백내장 수술 전후 0.05% 사이클로스포린 점안이 눈물막 및 각막수차에 미치는 영향
Effect of Cyclosporin A on Tear Film and Corneal Aberration after Cataract Surgery
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목적: 백내장 수술 전후 0.05% 사이클로스포린 점안액 사용이 눈물막 및 각막수차에 미치는 영향에 대하여 알아보고자 하였다. 대상과 방법: 백내장 수술을 시행 받은 47안을 대상으로 수술 전 1주부터 수술 후 3개월까지 0.05% 사이클로스포린 점안액을 사용한I군(23안)과 사용하지 않은 II군(24안)으로 나누어 수술 전, 수술 후 1개월 및 3개월째의 눈물막 파괴시간, 기본 눈물 분비, 각막/결막상피 병증, 안구 표면 질환 지수 증상 설문조사, 각막수차를 측정하였다. 결과: 수술 전과 비교하여 눈물막 파괴시간은 I군에서 수술 후 3개월(p=0.026) 때 호전된 양상을 보인 반면 II군에서는 변화 없었고,건성안 증상은 I군에서 수술 후 1개월(p=0.033), 3개월(p=0.003) 때 호전된 양상을 보인 반면 II군에서는 변화 없었다. 각막수차 중RMS total은 수술 전에 두 군에서 차이가 없었으나 3개월(p=0.015)째 I군이 유의미하게 감소하는 양상을 보였다. 또한 I군에서 Coma7 (Z3-1) (p=0.018), spherical aberration (Z40) (p=0.031)이 유의미하게 감소하였고, II군에서는 Trefoil 6 (Z3-3) (p=0.033)가 유의미하게 증가하는 소견을 보였다. 결론: 백내장 수술 전후 사이클로스포린 점안액 사용이 건성안 증상 및 눈물막의 안정에 도움을 주었으며, 이는 수술 후 각막수차를감소시키는 효과를 보였다.
Abstract
Purpose: To evaluate the efficacy of 0.05% cyclosporine A on tear film parameters and corneal aberration after cataract surgery. Methods: Patients who underwent cataract surgery were divided into 2 groups. Patients in Group I (23 eyes) were treated withcyclosporine A from 1 week before surgery to 3 months after surgery. Patients in Group II (24 eyes) underwent surgery withoutcyclosporine treatment. Tear film break-up time (BUT), Schirmer’s test I, Oxford scheme, Ocular surface disease index (OSDI),and corneal aberrations were evaluated before surgery and at 1 and 3 months after surgery. Results: In Group I, BUT was significantly improved at 3 months (p = 0.026) after surgery compared with the preoperative value. OSDI decreased significantly at 1 (p = 0.033) and 3 months (p = 0.003) after surgery compared with the preoperative value. However, there were no significant differences between preoperative and postoperative values of BUT and OSDI in Group II. Schirmer’s test results and the Oxford scheme were not significantly changed in either group. Preoperative root mean square(RMS) total values were not different between the 2 groups, but was different at postoperative 3 months (p = 0.015). Group I hada significantly lower value for total RMS than Group II. In Group I, Coma 7 (Z3-1) (p = 0.018) and spherical aberration (Z40) (p =0.031) were significantly decreased after surgery. In Group II, Trefoil 6 (Z3-3) (p = 0.033) was significantly increased after surgery. Conclusions: 0.05% cyclosporine A may be effective for improving dry eye syndrome and corneal aberration after cataract surgery.
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