백내장 수술 시 DisCoVisc의 특성과 유용성
Efficacy and Intraoperative Characteristics of DisCoVisc for Cataract Surgery
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목적: 중등도의 핵경화도를 지닌 백내장환자에서 백내장 수술 시 DisCoVisc의 특성과 유용성을 일반적인 응집성 점탄물질인 1% 히알우론산 나트륨와 비교하여 알아보고자 하였다. 대상과 방법: 중등도의 핵경화도를 지닌 60안을 대상으로 30안은 DisCoVisc를 사용하고, 30안에서 1% 히알우론산 나트륨을 사용하여초음파 유화술을 시행하였다. 술 중 평균 초음파세기, 회전진동 시간, 평균 회전진동 폭, 누적소비 에너지, 평형염액 사용량, 관류/흡입시 소요되는 시간, 술 전후의 각막내피세포수 및 중심각막두께를 측정하였다. 결과: 초음파역동에 관련된 인자는 DisCoVisc사용군과 1% 히알우론산 나트륨 사용군 사이에 유의한 차이는 없었다. 술 후 2개월에추적관찰 하였을 때 중심각막두께는 1% 히알우론산 나트륨 사용군이 유의한 증가를 보였고, 각막내피세포수의 감소는 DisCoVisc사용군에서 통계학적으로 유의하게 적었다. 결론: DisCoVisc는 각막내피세포 손상을 줄이고, 쉽게 관류/흡인되는 성질을 확인할 수 있었고, 분산성 점탄물질로 분류됨에도 응집성점탄물질의 특성을 가지고 있어 수정체 유화술시 유용한 점탄물질이라 여겨진다.
Abstract
Purpose: To compare the efficacy and intraoperative characteristics of DisCoVisc with those of Hyal 2000 (sodium hyaluronate 1.0%) in cataract surgery. Methods: Cataract surgery was performed on 60 eyes in 49 patients who were diagnosed with moderate cataracts. 30eyes were performed with DisCoVisc and a control group with 30 eyes using Hyal 2000 (sodium hyaluronate 1.0%). Phacodynamics was evaluated including ultrasound (US) time, mean US intensity, cumulative dissipated energy (CDE),and amount of used balanced salt solution. Corneal endothelium and corneal thickness were measured preoperatively and 1 day and 1 month and 2 months postoperatively. Results: There were no statistically significant differences in phacodynamic parameters in the two groups. The central corneal thickness change from preoperatively to postoperatively in the DisCoVisc group was +0.07 ± 2.44 μm and Hyal 2000group +0.84 ± 2.93 μm (p = 0.032) at 2 months. Corneal endothelial cell loss (ECL)(%) at 2 months was 7.67 ± 8.01% in DisCoVisc group and 13.23 ± 15.5% in the Hyal 2000 group (p = 0.005). Conclusions: There was signicant difference between DisCoVisc and Hyal 2000 in the changes of CCT, ECD (Endothelial cell density). (DisCoVisc is effective and provides advantages both cohesive OVDs and dispersive OVDs).
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