거대각막증에서의 백내장 적출 및 인공수정체 삽입술
Cataract Extraction and Intraocular Lens Implantation in Megalocornea
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목적: 거대각막증에서 백내장 적출 후 인공수정체 중심이탈 없이 시력호전을 보였던 환자를 보고하고자 한다. 증례요약: 양측성 거대각막증을 지닌 27세 남자 환자가 본원에 내원하였다. 3개월 전부터 진행해온 양안의 시력 저하 및 비문증을 호소하였다. 양안 각막 직경은 약 14 mm였고 초진 시 최대교정시력은 각각 우안 0.02, 좌안 0.5였다. 우안은 백색 백내장, 좌안은 핵경화백내장으로 수정체 편위는 발견되지 않았다. 우안은 전낭에 연속곡선수정체낭원형절개술을 시행하였으며 백내장 적출 후 수정체낭내에 인공수정체를 삽입하고 유리체 절제술을 시행하였다. 2개월 뒤 좌안은 백내장 적출 후 후낭에 광학부 포획술을 시도하였으나후낭 연속곡선수정체낭원형절개술 도중 방사상 파열로 전낭에 역 광학부 포획술을 시행하고 유리체절제술을 하였다. 인공수정체는양안 모두 광학부 6 mm, 전체 길이 12.5 mm인 인공수정체를 사용하였다. 우안은 인공수정체가 수정체낭 직경에 비해 작아 아래 방향으로 중심이탈이 일어났으나, 좌안은 전낭에 고정시킨 인공수정체가 중심을 잘 유지하고 있었으며 양안 모두 다른 합병증은 동반되지않았다. 양안 최대교정시력은 각각 0.8로 호전되었다.
Abstract
Purpose: To report a case that underwent successful centration of intraocular lens (IOL) and visual acuity improvement after cataract extraction in a megalocornic eye in our medical center. Case summary: A 27-year-old man with bilateral megalocorneas came to our medical center. The patient had progressive loss of vision and floaters in both eyes for 3 months. His horizontal corneal diameter was approximately 14 mm in both eyes. The initial best corrected visual acuity was 0.02 in the right eye and 0.5 in the left eye. There was a white cataract and nuclear sclerotic cataract without lens luxation, respectively. The cataract was extracted from the patient’s right eye after anterior continuous curvilinear capsulorrhexis (CCC), the preloaded custom IOL was inserted in the bag, and pars plana vitrectomy was performed. Two months later, after the cataract was extracted from the left eye, optic capture through a posterior capsule was attempted but converted to anterior capsule (reverse optic capture) because of the posterior CCC’s radial tear, and pars plana vitrectomy performed. The IOL had a 6 mm optic and an overall length of 12.5 mm. The IOL in the right eye was decentrated inferiorly in the bag due to a large capsule diameter, but the IOL captured through the anterior capsule in the left eye had good centration. The best corrected visual acuity of both eyes improved to 0.8 without other complications.
참고문헌 (12)
- Sharan S, "Anterior megalophthalmos in a family with 3 female siblings", J Cataract Refract Surg, 31, pp.1433~1436 (2005)
- Cho BC, "A case of megalocornea", J Korean Ophthalmol Soc, 26, pp.353~357 (1985)
- Javadi MA, "Cataract surgery and intraocular lens implantation in anterior megalophthalmos", J Cataract Refract Surg, 26, pp.1687~1690 (2000)
- de Sanctis U, "Cataract extraction in X-linked megalocornea: a case report", Cornea, 23, pp.533~535 (2004)
- Dohlman CH, "Megalocornea and cataract", Acta Ophthalmol, 36, pp.845~848 (1958)
- Lee GA, "Phacoemulsification in anterior megalophthalmos", J Cataract Refract Surg, 32, pp.1081~1084 (2006)
- Berry-Brincat A, "Megalocornea and bilateral developmental cataracts", J Cataract Refract Surg, 34, pp.168~170 (2008)
- Kwitko S, "Intraocular lens implantation in anterior megalophthalmus. Case report", Cornea, 10, pp.539~541 (1991)
- Oetting TA, "Bilateral Artisan lens for aphakia and megalocornea: long-term follow-up", J Cataract Refract Surg, 32, pp.526~528 (2006)
- Dua HS, "Cataract extraction and intraocular lens implantation in anterior megalophthalmos", J Cataract Refract Surg, 25, pp.716~719 (1999)
- Vaz FM, "Cataract surgery and anterior megalophthalmos: custom intraocular lens and special considerations", J Cataract Refract Surg, 33, pp.2147~2150 (2007)
- Assia EI, "Cataract surgery in megalocornea Comparison of 2 surgical approaches in a single patient", J Cataract Refract Surg, 35, pp.2042~2046 (2009)