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펨토초레이저 백내장수술 후 건성안에 대한 0.15% 무보존제 히알루론산나트륨의 임상적 효과

Effect of 0.15% Preservative-free Sodium Hyaluronate on Dry Eye Disease after Femtosecond Laser-assisted Cataract Surgery

김태임|정병훈|김강윤|김응권|김태환|서경률|전익현
대한안과학회 (The Korean Ophthalmological Society)|2021.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제62권 제7호|pp. 922-930

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키워드

Dry eye diseaseFemtosecond laserCataractArtificial tearHyaluronate
주제분류안과학

초록

목적: 펨토초레이저 백내장수술 후 발생하는 건성안에 대한 0.15% 무보존제 히알루론산나트륨 점안액의 임상적 효과를 분석하고자 하였다. 대상과 방법: 본원에서 진료 중인 건성안 환자들 중 펨토초레이저 백내장수술을 시행한 총 37안을 대상으로 수술 후 0.15% 무보존제히알루론산나트륨 점안액을 사용한 치료군 19안, 사용하지 않은 대조군 18안에 대해 수술 전, 후 1, 3개월째 각결막형광염색점수, 눈물막파괴시간, 1형 쉬르머검사, 안구표면질환지수, 눈꺼풀 마이봄샘 평가, 눈물 지질층 두께를 측정하였다. 결과: 치료군에서는 수술 후 3개월째 안구표면질환지수의 유의한 감소, 눈물막파괴시간의 증가, 각결막형광염색점수의 감소, 1형 쉬르머검사의 유의한 증가가 확인된 반면, 대조군에서는 수술 후 1, 3개월째 유의한 쉬르머검사의 감소, 1개월째 마이봄샘 성상 악화, 3개월째 눈물막파괴시간 감소가 관찰되었다. 안구표면질환지수는 수술 후 1, 3개월째 치료군에서 유의하게 낮았으며, 눈물막파괴시간은 수술 후 3개월째 치료군에서 유의하게 높게 나타났다. 또한 수술 후 3개월째 치료군에서 마이봄샘 성상이 유의하게 좋은 결과를 보였다. 이외에 각결막형광염색점수와 눈물 지질층 두께를 포함한 다른 건성안 지표에 대해서는 치료군과 대조군 간 유의한 차이를 보이지 않았다. 결론: 펨토초레이저 백내장수술 후 무보존제 0.15% 히알루론산나트륨 점안액 사용은 수술 후 발생하는 건성안 증상을 경감시키고 눈물막 안정성 향상에 도움을 줄 수 있다.

Abstract

Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond laser- assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film & Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months postoperatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the baseline, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at postoperative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye disease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.

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