단순소안구증에서 백내장수술의 임상결과
Clinical Results of Cataract Surgery in Nanophthalmic Eyes
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목적: 단순소안구증 환자에서 백내장수술 후 임상결과를 보고하고자 한다. 대상과 방법: 안축장 길이(20.5 mm 미만)에 의해 단순소안구증으로 진단받고 백내장수술을 받은 8명(13안)을 대상으로 시력, 현성굴절검사, 안축장, 전방깊이, 각막지름, 안압, 각막내피세포수, 술 중과 술 후 합병증 발생에 대해 의무기록을 후향적으로 조사하였다. 결과: 8명 13안 모두 초음파유화술을 시행받았으며 그 중 11안은 후방에 인공수정체를 삽입하였고, 2안은 섬모체 고랑에 삽입하였다. 술 후 2개월째 최대교정시력은 평균 2.1±2.0줄의 시력호전을 보였고, 술 후에도 안압이 조절되지 않아 섬유주절제술을 받은 1안을제외하고는 모든 안에서 안압이 안정화되었다. 술 중 부분층 공막절제를 시행받은 환자는 없었고, 술 중 또는 술 후에도 맥락막삼출이나 삼출망막박리는 발생하지 않았다. 술 후 2개월째 각막내피세포의 감소율은 12.6±17.7%였다. 결론: 소안구증 환자에서 투명각막절개를 이용한 초음파유화술과 후방인공수정체삽입술 후 대부분 심한 합병증 없이 시력호전을 보였다.
Abstract
Purpose: To evaluate the outcomes in patients with nanophthalmos that had phacoemulsification and intraocular lens (IOL) implantation. Methods: This retrospective study included 13 eyes of eight patients with nanophthalmos who had phacoemulsification with IOL implantation: Preoperative and postoperative manifest refraction, best-spectacle corrected visual acuity (BSCVA), preoperative axial length, anterior chamber depth, corneal diameter, manual keratometry, intraocular pressure (IOP), and postoperative complications were analyzed. Results: Eight patients (13 eyes) had phacoemulsification with IOL implantation, 11 eyes by posterior chamber IOL implantation,and two eyes by ciliary sulcus fixation. The mean change in visual acuity from preoperative to postoperative was 2.1±2.0 lines. IOP was well controlled postoperatively, but one eye required a trabeculectomy. No patients required partial sclerotomy during the operation. Choroidal effusions or choroidal detachment was not observed intraoperatively or postoperatively. The mean endothelial cell loss was 12.6±17.7% at two months postoperative. Conclusions: The results of phacoemulsification and IOL implantation through clear corneal incision in nanophthalmic patients are encouraging. Most patients showed improved visual acuity without severe complications.
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