Evaluation of Anterior Segment Parameters in Cataract Patients With Pseudoexfoliation Before and After Cataract Surgery by Anteri̇or Segment Optical Coherence Tomography
Abstract
Amaç: Psödoeksfoliasyonlu katarakt hastalarının katarakt cerrahisi öncesi ve sonrası 1. hafta, 1. ay ve 6. ayda ön segment parametrelerinin ön segment optik koherens tomografi (ÖS-OKT), optik biyometri ve speküler mikroskopi ile değerlendirilmesini ve değişimin karşılaştırılmasını amaçladık. Gereç ve Yöntem: Bu çalışmada Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Polikliniği'ne başvuran psödoeksfoliasyonlu katarakt tanısı almış ve sonrasında katarakt cerrahisi yapılan 30 hastanın 30 gözü dâhil edilmiştir. Çalışmamız prospektif bir çalışma olarak tasarlanmıştır. Çalışmaya dâhil ettiğimiz hastaların detaylı preoperatif muayenesi yapılmış ve sonrasında postoperatif 1. hafta, 1. ay ve 6. ay kontrolü yapılmıştır. Hastalarımızın ÖS-OKT, optik biometri, speküler mikroskopi ile göz filmleri çekilmiştir. ÖS-OKT kullanılarak elde edilen görüntüler Image J programına aktarılıp santral kornea kalınlığı (SKK), ön kamara açısı (ÖKA 500), açı açıklık mesafesi (AAM 500, AAM 750), trabeküler iris boşluk alanı (TİBA 500, TİBA 750), Schlemm kanal alanı (SKA), Schlemm kanal çapı (SKÇ), iris stromal kalınlık (İSK) değerleri manuel olarak ölçülmüştür. Optik biyometri ile aksiyel uzunluk (AU), pupilla çapı (PÇ), ortalama keratometri (Km), ön kamara derinliği (ÖKD) değerleri ve speküler mikroskopi ile endotel hücre yoğunluğu (EHY) ölçülerek katarakt cerrahisi öncesi ve sonrası karşılaştırılmıştır. Bulgular: Ortalama yaşı 73,7±7,2 yıl olan 19 erkek (%63) 11 kadın (%37) toplam 30 hastanın 30 gözü incelendi. En iyi düzeltilmiş görme keskinliği (EDGK), AAM 500-n, AAM 500-t, AAM 750-n, AAM 750-t, TİBA 500-n, TİBA 500-t, TİBA 750-n, TİBA 750-t, ÖKA 500-n, ÖKA 500-t ve ÖKD değerlerinde operasyon öncesine göre operasyon sonrası dönemlerde anlamlı artış olduğu izlendi (p<0,001). SKA-n, SKA-t, SKÇ-n, SKÇ-t parametrelerinde postoperatif ölçümlerde preoperatif ölçümlere göre anlamlı artış olduğu izlendi (p<0,05). Postoperatif 1. hafta SKK değeri preoperatif, postoperatif 1. ay ve postoperatif 6. ay SKK değerlerine göre anlamlı derecede yüksek bulundu (p<0,046). Preoperatif, Postoperatif 1. ay ve postoperatif 6. ay değerleri arasında istatistiksel olarak anlamlı derecede bir farklılık izlenmedi. Göz içi basıncı (GİB), EHY parametrelerinde postoperatif ölçümlerde preoperatif ölçümlere göre anlamlı düşüş olduğu izlendi (p<0,01). İSK-n, İSK-t, AU, Km, PÇ postoperatif değerlerinde preoperatif değerlerine göre anlamlı fark saptanmadı. Sonuç: Çalışmamızda fakoemülsifikasyon cerrahisinin psödoeksfoliasyonlu katarakt olgularında postoperatif 1. hafta, 1. ay, 6. ay dönemlerinde preoperatif döneme göre ön segment parametrelerinde anlamlı değişikliklere neden olduğu gözlendi. Anahtar Kelimeler: Psödoeksfoliasyon, katarakt, ön kamara açısı, ön segment optik koherens tomografi, Schlemm kanalı, iris stromal kalınlığı
Purpose: We aimed to evaluate the anterior segment parameters of pseudoexfoliation cataract patients before and after cataract surgery, in the first week, first month and sixth month, by anterior segment optical coherence tomography (AS-OCT), optical biometry and specular microscopy for comparing the changes. Materials and Methods: In this study, 30 eyes of 30 patients who applied to Van Yüzüncü Yıl University Faculty of Medicine, Department of Ophthalmology outpatient clinic, were diagnosed with pseudoexfoliation cataract and subsequently underwent cataract surgery were included. Our study was designed as a prospective study. The patients we included in the study underwent a detailed preoperative examination, and then post-operative controls were performed during the first week, first month and sixth month. Patient's eye examinations were performed using AS-OCT, optical biometry, and specular microscopy. The images obtained using AS-OCT were transferred to the Image J program and the central corneal thickness (CCT), anterior chamber angle (ACA 500), angle opening distance (AOD 500, AOD 750), trabecular iris space area (TISA 500, TISA 750), Schlemm's canal area (SCA), Schlemm's canal diameter (SCD), iris stromal thickness (IST) values were measured as manual. Axial length (AU), pupil diameter (PD), mean keratometry (Km), and anterior chamber depth (ACD) values were measured by optical biometry, and endothelial cell density (ECD) was measured by specular microscopy and compared before and after cataract surgery. Results: Thirty eyes of a total of 30 patients, 19 males (63%) and 11 females (37%) with a mean age of 73.7±7.2 years, were examined. Best corrected visual acuity (BCVA), AOD 500-n, AOD 500-t, AOD 750-n, AOD 750-t, TISA 500-n, TISA 500-t, TISA 750-n, TISA 750-t, ACA 500-n, ACA 500-t and ACD values increased significantly in the postoperative period compared to the preoperative period (p<0.001). It was observed that there were significant increases in the parameters SCA-n, SCA-t, SCD-n, and SCD-t in postoperative measurements compared to preoperative measurements (p<0.05). CCT value in the postoperative first week was found to be significantly higher than the preoperative, postoperative first month and postoperative sixth-month CCT values (p<0.046). There were differences of significant degree between the preoperative, postoperative first month and postoperative sixth month values as statistical. A significant decrease was observed in intraocular pressure (IOP) and ECD parameters in postoperative measurements compared to preoperative measurements (p<0.01). There were no significant differences in the postoperative values of IST-n, IST-t, AL, Km, and PD compared to preoperative values. Conclusion: In our study, it was observed that phacoemulsification surgery caused significant changes in anterior segment parameters in pseudoexfoliation cataract cases in the postoperative first week, first month, and sixth month periods compared to the preoperative period. Keywords: Pseudoexfoliation syndrome, cataract, anterior chamber angle, anterior segment optical coherence tomography, Schlemm's canal, iris stromal thickness
Purpose: We aimed to evaluate the anterior segment parameters of pseudoexfoliation cataract patients before and after cataract surgery, in the first week, first month and sixth month, by anterior segment optical coherence tomography (AS-OCT), optical biometry and specular microscopy for comparing the changes. Materials and Methods: In this study, 30 eyes of 30 patients who applied to Van Yüzüncü Yıl University Faculty of Medicine, Department of Ophthalmology outpatient clinic, were diagnosed with pseudoexfoliation cataract and subsequently underwent cataract surgery were included. Our study was designed as a prospective study. The patients we included in the study underwent a detailed preoperative examination, and then post-operative controls were performed during the first week, first month and sixth month. Patient's eye examinations were performed using AS-OCT, optical biometry, and specular microscopy. The images obtained using AS-OCT were transferred to the Image J program and the central corneal thickness (CCT), anterior chamber angle (ACA 500), angle opening distance (AOD 500, AOD 750), trabecular iris space area (TISA 500, TISA 750), Schlemm's canal area (SCA), Schlemm's canal diameter (SCD), iris stromal thickness (IST) values were measured as manual. Axial length (AU), pupil diameter (PD), mean keratometry (Km), and anterior chamber depth (ACD) values were measured by optical biometry, and endothelial cell density (ECD) was measured by specular microscopy and compared before and after cataract surgery. Results: Thirty eyes of a total of 30 patients, 19 males (63%) and 11 females (37%) with a mean age of 73.7±7.2 years, were examined. Best corrected visual acuity (BCVA), AOD 500-n, AOD 500-t, AOD 750-n, AOD 750-t, TISA 500-n, TISA 500-t, TISA 750-n, TISA 750-t, ACA 500-n, ACA 500-t and ACD values increased significantly in the postoperative period compared to the preoperative period (p<0.001). It was observed that there were significant increases in the parameters SCA-n, SCA-t, SCD-n, and SCD-t in postoperative measurements compared to preoperative measurements (p<0.05). CCT value in the postoperative first week was found to be significantly higher than the preoperative, postoperative first month and postoperative sixth-month CCT values (p<0.046). There were differences of significant degree between the preoperative, postoperative first month and postoperative sixth month values as statistical. A significant decrease was observed in intraocular pressure (IOP) and ECD parameters in postoperative measurements compared to preoperative measurements (p<0.01). There were no significant differences in the postoperative values of IST-n, IST-t, AL, Km, and PD compared to preoperative values. Conclusion: In our study, it was observed that phacoemulsification surgery caused significant changes in anterior segment parameters in pseudoexfoliation cataract cases in the postoperative first week, first month, and sixth month periods compared to the preoperative period. Keywords: Pseudoexfoliation syndrome, cataract, anterior chamber angle, anterior segment optical coherence tomography, Schlemm's canal, iris stromal thickness
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Göz Hastalıkları, Eye Diseases
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