다이오드 레이저를 사용한 눈물소관경유 눈물주머니코안연결술의 수술 결과
The Long-Term Results of Transcanalicular Dacryocystorhinostomy with a Diode Laser
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목적: 다이오드 레이저를 사용한 눈물소관경유 눈물주머니코안연결술의 수술 결과를 보고하고자 한다. 대상과 방법: 2004년 5월부터 2010년 4월까지 본원에서 다이오드 레이저를 사용한 눈물소관경유 눈물주머니코안연결술을 시행 받은환자 71명(76안)을 대상으로 해부학적 성공률과 기능적 성공률을 조사하였다. 결과: 1차 눈물소관경유 레이저 눈물주머니코안연결술을 시행 받은 환자의 해부학적 성공률은 73.9% (51/69)였으며, 기능적 성공률은62.3% (43/69)이었다. 실패원인으로는 막성폐쇄가 50.0%로 가장 많았으며 육아종 38.9%, 비강내협착 5.6%, 눈물소관폐쇄 5.6%이었다. 타눈물주머니코안연결술에 실패 후 2차로 눈물소관경유 레이저 눈물주머니코안연결술을 시행 받은 환자의 해부학적 성공률은42.9% (3/7)이었으며, 기능적 성공률은 42.9% (3/7)이었다. 결론: 다이오드 레이저를 사용한 눈물소관경유 눈물주머니코안연결술은 기존의 내시경적 또는 피부절개 눈물주머니코안연결술에 비해성공률이 크게 떨어지지 않으며 최소 침습적인 수술이고 외래에서 수술이 가능하다는 점에서 장점을 지닌 수술방법이라 생각한다.
Abstract
Purpose: This study evaluated the clinical outcomes of transcanalicular laser-assisted dacryocystorhinostomy (TCL-DCR)using a diode laser in patients with nasolacrimal duct obstruction (NLDO). Methods: A total of 71 patients (76 eyes) who underwent TCL-DCR between May 2004 and April 2010 were analyzed. The functional and anatomic success rates were evaluated and the causes of failure were analyzed. Results: The anatomic and functional success rates in primary TCL-DCR were 73.9% (51 of 69 eyes) and 62.3% (43 of 69), respectively. The causes of failure were membranous obstruction in 50.0% of the cases, granuloma formation in 38.9%, synechia formation in 5.6%, and canalicular stenosis in 5.6%. The anatomic and functional success rates were both 42.9% (3 of 7eyes) after TCL-DCR revision. Conclusions: The success rate of TCL-DCR is relatively comparable to that of conventional surgery. Additionally, the advantages of the procedure are its minimal invasiveness and convenience in an outpatient setting, suggesting that TCL-DCR may be an effective procedure for primary and secondary NLDO.
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