» arhiv
Možnosti:
[Prikaži v obliki za tiskanje]
[Naloga še ni vpisana v zbirko Cobiss]
ID naloge: 138 Letnik: 2003 Predmet: oftalmologija
SPREMEMBA DEBELINE IN UKRIVLJENOSTI ROŽENICE PO ODSTRANITVI PTERIGIJA
Avtor: Nina Kobilica
Mentor: doc. dr. Brigita Drnovšek Olup
Somentor: mag. Kristina Mikek
IZHODIŠCE: V terapiji pterigija uporabljajo razlicne kirurške tehnike, vcasih v kombinaciji s konservativno terapijo. Po operaciji pogosto pride do stanjšanja roženice, ki jo lahko izmerimo z razlicnimi metodami.
NAMEN: Ugotoviti smo želeli spremembe v ukrivljenosti in debelini roženice po operativni odstranitvi pterigija.
HIPOTEZE: Kot izhodišce raziskave smo postavili naslednje hipoteze: bolniki imajo po operaciji pterigija manj subjektivnih težav. Roženica se po operaciji manjša stanjša. Ultrazvocna in racunalniško podprta pahimetrija (Orbscan II) sta primerljivi metodi merjenja debeline roženice. Povprecna ukrivljenost roženice (Kpovp) je po operaciji vecja. Razlika med vodoravno in navpicno ukrivljenostjo roženice ( K) se po operaciji zmanjša.
METODE: V raziskavi smo ovrednotili uspeh naše kirurške terapije (tehnika gole belocnice) tako, da smo primerjali bolnikove simptome pred in po operaciji in z racunalniško podprto topografijo (Orbscan II) izmerili ukrivljenost roženice (Kpovp, K), ravno tako pred in po operaciji. Debelino roženice smo izmerili z ultrazvocno in racunalniško podprto pahimetrijo. V raziskavo smo vkljucili 42 bolnikov, na kontrolni pregled in preiskave po posegu se je oglasilo 21 bolnikov, ki smo jih zajeli v koncno analizo.
REZULTATI: Rezultati kažejo, da so simptomi pterigija po operativnem posegu bistveno manj izraženi, kot pred operacijo. Tudi ukrivljenost roženice, kot jo prikazujeta kazalca Kpovp (p=0.07, rezultat je zelo blizu statisticni znacilnosti) in K (p=0.05) je povecana. Stanjšanja debeline roženice po operativnem posegu nismo uspeli dokazati. Razlik v debelini roženice, izmerjenih z razlicnima metodama, po operaciji ni (p=0.979), vsaka metoda pa je pokazala nekaj omejitev pri merjenju debeline roženice.
ZAKLJUCKI: Tehnika gole belocnice je uspešna kirurška terapija, ki bistveno zmanjša simptome bolnikov s pterigijem in poveca ukrivljenost roženice. Stanjšanja debeline roženice po operaciji nismo dokazali. Glede na pogostnost recidiva pterigija priporocamo rutinsko merjenje debeline roženice po operaciji. Rezultati meritev obeh metod po operaciji so primerljivi, glede na dodatne stranske ucinke pri meritvah z ultrazvocno pahimetrijo priporocamo uporabo racunalniško podprte pahimetrije.
«»
[Abstract / English version]
SPREMEMBA DEBELINE IN UKRIVLJENOSTI ROŽENICE PO ODSTRANITVI PTERIGIJA
Author: Nina Kobilica
Mentor: doc. dr. Brigita Drnovšek Olup
Co-mentor: mag. Kristina Mikek
BACKGROUND: Pterygium therapy includes different surgical techniques, sometimes in combination with a conservative therapy. Thining of cornea, which can be evaluated with different methods, is often found after an operative procedure.
AIM: We wanted to determine the differences in corneal curvature and corneal thickness after operative removal of pterygium.
HYPOTHESES: The following hypotheses were proposed: Patients have fewer symptoms after pterygium surgery. The corneal thickness decreases after surgery. Ultrasound and computerized (Orbscan II) pachymetry are comparable methods for measuring corneal thickness. The corneal curvature increases after pterygium surgery.
METHODS: In our study we evaluated therapeutic efficacy of our surgical method (bare sclera technique). We compared the patient symptoms before and after the pterygium surgery. In addition a corneal curvature (Mean Pwr, Astig Pwr) was determined using computer corneal tophography (Orbscan II) before and after the surgical procedure. The corneal thickness was evaluated with ultrasound pachymetry and Orbscan II pachymetry. Forty-two patients entered the study. The clinical examination and the investigations were performed in 21 patients, which were included in the final analyses.
RESULTS: Our results show that the pterygium symptoms markedly diminished after the surgery. The corneal curvature, as determined by Mean Pwr (p=0.07) and Astig Pwr (p=0.05) also increased. We were not able to demonstrate the reduction of the corneal thickness after the surgery. Our comparisons reveal similar results of postoperative ultrasound and computerized pachymetry measurements after the pterygium surgery (p=0.979).
CONCLUSIONS: Our therapy is an effective surgical method which markedly reduces the patient symptoms and increases the corneal curvature. We were not able to demonstrate the thining of the cornea after the surgery. Since a regrowth of a pterygium is common, we suggest a routine evaluation of the corneal thickness after the surgery. Both of the methods have limitations, we need to be aware of. Because of significant side effects of ultrasound pachymetry measurements, we suggest a computerized pachymetry as a method of choice for evaluation of the corneal thickness.
|
|
 |
Išči po nalogah
Brskaj po nalogah
|
