إمكانية التحكم بحرج البصر الناجم عن جراحة الساد بوضع قطبة جانبية
Abstract
يعتبر حرج البصر من أهم الاختلاطات التي تواجه جراحي العينية بعد جراحة الساد خاصةً الجراحة التقليدية وكمحاولة منا لتخفيف الحرج بعد الجراحة أجريت الدراسة على 28 مريضاً ساداً ( 28 عين ) غير مناسب لجراحة الفاكو من مراجعي العيادة العينية في مشفى الأسد الجامعي باللاذقية بين عامي 2005 -2006. وتم إجراء العمل الجراحي عند جميع المرضى بالطريقة نفسها (شق قرني مع خياطة مستمرة بشكل حلزوني مع قطبة جانبيـة )،
وكانت النتائج كمايلي: أثرت القطبة الجانبية على حرج البصر بشكل إيجابي و متفاوت. وعند دراسة سبب تفاوت التأثير تبين أن القطب الأقل تأثيراً على الحرج كانت إما رخوة بسبب ارتخاء العقدة أو أنها لم تأخذ سماكة كافية من القرنية أو صغيرة, وهذا بمجمله يعتبر خطأ تكنيكاً جراحياً وبلغت نسبتها 17.857% وهو وارد الحدوث, لأنه يعود إلى خبرة الجراح وظروف الدراسة. أما القطب الأكثر تأثيراً على الحرج فكانت ذات توضع جيد وأطول من مماثلاتها 82.143%. ومن هنا نؤكد على القدرات الكامنة وراء وضع مثل هذه القطب وعلى خبرة الجراح في وضعها ولابدّ من استكمال مثل هذه الطرق و تطويرها للحصول على نتائج أفضل علماً أن P = 0.02 عند درجات حرية ά = 5%2.507, te=.
Astigmatism is considered of the most important obstacles facing the ophthalmologic surgeons after traditional cataract surgery. As an attempt by us to reduce the astigmatism after surgery, a study was made on 28 cataract patients unfit for phaco surgery of those referring to the Ophthalmologic Clinic in Al-Assad University Hospital in Lattakia between the two years 2005 and 2006. The surgery was operated to all the patients in the same way (clear corneal wound with continuous spiral suture & a side suture (.
Results show that the side stitch affected the astigmatism positively but in different rates. Studying the reason of difference in effect has shown that the stitches of lesser effect on the Astigmatism were either loose due to the knot loosening, or have not taken adequate thickness from the cornea, or were small. This is totally considered a technical surgical error. Their rate amounted to 17.857%. This may happen because it is related to the experience of the surgeon and the study conditions; while the stitches of more effect on the astigmatism were those well placed and longer from the other stitches, with a rate of 82.143 %. Thus, we confirm the role of the potential capacities in placing such stitches and the experience of the surgeon in placing them. Accordingly, such methods should be complemented and developed to obtain better results; with the consideration that P=0.02 at te=2.507,ά=5 %.
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