섬모체고랑에 한조각 인공수정체를 넣은 환자들의 임상결과
Clinical Outcome of Ciliary Sulcus-Implanted Single-Piece Foldable Acrylic Intraocular Lens
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목적: 후낭파열이 생겨 섬모체고랑에 한조각 인공수정체를 넣은 환자들에서의 합병증 발생 및 굴절검사 결과에 대해 알아보았다. 대상과 방법: 2014년 1월부터 2015년 6월까지 본원에서 후낭파열이 생겨 섬모체고랑에 한조각 인공수정체(RAYNER 920H Superflex)를 넣은 환자들을 대상으로 후향적 연구를 진행하였다. 인공수정체는 술 전 목표했던 인공수정체 값에서 1.0디옵터 줄여서 삽입하였으며 술 후 3개월에 최대교정시력 및 나안시력, 굴절검사를 시행하였다. 결과: 총 17명의 환자가 후낭파열이 생겨 섬모체고랑에 한조각 인공수정체를 삽입하였으며 3안에서 각막 부종, 1안에서 전방 염증소견, 3안에서 일시적 안압 상승의 소견을 보였으나 적절한 치료에 의해 회복되었다. 인공수정체 중심이탈 등의 특이 부작용 소견은 관찰되지 않았으며 수술 3달 후 평균 술 후 구면대응치 값은 -0.79 ± 0.39 (-0.25~-1.5)디옵터, 평균 나안시력은 0.77 ± 0.22 (0.4~1.0) 평균 최대교정시력은 0.94 ± 0.08 (0.8~1.0)로 나타났다. 결론: 한조각 인공수정체(RAYNER 920H)를 넣은 환자에서 임상적으로 유의한 인공수정체와 관련된 부작용은 발생하지 않았으며 1.0 디옵터 줄여서 삽입했을 경우 평균 술 후 구면대응치 값은 -0.79 (-0.25~-1.50)디옵터로 나타났다.
Abstract
Purpose: To evaluate complications and refractive outcomes of implantation of a single-piece acrylic intraocular lens (SPA-IOL) in the ciliary sulcus during phacoemulsification complicated with posterior capsule tear (PCT). Methods: This retrospective study included patients who visited our hospital from 2014 January to 2015 June with implantation of a SPA-IOL (RAYNER 920H Superflex) in the ciliary sulcus during phacoemulsification complicated with PCT. Patients had their IOL power reduced by 1 diopter (D) from that calculated for in-the-bag implantation. At 3 months after operation, best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA) and a refraction test were performed. Results: PCT requiring implantation of IOL in the ciliary sulcus occurred in 17 eyes. Postoperative complications included corneal edema (3 eyes), anterior segment inflammation (1 eye), intraocular pressure elevations (3 eyes). However, improvements resulting from proper management and no significant IOL decentration were observed. At 3 months after operation, the mean spherical equivalent was －0.79 ± 0.39 D (－0.25 to －1.5 D), the mean UCVA was 0.77 ± 0.22 (0.4 to 1.0), and the mean BCVA was 0.94 ± 0.08 (0.8 to 1.0). Conclusions: Sulcus implantation of a SPA-IOL (RAYNER 920H Superflex) has no clinically significant complication, and the mean spherical equivalent after 3 months with a power reduction of 1.0 D was －0.79 ± 0.39 D (－0.25 to －1.5 D).
참고문헌 (19)
- Chang DF, "Single versus three piece acrylic IOLs", Br J Ophthalmol, 88, pp.727~728 (2004)
- Schulze S., "Implantation of intraocular lenses in the ciliary sulcus", Ophthalmologe, 111, pp.305~309 (2014)
- Chang DF., "Complications of sulcus placement of single-piece acrylic intraocular lenses : recommendations for backup IOL implantation following posterior capsule rupture", J Cataract Refract Surg, 35, pp.1445~1458 (2009)
- Mamalis N, "Sulcus placement of single-piece acrylic intraocular lenses", J Cataract Refract Surg, 35, pp.1327~1328 (2009)
- Dubey R., "Improved refractive outcome for ciliary sulcus-implanted intraocular lenses", Ophthalmology, 119, pp.261~265 (2012)
- Bar-Sela SM., "Intermediate term follow-up after a single-piece-acrylic intraocular lens implantation in the ciliary sulcus-a cross-sectional study", BMC Ophthalmol, 13, pp.76~ (2013)
- Hong Y., "Pigment dispersion glaucoma induced by the chafing effect of intraocular lens haptics in Asian eyes", Curr Eye Res, 38, pp.358~362 (2013)
- Renieri G., "Sulcus implantation of a single-piece foldable acrylic intraocular lens after posterior capsular rupture in cataract surgery", Eur J Ophthalmol, 22, pp.950~955 (2012)
- Ionides A., "Visual outcome following posterior capsule rupture during cataract surgery", Br J Ophthalmol, 85, pp.222~224 (2001)
- Zarei-Ghanavati S., "Simple method to evaluate adequacy of capsule for foldable intraocular lens implantation in the sulcus", J Cataract Refract Surg, 35, pp.222~225 (2009)
- Taskapili M., "Single-piece foldable acrylic intraocular lens implantation in the sulcus in eyes with posterior capsule tear during phacoemulsification", J Cataract Refract Surg, 31, pp.1593~1597 (2005)
- Kirk KR., "Pathologic assessment of complications with asymmetric or sulcus fixation of square-edged hydrophobic acrylic intraocular lenses", Ophthalmology, 119, pp.907~913 (2012)
- Uy HS., "Pigment release and secondary glaucoma after implantation of single-piece acrylic intraocular lenses in the ciliary sulcus", Am J Ophthalmol, 142, pp.330~332 (2006)
- LeBoyer RM., "Acute haptic-induced ciliary sulcus irritation associated with single-piece AcrySof intraocular lenses", J Cataract Refract Surg, 31, pp.1421~1427 (2005)
- Micheli T., "Acute haptic-induced pigmentary glaucoma with an AcrySof intraocular lens", J Cataract Refract Surg, 28, pp.1869~1872 (2002)
- Kohnen T., "Solving intraocular lens-related pigment dispersion syndrome with repositioning of primary sulcus implanted single-piece IOL in the capsular bag", J Cataract Refract Surg, 35, pp.1459~1463 (2009)
- Birner B., "Pigment dispersion syndrome and pigmentary glaucoma. Morphometric analysis of the anterior chamber segment with SL-OCT", Ophthalmologe, 111, pp.638~643 (2014)
- Niyadurupola N., "Pigment dispersion syndrome and pigmentary glaucoma-a major review", Clin Experiment Ophthalmol, 36, pp.868~882 (2008)
- Wintle R., "Pigment dispersion with elevated intraocular pressure after AcrySof intraocular lens implantation in the ciliary sulcus", J Cataract Refract Surg, 27, pp.642~644 (2001)