İntraoperatif ve preoperatif mitomisin-c uygulanan pterjium ameliyatlarindan sonra gelişen skleromalaziye klinik ve cerrahi yaklaşım
Küçük Resim Yok
Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Medical Network
Erişim Hakkı
CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: İntraoperatif ve preoperatif mitomisin-C uygulanan pterjium ameliyatlarindan sonra gelişen skleromalaziye klinik ve cerrahi yaklaşimlari belirlemek. Gereç ve Yöntem: Kliniğimizde preoperatif mitomisin-C uygulanarak, primer pterjium ameliyati olan 33 ve 50 yaşlarindaki erkek hastalarda (Olgu 1-2) ameliyat sonrasi ilk bir hafta içinde inflamasyonsuz nekrotizan sklerit (skleromalazi) gelişti. Yaklaşik 6 ay önce başka bir merkezde intraoperatif mi tomisin- C uygulanarak pterjium ameliyati geçirmiş, 53 yaşinda erkek hasta (Olgu 3) da ayni tani ile kliniğimize başvurdu. Öncelikle tüm olgulara tibbi tedavi uygulandi. Tedavinin başarisiz olduğu olgulardan, olgu 2'ye amnion membran transplantasyonu (AMT), en geniş skleromalazili alana sahip olan ol - gu 3'e homolog sklera yamasi uygulandi. Tibbi ve cerrahi tedavilerin etkinliği araştirildi. Bulgular: Olgu 1 medikal tedaviden en fazla faydayi gördü. Skleromalazik alani hizla daraldi ve çevre dokulari damarlandi. Diğer olgularda sklera incelmesi tibbi tedavi ile gerilemedi. AMT uygulanan olgu 2'ye cerrahiden 1 hafta sonra yerleştirilen zarlarin gevşemesi üzerine, transplantasyon tekrarlandi ve başarili olundu. Skleral yama uygulanan olguda greft reddi gelişti. Bu olguya da AMT planlandi ancak, hasta kontrollere gelmediğinden uygulanamadi. Sonuç: Skleromalazi, mitomisin-C ile kombine pterjium ameliyatlarinin önemli bir komplikasyo - nudur. Uyguladiğimiz klinik ve cerrahi yaklaşimlarla tedavide başariya ulaşmak mümkündür. Skle - romalazi oluşumunu azaltmak için mitomisin-C'nin seçilmiş olgularda, çok dikkatli kullanilmasi gerektiğini düşünmekteyiz.
Purpose: To describe clinical and surgical approach to scleromalacia which occurred as a complication of pterygium surgery combined with intraoperative or preoperative mitomycin-C. Material and Methods : Necrotizing scleritis (scleromalacia) developed in two patients (33 and 53 years old men as case 1 and 2) who had been operated for primary pterygium surgery with preoperative mitomycin-C application. Case 3 who had a pterjium operation with intraoperative mitomycin-C application, came with the same diagnosis. Primarily, medical treatments were initiated. Amniotic membrane transplantation (AMT) and scleral patch grafting and were performed to the patients who were irresponsive to treatments. Results: Case 1, had much benefit from the medical treatment and as the size of his defect became smaller, the thickening of the sclera and new vessels surrounding the area became apparent. For case 2, one week after the AMT, the operation had to be repeated due to infection and loosening of the transplanted membrane. In the second operation of case 2, AMT was successful. After scleral patch grafting, the transplanted tissue was rejected and AMT was planned for case 3, but could not be performed due to patient's incomplience Conclusion: Scleromalacia is an important complication of pterygium surgery with mitomycin-C. By these clinical and surgical interventions, it's possible to achieve a satisfactory treatment for this complication. In order to reduce the occurrence of scleromalacia, mitomycin-C should be used with great caution in special, selected cases.
Purpose: To describe clinical and surgical approach to scleromalacia which occurred as a complication of pterygium surgery combined with intraoperative or preoperative mitomycin-C. Material and Methods : Necrotizing scleritis (scleromalacia) developed in two patients (33 and 53 years old men as case 1 and 2) who had been operated for primary pterygium surgery with preoperative mitomycin-C application. Case 3 who had a pterjium operation with intraoperative mitomycin-C application, came with the same diagnosis. Primarily, medical treatments were initiated. Amniotic membrane transplantation (AMT) and scleral patch grafting and were performed to the patients who were irresponsive to treatments. Results: Case 1, had much benefit from the medical treatment and as the size of his defect became smaller, the thickening of the sclera and new vessels surrounding the area became apparent. For case 2, one week after the AMT, the operation had to be repeated due to infection and loosening of the transplanted membrane. In the second operation of case 2, AMT was successful. After scleral patch grafting, the transplanted tissue was rejected and AMT was planned for case 3, but could not be performed due to patient's incomplience Conclusion: Scleromalacia is an important complication of pterygium surgery with mitomycin-C. By these clinical and surgical interventions, it's possible to achieve a satisfactory treatment for this complication. In order to reduce the occurrence of scleromalacia, mitomycin-C should be used with great caution in special, selected cases.
Açıklama
Anahtar Kelimeler
Skleromalazi, Amnion membran transplantasyonu (AMT), mitomisin-C, Scleromalacia, Amniotic membrane transplantation (AMT), mitomycin-C
Kaynak
MN Oftalmoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
14
Sayı
2
Künye
Helvacıoğlu, F., Tuğcu, B. ve Şencan, S. (2007). İntraoperatif ve preoperatif mitomisin-c uygulanan pterjium ameliyatlarindan sonra gelişen skleromalaziye klinik ve cerrahi yaklaşım / Clinical and surgical approac to scleromacia which was developed after pterygium surgery with intraoperative or preoperative mitomycin-c application. MN Oftalmoloji, Medical Network. 14(2), s. 83-86.
