Anatomski i funkcionalni faktori koji utiču na rezultate klasične hirurške procedure kod bolesnika sa regmatogenom ablacijom retine

  • Igor Kovačević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ivan Stefanović Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Bojana Radović Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
  • Jelena Karadžić Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
  • Dragana Kovačević Pavićević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Olgica Djurković Djaković Institute for Medical Research, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP141001175K
Ključne reči: retinal diseases||, ||retina, bolesti, retinal detachment||, ablacija, ophthalmologic surgical procedures||, ||hirurgija, oftalmološka, procedure, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod/Cilj. Regmatogena ablacija retine je oboljenje zadnjeg segmenta oka koje, ako se ne leči, može dovesti do slepila. Trenutno, jedini način lečenja je hirurški i opcije su klasična metoda (scleral buckling), pars plana vitrektomija i pneumoretinopeksija. Mnogi faktori mogu uticati na ishod operacije. Jasno definisane hirurške indikacije su ključne za postizanje dobrih postoperativnih rezultata. Cilj ove studije bio je da se procene faktori koji utiču na anatomski i funkcionalni ishod lečenja klasičnom metodom lečenja bolesnika sa regmatogenom ablacijom retine sa zahvaćenom makulom. Metode. U prospektivnu, nerandomizovanu, interventnu studiju bili su uključeni svi bolesnici operisani klasičnom metodom zbog ablacije retine sa zahvaćenom makulom, u tercijarnom centru za vitreoretinalnu hirurgiju. Rezultati. Ukupno 168 bolesnika (starosti 58,2 ± 13,9 godina) bilo je uključeno u studiju. Postoperativno, anatomski uspeh postignut je kod 152 (90,5%) bolesnika. Parametri koji su uticali na anatomski uspeh operacije bili: su broj ruptura retine (p = 0,040), status sočiva (p = 0,041), preoperativno prisustvo proliferativne vitreoretinopatije (p < 0,001), starost (p = 0,049) i, granično, prisustvo tipičnih simptoma (p = 0,057). Dužina odvojenosti makule, ranije povrede oka i refrakcija oka nisu uticali na anatomski rezultat. Funkcionalni uspeh procenjivan je na osnovu postoperativne vidne oštrine i zavisio je uglavnom od preoperativne dužine trajanja odvojenosti makule. Vidna oštrina 0,4 ili bolja bila je značajno češće postignuta ako je dužina trajanja odvojenosti makule bila do sedam dana (p < 0,001). Refrakcija oka i životno doba bolesnika nisu uticali na funkcionalni ishod operacije. Zaključak. Klasična metoda scleral buckling je efikasna hirurška procedura za nekomplikovane slučajeve ablacije retine. Kada je makula zahvaćena, najbolji rezultati postižu se operacijom u toku prvih sedam dana od početka simptoma.

Biografije autora

Igor Kovačević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vitreoretinal surgery Department, Ophthalmology specialist
Aleksandra Radosavljević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Uveitis Department, ophthalmology specialist
Ivan Stefanović, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vitreoretinal surgery Department, Professor, Chief of Department
Bojana Radović, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
Vitreoretinal surgery Department, Ophthalmology resident
Jelena Karadžić, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
Vitreoretinal surgery Department, Ophthalmology specialist
Dragana Kovačević Pavićević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Uveitis Department, professor, Chief of Department
Olgica Djurković Djaković, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
Chief of Department

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Objavljeno
2017/06/21
Broj časopisa
Vol. 74 Br. 3 (2017)
Rubrika
Originalni članak