당뇨와 비당뇨병 환자의 백내장수술 후 눈물 지질층 두께의 변화
Changes in Tear Lipid Layer Thickness after Cataract Surgery in Diabetic and Non-diabetic Patients
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목적: 당뇨와 비당뇨병 환자에서 백내장수술 전후의 눈물 지질층 두께와 건성안 지표들을 비교하고자 한다. 대상과 방법: 백내장수술을 시행받은 환자를 후향적으로 연구하였다. 비당뇨 백내장 환자(I군) 36명의 65안과 당뇨가 있는 백내장 환자(2군) 23명의 35안을 대상으로 연구했다. 눈물 지질층 두께, 부분 눈꺼풀 깜박임 비율, 눈물막파괴시간, strip meniscometry검사를수술 전과 수술 후 1개월, 2개월째에 측정되었고 안구표면질환지수 설문지는 수술 전과 2개월 후에 실시하여 두 군을 비교 분석하였다. 결과: I군에서 strip meniscometry 검사는 수술 전 3.2 ± 1.4 mm, 1개월 2.3 ± 1.0 mm, 2개월 2.5 ± 1.0 mm로 수술 전보다 유의하게감소하였다(p<0.05). 눈물막파괴시간검사는 수술 전 3.4 ± 1.6초, 1개월 3.0 ± 1.5초, 2개월 2.9 ± 1.5초로 수술 전보다 유의하게감소하였다(p<0.05). 안구표면질환지수 점수는 수술 전 30.8 ± 21.3점, 2개월 20.0 ± 15.8점으로 수술 전보다 유의하게 낮았다(p<0.05). II군에서는 눈물막파괴시간검사는 수술 전 3.6 ± 1.3초, 1개월 3.0 ± 1.0초, 2개월 3.1 ± 1.0초로 수술 전보다 유의하게감소하였다(p<0.05). 안구표면질환지수 점수는 수술 전 30.0 ± 20.6점, 2개월 19.0 ± 16.0점으로 수술 전보다 유의하게 낮았다(p<0.05). 두 군 모두 수술 전, 후 눈물 지질층 두께에 유의한 차이가 없었다. 결론: 백내장수술 전, 후 각 군에서는 건성안 지표의 차이가 있었지만 두 군 간에서는 차이가 없었다.
Abstract
Purpose: To compare tear film lipid layer thickness (LLT) and dry eye parameters between non-diabetic and diabetic patients after cataract surgery. Methods: We retrospectively studied patients who underwent cataract surgery. We enrolled 65 eyes of 36 patients with cataracts but not diabetes (group I) and 35 eyes of 23 patients with both cataracts and diabetes (group II). The LLT, partial blink rate, tear break-up time (TBUT), and strip meniscometry tests were performed preoperatively and 1 and 2 months after surgery. The ocular surface disease index (OSDI) questionnaire was completed before and 2 months after surgery by both groups. Results: In group I, the strip meniscometry test value was 3.2 ± 1.4 mm before surgery, 2.3 ± 1.0 mm at 1 month, and 2.5 ± 1.0 mm at 2 months, thus significantly less than before surgery (p < 0.05). The TBUT result was 3.4 ± 1.6 seconds before surgery, 3.0 ± 1.5 seconds at 1 month, and 2.9 ± 1.5 seconds at 2 months, thus significantly less than before surgery (p < 0.05). The OSDI score was 30.8 ± 21.3 before surgery and 20.0 ± 15.8 at 2 months, thus significantly lower than before surgery (p < 0.05). In group II, the TBUT decreased significantly from the preoperative value of 3.6 ± 1.3 seconds to 3.0 ± 1.0 seconds at 1 month and 3.1 ± 1.0 seconds at 2 months (p < 0.05). The OSDI score was 30.0 ± 20.6 before surgery and 19.0 ± 16.0 at 2 months, thus significantly lower than before surgery (p < 0.05). Neither group evidenced any significant difference in the LLT before and after surgery. Conclusions: There was a difference in dry eye parameters in each group before and after cataract surgery, but there was no difference between the two groups.
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