국내 아이스텐트 인젝트와 젠의 단독 시행 및 백내장 병합술 성공률 비교와 예후인자 분석
Short-term Outcomes and Prognostic Factor of Cataract Combined Surgery with iStent Inject versus XEN
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목적: 국내에서 시행한 아이스텐트 인젝트(iStent inject®)와 젠(XEN®)의 단독 및 백내장 병합술의 안압하강 효과, 성공률, 예후인자, 수술 후 합병증에 대해 비교하고자 한다. 대상과 방법: 국내에서 개방각녹내장으로 진단받은 환자를 대상으로 아이스텐트 인젝트 삽입술과 젠 삽입술을 단독 혹은 백내장수술과 병합하여, 수술 후 6개월 이상 추적 관찰이 가능했던 총 83안을 대상으로 의무기록을 통하여 후향적 분석하였다. 수술 성공 여부는수술 후 안압이 21 mmHg 미만이며, 수술 전 안압에 비해 20% 이상 감소하였을 경우로 하였다. 결과: 수술 후 6개월째 평균 안압하강률은 아이스텐트 인젝트 단독 삽입술(A군, 24안)이 33.80%, 젠 단독 삽입술(B군, 15안)이24.91%, 아이스텐트 인젝트 삽입술과 백내장수술 병합(A-1군, 32안)이 20.47%, 젠 삽입술과 백내장수술 병합(B-1군, 12안)이 30.39% 로 모두 통계적으로 유의한 안압하강을 보였다. 수술 후 6개월째 안압이 수술 전 안압에 비해 20% 이상 감소한 비율은 A군이 45.5% ± 11.2%, B군이 52.8% ± 15.4%, A-1군이 51.9% ± 9.0%, B-1군이 83.3% ± 10.8%였다. A군과 B군의 성공률 차이는 유의하지않았으며(p=0.574), A-1군과 B-1군 또한 성공률 차이는 통계적으로 유의하지 않았다(p=0.079). 결론: 아이스텐트 인젝트 삽일술과 젠 삽입술 모두 안압 하강에 유의미한 효과가 있으며, 단독 삽입술과 백내장 병합술 모두 통계적으로 유의미한 안압하강 결과를 얻을 수 있었다. 젠 삽입술은 통계적으로 유의하게 사용 안압약의 감소를 이끌어 냈다.
Abstract
Purpose: To analyze the intraocular pressure (IOP) lowering effect, prognostic factors, and complications that occurred after iStent inject® or XEN® implantation in South Korea. Methods: We retrospectively analyzed 83 eyes with glaucoma who were followed-up for more than 6 months after iStent inject® or XEN® implantation alone or combination with cataract surgery. The success of surgery was defined as an IOP ≤21 mmHg and IOP reduction ≥20% from preoperative IOP. Results: The average IOP drop rate for 6 months after surgery was 33.80% for iStent inject® (group A, 24 eyes), 24.91% for XEN® (group B, 15 eyes), 20.47% for combined iStent inject® and cataract surgery (group A-1, 32 eyes), and 30.39% for combined XEN® and cataract surgery. The cumulative success rate of 6 months after surgery was 45.5% ± 11.2% for group A, 52.8% ± 15.4% for group B, 51.9% ± 9.0% for group A-1, and 83.3% ± 10.8% for group B-1. The difference in success rates between groups A and B was not statistically significant (p = 0.574), and also between groups A-1 and B-1 (p = 0.079). Conclusions: iStent inject® and XEN® both have a significant effect on lowering IOP, regardless of combining cataract surgery. XEN® implantation led to a statistically significant reduction in IOP lowering medications.
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