안구건조증 환자의 백내장수술 후 0.05% 및 0.1% 사이클로스포린의 치료 효과 비교
Comparison of the Effects of 0.05% and 0.1% Cyclosporine for Dry Eye Syndrome Patients after Cataract Surgery
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목적: 백내장수술 후 0.05% 사이클로스포린과 0.1% 사이클로스포린 점안액 사용이 안구건조증에 미치는 영향을 비교하고자 한다. 대상과 방법: 백내장수술을 받은 안구건조증 환자를 대상으로 의무기록을 조사하여 분석하였다. 술 후 3개월간 0.05% 사이클로스포린을 사용한 군, 0.1% 사이클로스포린을 점안한 군으로 분류하였다. 수술 전, 술 후 2주, 1달, 3달째 쉬르머검사, 눈물막파괴시간, 각결막염색, 안구표면질환지수, 눈물 내 MMP-9 등의 안구건조증 관련 검사를 시행하여 각 군의 변화를 비교하였으며, 안구건조증 정도에따라 환자들을 분류하여 각 군의 변화를 확인하였다. 결과: 총 84명, 84안이 포함되었다. 전체 환자에서 쉬르머검사는 0.05% 사이클로스포린군에서 수술 전과 비교하여 술 후 3달째 유의한 호전을 보였다. 각결막염색은 0.05% 사이클로스포린군에서는 술 후 3달째 유의하게 향상되었으며, 0.1% 사이클로스포린군에서는술 후 1달, 3달째 유의한 향상을 보였다. 안구표면질환지수와 눈물 내 MMP-9 검사에서는 두 군 모두 술 후 2주때부터 호전되었다. 전체 환자에서 두 군 간의 수술 전후 안구건조증 개선 정도는 유의한 차이가 없었다. 안구건조증 2단계 환자에서 술 후 3달째 0.05% 사이클로스포린군은 쉬르머검사, 0.1% 사이클로스포린군은 눈물막파괴시간에서 유의한 호전을 보였다. 결론: 안구건조증 환자의 백내장수술 후 0.05%과 0.1% 사이클로스포린 점안액을 사용한 두 군에서 모두 안구건조증 증상 및 안구염증 수치의 호전을 보였으며, 두 약제의 효과는 유사하였다.
Abstract
Purpose: We compared the effects of 0.05% and 0.1% cyclosporine on dry eye symptoms following cataract surgery. Methods: We retrospectively reviewed the medical records of patients with dry eye syndrome who underwent cataract surgery. The patients were separated into 0.05% and 0.1% cyclosporine groups. Each group had been treated with their routine eye drops for 3 months after cataract surgery. We evaluated dry eye symptoms and signs using the Schirmer test, tear film breakup time (TBUT), corneal and conjunctival staining score, ocular surface disease index (OSDI), and matrix metalloproteinase 9 (MMP-9) testing of the tear film preoperatively and at 2 weeks, 1 month, and 3 months postoperatively. We also compared dry eye symptoms between the groups by dividing all patients according to dry eye severity. Results: The study included 84 eyes (84 patients). The 0.05% cyclosporine group had an increase in the Schirmer test and improved corneal and conjunctival staining scores at 3 months postoperatively. The 0.1% cyclosporine group had improved corneal and conjunctival staining scores at 1 and 3 months postoperatively. The OSDI and MMP-9 results indicated a significant decrease in both groups at 2 weeks, 1 month and 3 months postoperatively. There were no significant differences in the change in dry eye symptoms after cataract surgery between the 0.05% and 0.1% cyclosporine groups. In the patients with level II dry eye syndrome, the 0.05% cyclosporine group showed a significant increase in the Schirmer test compared to the 0.1% cyclosporine group at 3 months postoperatively. The 0.1% cyclosporine group showed a significant improvement in TBUT compared to the 0.05% cyclosporine group at 3 months postoperatively. Conclusions: Both 0.05% and 0.1% cyclosporine are effective treatments for improving dry eye symptoms and ocular surface inflammation after cataract surgery. Both eye drops are considered to have similar effectiveness.
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