급성폐쇄각녹내장에서 백내장 술 후 홍채섬유주접촉지표 변화
Iris-trabecular Contact Index Change after Cataract Surgery in Acute Angle Closure Glaucoma
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초록
목적: 급성폐쇄각녹내장 환자에서 백내장 술 후 홍채섬유주접촉지표(iris-trabecular contact index, ITC index)의 변화를 알아보고자 하였다. 대상과 방법: 급성폐쇄각녹내장 기왕력이 있는 12명 17안에서 백내장 수술 전후에 파장 가변 빛간섭단층촬영을 시행하였다. 수정체아치높이(lens vault, LV), ITC index와 안압, 전방 깊이, 전방 부피, 전방각 수치의 상관관계를 백내장 수술 전후로 분석하였다. 결과: 백내장 수술 후 안압(p=0.007), 전방 깊이(p<0.001), 전방 부피(p<0.001), 전방각 지표(p=0.001)와 ITC index (p=0.012)는 모두 유의하게 호전되었다. ITC index는 백내장 수술 전 88.42 ± 23.59%에서 수술 후 48.91 ± 35.13%로 감소되었다(p=0.012). 수술 전 LV는 전방 깊이(p=0.075), 전방 부피(p=0.864), 전방각 수치(p=0.112-0.707), ITC index (p=0.288)와 유의한 상관관계를 보이지 않았다. ITC index는 수술 전 안압(p=0.021), 전방 깊이(p=0.002), 전방 부피(p<0.001), 전방각 수치(p=0.001-0.030)와 유의한 상관관계를 보였으나 수술 후에는 이들 지표와 유의한 상관관계가 없었다(p=0.223/0.206/0.761/0.096-0.819). 결론: 급성폐쇄각녹내장 환자에서 백내장 술 후 ITC index는 유의하게 호전되었으나, 전방각 폐쇄는 일부 남아 있었다.
Abstract
Purpose: To evaluate the change of iris-trabecular contact index (ITC index) after cataract surgery in acute angle closure glaucoma. Methods: Twelve patients (17 eyes) who had a history of acute angle closure glaucoma underwent swept source optical coherence tomography before and after cataract surgery. Correlations between lens vault (LV), ITC index and intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), and angle parameters were analyzed before and after cataract surgery. Results: IOP (p = 0.007), ACD (p < 0.001), ACV (p < 0.001), angle parameters (p = 0.001), and ITC index (p = 0.012) were improved after cataract surgery. ITC index decreased from 88.42 ± 23.59% to 48.91 ± 35.13% after cataract surgery (p = 0.012). There was no correlation between LV and ACD (p = 0.075), ACV (p = 0.864), angle parameter (p = 0.112-0.707), or ITC index (p = 0.288) before cataract surgery. The correlations between ITC index and IOP (p = 0.021), ACD (p = 0.002), ACV (p < 0.001), and angle parameter (p = 0.001-0.030) were statistically significant before surgery but not statistically significant (p = 0.223/0.206/0.761/ 0.096-0.819) after surgery. Conclusions: ITC index significantly improved after cataract surgery, but part of angle closure was not resolved in some cases of acute angle closure glaucoma.
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