유리체내로 낙하된 수정체 조각에 대한 23게이지와 25게이지의 유리체절제술 결과 비교
Comparison between 23-gauge versus 25-gauge Vitrectomy Outcomes for Dropped Lens Fragments in the Vitreous Cavity
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목적: 백내장수술 도중 유리체내로 낙하된 수정체 조각에 대한 23게이지와 25게이지 미세절개유리체절제술의 결과를 비교해보고자 한다. 대상과 방법: 2014년 1월 1일부터 2017년 12월 31일까지 유리체내로 낙하된 수정체 조각에 대해 23게이지, 25게이지 유리체절제술을 시행 받은 66명 66안을 대상으로 유리체절제술 종류, 평균 수술 시간, 시력, 합병증 등을 후향적으로 분석하였다. 결과: 23게이지, 25게이지 유리체절제술을 시행 받은 환자는 각각 41안, 25안이었다. 수술 전 평균최대교정시력(logMAR)은 23게이지군에서는 1.79 ± 1.12에서 0.36 ± 0.63으로, 25게이지군에서는 1.82 ± 1.15에서 0.31 ± 0.53으로 유의하게 호전되었다(p<0.001). 평균 수술 시간은 23게이지군이 33.0 ± 6.8분, 25게이지군이 32.3 ± 6.9분으로 두 군 간의 차이는 없었다(p=0.694). 수술 후 합병증은 23게이지군에서 2안(4.9%)에서 낭포황반부종이 발생하였으나 두 군 간 유의한 차이는 없었다(p=0.262). 결론: 백내장수술 도중 유리체내로 낙하된 수정체 조각에 대한 23게이지, 25게이지 미세절개유리체절제술은 절개창 크기를 줄이고 수술 시간을 단축하면서도 안전하고 효과적인 수술 방법으로 생각된다.
Abstract
Purpose: This study aimed to compare the surgical outcomes of 23-gauge (g) micro-incision vitrectomy surgery (MIVS) and 25-g MIVS for lens fragments that dropped into the vitreous cavity during cataract surgery. Methods: This study was a comparative, retrospective, and interventional case series study based on a medical records review. Sixty-six eyes of 66 patients with dropped lens fragments in the vitreous cavity during MIVS, performed between January 1, 2014 and December 31, 2017, were included. The characteristics of the patients and their visual acuity, operation time duration, and complication rate were analyzed retrospectively. Results: 23-MIVS and 25-g MIVS were performed on 41 and 25 eyes, respectively. The mean value of best-corrected visual acuity (logMAR) improved significantly from 1.79 ± 1.12 to 0.36 ± 0.63 in the 23-g group and from 1.82 ± 1.15 to 0.31 ± 0.53 in the 25-g group (p < 0.001). The mean operation time was 33.0 ± 6.8 minutes in the 23-g group and 32.3 ± 6.9 minutes in the 25-g group, with no significant difference between the two groups (p = 0.694). There were two cases of postoperative cystoid macular edema in the 23-g group; however, no significant difference with regard to postoperative complications was found between the two groups (p = 0.262). Conclusions: 23- and 25-g MIVS for lens fragments dropped into the vitreous cavity during cataract surgery is a comparably safe and effective method for reducing the size of the incision and shortening the operation time.
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