유리체절제술과 백내장병합수술 후 앞방 깊이와 안구 길이 및 굴절력의 변화 측정
The Changes of Anterior Chamber Depth, Axial Length, Refractive Errors after Combined Vitrectomy
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목적: 유리체절제술과 백내장 병합수술을 받은 환자에서 수술 전후의 앞방 깊이, 안구 길이의 변화를 관찰하고 굴절력 변화와의 관계를알아보고자 하였다. 대상과 방법: 유리체절제술과 백내장 병합수술을 시행 받은 22안과 유리체절제술만 시행 받은 20안, 백내장 수술만 시행 받은 28안을대상으로 술 전, 술 후 3개월째 앞방 깊이, 안구 길이, 굴절력을 측정하여 통계학적으로 분석하였다. 결과: 70명 70안을 대상으로 하였다. 병합수술군과 백내장수술군은 술 후 앞방 깊이가 의미있게 증가하였으며(p˂0.001), 병합수술군에서 증가 정도가 더 뚜렷하였다(p=0.030). 유리체절제술군은 술 후 앞방 깊이가 감소하였다(p˂0.001). 안구 길이는 병합수술군과 유리체절제술군 모두 술 후 의미있는 변화를 보이지 않았으며(p=0.612, p=0.090), 백내장수술군은 술 후 안구길이가 감소하였다(p=0.022). 굴절력은 병합수술군과 백내장수술군은 술 전 목표치에 비하여 원시 변화를 보였고, 유리체절제술군은 술 전 굴절률에 비하여 술 후근시변화를 보였으나 의미있는 차이는 없었다(p=0.292, p=0.251, p=0.068). 결론: 병합수술을 시행한 환자군에서 앞방 깊이가 의미있게 증가하였으며, 안구길이 및 굴절률에서는 의미있는 차이가 관찰되지 않았다.
Abstract
Purpose: To evaluate the changes of anterior chamber depth (ACD), Axial length (AXL) after combined vitrectomy and cataract surgery and to analyze the association with refractive errors. Methods: In 22 eyes who underwent combined vitrectomy and cataract surgery (PPV-Phaco group), 20 eyes who underwent vitrectomy-only (PPV-only group) and 28 eyes who underwent uncomplicated cataract surgery (Phaco-only group),ACD and AXL were measured with IOL master (Carl Zeiss Jena, Germany) preoperatively and 3 months postoperatively. We compared the preoperative desired refraction and postoperative 3 months refraction. Results: ACD were increased in PPV-Phaco group and Phaco-only group (all, p < 0.001) and this change was more prominent in PPV-Phaco group (p = 0.030). In PPV only group, ACD was decreased (p < 0.001). The AXL after surgery was not significant different from the preoperative AXL in PPV-Phaco and PPV only groups (p = 0.612, p = 0.090). But the AXL was decreased in Phaco-only group (p = 0.022). Hyperopic shifting were noticed in PPV-Phaco and phaco-only groups, but myopic shifting was noticed in PPV-only group. However, these changes were not statistically significant (p = 0.292, p =0.251, p = 0.068). Conclusions: ACD was increased after combined vitrectomy and cataract surgery. AXL was not changed. The hyperopic shifting was noticed after combined vitrectomy and cataract surgery, but was not statistically significant.
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