노출된 다공성 안와 삽입물에서 공여 부위에 따른 자가 진피지방 이식술의 치료 결과
Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants
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목적: 노출된 다공성 안와 삽입물에서 공여 부위에 따른 자가 진피지방 이식술의 치료 결과를 비교하고자 하였다. 대상과 방법: 2001년 1월부터 2010년 12월까지 본원 안과에서 다공성 안와 삽입물 노출 진단 하에 자가 진피지방 이식술을 시행 받았으며 술 후 최소 12개월 이상 추적 관찰된 환자군 17명 17안을 공여 부위에 따라 대퇴부와 복부로 나누어 의무기록을 후향적으로 조사하여 이식 결과 및 합병증을 비교하였다. 결과: 대퇴부를 공여부위로 사용한 9명 9안과 복부를 공여부위로 사용한 8명 8안의 이식 성공률은 대퇴부 8안(88.9%), 복부 8안(100%)으로 두 군간 통계적으로 유의한 차이를 보이지 않았다(p=1.000). 안구 부위 합병증은 이식 조직 감염(대퇴부 11.1%, 복부0%)과 윗눈꺼풀 고랑 형성(대퇴부 22.2%, 복부 25.0%)이 관찰되었으며, 공여 부위 합병증은 압통(대퇴부 55.6%, 복부 25.0%), 봉합 열개(대퇴부22.2%, 복부 25.0%) 및 반흔 형성(대퇴부 33.3%, 복부 12.5%)이 있었으며, 보행 관련 합병증은 보행시 동통(대퇴부 55.6%, 복부25.0%) 및 절뚝거림(대퇴부 22.2%, 복부 12.5%)이 있었다. 모든 합병증의 발생률은 두 군간 통계적으로 유의한 차이를 보이지 않았다(p˃0.05). 결론: 노출된 다공성 안와 삽입물의 자가 진피지방 이식술에서 대퇴부와 복부는 모두 효과적인 공여부위로 고려될 수 있다.
Abstract
Purpose: To compare the outcomes of autogenous dermis fat grafting with different donor sites in the treatment of exposed porous orbital implants. Methods: The present study retrospectively evaluated the medical records of 17 patients (17 anophthalmic eyes) who had undergone autogenous dermis fat grafting based on the diagnosis of exposed porous orbital implants and were regularly followed up for at least 12 months since the surgery from January 2001 to December 2010. The patients were divided into 2 groups (thigh and abdomen) according to the site of the donor grafting. The treatment outcome and complications were compared between the 2 groups. Results: The success rate of thigh dermis fat grafting was 88.9% (8/9) and 100.0% (8/8) in the abdominal dermis fat grafting,and there was no statistically significant difference between the 2 groups (p = 1.000). Regarding ocular complications,graft tissue infection (thigh 11.1%, abdomen 0%) and superior sulcus deformity (thigh 22.2%, abdomen 25.0%) were present. Regarding donor site complications, tenderness (thigh 55.6%, abdomen 25.0%), dehiscence (thigh 22.2%, abdomen 25.0%) and scar formation (thigh 33.3%, abdomen 25.0%) were observed. In the gait associated complications, pain (thigh 55.6%, abdomen 25.0%) and limping (thigh 22.2%, abdomen 12.5%) were observed. The rate of all complications showed no statistically significant difference between the thigh dermis fat grafting and the abdominal dermis fat grafting (all p > 0.05). Conclusions: Thigh and abdomen can both be considered as an effective donor site for the autogenous dermis fat grafting in the treatment of exposed porous orbital implants.
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