백내장 수술 전 마이봄선 질환이 수술 후의 건성안에 미치는 영향
The Influence of Preoperative Meibomian Gland Disease on Dryness after Cataract Surgery
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목적: 마이봄선 질환과 같은 술 전 요인이 백내장 수술 후 건조증에 영향을 주는지 알아보고자 한다. 대상과 방법: 백내장 수술을 받은 85명, 100안이 본 연구의 대상이었다. 술 전 마이봄선 질환(Meibomian gland disease, MGD)의 정도(MGD I, II, III군)에 따라 군을 나누었고, 술 전, 술 후 1, 2, 5, 9주에 눈물막 파괴시간, 쉬르머 검사, 각막 염색을 측정하고 안구표면질환 지수를 통해 건성안 증상을 평가하였다. 각 MGD군에 따라 술 전과 후의 건성안 지표에 차이가 있는지 관찰하였다. 결과: 술 전 건성안 지표를 세 군에서 비교했을 때, 마이봄선 질환이 심할수록 안구표면질환 지수가 컸고 눈물막 파괴시간이 짧았다(p ＜0.05). 술 후 건성안 지표를 술 전과 비교했을 때 MGD II, III군에서는 술 전에 비해 술 후 모든 시점에서 안구표면질환 지수가 유의하게 증가하고 눈물막 파괴시간이 짧아졌다. 또한 각 군 간 비교에서, MGD III군이 MGD I, II군보다 모든 시점에서 안구표면질환 지수가 커졌고, 술 전, 술 후 1주와 술 후 9주에 MGD III군이 MGD I, II군보다 눈물막 파괴시간이 유의하게 짧아져 있었다(p＜0.05). 결론: 술 전 마이봄선 질환이 심할수록 백내장 수술 후 건성안 악화 가능성이 크므로 저자들은 술 전 마이봄선 질환의 정도에 상응하는 건성안 예방 및 치료가 필요할 수 있음을 제시하는 바이다.
Abstract
Purpose: The aim of this study is to analyze the influence of preoperative meibomian gland disease (MGD) on the postoperative dry eye disease after cataract surgery. Methods: 100 eyes of 85 patients who had undergone cataract surgery were enrolled. Patients were stratified into three groups by the severity of meibomian gland disease (MGD Grade I, MGD Grade II and MGD Grade III). In each group, we recorded the indexes of dry eye such as Ocular surface disease index, tear breakup time, Schirmer’s test and Corneal staining at preoperatively and postoperative week 1, 2, 5, 9. We compared the indexes, preoperatively and postoperatively between three groups. Results: In comparison of the preoperative indexes between groups, the more severe meibomian gland disease the patients have, the higher Ocular surface disease index and the shorter tear breakup time were observed (p < 0.05). In comparison the preoperative with the postoperative indexes, Ocular surface disease index was higher and tear breakup time was shorter at every postoperative moment in MGD Grade (Gr) II and Gr III. In comparison between MGD groups, MGD Gr III showed higher ocular surface disease index than MGD Gr I and Gr II at every follow up point, and shorter tear breakup time than MGD Gr I and Gr II at preoperative and postoperative week 1 and 9 (p < 0.05). Conclusions : The severity of meibomian gland disease which exist preoperatively can affect the aggravation of dry eye disease after cataract surgery. Therefore, the treatment of meibomian gland disease before cataract surgery can be a therapeutic option to prevent aggravation of dry eye after cataract surgery.
참고문헌 (27)
- 노영래, "백내장 수술 후 발생하는 안구건조증의 임상양상 및 영향을 미치는 요인에 대한 분석", 대한안과학회지, 52(9), pp.1030~1038 (2011), 대한안과학회
- Kohlhaas M, "Corneal sensation after cataract and refractive surgery", J Cataract Refract Surg, 24, pp.1399~1409 (1998)
- 조양경, "Dry Eye After Cataract Surgeryand Associated Intraoperative Risk Factors", Korean Journal of Ophthalmology, 23(2), pp.65~73 (2009), 대한안과학회
- Ram J., "Outcomes of phacoemulsification in patients with dry eye", J Cataract Refract Surg, 28, pp.1386~1389 (2002)
- Roberts CW., "Dry eye symptoms following cataract surgery", Insight, 32, pp.14~21 (2007)
- Hykin PG., "Age-related morphological changes in lid margin and meibomian gland anatomy", Cornea, 11, pp.334~342 (1992)
- Mathers WD., "Meibomian gland dysfunction in chronic blepharitis", Cornea, 10, pp.277~285 (1991)
- Schiffman RM., "Reliability and validity of the Ocular Surface Disease Index", Arch Ophthalmol, 118, pp.615~621 (2000)
- Bron AJ., "Grading of corneal and conjunctival staining in the context of other dry eye tests", Cornea, 22, pp.640~650 (2003)
- Cho JH., "Assessment of meibomian gland dysfunction and comparison of the results of BUT and Schirmer test according to meibomian gland state", J Korean Ophthalmol Soc, 41, pp.1875~1882 (2000)
- Foulks GN, "The correlation between the tear film lipid layer and dry eye disease", Survey Ophthalmol, 52, pp.369~374 (2007)
- Horwath-Winter J., "Early changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy", J Cataract Refract Surg, 30, pp.2316~2321 (2004)
- Li XM., "Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery", Cornea, 26(9 Suppl1), pp.S16~S20 (2007)
- Ang RT., "Dry eye after refractive surgery", Curr Opin Ophthalmol, 12, pp.318~322 (2001)
- Belmonte C., "Eye dryness sensations after refractive surgery: impaired tear secretion or "phantom" cornea?", J Refract Surg, 23, pp.598~602 (2007)
- Xu KP., "Decrease in corneal sensitivity and change in tear function in dry eye", Cornea, 15, pp.235~239 (1996)
- Hiroko BM., "Cataract surgery: technique, complications, and management" (2004), WB Saunders
- Walker TD, "Benzalkonium toxicity", Clin Experiment Ophthalmol, 32, pp.657~ (2004)
- Bron AJ., "The contribution of meibomian disease to dry eye", Ocul Surf, 2, pp.149~165 (2004)
- Foulks GN, "Ocular Surface Disease: Medical and Surgical Management" (2002), Springer
- Foulks GN., "Meibomian gland dysfunction : a clinical scheme for description, diagnosis, classification, and grading", Ocul Surf, 1, pp.107~126 (2003)
- Goto E., "Tear evaporation dynamics in normal subjects and subjects with obstructive meibomian gland dysfunction", Invest Ophthalmol Vis Sci, 44, pp.533~539 (2003)
- Perry HD., "Dry eye diagnosis and management in 2004", Curr Opin Ophthalmol, 15, pp.299~304 (2004)
- Smith J., "Current patterns in the use of diagnostic tests in dry eye evaluation", Cornea, 27, pp.656~662 (2008)
- Nichols KK., "The repeatability of clinical measurements of dry eye", Cornea, 23, pp.272~285 (2004)
- Nichols KK., "The lack of association between signs and symptoms in patients with dry eye disease", Cornea, 23, pp.762~770 (2004)
- Nichols KK, "Patient-reported symptoms in dry dye disease", Ocul Surf, 4, pp.137~145 (2006)