South Clin Ist Euras. 2021; 32(4): 406-411 | DOI: 10.14744/scie.2021.32650

Derin Anterior Lameller Keratoplasti ve Penetran Keratoplasti Sonrasý Glokom Ýnsidansý

Ulviye Kivrak¹, Süleyman Kuðu², Baran Kandemir¹, Burak Tanyildiz¹, Hatice Selen Kanar^1
1Ýstanbul Dr. Lütfi Kýrdar Kartal Þehir Hastanesi
²Ýstanbul Haydarpaþa Numune Eðitim Ve Araþtýrma Hastanesi

GÝRÝÞ ve AMAÇ: Derin anterior lameller keratoplasti (DALK) ve penetran keratoplasti (PK) sonrasý geliþen glokom insidansýný ve anti-glokomatöz tedavisiye yanýtý karþýlaþtýrmalý olarak deðerlendirmek.
YÖNTEM ve GEREÇLER: Bu geriye dönük çalýþmada 146 DALK’li ve 156 PK’li hasta deðerlendirildi. Tüm hastalar keratoplasti iþleminden sonra 1., 3., 6., 12. ve 24. aylardada takip edildi. Glokom ve glokom tedavilerinin risk faktörleri ve insidansý hem DALK hem de PK gruplarýnda deðerlendirildi.
BULGULAR: Çalýþmaya DALK prosedürü olan 156 göz ve PK prosedürü olan 163 göz dahil edildi. DALK grubundaki 11 göze (%7.05) ve PK grubundaki 16 göze (%9.81) glokom tanýsý kondu (p=0.42). Ortanca anti-glokom ilacý sayýsý DALK gruplarýnda 1.0 ve PK gruplarýnda 1.5
idi (p=0.01). PK sonrasý glokomlu 16 gözün 4’üne (%25) mitomisin C ile trabekülektomi yapýldý (p=0.01). DALK grubunda hastalar cerrahi
müdahale olmaksýzýn tek anti-glokomatöz tedavi ile takip edildi.
TARTIÞMA ve SONUÇ: Çalýþma grubumuzda glokom insidansý DALK’li gözlerde %7, PK’li gözlerde %9.8 idi. Ancak, glokom ilacý sayýsý PK iþlemi olan gözlerde
DALK iþlemi olan gözlere göre anlamlý olarak daha yüksekti (p=0.01). Dahasý, DALK’li gözlerde, PK’li gözlere kýyasla mitomisin C ile trabekülektomi cerrahisine daha az gereksinim duyulmuþtur. Bu nedenle; sonuçlarýmýz, DALK prosedürünün glokom geliþimi açýsýndan PK’den daha uygun ve daha güvenli olabileceðini düþündürdü.

Anahtar Kelimeler: Derin anterior lameller keratoplasti, glokom; penetran keratoplasti; trabekülektomi.

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The Incidence of Glaucoma Following Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty

Ulviye Kivrak¹, Süleyman Kuðu², Baran Kandemir¹, Burak Tanyildiz¹, Hatice Selen Kanar^1
1Department of Ophthalmology, Kartal Dr. Lütfi Kirdar City Hospital, Ýstanbul, Turkey
²Department of Ophthalmology, Ýstanbul Haydarpaþa Numune Training and Research Hospital, Ýstanbul, Turkey

INTRODUCTION: To evaluate the incidence of glaucoma and the response rates to anti-glaucoma treatment after deep anterior lamellar keratoplasty (DALK) in comparison with penetrating keratoplasty (PK).
METHODS: In this retrospective study, 146 patients with DALK and 156 patients with PK were evaluated. All patients were followed up on the 1st, 3rd, 6th, 12th and 24th days after the keratoplasty procedure. The risk factors and incidence of glaucoma and glaucoma treatments were assessed in both the DALK and the PK groups.
RESULTS: A total of 156 eyes with DALK procedure and 163 eyes with PK procedure were included. Eleven eyes in the DALK group (7.05%) and 16 eyes in the PK group (9.81%) were diagnosed with glaucoma (p=0. 42). The median number of anti-glaucoma drugs was 1.0 in DALK groups and 1.5 in PK groups (p=0.01). Trabeculectomy with mitomycin C was performed in 4 of the 16 eyes (25%) with glaucoma after the PK (p=0.01). In the DALK group, patients were followed up with mono anti-glaucoma treatment therapy without surgical intervention.
DISCUSSION AND CONCLUSION: In our study group, the incidence of glaucoma was 7% in eyes with DALK and 9.8% in eyes with PK. However, the number of glaucoma drugs was significantly higher in eyes with PK procedure than eyes with DALK procedure (p=0.01). Moreover, eyes with DALK have needed less trabeculectomy with mitomycin C compared to eyes with PK. Therefore; our results suggested that the DALK procedure might be more appropriate and safer than PK concerning glaucoma development.

Keywords: Deep anterior lamellar keratoplasty, glaucoma; penetrating keratoplasty; trabeculectomy.

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