합성경막을 이용한 아메드밸브삽입술 후 발생한 공막융해와 동반된 튜브 짓무름
Tube Erosion with Scleral Melting after Ahmed Valve Implantation Using a Synthetic Dural Substitute
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목적: 합성경막을 이용한 아메드밸브삽입술에서 튜브 짓무름이 발생한 다섯 증례를 보고하고자 한다. 증례요약: 안압 조절을 위해 합성경막을 이용한 아메드밸브삽입술을 시행한 5명의 녹내장 환자에서 2-4개월 후 결막 및 부분층 공막터널 융해와 더불어 튜브 짓무름이 발생하였으며, 안내염 등의 이차적인 합병증을 막기 위해 재수술이 필요하게 되었다. 결론: 아메드밸브삽입술에서 합성경막을 이용하는 경우 부분층 공막터널을 병행하여 수술하는 경우에도 공막터널의 융해와 동반된 튜브 짓무름이 발생하여 이에 따른 이차적인 합병증이 발생할 수 있는 위험성이 있다.
Abstract
Purpose: The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France). Case summary: Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis. Conclusions: This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.
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