위눈꺼풀수술 후 0.15% 히알루론산 나트륨 점안액이 안구 표면에 미치는 임상적 효과
Efficacy of 0.15% Sodium Hyaluronate Eye Drops in Patients’ Ocular Surface after Upper Eyelid Surgery
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목적: 무방부제성 0.15% 히알루론산 나트륨 점안액이 위눈꺼풀수술 후 안구 표면에 미치는 임상적 효과를 알아보고자 하였다. 대상과 방법: 2018년 12월부터 2019년 5월까지 위눈꺼풀수술을 시행 받은 43명의 환자를 수술 후 무방부제성 0.15% 히알루론산 나트륨 점안액을 사용한 A군(23명 23안), 사용하지 않은 B군(20명 20안)으로 분류하였다. 안구 표면질환지수, 눈물막파괴시간, 쉬르머검사, 플루레신을 이용한 각막염색점수, 마이봄샘 질 및 배출 점수, 마이봄점수를 수술 전과 수술 후 1주째, 1개월째 및 2개월째 각각 시행하여 비교 분석하였다. 결과: 안구 표면질환지수, 눈물막파괴시간, 각막염색점수는 A군에서 수술 전과 비교하였을 때, 수술 후 1주일째 증가(p＜0.05)하였다가 수술 후 1개월째 및 2개월째는 유의한 차이를 보이지 않았다. B군에서 안구 표면질환지수, 눈물막파괴시간, 각막염색점수는 수술 전과 비교하였을 때, 수술 후 1주일째 및 1개월째 증가(p＜0.05)하였다가 수술 후 2개월째는 유의한 차이를 보이지 않았다. 수술 후 1개월째 안구 표면질환지수(p=0.03)와 각막염색점수(p＜0.01)는 두 군 간에 차이를 보였으나, 눈물막파괴시간은 두 군 간의 유의한 차이가 없었다. 쉬르머검사 수치, 마이봄샘 질 및 마이봄샘 배출 점수, 마이봄점수는 각 군 내에서 수술 전후 차이를 보이지 않았으며, 모든 기간 동안 두 군 간에 유의한 차이를 보이지 않았다. 결론: 위눈꺼풀수술 후 무방부제성 0.15% 히알루론산 나트륨 점안액은 초기 안구건조증 증상과 안구 표면 손상의 빠른 완화에 도움이 됨을 알 수 있었다.
Abstract
Purpose: To evaluate the clinical efficacy of preservative-free 0.15% sodium hyaluronate eye drops on the ocular surface after upper eyelid surgery. Methods: This study included 43 patients who underwent upper eyelid surgery between December 2018 and May 2019. Patients were randomly assigned to group A (those treated with preservative-free 0.15% sodium hyaluronate eye drops) and group B (the control group). Ocular surface disease index score (OSDI), tear break up time (TBUT), Schirmer’s test, corneal staining score (CSS), meibomian gland (MG) quality, MG expressibility, and meiboscore were evaluated before surgery and at 1 week, 1 month, and 2 months after surgery. Results: In group A, OSDI and TBUT showed a significant increase at 1 week after surgery compared with baseline values (all p < 0.05). In group B, OSDI, TBUT, and CSS were significantly higher at 1 week and 1 month after surgery (all p < 0.05), whereas there were no significant changes at 2 months after surgery compared with baseline values. At 1 month after surgery, OSDI (p = 0.03) and CSS (p < 0.01) showed significant changes between group A and group B; however, there was no significant change in the TBUT. There were no significant within-group differences in Schirmer’s test values, MG quality, MG expressibility, or meiboscore, and there were no significant between-group differences over time. Conclusions: Preservative-free 0.15% sodium hyaluronate eye drops were shown to be an effective treatment for early dry-eye symptoms and ocular surface damage after upper eyelid surgery.
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