSDLC) in advanced glaucoma refractory to medical or surgical treatment. Material and Method: The data of subjects who were treated with TSDLC between 2009 and 2011 were retrospectively reviewed. Intraocular pressure before and after treatment, visual acuity, the number of medications and complications were analysed. Success was defined as final IOP of 6-22 mmHg with or without antiglaucomatous medications. Results: Thirty seven eyes of 37 patients were included in the study. Mean age of patients and mean follow-up time were 61.73±17.13 years (range: 19-80 years) and 8.06±5.81 months (range: 3-22 months), respectively. Mean pretreatment IOP was 38.68±8.94 mmHg and IOP was 26.46±11.34 mmHg (p <0.01) at the second week, whereas it was 24.97±10.84 mmHg (p<0.01) at the last visit. IOP of less than 22 mmHg was achieved in 40.5% of eyes at the last visit. Mean treatment number per eye was 1.48±0.73, and more than one treatment was required in 13 (35.1%) eyes. Preoperative and postoperative mean total antiglaucomatous medications were 3.14±1.18 and 2.76±1.23, respectively. No phthisis bulbi or persistent hypotonia developed during the follow-up period. Discussion: TSDLC is an effective and safe method for the treatment of refractory glaucoma. It also served to reduce the number of antiglaucoma medications, thus improving both the quality of life of the patients and their compliance to therapy.
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Kaynak
Türk Oftalmoloji Dergisi
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Cilt
42
Sayı
6
