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하부열공망막박리에서 실리콘기름 충전술의 수술결과 및 의의

Surgical Outcome and Significance of Silicone Oil Tamponade for Inferior Rhegmatogenous Retinal Detachment

이수정|박정민|서상진
대한안과학회 (The Korean Ophthalmological Society)|2012.09|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제53권 제9호|pp. 1296-1303

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키워드

Scleral bucklingSilicone oil tamponadeInferior rhegmatogenous retinal detachment23-gauge transconjunctival sutureless vitrectomy
주제분류안과학

초록

목적: 하부열공망막박리 환자에서 실리콘기름 충전술과 공막돌융슐 및 가스충전술의 수술결과를 비교하고 실리콘기름 충전술이 기존수술방법의 대안이 될 수 있는지 평가해보고자 하였다. 대상과 방법: 하부열공망막박리 환자을 대상으로 23게이지 유리체절제술 및 실리콘 기름 충전술을 시행한 군(1군)과 공막돌융술 및 20게이지 유리체절제술, 육불화황 가스충전술을 시행한 군(2군)으로 나누어 수술 성공률, 합병증, 시력 및 안압 변화, 수술시간 등을 후향적으로 조사하였다. 결과: 일차 수술 성공률은 1군이 94%, 2군이 78%였으며, 최종 성공률은 양 군 모두 100%를 보였다. 두 군 간에 안압변화, 합병증정도는 차이가 없었다. 술 후 시력호전 정도는 1군에서 높았으며, 수술 시간은 1군에서 짧았다. 결론: 하부열공망막박리 환자에서 실리콘 기름 충전술을 시행한 군은 기존의 수술방법과 비교해서 해부학적 성공률 및 합병증 발생측면에서 차이가 없었으며, 수술술기가 간단하여 수술시간을 단축시킬 수 있었다. 이는 하부열공망막박리 환자에서 실리콘 기름 충전술이 기존 수술방법의 대안으로서의 의미를 가지며, 특히 자세유지가 힘든 환자에서 도움이 될 것으로 생각한다.

Abstract

Purpose: To compare the surgical outcomes of 23-gauge transconjunctival sutureless vitrectomy (TSV) with silicone oil tamponade versus 20-gauge PPV with sclera buckling (SB) and SF6 gas tamponade for the repair of rhegmatogenous retinal detachment (RRD) with inferior breaks. In addition, silicone oil tamponade was evaluated as an alternative option for patients with inferior RRD. Methods: Two different types of surgery were performed on two groups of patients with inferior RRD: 23-gauge TSV with silicone oil tamponade (group 1) and 20-gauge PPV with SB and SF6 gas tamponade (group 2). The preoperative clinical features, anatomical success rate, complications, functional outcomes (visual acuity, VA, intraocular pressure, IOP), and surgical time were retrospectively evaluated. Results: The primary surgical success rates were 94% and 78% in groups 1 and 2, respectively. The final success rate was 100% in both groups. Therefore, in terms of success rate, there was no difference between the two groups. No statistically significant difference in IOP change or complication rate was observed between the two groups. VA change was significantly better and surgical time was shorter in group 1. Conclusions: No statistically significant difference of anatomical success rate or complication rate between 23-gauge TSV with silicone oil tamponade and 20-gauge PPV with SB and SF6 gas tamponade was found for inferior RRD. However, surgical time was shorter in group 1. A 23-gauge TSV with silicone oil tamponade could be an alternative to 20-gauge PPV with SB and SF6 gas tamponade for patients with inferior RRD, especially patients who cannot maintain a prone posture.

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