Optik Disk Pit Makülopatide İki Farklı İç Sınırlayıcı Membran Soyma Tekniği ile Optik Disk Pit’e İç Sınırlayıcı Membran Flep Transplantasyonu
Author :
Abstract
Amaç: İki farklı iç sınırlayıcı membran (İSM) soyma tekniği ile elde edilen İSM flebinin optik disk pit’e (ODP)
transplantasyonu yapılarak tedavi edilen optik disk pit-makülopatili (ODP-M’li) dört hastanın sunumu.
Metod ve Hastalar: ODP-M’li 4 hastanın bir gözüne 23 gauge pars plana vitrektomi uygulandı. Üç hastaya
İSM soyulması, ODP’e serbest İSM flep transplantasyonu ve %15-17 perfloropropan (C3F8) gaz tamponadı
uygulandı. Bu 3 hastada, İSM tamamen soyulduktan sonra ODP’e transplante edildi. Bir hastada, İSM’nin nazal
parçası soyulmadan bırakıldıktan sonra İSM’nin soyulmuş parçası soyulmamış kısım üzerine katlanarak ODP’e
transplante edildi.
Bulgular: Tüm olgularda postoperatif 3. ayın sonunda seröz makula dekolmanı ve intraretinal çok tabakalı sıvı
geriledi. Ameliyat sonrası 3. ayda tüm hastalarda makula kalınlığı azaldı ve en iyi düzeltilmiş görme keskinliği
(EİDGK) arttı. İki hastada (Olgu 2, 3) beklenmedik bir makula deliği (MD) gelişti. Bu hastalardan birinde daha
geniş İSM soyulmasıyla MD kapandığı ve EİDGK’nin arttığı gözlendi.
Sonuçlar: ODP’e İSM flep transplantasyonu, ODP-M tedavisinde etkili bir cerrahi teknik olarak gözlenmiştir.
Ayrıca ODP’e İSM transplantasyonu sonrası gelişen kalıcı MD’in kapatılmasında ikincil daha geniş İSM
soyulmasının etkili olduğu gözlendi.
Keywords
Abstract
Purpose: To report four patients with optic disc pit-maculopathy (ODP-M) treated with transplantation of
internal limiting membrane (ILM) flap, obtained by two different ILM peeling techniques, into the optic disc
pit (ODP).
Method and Patients: One eye of 4 patients with ODP-M underwent 23 gauge pars plana vitrectomy. Three
patients underwent ILM peeling, free ILM flap transplantation to ODP, and 15-17% perfluoropropane (C3F8)
gas tamponade. In these 3 patients, the ILM was transplanted to ODP after complete peeling. In one patient,
the nasal fragment of the ILM was left unpeeled and then the peeled ILM flap was folded over the unpeeled
portion and transplanted into ODP.
Results: Serous macular detachment and intraretinal multilayered fluid regressed at the end of the postoperative
3rd month in all cases. In all patients, macular thickness decreased and best-corrected visual acuity (BCVA)
increased in the postoperative 3rd month. An unexpected macular hole (MH) developed in two patients (Case
2, 3). In one of these patients, MH was closed by peeling the wider ILM, and it was observed that BCVA
increased.
Conclusions: ILM flap transplantation to ODP has been observed as an effective surgical technique for the
treatment of ODP-M. In addition, a wider ILM peeling was
Keywords
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