Nd:YAG 레이저 수정체낭원형절개확장술과 원형절개 형태변화효과
Continuous Curvilinear Capsulorhexis (CCC) Remodeling after CCC Widening with a Nd:YAG Laser
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서론: 수정체낭원형절개의 수축에 대해 Nd:YAG 레이저를 사용하여 원형절개확장술을 시행하였고, 이후 수정체낭원형절개의 수축이 추가적으로 진행이 되는지를 관찰하였다. 또한 수정체낭원형절개의 형태변화에 미치는 요인에는 어떠한 것이 있는지를 조사하여 보았다. 대상과 방법: 2002년 1월부터 2010년 12월까지 수정체낭원형절개확장술을 시행 받은 환자들의 의무기록을 후향적으로 분석하였다. 백내장수술만 단독으로 시행 받았거나 백내장과 유리체절제술의 병합수술을 받은 경우를 연구에 포함시켰다. 원형절개의 형태는 완전한원형으로 형태변화된 경우 a형, 절개부위가 벌어져 불가사리형태로 된 것을 b형, 절개부위가 그대로 오므려져 있는 경우를 c형으로분류하여 각 형태변화에 미치는 요인을 분석하였다. 결과: 연구대상은 316명, 424안이었고, 형태변화에 미치는 요인은 수술 후 수정체낭원형절개확장술까지의 시기에 따라 유의한 차이가있었고, 나이, 성별, 당뇨, 인공수정체의 종류, 수술의 종류 등과는 유의한 상관관계가 없었다. 결론: Nd:YAG 레이저를 이용한 원형절개확장술은 효과적이고 부작용이 적으며 이른 시기에 시행되었을 때 더욱 원형에 가깝게 형태변화될 것을 기대할 수 있다.
Abstract
Purpose: To analyze the factors that affected continuous curvilinear capsulorhexis (CCC) remodeling to different shapes after CCC widening with Nd:YAG laser. Methods: The medical records of patients who underwent CCC widening with Nd:YAG laser between January 2002 and December 2010 in our clinic were retrospectively reviewed. Eyes that underwent phacoemulsification surgery alone or combined phacoemulsification surgery and vitrectomy were eligible for the study. A remodeled CCC with a nearly complete circle was classified as type a, starfish-shape as type b, and not remodeled CCC as type c, The factors that affected CCC remodeling were analyzed. Results: Among 424 eyes of 316 patients, the type of CCC remodeling had a significant correlation with the time period from phacoemulsification surgery to Nd:YAG CCC widening. There was no significant correlation with age, sex, diabetes,type of intraocular lens, type of surgery and indications for surgery. Conclusions: CCC widening using Nd:YAG laser was effective and had minimal complications. The sooner the procedure was performed, the more circular CCC remodeling occurred. The capsule’s elasticity may influence CCC remodeling, but more studies are needed to clarify other factors.
참고문헌 (20)
- Steinert RF, "Cataract Surgery", pp.552~554 (2004), Saunders
- Masket S., "Postoperative complications of capsulorhexis", J Cataract Refract Surg, 19, pp.721~724 (1993)
- Davison JA., "Capsule contraction syndrome", J Cataract Refract Surg, 19, pp.582~589 (1993)
- Hayashi H, "Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome", Br J Ophthalmol, 82, pp.1429~1432 (1998)
- Hayashi K, "Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa", Ophthalmology, 105, pp.1239~1243 (1998)
- Hayashi H, "Area reduction in the anterior capsule opening in eyes of diabetes mellitus patients", J Cataract Refract Surg, 24, pp.1105~1110 (1998)
- Joo CK, "Capsular opening contraction after continuous curvilinear capsulorhexis and intraocular lens implantation", J Cataract Refract Surg, 22, pp.585~590 (1996)
- Sung MK, "The evaluation of capsule contraction syndrome", J Korean Ophthalmol Soc, 36, pp.1454~1461 (1995)
- Yasuda A, "Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation", Am J Ophthalmol, 130, pp.836~837 (2000)
- Musa F, "Choroidal effusion and hypotony caused by severe anterior lens contraction following cataract surgery", Eur J Ophthalmol, 14, pp.153~155 (2004)
- Richter-Mueksch S, "Uveal and capsular biocompatibility after implantation of sharp-edged hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in eyes with pseudoexfoliation syndrome", J Cataract Refract Surg, 33, pp.1414~1418 (2007)
- Cochener B, "Capsule contraction after continuous curvilinear capsulorrhexis: poly(methyl methacrylate) versus silicone intraocular lenses", J Cataract Refract Surg, 25, pp.1362~1369 (1999)
- Sacu S, "Influence of optic edge design, optic material, and haptic design on capsular bend configuration", J Cataract Refract Surg, 31, pp.1888~1894 (2005)
- Mingels A, "Comparison of two acrylic intraocular lenses with different haptic designs in patients with combined phacoemulsification and pars plana vitrectomy", Eye (Lond), 21, pp.1379~1383 (2007)
- Matsuda H, "Anterior capsular contraction after cataract surgery in vitrectomized eyes", Am J Ophthalmol, 132, pp.108~109 (2001)
- Kato S, "Anterior capsular contraction after cataract surgery in eyes of diabetic patients", Br J Ophthalmol, 85, pp.21~23 (2001)
- Lee SY, "Reduction in the area of anterior capsular opening after acryl intraocular lens implantation: diabetics vs. nondiabetics", J Korean Ophthalmol Soc, 41, pp.1158~1163 (2000)
- Steinert RF, "Cataract Surgery", pp.475~ (2004), Saunders
- Mohr AM, "Diathermy capsulotomy to remove fibrotic anterior capsules in pseudophakic eyes", J Cataract Refract Surg, 23, pp.244~247 (1997)
- Hayashi K, "Prevention of anterior capsule contraction by anterior capsule relaxing incisions with neodymium: yttrium-aluminum-garnet laser", Am J Ophthalmol, 146, pp.23~30 (2008)