이전에 인공수정체 공막고정술 시행 후 발생한 인공수정체탈구에서 공막고정술 재수술의 결과
Outcomes of Re-fixation after the First Intraocular Lens Scleral Fixation
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 일차 인공수정체 공막고정술 시행 이후 재탈구된 인공수정체에 대한 이차 인공수정체 공막고정술의 임상 결과에 대해 알아보고자 하였다. 대상과 방법: 이전에 인공수정체 공막고정술을 시행 받은 환자들 중 인공수정체탈구가 발생하여 유리체절제술 및 이차 인공수정체공막고정술을 시행한 환자를 대상으로 후향적 의무기록을 분석하였다. 이전의 일차 수술 후 1개월에 측정된 시력을 이차 수술 후 1개월에 측정한 시력과 구면렌즈대응치를 서로 비교하였으며, 이차 수술 후 합병증 발생 여부를 확인하였다. 결과: 전체 21안을 대상으로 연구를 시행하였다. 13안(61.9%)의 경우 인공수정체의 완전한 탈구가 발생하여 기존의 인공수정체교환술을 시행하였으며, 8안(38.1%)의 경우 탈구가 발생한 한 쪽 지지부만 고정하였다. 최대교정시력(logMAR)은 일차 수술 후 평균 0.17 ± 0.25였으며, 이차 수술 후 평균 0.11 ± 0.23으로 유의한 차이가 없었다(p=0.073). 구면렌즈대응치는 일차 수술 후 평균 -0.94 ± 1.69 diopters (D)였으며, 이차 수술 후 평균 -0.58 ± 1.46 D로 유의한 차이가 없었다(p=0.076). 8안(38.1%)에서 일시적인 안압상승, 봉합사노출과 같은 합병증이 발생하였으나 수술적 처치를 요하는 경우는 없었다. 결론: 인공수정체 공막고정술을 한 후 발생한 인공수정체탈구에 대한 이차 인공수정체 공막고정술을 통해 일차 수술과 비슷한 결과를 얻을 수 있었으며, 심각한 합병증은 없었다.
Abstract
Purpose: To investigate the outcomes of re-fixation after the first intraocular lens (IOL) scleral fixation. Methods: We retrospectively reviewed the charts of patients who underwent second IOL scleral fixation and vitrectomy for dislocation of IOL after the first IOL scleral fixation. We compared the best-corrected visual acuity (BCVA) and spherical equivalent (SE) after 1 month of the first and second surgery, and noted the complications. Results: We included 21 eyes that underwent second IOL scleral fixation: 13 eyes (61.9%) with IOL exchange and eight (38.1%) with one-haptic fixation. Mean BCVAs (LogMAR) were 0.17 ± 0.25 and 0.11 ± 0.23 after the first and second surgery, respectively (p = 0.073); mean SEs were -0.94 ± 1.69 and -0.58 ± 1.46 diopters after the first and second surgery, respectively (p = 0.076). Postoperative complications occurred in eight eyes (38.1%), including temporarily increased intraocular pressure and suture knots exposure. However, none of the complications required re-operation. Conclusions: The outcomes of primary and secondary IOL fixation were similar, and there were no serious complications of the second surgery.
참고문헌 (20)
- Malbran ES, "Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction", Int Ophthalmol, 9, pp.151~160 (1986)
- Lewis JS, "Sulcus fixation without flaps", Ophthalmology, 100, pp.1346~1350 (1993)
- Kokame GT, "Long-term outcome of pars plana vitrectomy and sutured scleral-fixated posterior chamber intraocular lens implantation or repositioning", Am J Ophthalmol, 189, pp.10~16 (2018)
- Kim SJ, "Long-term stability and visual outcomes of a single-piece, foldable, acrylic intraocular lens for scleral fixation", Retina, 29, pp.91~97 (2009)
- Bading G, "Long-term safety and functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens implantation", Am J Ophthalmol, 144, pp.371~377 (2007)
- Vote BJ, "Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation", Am J Ophthalmol, 141, pp.308~312 (2006)
- 이정민, "접형인공수정체 공막고정술의 임상적 양상", 대한안과학회지, 45(12), pp.9~9 (2004), 대한안과학회
- Jongebloed WL, "Degradation of polypropylene in the human eye : a SEM-study", Doc Ophthalmol, 64, pp.143~152 (1986)
- Price MO, "Late dislocation of scleral-sutured posterior chamber intraocular lenses", J Cataract Refract Surg, 31, pp.1320~1326 (2005)
- McAllister AS, "Visual outcomes and complications of scleral-fixated posterior chamber intraocular lenses", J Cataract Refract Surg, 37, pp.1263~1269 (2011)
- Lee GI, "Risk factors for intraocular lens dislocation after phacoemulsification : a nationwide population-based cohort study", Am J Ophthalmol, 214, pp.86~96 (2020)
- Ryu SY, "Incidence and characteristics of cataract surgery in South Korea from 2011 to 2015 : a nationwide population-based study", Clin Exp Ophthalmol, 48, pp.319~327 (2020)
- Oh SY, "Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation", Eye(Lond), 29, pp.757~763 (2015)
- Shin YI, "Surgical outcome of refixation versus exchange of dislocated intraocular lens : a retrospective cohort study", J Clin Med, 9, pp.3868~ (2020)
- Rishi P, "Surgical refixation of posteriorly dislocated intraocular lens with scleral-tuck technique", Indian J Ophthalmol, 65, pp.365~370 (2017)
- 강혜민, "Late-Onset Citrobacter koseri Endophthalmitis with Suture Exposure after Secondary Intraocular Lens Implantation", Korean Journal of Ophthalmology, 25(4), pp.285~288 (2011), 대한안과학회
- Do JR, "A 1-year prospective comparative study of sutureless flanged intraocular lens fixation and conventional sutured scleral fixation in intraocular lens dislocation", Ophthalmologica, 244, pp.68~75 (2021)
- Chan CC, "Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration : clinical results", J Cataract Refract Surg, 32, pp.121~128 (2006)
- Ascaso FJ, "Epidemiology, etiology, and prevention of late IOL-capsular bag complex dislocation : review of the literature", J Ophthalmol, 2015, pp.805706~ (2015)
- Ransdell LB, "International perspectives : the influence of gender on lifetime physical activity participation", J R Soc Promot Health, 124, pp.12~14 (2004)