빛간섭단층촬영을 이용한 2.2 mm 동축 소절개와 2.75 mm 절개백내장 수술 후 중심황반두께 및 부피의 변화 비교
Change in Central Macular Thickness after 2.2-mm Microincision Coaxial versus 2.75-mm Small Incision Cataract Surgery
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목적: 2.2 mm 동축 소절개 백내장 수술 후 중심황반두께 및 부피의 변화를 고전적인 2.75 mm 절개 백내장 수술과 비교해 보고자하였다. 대상과 방법: 본 연구는 후향적 연구로서, 합병증 없이 종료된 백내장 수술 환자 48안을 대상으로, 고전적인 백내장 수술을 시행 받은군(SICS군)과, 동축 소절개 백내장 수술을 받은 군(MICS군)으로 분류하였다. 각 수술 방법에 따른 중심황반두께 및 부피의 변화 정도를 알아보기 위해 수술 전과 수술 후 1일, 1주일, 1개월과 2개월의 빛간섭단층촬영을 추적 관찰하였다. 결과: 두 군 간에 수술 중 사용된 초음파에너지의 양과 초음파 시간, 관류액의 양이 통계적으로 유의한 차이를 보이지 않았다(p＞0.05). 수술 후 1일, 1주일, 1개월과 2개월의 경과관찰에서 SICS군에 비해 MICS군의 평균 중심황반두께가 증가되어 있었고, 특히 수술후 1개월째 두 군 간 유의한 차이를 보였다(p=0.04). 중심황반부의 평균 부피의 경우에는 MICS군에서 더 증가되어 있는 경향을 보였으나, 두 군 간 통계적으로 유의한 차이는 보이지 않았다(p＞0.05). 결론: 합병증 없이 종료된 2.2 mm 동축 소절개 백내장 수술과 2.75 mm 절개 고전적 백내장 수술을 비교해 보았을 때 각막 절개창의크기가 작을 경우 중심황반두께 및 황반부의 평균 부피가 증가하는 양상을 보이고, 수술 후 1개월째에 통계적으로 유의한 중심황반두께 증가를 나타냈다.
Abstract
Purpose: To evaluate the central macular thickness and volume changes after conventional 2.75-mm small incision cataract surgery(SICS) and 2.2-mm microincision coaxial cataract surgery (MICS). Methods: We performed a retrospective chart review of 48 eyes undergoing uneventful phacoemulsification and divided the subjectsinto two groups, SICS and MICS. To evaluate the central macular thickness and volume changes after cataract surgery, opticalcoherence tomography (OCT) was used before and at one day, one week, one month, and two months postoperatively. Results: No statistically significant difference was found in the intraoperative phacoemulsification power, phaco time, or volumeof intraoperative irrigation solution between the two groups (p > 0.05). The average central macular thickness increased in theMICS group compared to the SICS group at every postoperative time point, and the difference was statistically significant atpostoperative one month (p = 0.04). The average central macular volume was elevated in the MICS group; however, the differencewas not significant (p > 0.05). Conclusions: Central macular thickness and volume change were greater in the MICS group compared to the SICS group, andthe difference in central macular thickness between the two groups was significant at postoperative one month. Careful follow-upexaminations should be performed using OCT at this postoperative time point, especially in patients who received cataract surgerywith smaller incision size.
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