눈물주머니코안연결술 후의 눈물막의 변화에 대한 연구
The Changes in Tear Film After Dacryocystorhinostomy
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목적: 눈물주머니코안연결술 전후의 눈물막 및 안구표면의 변화에 대하여 알아보고자 하였다. 대상과 방법: 코눈물관 폐쇄가 있는 환자에서 한쪽 코경유 눈물주머니코안연결술을 시행받고 3개월 이상 성공적인 수술결과를 보인40명을 대상으로 수술 전후 양안의 기본눈물분비량, 눈물막파괴시간, 각막지각, 눈물청소율, 각막상피병증을 조사하였다. 결과: 대상자 40명 중 남자가 8명, 여자가 32명이었고 평균연령은 57.4±13.2세(29~77세)였다. 수술한 눈에서 기본눈물분비량과 눈물막파괴시간은 술 전 13.21±3.79 mm와 8.20±2.30초였고, 술 후 3개월째 9.13±3.77 mm (p=0.01)와 6.27±2.20초(p=0.03)로 유의한차이가 있었다. 각막지각, 눈물청소율, 각막상피병증은 술 전 57.89±4.18 mm, 3.26±0.91, 0.12±0.53에서 술 후 3개월째 57.75±3.55mm, 3.04±0.87, 0.13±0.54였다(p＞0.05). 반대편 눈에서 유의한 변화는 없었다. 결론: 코경유 눈물주머니코안연결술 시행 후 수술안의 기본눈물분비량, 눈물막파괴시간의 감소를 보이므로 눈물막 변화에 주의를 기울여야 할 것으로 생각된다.
Abstract
Purpose: This study was performed to evaluate the changes in tear film and ocular surface after dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction. Methods: Forty subjects who showed successful results at three months after endoscopic DCR were investigated. The changes in tear breakup time (BUT), basal secretion test (BST), corneal sensitivity test (CST), tear clearance rate (TCR) and keratoepitheliopathy (KEP) were evaluated. Results: The mean age was 57.4±13.2 years (29~77 years). Preoperative BST and BUT in eyes which underwent DCR were 13.21±3.79 mm and 8.20±2.30 seconds, respectively. Three months after the operation, the respective values were 9.13±3.77 mm (p=0.01) and 6.27±2.20 seconds (p=0.03). Preoperative CST, TCR and KEP in eyes which underwent DCR were 57.89±4.18 mm,3.26±0.91 and 0.12±0.53, respectively. Three months after the operation, the respective values were 57.75±3.55 mm (p=0.32),3.04±0.87 (p=0.08) and 0.13±0.54 (p=0.08). No changes were observed between the preoperative and postoperative tear parameters in fellow eyes. Conclusions: The changes in tear film parameters including BST and BUT should be considered in patients who receive endoscopic DCR.
참고문헌 (16)
- 이태수, "소아와 성인에서 풍선관 비루관 성형술의 수술 성적", 대한안과학회지, 44(4), pp.4~799 (2003), 대한안과학회
- Bartley GB, "Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature", Ophthal Plast Reconstr Surg, 9, pp.11~26 (1993)
- Weidenbecher M, "Endoscopic endonasal dacryocystorhinostomy:results in 56 patients", Ann Otol Rhinol Laryngol, 103, pp.363~367 (1994)
- Boush GA, "Results of endonasal laserassisted dacryocystorhinostomy", Ophthalmology, 101, pp.955~959 (1994)
- Lee SH, "Long Term Surgical Efficacy of Endonasal Dacryocystorhinostomy", J Korean Ophthalmol Soc, 41, pp.307~313 (2000)
- 이태수, "실패한 코경유눈물주머니코안연결술에서 교정수술의 결과", 대한안과학회지, 48(2), pp.186~192 (2007), 대한안과학회
- Yung MW, "Analysis of the results of surgical endoscopic dacryocystorhinostomy: effect of the level of obstruction", Br J Ophthalmol, 86, pp.792~794 (2002)
- Mandeville JT, "Obstruction of the lacrimal drainage system", Curr Opin Ophthalmol, 13, pp.303~309 (2002)
- Stahl U, "Prospective controlled study of vapor pressure tear osmolality and tear meniscus height in nasolacrimal duct obstruction", Am J Ophthalmol, 141, pp.1051~1056 (2006)
- Fayet B, "Complications of standardized endonasal dacryocystorhinostomy with unciformectomy", Ophthalmology, 111, pp.837~845 (2004)
- Saratziotis A, "Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction: creating a window with a drill without use of mucosal flaps", Acta Otolaryngol, 31, pp.1~4 (2008)
- Narioka J, "Changes in lumen width of nasolacrimal drainage system after adrenergic and cholinergic stimulation", Am J Ophthalmol, 141, pp.689~698 (2006)
- Narioka J, "Effects antagonist on width of nasolacrimal drainage system lumen", J Ocul Pharmacol Ther, 23, pp.467~475 (2007)
- Kubo M, "Tear lipid layer interference changes after dacryocystorhinostomy", Jpn J Ophthalmol, 45, pp.653~656 (2001)
- Francis IC, "Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction", Am J Ophthalmol, 139, pp.493~497 (2005)
- Yen MT, "The effect of punctal occlusion on tear production, tear clearance, and ocular surface sensation in normal subjects", Am J Ophthalmol, 131, pp.314~323 (2001)