눈물길폐쇄 환자의 실리콘관삽입술에서 눈물길미세내시경 사용이 수술 시간에 미치는 영향
Effect of Lacrimal Endoscopy on Operation Time in Silicone Tube Intubation for Nasolacrimal Duct Obstruction
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목적: 눈물길폐쇄 환자의 실리콘관삽입술에서 눈물길미세내시경 사용이 수술 시간에 미치는 영향에 대해 분석하고자 하였다. 대상과 방법: 2019년 1월부터 2023년 2월까지 성인 후천 눈물길폐쇄를 진단받고 실리콘관삽입술을 시행받은 107명 168안을 대상으로 후향적 의무기록 조사를 시행하였다. 눈물길미세내시경 사용과 수술 시간의 상관관계와 눈물길미세내시경 사용에 따라 수술 시간이 수술 성공률에 미치는 영향에 대해 분석하였다. 결과: 168안 중 눈물길미세내시경을 사용한 군은 58안, 사용하지 않은 군은 110안이었다. 수술 시간은 눈물길미세내시경을 사용한 군이 평균 10.98 ± 2.24분, 사용하지 않은 군이 평균 12.44 ± 4.08분으로 눈물길미세내시경을 사용한 군이 사용하지 않은 군보다 상대적으로 짧았고 통계적으로 유의한 차이가 있었다(p=0.003). 수술 시간에 따른 수술 성공률 변화를 분석하였을 때 전체 대상자군에서 수술 시간이 1분 증가할 때 수술 성공률은 0.877배로 감소하는 결과를 보였고 통계적 유의성이 있었다(p=0.022). 눈물길미세내시경을 사용한 군은 수술 시간과 수술 성공률의 관계에서 통계적 유의성이 없었으나, 눈물길미세내시경을 사용하지 않은 군에서는 수술 시간이 1분 증가할 때 수술 성공률은 0.865배로 감소하는 결과를 보였으며 통계적 유의성이 있었다(p=0.019). 결론: 눈물길폐쇄 환자의 실리콘관삽입술에서 눈물길미세내시경은 눈물길 내부를 전반적으로 확인하여 눈물길폐쇄의 원인과 정도를 정확히 진단하면서 합병증을 예방하고 수술 시간을 단축시킬 수 있는 효과적인 치료법으로 생각된다.
Abstract
Purpose: To evaluate the effect of lacrimal endoscopy on operation time in silicone tube intubation for patients with nasolacrimal duct obstruction. Methods: We conducted retrograde chart review of 168 eyes of 107 patients who were diagnosed with acquired nasolacrimal duct obstruction and underwent silicone tube intubation from January 2019 to February 2023. We analyzed relationship between use of lacrimal endoscopy and operation time, and effect of operation time on success rate of surgery according to use of lacrimal endoscopy. Results: Of 168 eyes, 58 eyes underwent silicone tube intubation with lacrimal endoscopy, and 110 eyes underwent silicone tube intubation without lacrimal endoscopy. Average operation time was 10.98 ± 2.24 minutes in the group with lacrimal endoscopy, and 12.44 ± 4.08 minutes in the group without lacrimal endoscopy. Operation time in the group with lacrimal endoscopy was relatively shorter and statistically significant (p = 0.003). When analyzing correlation between operation time and success rate, success rate decreased by 0.877 times when operation time increased by 1 minute in the entire group, and there was statistical significance (p = 0.022). There was no statistical significance in the correlation between operation time and success rate in the group with lacrimal endoscopy. And in the group without lacrimal endoscopy, success rate decreased by 0.865 times when operation time increased by 1 minute, and there was statistical significance (p = 0.019). Conclusions: In silicone tube intubation for nasolacrimal duct obstruction, Lacrimal endoscopy is considered an effective treatment that can shorten operation time and prevent complications while accurately diagnosing cause and extent of obstruction by investigating the inside of the nasolacrimal duct.
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