원발폐쇄각녹내장에서 주변 레이저홍채절개술 및 홍채성형술 후 전방 지표의 장기 변화 결과
Long-term Outcome of Anterior Chamber Parameters after Laser Iridotomy and Iridoplasty in Primary Angle Closure Glaucoma
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목적: 원발폐쇄각녹내장 환자를 대상으로 주변 레이저홍채절개술 및 홍채성형술을 시행한 후 전방 지표의 변화를 이중샤임플러그분석기를 사용하여 장기간에 걸쳐 조사하고자 하였다. 대상과 방법: 원발폐쇄각녹내장을 진단받고 레이저를 시행받은 32명의 환자들의 32안이 본 후향적 연구에 포함되었다. 급성폐쇄각발작 사례는 제외하였다. 이중샤임플러그검사는 레이저를 시행하기 전과 1주일 후, 매년마다 시행하였다. 전방깊이, 전방부피, 평균 전방각도 및 안압을 조사하였다. 결과: 평균 추적 관찰 기간은 32.28 ± 13.34개월이었으며, 연구에 포함된 환자들의 기저치는 다음과 같다: 연령, 63 ± 7.9세; 여성, 62.5%; 안압, 15.48 ± 4.79 mmHg; 전방깊이, 2.09 ± 0.19 mm; 시야검사의 mean deviation, -7.97 ± 8.49 dB. 전방깊이는 기저치에서 2.15 ± 0.32 mm로 증가하였으나 통계적으로 유의하지는 않았다(p=0.136). 전방부피는 레이저 후 기저치 78.32 ± 11.49 mm3에서 83.04 ± 11.16 mm3로 유의하게 증가하였다(p=0.011). 평균 전방 각도는 레이저 후 기저치 26.86 ± 2.53°에서 28.82 ± 4.64°로유의하게 증가하였다(p=0.022). 안압은 레이저 후 기저치에서 13.06 ± 2.21 mmHg로 유의하게 감소하였다(p=0.001). 결론: 원발폐쇄각녹내장 환자에서 레이저 시행 후 전방각 지표들이 효과적으로 개선되었으며 장기간에 걸친 추적 관찰 동안 개선된상태가 유지되었다. 또한 안압은 레이저 시행 후 2.5년 이상의 장기 추적 관찰 동안 유의하게 감소하였다.
Abstract
Purpose: To investigate the long-term outcomes of anterior chamber angle parameters in patients with primary angle closure glaucoma (PACG) after peripheral laser iridotomy (LI) combined with iridoplasty (PI) using a dual Scheimpflug analyzer. Methods: This retrospective study included 32 eyes in 32 patients diagnosed with PACG who underwent LI plus PI. Patients with an acute angle closure crisis were excluded. Dual Scheimpflug analyzer images were acquired before and 1 week after LI plus PI, and yearly afterwards. Anterior chamber depth (ACD) and volume (ACV), mean anterior chamber angle (ACA), and intraocular pressure (IOP) were also measured. Results: The mean follow-up was 32.28 ± 13.34 months. Baseline demographics were age 63 ± 7.9 years, 62.5% female, IOP 15.48 ± 4.79 mmHg, ACD 2.09 ± 0.19 mm, and visual field mean deviation -7.97 ± 8.49 dB. ACD increased from baseline to 2.15 ± 0.32 mm, but it was not significant (p = 0.136). ACV increased significantly from 78.32 ± 11.49 mm at baseline to 83.04 ± 11.16 mm at the last visit after LI (p = 0.011). The mean ACA increased significantly from 26.86 ± 2.53° at baseline to 28.82 ± 4.64° at the last visit (p = 0.022). IOP decreased significantly from baseline to 13.06 ± 2.21 mmHg at the last visit (p = 0.001). Conclusions: The ACA parameters improved after LI combined with PI in patients with PACG and remained so on long-term follow- up. IOP was also significantly reduced for more than 2.5 years after LI plus PI.
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