기체망막유착술의 결과 및 성공에 영향을 미치는 인자
The Success Rate and Factors Influencing the Results of Pneumatic Retinopexy
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목적: 열공성 망막박리의 1차 치료로 기체망막유착술과 국소 레이져 광응고술을 받은 환자들에서, 재유착 성공률과 그의 영향 인자들을알아보고 높은 성공률을 얻을 수 있는 적응증을 정립하고자 하였다. 대상과 방법: 2003년 1월에서 2011년 12월간 열공성 망막박리 환자 중 1차 치료로 기체망막유착술을 받고 3개월 이상 추적 관찰한150명 152안을 대상으로 나이, 성별, 열공의 위치와 개수, 망막박리의 이환 기간 및 범위와 성공률과의 관계를 후향적으로 분석하였다. 결과: 기체망막유착술의 1차 성공률은 72.37%이며, 비고도근시, 유수정체안인 경우, 망막박리의 범위가 좁을수록, 상부의 망막열공의경우 성공률이 높았다. 이를 바탕으로 -6디옵터 이하의 비고도근시안, 유수정체안이면서 3사분면 이하의 망막박리를 일으킨 상부 열공 환자만을 대상으로 할 경우, 85.87%의 성공률을 보였다. 결론: 열공성 망막박리환자에서 기체망막유착술은 70% 이상의 재유착률을 보일 수 있는 시술이며, 이 중 비고도근시안, 유수정체안,3사분면 이하의 망막박리가 있는 상부 망막 열공 환자를 대상으로 시행하면 85.87%의 성공률을 보여, 이러한 적응증을 가진 환자에게시행할 경우 더 높은 재유착률을 얻을 수 있을 것으로 생각한다.
Abstract
Purpose: To evaluate the success rate of pneumatic retinopexy and the preoperative factors influencing the results in the rhegmatogenous retinal detachment patients. Methods: We analyzed retrospectively the preoperative and postoperative retinal findings and postoperative complication in 152 eyes of 150 patients with uncomplicated rhegmatogenous retinal detachment, who had undergone pneumatic retinopexy and were followed up for at least 3 months. We analyzed preoperative factors, including age, sex, location and numbers of retinal tears, duration of retinal detachment, lens status, and refractive error. Results: The success rate of the initial surgery was 72.37%. The success rate was significantly higher in non-high myopic and phakic eyes, and when the retinal detachment was less than 3 quadrants with the retinal break located superiorly. Accordingly, the success rate was 85.87% (79 of 92 eyes). Conclusions: In the present study, the anatomical success rate of primary pneumatic retinopexy was more than 70%. If pneumatic retinopexy is performed to non-high myopic, phakic eyes, and retinal detachment is less than 3 quadrants with superior retinal break, the surgeon can expect good anatomical outcomes and consider pneumatic retinopexy as a first management in rhegmatogenous retinal detachment patients.
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