Künt göz travmalı olgularda geç dönem iridokorneal açı ve kornea endotel değişikliklerinin değerlendirilmesi
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Dosyalar
Tarih
2011
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Künt göz travmasının iridokorneal açı ve kornea endoteli üzerine geç dönem etkilerini araştırdığımız bu çalışmada; Trakya Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı'nda takip ve tedavileri yapılan 31'i hifemalı, 20'si hifemasız 51 künt göz travmalı olgunun klinik verileri retrospektif olarak incelendi. Çalışmaya alınan olguların dosya kayıtlarından ilk muayeneleri, kontrol muayeneleri, iridokorneal açı ve kornea endoteli hücre analiz bulguları elde edilerek, olguların kontrol gözlerine ait bulgularıyla karşılaştırıldı. Yapılan istatistiksel değerlendirmeler sonunda; travmatik hifemalı olguların, yaş ortalamalarının hifemasız olgulara göre daha küçük olduğu ve hifemalı olguların sağlık kurumuna daha erken başvurdukları tespit edildi. Başvuru görme keskinliği bakımından iki grup arasında fark olmadığı, ancak başvuru göz içi basıncının hifemalı grupta daha yüksek olduğu görüldü. Sonuç görme keskinliği bakımından gruplar arasında istatistiksel olarak anlamlı farklılık görülmedi. Hifemalı grubun %67.7'sinde, hifemasız grubun %20'sinde değişik derecelerde iridokorneal açı resesyonu tespit edildi. Hifemalı grubun %54.8'inde, hifemasız grubun %10'unda periferik anterior sineşi saptandı. Hifemalı gruptan 2 olguda (%6.5) sekonder glokom geliştiği görüldü. Olguların travmatize gözlerine ait kornea endotel hücre analizi sonuçları değerlendirilip, kontrol gözleriyle karşılaştırıldığında; santral, alt, temporal, nazal kadranlardaki endotel hücre yoğunluğu azalırken, üst kadran endotel hücre yoğunluğunun travmadan etkilenmediği görüldü. Hifemalı grupta; santral, alt, temporal ve nazal kadranlarda, hifemasız grupta ise temporal kadranda endotel hücre yoğunluğunun azaldığı belirlendi. Kornea endotel hücre yoğunluğundaki azalmanın, travmatik katarakt, lens subluksasyonu ve periferik anterior sineşi varlığı ile ilişkili olduğu görüldü. Künt göz travmaları, erken dönemde klinik önemi olmayan, ancak geç dönemde izlem gerektirecek iridokorneal açı ve kornea endotel değişikliklerine neden olabilmektedir. İridokorneal açı değişiklikleri sonucu ortaya çıkan sekonder glokom izlem gerektirirken, kornea endotel hücre yoğunluğundaki değişikliklerin geç dönemde de klinik önemi olmadığı sonucuna varılmıştır. Anahtar kelimeler: Künt göz travması, hifema, iridokorneal açı, kornea endoteli.
Abstract
In this study where we investigated the long term effects of blunt eye trauma on the iridocorneal angle and the corneal endothelium; clinical data of 51 blunt eye trauma patients (20 presenting with hyphema and 31 without it) who were followed up and treated at the Ophthalmology Department of the Faculty of Medicine Trakya University were retrospectively studied. Data on the initial eye examinations, follow-up examinations, iridocorneal angle and corneal endothelial cell analysis results obtained from the records of patients included in the study was compared to that of the control patients eyes. In the statistical analysis, the mean age of the patients presenting with trauma-related hyphema was seen to be younger than that of those patients presenting without hyphema; and that the patients with hyphema sought medical help earlier than those without hyphema. While there was no difference in visual acuity between the two groups during the initial visit, the intraocular pressure in the patients with hyphema was higher than in the patient group without hyphema. The difference in the resultant visual acuity between the two groups was statistically non-significant. 67.7% of the patients presenting with hyphema and 20% of those presenting without hyphema had different degrees of iridocorneal angle recessions. Peripheral anterior synechiae was seen in 54.8% of the patients presenting with hyphema and 10% of those presenting without hyphema. Two patients (6.5%) in the hyphema group developed secondary glaucoma. Upon comparison of the injured eye's corneal endothelial cell analysis results with those of the patient controls eyes; a trauma-related endothelial cell density reduction was seen in the lower, central, temporal and nasal quadrants whereas no endothelial cell density change was observed in the upper quadrant. While in the hyphema group endothelial cell density reduction was seen in the lower, central, temporal and nasal quadrants; in the patient group without hyphema this reduction was only observed in the temporal quadrant. The reduction in endothelial cell density was associated with traumatic cataract, lens subluxation and Peripheral anterior synechiae. Blunt eye traumas bear no short term clinical significance but can cause long term iridocorneal angle and corneal endothelium changes that may require monitoring. It was concluded that while glaucoma secondary to iridocorneal angle changes needs monitoring, corneal endothelium density changes have no long term clinical significance. Key words: Blunt eye trauma, hyphema, iridocorneal angle, corneal endothelium
Abstract
In this study where we investigated the long term effects of blunt eye trauma on the iridocorneal angle and the corneal endothelium; clinical data of 51 blunt eye trauma patients (20 presenting with hyphema and 31 without it) who were followed up and treated at the Ophthalmology Department of the Faculty of Medicine Trakya University were retrospectively studied. Data on the initial eye examinations, follow-up examinations, iridocorneal angle and corneal endothelial cell analysis results obtained from the records of patients included in the study was compared to that of the control patients eyes. In the statistical analysis, the mean age of the patients presenting with trauma-related hyphema was seen to be younger than that of those patients presenting without hyphema; and that the patients with hyphema sought medical help earlier than those without hyphema. While there was no difference in visual acuity between the two groups during the initial visit, the intraocular pressure in the patients with hyphema was higher than in the patient group without hyphema. The difference in the resultant visual acuity between the two groups was statistically non-significant. 67.7% of the patients presenting with hyphema and 20% of those presenting without hyphema had different degrees of iridocorneal angle recessions. Peripheral anterior synechiae was seen in 54.8% of the patients presenting with hyphema and 10% of those presenting without hyphema. Two patients (6.5%) in the hyphema group developed secondary glaucoma. Upon comparison of the injured eye's corneal endothelial cell analysis results with those of the patient controls eyes; a trauma-related endothelial cell density reduction was seen in the lower, central, temporal and nasal quadrants whereas no endothelial cell density change was observed in the upper quadrant. While in the hyphema group endothelial cell density reduction was seen in the lower, central, temporal and nasal quadrants; in the patient group without hyphema this reduction was only observed in the temporal quadrant. The reduction in endothelial cell density was associated with traumatic cataract, lens subluxation and Peripheral anterior synechiae. Blunt eye traumas bear no short term clinical significance but can cause long term iridocorneal angle and corneal endothelium changes that may require monitoring. It was concluded that while glaucoma secondary to iridocorneal angle changes needs monitoring, corneal endothelium density changes have no long term clinical significance. Key words: Blunt eye trauma, hyphema, iridocorneal angle, corneal endothelium
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Künt Göz Travması, Hifema, İridokorneal Açı, Kornea Endoteli, Blunt Eye Trauma, Hyphema, Iridocorneal Angle, Corneal Endothelium
