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Elli dokuz yaşında kadın hasta, sağ gözde 3 gün önce gelişen ağrı ve görme azalması ile kliniğimize başvurdu. Hastanın 1 yıl önce dış merkezde glokom nedeni ile Express tüp implantasyonu, 8 ay önce fakoemülsifikasyon-iol ve 1 ay önce de trabekülektomi operasyonu geçirdiği öğrenildi. Göz içi basıncı GİB yüksek bulunan hastaya ikinci kez trabekülektomi operasyonu uygulandı ve hastanın GİB’i 1 yıl stabil kaldı. Bir yıl sonraki kontrolde GİB’i 45 mmHG ölçülen hastaya süperotemporal kadrandan Ahmed glokom valf AGV implantasyonu uygulandı. Postoperatif 1. günde GİB’i 13 mmHG ölçüldü. Hastanın postoperatif 3. ay kontrolünde sağ gözde ağrı ve çift görme şikayeti mevcuttu. Yapılan muayenesinde sağ göz primer pozisyonda ekzotropyasının olduğu ve pitozis geliştiği izlendi. Ayrıca 8 kadran göz hareketlerinde kısıtlılık izlendi. Sağ göz fundus fotoğrafı görüntüsünde insiklotorsiyonu mevcuttu. Çekilen orbital manyetik rezonans görüntülemede sağ göz süperolateralinde lakrimal glanda bitişik komşuluk gösteren fibrozis lezyon saptandı. AGV eksplantasyonu uygulanan hastanın 1. gün muayenesinde göz hareketlerinin normale döndüğü ve insiklotorsiyonunun düzeldiği gözlendi. Bu çalışmada, AGV cerrahisinin bir komplikasyonu olan şaşılık ve diplopi gelişimi ile tedavisinde AGV eksplantasyonu tanımlanmıştır
A female patient, aged fifty and nine years old, went to our clinic with pain and vision reduction developed 3 days ago in the right hand. The patient was diagnosed 1 year ago with an Express tube implantation due to glocom in the external center, 8 months ago with a fakoemulsification-iol and 1 month ago with a trabeculectomy surgery. The patient with high intraocular pressure was performed for the second time a trabeculectomy surgery and the patient's GIB remained stable for 1 year. A year later, the patient with a GIB measurement of 45 mmHG was applied to the supertemporal staff of the Ahmed glokom valve AGV implantation. In the postoperative 1 day, the GIB was measured by 13 mmHG. The patient's postoperative 3 month check was present with right-hand pain and double vision complaints. In the examination was observed that the right eye in the primary position was exotropy and pitoosis developed. There were also 8 restrictions in eye movements. In the right eye fundus picture there was insictoration. In the drawn orbital magnetic resonance imaging, a fibrosis injury was detected in the right eye superolateral, indicating the neighborhood of the lakrimal gland. In the first day of the patient’s examination with AGV explanation, the eye movements returned to normal and the inseclotortion improved. In this study, AGV expansion was identified in the treatment with a complication of AGV surgery and the development of diplopy.
A 59-year-old female patient presented at our clinic with pain and decreased visual acuity for 3 days in the right eye. Because of glaucoma, the patient had a history of Express tube implantation surgery 1 year ago, phacoemulsification-intraocular lens surgery 8 months ago and trabeculectomy 1 month ago in another clinic. Trabeculectomy was performed for the second time to the patient with high intraocular pressure IOP and the patient's IOP was stabilized for 1 year. First year later control, Ahmed glaucoma valve AGV implantation was performed to the superotemporal quadrant of the patient whose IOP was 45 mmHG. On the first postoperative day, IOP was determined to 13 mmHg. The patient complained of pain and diplopia of the right eye at the post-operative third month followup. The right eye had exotropia in the primary position, and ptosis had developed. There was also limitation of eight quadrant eye movements. The right eye fundus photograph showed incyclotorsion. On orbital magnetic resonance imaging, a superficial lesion of the right eye fibrosis adjacent to the lacrimal gland was detected. On the first day of the AGV explantation, the patient's eye movements were normal and the incyclotorsion had been corrected. In this case, we present AGV explantation as the treatment of strabismus and diplopia as a complication of AGV surgery
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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