25게이지 평면부 유리체절제술 후 안구표면 상태의 변화
Changes in Ocular Surface Status after 25-gauge Pars Plana Vitrectomy
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목적: 비침습 안구표면 분석기를 이용하여 25게이지 평면부 유리체절제술을 시행받은 환자의 안구표면의 변화를 분석하고자 한다. 대상과 방법: 25게이지 평면부 유리체절제술을 시행받은 82명 163안을 대상으로 의무기록 분석을 통한 후향적 연구를 시행하였다. 비접촉식 안구표면 분석기를 이용하여 수술 전, 수술 한 달 뒤, 수술 세 달 뒤의 비침습눈물막파괴시간, 지질층 두께, 마이봄샘 소실, 눈물띠 높이를 각각 측정하였다. 각 항목을 통계적으로 비교하고, 수술 한 달 뒤 낮은 비침습눈물막파괴시간에 영향을 미치는 요인에대해 분석하였다. 결과: 25게이지 평면부 유리체절제술을 받은 눈은 수술 전과 비교하여 한 달 뒤 비침습눈물막파괴시간이 통계적으로 유의미하게 낮게측정되었다(p=0.003). 수술을 시행받지 않은 반대안과 비교하여 수술안에서 한 달 뒤 비침습눈물막파괴시간이 통계적으로 유의미하게 낮게 측정되었다(p=0.006). 높은 연령과 수술 전 낮은 비침습눈물막파괴시간은 이에 대한 위험인자였다(p=0.029, p=0.002). 결론: 25게이지 평면부 유리체절제술은 한 달 뒤 비침습눈물막파괴시간을 유의미하게 감소시킬 수 있다.
Abstract
Purpose: We used a noninvasive ocular surface analyzer to explore changes in the ocular surface parameters of patients who underwent 25-gauge pars plana vitrectomy (PPV). Methods: The medical records of 82 patients (163 eyes) who underwent PPV were retrospectively reviewed. The non-invasive tear film break-up time (NIBUT), the lipid layer thickness, meibomian gland loss status, and the tear meniscus height were measured before, and 1 and 3 months after treatment. Consecutive changes in the ocular surface indices of operative and non-operative fellow eyes were statistically compared. Also, factors that reduced the NIBUT at 1 month after surgery were analyzed. Results: One month after surgery, the NIBUT was significantly decreased in the operative group compared to before surgery (p = 0.006). Compared to non-operative eyes, the NIBUT of operative eyes decreased significantly 1 month after surgery (p = 0.003). Older age and lower preoperative NIBUT (p = 0.029, p = 0.002) were significantly associated with lower NIBUT 1 month after surgery. Conclusions: Twenty-five gauge PPV significantly reduces the NIBUT 1 month after surgery.
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