원발성열공망막박리 환자에서 단독유리체절제술과 수정체유화술 및 유리체절제술병합술의 결과 비교
Phacovitrectomy versus Vitrectomy only for Primary Rhegmatogenous Retinal Detachment Repair
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목적: 원발성 열공망막박리 환자(RRD)에서 유리체절제술 및 수정체유화술을 동시에 시행한 경우와 유리체절제술만 단독으로 시행한 경우의 결과를 서로 비교해 보았다. 대상과 방법: RRD로 진단받은 환자를 유리체절제술만 시행한 Group I, 유리체절제술과 수정체유화술을 동시 시행한 Group II로 나누어 해부학적 수술성공률, 최대교정시력 및 합병증 등을 비교하였다. 결과: Group I의 경우 21안(84.0%), Group II의 경우 27안(90.0%)이 재유착 되었고 두 군 간의 통계적으로 유의한 차이는 없었다. 최대 교정시력(logMAR) 또한 두 군 모두 통계적으로 유의한 호전을 보였으나 두 군 간의 차이는 없었다(p=0.102). Group I의 경우 백내장이 발생 또는 진행하여 17안(68.0%)안에서 술 후 1년 이내에 백내장 수술을 시행하였다. 결론: RRD의 유리체절제술 시 수정체유화술과의 동시수술은 단독 유리체절제술과 해부학적, 기능적 성공률에 의미 있는 차이는 없었 으나, 추가 수술을 피하고 주변부 유리체절제를 용이하게 할 수 있는 장점이 있어 수정체 혼탁 여부와 무관하게 조절기능의 장애가 임박한 연령 이상에서는 적극 고려해 볼 수 있겠다.
Abstract
Purpose: To compare the outcomes of phacovitrectomy and vitrectomy only for treatment of primary rhegmatogenous retinal detachment. Methods: The anatomical success, functional success, and complications between Group I patients who underwent vitrectomy only and Group II patients who underwent phacovitrectomy for primary rhegmatogenous retinal detachment were retrospectively compared. Results: Twenty-one eyes (84.0%) in Group I had reattachment after vitrectomy only, and 27 eyes (90.0%) in Group II had reattachment after phacovitrectomy. However, the differences in the measures attributes were not statistically significant (p = 0.271). The logMAR visual acuity improved in both groups with no statistically significant difference between the two groups (p = 0.102). Postoperative complications included cataract progression in 20 eyes (80.0%) in Group I and 17 of the 20 eyes (68.0%) underwent cataract surgery within one year after the first surgery. Conclusions: Phacovitrectomy, irrespective of severe lens opacity, is a relatively effective combined surgical procedure in older patients with primary rhegmatogenous retinal detachment and impending presbyopia. The procedure allows for easy access to the periphery during vitreous shaving and prevents the need for a second cataract operation.
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