당뇨 환자에서 비스테로이드 항염증제 점안이 백내장 수술 후 황반부종 발생에 미치는 효과
Effect of Non-Steroidal Anti-Inflammatory Drugs on Cystoid Macular Edema in Diabetic Patients after Cataract Surgery
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목적: 당뇨가 있는 환자에서 백내장수술 후 비스테로이드 항염증제 사용이 황반부종 예방효과가 있는지 알아보았다. 대상과 방법: 당뇨가 있는 환자 중에서 백내장수술 3일 전부터 4주 후까지 Pranoprofen을 점안한 51안을 실험군으로 하고, 점안하지않은 54안을 대조군으로 하였으며, 빛간섭전산화단층촬영을 이용하여 수술 전, 후 황반부 두께 및 부피의 변화를 비교 분석하였다. 결과: 백내장수술 후 실험군에서 중심 황반 두께의 변화량은 1개월째 7.72 ± 13.04 μm, 2개월째 7.15 ± 13.62 μm였고, 대조군에서는1개월째 15.96 ± 18.64 μm, 2개월째 13.24 ± 16.91 μm로 실험군에서 더 유의하게 적은 결과를 보였다(p＜0.05). 황반 부피는 수술후 1개월째 0.33 ± 0.49 mm3, 수술 후 2개월째 0.31 ± 0.43 mm3로 실험군에서 더 유의하게 적은 결과를 보였다(p＜0.05). 결론: 당뇨가 있는 환자에서 백내장수술 후 비스테로이드 항염증제를 점안하였을 경우 황반부 두께 및 황반 부피의 증가 정도가 유의하게 적어 황반부종의 발생을 예방할 수 있을 것으로 보인다.
Abstract
Purpose: The present study analyzed the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on cystoid macular edema in diabetic patients after cataract surgery. Methods: Among 105 eyes of 84 diabetic patients, 43 patients who were administered Pranopulin® (JW pharmaceutical,Korea) starting 3 days before surgery comprised the experimental group. The control group included 41 patients who were not given Pranopulin®. The results consisted of macular thickness measurements and total macular volume which were quantified by optical coherence tomography (OCT, Carl Zeiss Meditec). Results: Macular thickness of the experimental group was 7.72 ± 13.04 μm at postoperative 1 month, 7.15 ± 13.62 μm at postoperative 2 months and was significantly thinner than in the control group (p < 0.05). Macular volume of the experimental group was 0.33 ± 0.49 mm3 at postoperative 1 month, 0.31 ± 0.43 mm3 at postoperative 2 months and was also significantly smaller than in the control group (p < 0.05). Conclusions: Using NSAIDs prophylactically before cataract surgery can effectively reduce the risk of postoperative cystoid macular edema in diabetic patients.
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