열공망막박리환자에서 과불화탄소액 없이 망막열공을 통한 망막하액 배출을 시행한 유리체절제술
Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment
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목적: 열공망막박리환자에서 망막절개를 하지 않고 과불화탄소액의 사용 없이 망막열공을 통해 망막하액을 배출함으로써, 과불화탄소액 또는 망막절개로 인한 망막손상을 최소화할 수 있는 수술 방법의 효용성에 대해 알아보고자 한다. 대상과 방법: 2014년 2월부터 2017년 12월까지 본원에서 열공망막박리로 진단받고 과불화탄소액의 사용 없이 망막열공을 통해 망막하액을 배출하는 방법으로 유리체절제술을 시행한 환자 중 6개월 이상 추적 관찰이 가능했던 41명 41안과 과불화탄소액을 사용한 40명40안을 대상으로 후향적으로 조사하였다. 결과: 일차 수술 성공률은 과불화탄소액을 사용하지 않은 군과 사용한 군에서 각각 97.6%, 97.5%로 두 군 모두 1안에서 망막박리가재발하였으며, 최종 성공률은 100%였다. 평균 logMAR 최대교정시력은 과불화탄소액을 사용하지 않은 군에서는 수술 전 0.87 ± 0.80 에서 수술 후 6개월에 0.30 ± 0.30, 과불화탄소액을 사용한 군에서는 수술 전 0.86 ± 0.71에서 수술 후 6개월에 0.42 ± 0.52로두 군 모두 유의한 시력 호전을 보였다(p<0.01). 과불화탄소액 사용 유무에 따른 합병증 발생에서는 유의한 차이가 없었다. 결론: 열공망막박리환자에서 과불화탄소액을 사용하지 않고 망막열공을 통해 망막하액을 배출한 수술 방법은 심각한 합병증 없이기능적 회복과 해부학적 복원을 이루어 낼 수 있었다.
Abstract
Purpose: To evaluate the efficiency of a surgical method using original breaks to drain subretinal fluid without using retinotomy and perfluorocarbon liquid for patients with rhegmatogenous retinal detachment (RRD). Methods: A retrospective chart review comparing 41 eyes of 41 patients who received vitrectomy, and used original breaks to drain subretinal fluid without using perfluorocarbon liquid, and 40 eyes of 40 patients who received vitrectomy using perfluorocarbon liquid for simple RRD between February 2014 and December 2017 was conducted. All patients were followed for a minimum of 6 months after surgery. Results: The primary anatomical success percentages were 97.6% and 97.5% for groups that did not and did use perfluorocarbon liquid, respectively. Retinal detachment recurred in one eye from both groups. The final success percentage was 100%. The preoperative mean logMAR best-corrected visual acuity (BCVA) of 0.87 ± 0.80 improved to 0.30 ± 0.30 at postoperative 6 months for the group that did not use perfluorocarbon liquid, while it improved from 0.86 ± 0.71 to 0.42 ± 0.52 for the group that did use perfluorocarbon liquid. Both groups showed significant BCVA improvement (p < 0.01). There was no significant difference in the incidence of complications caused by the use of perfluorocarbon liquid. Conclusions: Using original breaks to drain subretinal fluid without perfluorocarbon liquid in cases with RRD may be an effective and safe surgical technique for functional and anatomical recovery without serious complications.
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