백내장수술 또는 유리체절제술과 백내장병합수술 후수정체 후낭혼탁 발생의 위험인자
Risk Factors for Development of Posterior Capsule Opacification after Cataract Surgery or Combined Vitreoretinal Surgery
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목적: 백내장수술을 단독으로 받은 환자와 백내장수술과 유리체망막수술을 병행한 환자에서 수정체 후낭혼탁발생의 위험인자를 분석하였다. 대상과 방법: 동일한 술자에 의해 백내장수술 또는 유리체망막수술과 백내장병합수술을 시행 받은 환자 272안을 대상으로 후향적으로조사하였다. 성별, 나이, 당뇨여부, 수정체 전낭원형절개크기, 인공수정체형태, 수술 중 유리체강내 베바시주맙이나 가스, 실리콘기름주입여부를 조사하여 다중로지스틱 회귀분석으로 후낭혼탁에 영향을 미치는 인자들을 알아보았다. 결과: 272안 중 55안(20.2%)에서 후낭혼탁이 발생하였다. 평균연령은 63.3 ± 12.1세(23-85세)였으며 평균추적관찰기간은 17.3 ± 3개월이었다. 나이(p＜0.05), 수정체 전낭원형절개크기(p=0.009), 유리체망막수술병행여부(p=0.014), 수술 중 가스나 실리콘기름 주입여부(p=0.009, 0.005)에 따른 수정체 후낭혼탁 발생빈도 비교에서 유의한 차이를 보였다. 그 외 성별, 당뇨, 인공수정체형태, 유리체강내 베바시주맙주입여부에 따른 후낭혼탁 발생빈도 비교에서는 통계적으로 의미 있는 차이를 보이지 않았다(p＞0.05). 결론: 수정체 후낭혼탁에 연관된 위험인자는 나이가 어린 경우, 큰 수정체 전낭원형절개크기, 유리체망막수술을 병행하거나 수술 중유리체강내 가스나 실리콘기름 주입을 한 경우였다.
Abstract
Purpose: To evaluate the risk factors for the development of posterior capsule opacification (PCO) after cataract surgery or combinedcataract and vitreoretinal surgery. Methods: In the present study all surgical procedures were performed by the same surgeon. We retrospectively reviewed 272consecutive eyes that received cataract surgery or combined cataract and vitreoretinal surgery. The risk factors including gender,age, diabetes, continuous curvilinear capsulorhexis (CCC) size, intraocular lens shape, intraoperative intravitreal bevacizumab,gas, and silicone oil injections were evaluated using multiple logistic regression analysis. Results: PCO developed in 55 (20.2%) out of 272 eyes. The mean age was 63.3 ± 12.1 years (range 23‐85 years) and mean follow‐up period was 17.3 ± 3 months. A correlation existed between the development of the PCO and age (p < 0.05), CCC size (p= 0.009), vitreoretinal surgery (p = 0.014), intraoperative intravitreal gas (p = 0.009) and silicone oil injections (p = 0.005). However, no statistical correlation with gender, diabetes, intraocular lens shape, or intraoperative intravitreal bevacizumab injectionwas observed (p > 0.05). Conclusions: The risk factors associated with PCO included young age, large CCC size, combined cataract and vitreoretinal surgery,intraoperative intravitreal gas and silicone oil injections.
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