양막콘택트렌즈와 일시적 양막이식술의 임상적 유용성 비교에 대한 연구
Comparison between Placement of an Amniotic Membrane Contact Lens and Temporary Amniotic Membrane Transplantation
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목적: 지속각막상피결손 환자에서 양막콘택트렌즈와 일시적 양막이식술의 임상적 유용성을 비교해보고자 하였다. 대상과 방법: 2019년 11월부터 2022년 7월까지 지속각막상피결손이 있는 환자에게 양막콘택트렌즈(1주간 적용) 또는 일시적 양막이식술(2주간 적용)을 적용하였으며 이에 대하여 후향적 분석을 시행하였다. 술 전과 술 후 최대교정시력, 각막지각, 눈물막파괴시간, 각막혼탁도를 측정하였으며, 경과 관찰 기간 중 치료 성공률 및 기타 합병증에 관하여 분석을 시행하였다. 결과: 대상자는 양막콘택트렌즈 32명 32안, 일시적 양막이식술 20명 20안이었다. 양막콘택트렌즈 대상자의 경우 적용 전후 최대교정시력, 각막지각, 눈물막파괴시간, 각막혼탁도 부분에서 모두 유의한 차이를 보였다(p-value<0.05). 일시적 양막이식술 대상자의 경우적용 전후 최대교정시력, 각막지각, 눈물막파괴시간, 각막투명도 부분에서 유의한 차이를 보였다(p-value<0.05). 양막콘택트렌즈와일시적 양막이식술의 전후 변화를 비교하였을 때는 최대교정시력, 각막지각, 눈물막파괴시간, 각막투명도 부분에서 모두 유의한 차이를 보이지 않았다(p-value>0.05). 결론: 지속각막상피결손 환자에서 양막콘택트렌즈는 외래 기반으로 시행 가능한 효과적인 시술로 일시적 양막이식술과 비교하였을때 유용성에서 유의한 차이를 보이지 않았다.
Abstract
Purpose: We compared the clinical utilities of an amniotic contact lens and temporary amniotic membrane transplantation in patients with persistent corneal epithelial defects. Methods: Patients diagnosed with persistent corneal epithelial defects from November 2019 to July 2022 were randomly assigned to either lens placement for 2 weeks or temporary transplantation for 1 week, and the outcomes were retrospectively analyzed. The best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were measured before and after the interventions. The treatment success rates, recurrences, and other complications were analyzed during the follow- up period. Results: We placed lenses in 32 patients (32 eyes) and 20 patients (20 eyes) underwent transplantation. In both groups, significant differences in best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were apparent after intervention vs. before. None of the parameters showed any significant differences in terms of their rates of change. Conclusions: In patients with persistent corneal epithelial defects, amniotic contact lens placement is an effective outpatient procedure and is not inferior to temporary amniotic membrane transplantation.
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