방사상 각막절개술 후 백내장 수술을 시행한 1예
A Case of Cataract Surgery after Radial Keratotomy
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목적: 방사상 각막절개술을 시행한 눈에서 백내장 수술 시 투명각막절개를 이전 방사상 절개부를 피하여 시행하여 절개부 벌어짐 없이수술을 종료할 수 있었던 1예를 경험하여 이를 보고하고자 한다. 증례요약: 59세 여자 환자가 양안 시력저하를 주소로 내원하였다. 내원 11년 전 근시 교정을 위하여 양안 방사상 각막 절개술을 시행받았다. 세극등현미경검사상 양안 각막에 방사상 각막 절개술의 8방향 절개 반흔 관찰되었고 백내장 소견 보였다. 양안 초음파 수정체유화술 및 인공 수정체 후낭 삽입술을 1주일 간격으로 시행하였다. 우안 수술 시 이전 방사상 절개부를 걸쳐 투명각막절개 시행하였고, 술 중 절개부 벌어짐이 발생하여 각막봉합 후 초음파 유화술을 진행하였다. 좌안 수술 시에는 방사상 절개부를 피하여 투명각막절개를 시행하였고 절개부 벌어짐 없이 수술을 마쳤다. 결론: 방사상 각막절개술을 시행한 눈에서 백내장 수술을 시행한 경우 이전 절개부 사이로 각막절개를 시행하여 절개부 벌어짐 없이안정적으로 수술을 종료하였다. 국내에서도 방사상 각막절개술을 시행 받은 환자들의 연령이 증가함에 따라 이에 대한 고려가 필요하다고 생각한다.
Abstract
Purpose: To report a patient who underwent successful cataract surgery without wound dehiscence in the eye that had undergoneprevious radial keratotomy by performing a clear corneal incision between previous incisions. Case summary: A 59-year-old female visited our medical center for decreased vision. The patient underwent radial keratotomyfor correction of myopia in both eyes 11 years prior. On slit-lamp examination, cataract and eight radial keratotomy incisionswere found. Phacoemulsification and posterior capsule intraocular lens implantation were performed for both eyes at a one-weekinterval. For the right eye, a clear corneal incision was made over the previous incision scar and wound dehiscence was successfullymanaged by prompt corneal suturing. For the left eye, a clear corneal incision was made between the previous incision scars,and wound dehiscence did not occur. Conclusions: As radial keratotomy patients age, cataract surgery should be considered. A successful surgery was possible withoutwound dehiscence in an eye that had undergone previous radial keratotomy in which a clear corneal incision was made betweenprevious incision scars.
참고문헌 (23)
- Fyodorov SN, "Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree", Ann Ophthalmol, 11, pp.1885~1890 (1979)
- Budak K, "Dehiscence of a radial keratotomy incision during clear corneal cataract surgery", J Cataract Refract Surg, 24, pp.278~280 (1998)
- Behl S, "Rupture of a radial keratotomy incision after 11years during clear corneal phacoemulsification", J Cataract Refract Surg, 27, pp.1132~1134 (2001)
- Girard LJ, "Delayed wound healing after radial keratotomy", Am J Ophthalmol, 99, pp.485~486 (1985)
- Chu R, "Duane's clinical ophthalmology" (2006), Lippincott Williams & Wilkins
- Binder PS, "An ultrastructural and histochemical study of long-term wound healing after radial keratotomy", Am J Ophthalmol, 103, pp.432~440 (1987)
- Maxwell WA, "Myopic keratomileusis: initial results and myopic keratomileusis combined with other procedures", J Cataract Surg, 13, pp.518~524 (1987)
- Beatty RF, "Penetrating keratoplasty after radial keratotomy", J Refract Surg, 2, pp.207~214 (1986)
- McNeill JI, "Corneal incision dehiscence during penetrating keratoplasty nine years after radial keratotomy", J Cataract Refract Surg, 19, pp.542~543 (1993)
- Freeman M, "Dehiscence of radial keratotomy incision during phacoemulsification", Eye(Lond), 18, pp.101~103 (2004)
- Chen L, "Analysis of intraocular lens power calculation in post-radial keratotomy eyes", J Cataract Refract Surg, 29, pp.65~70 (2003)
- 한의석, "방사상각막절개술을 받은 고도근시안의 인공수정체 도수 계산", 대한안과학회지, 47(8), pp.1244~1250 (2006), 대한안과학회
- Holladay JT, "Cataract surgery in patients with previous keratorefractive surgery (RK, PRK and LASIK)", Ophthalmic Pract, 15, pp.238~244 (1997)
- Seitz B, "Intraocular lens power calculation in eyes after corneal refractive surgery", J Refract Surg, 16, pp.349~361 (2000)
- Holladay JT, "Consultations in refractive surgery", J Refract Corneal Surg, pp.203~205 (1989)
- Hoffer KJ, "Intraocular lens power calculation for eyes after refractive keratotomy", J Refract Surg, 11, pp.490~493 (1995)
- Lyle WA, "Intraocular lens power prediction in patients who undergo cataract surgery following previous radial keratotomy", Arch Ophthalmol, 115, pp.457~461 (1997)
- Celikkol L, "Calculation of intraocular lens power after radial keratotomy with computerized videokeratography", Am J Ophthalmol, 120, pp.739~750 (1995)
- Srivannaboon S, "Accuracy of Orbscan total optical power maps in detecting refractive change after myopic laser in situ keratomileusis", J Cataract Refract Surg, 25, pp.1596~1599 (1999)
- Holladay JT, "Corneal power measurements using scheimpflug imaging in eyes with prior corneal refractive surgery", J Refract Surg, 25, pp.862~868 (2009)
- Potvin R, "New algorithm for post-radial keratotomy intraocular lens power calculations based on rotating Scheimpflug camera data", J Cataract Refract Surg, 39, pp.358~365 (2013)
- Damiano RE, "Purse-string sutures for hyperopia following radial keratotomy", J Refract Surg, 14, pp.408~413 (1998)
- Nosé W, "Corneal suture for the correction of hyperopia following radial keratotomy", J Refract Surg, 23, pp.523~527 (2007)