섬유주 미세우회 스텐트(iStent)삽입술의 단기간 치료 성적 및 수술 성공률 분석
Short-term Outcomes and Prognostic Factors of iStent in the Republic of Korea
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목적: 개방각녹내장 환자에서 섬유주 미세우회 스텐트삽입술 후 안압하강 효과, 수술 성공률과 예후 인자를 분석하고자 하였다. 대상과 방법: 개방각녹내장으로 섬유주 미세우회 스텐트삽입술을 시행받고 6개월 이상 추적 관찰이 가능했던 33명 33안을 대상으로 의무기록을 통해 후향적으로 분석하였다. 수술 성공은 녹내장 약물 사용 여부와 관계없이 수술 후 안압이 21 mmHg 미만이고, 20% 이상 안압이 감소한 경우로 정의하였다. 결과: 섬유주 미세우회 스텐트삽입술 후 6개월간의 추적 관찰 동안 안압은 수술 전 23.70 ± 6.26 mmHg에서 수술 6개월 후 18.03 ± 4.64 mmHg로, 녹내장 약물은 수술 전 3.73 ± 0.67개에서 수술 6개월 후 3.43 ± 0.67개로 모두 통계적으로 유의하게 감소하였다(각각, p<0.001 및 p=0.027). 섬유주 미세우회 스텐트 단독군에서 수술 6개월 후 누적 수술 성공률은 33.7 ± 5.5%였다. 수술 실패의 위험인자를 다중회귀분석으로 시행한 결과, 나이가 많을수록 수술 실패가 더 높은 것으로 나타났다(odds ratio 1.076, 95% 신뢰구간 0.996-1.164, p=0.045). 결론: 한국인에서 섬유주 미세우회 스텐트삽입술은 유의한 안압하강이 나타났으며, 특히 젊은 환자에서, 더 좋은 수술 성공률을 보이는 것으로 나타났다.
Abstract
Purpose: To evaluate the intraocular pressure (IOP) reduction, success rate and prognostic factors after trabecular micro-bypass stent implantation in patients with open-angle glaucoma. Methods: We retrospectively reviewed 33 eyes of 33 patients with open-angle glaucoma who were followed-up for more than 6 months after trabecular micro-bypass stent implantation. The success of surgery was defined as an IOP ≤ 21 mmHg and an IOP reduction ≥ 20% from baseline, regardless of whether glaucoma medication was used. Results: During the follow-up at 6 months after trabecular micro-bypass stent implantation, the IOP was significantly decreased from 23.70 ± 6.26 mmHg before surgery to 18.03 ± 4.64 mmHg after 6 months, and the glaucoma medication was significantly decreased from 3.73 ± 0.67 before surgery to 3.43 ± 0.67 after 6 months (p < 0.001 and p = 0.027, respectively). The success rate at 6 months was 33.7 ± 5.5% in patients with only trabecular micro-bypass stent implantation. Using multiple regression analyses of the risk factors, age was associated with success rate (odds ratio, 1.076; 95% confidence interval, 0.996-1.164; p = 0.045). Conclusions: In patients in the Republic of Korea, trabecular micro-bypass stent implantation was an effective surgery for IOP reduction, and showed a better surgical success rate in younger patients.
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