인공수정체공막고정술 이후 발생한 인공수정체 동공끼임환자에서 레이저홍채절개술의 치료 2예
Two Cases of Intraocular Lens Pupillary Optic Capture Treated with Argon Laser Iridotomy
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목적: 인공수정체공막고정술 이후 발생한 인공수정체 동공끼임환자에서 아르곤레이저홍채절개술을 통해 치료한 증례 2예를 보고하고자 한다. 증례요약: (증례 1) 69세 남자 환자가 갑작스러운 좌안 시력저하로 내원하였다. 최대교정시력 좌안 안전수지 30 cm였고, 세극등현미경검사상 좌안 인공수정체 불완전 이탈이 확인되었다. 인공수정체공막고정술 및 앞유리체절제술을 시행하였으며 이후 경과 관찰 도중 외상 등 특별한 원인 없이 인공수정체 동공끼임이 2회 반복되었고, 인공수정체 재위치 및 레이저홍채절개술을 시행하였다. (증례 2) 77세 남자 환자가 3-4일 전부터 발생한 좌안 충혈을 주소로 내원하였다. 최대교정시력은 좌안 0.4 logMAR였고, 세극등현미경검사상 좌안 인공수정체 불완전 이탈이 확인되었다. 좌안 인공수정체공막고정술 및 앞유리체절제술을 시행하였으며, 이후 경과 관찰 도중 발생한 인공수정체 동공끼임이 발견되어 인공수정체 재위치 및 레이저홍채절개술을 시행하였다. 결론: 인공수정체공막고정술 이후 중심이탈 또는 뒤틀림 등의 소견이 없던 눈에서 동공끼임이 발생하였을 경우에 레이저홍채절개술시행이 재발을 억제할 수 있는 치료 방법으로 고려될 수 있겠다.
Abstract
Purpose: We report two cases of intraocular lens (IOL) pupillary optic capture following IOL scleral fixation treated with argon laser iridotomy. Case summary: (Case 1) A 69-year-old man presented with suddenly decreased visual acuity of the left eye. The best-corrected visual acuity was finger count (FC) 30 cm in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed and no specific findings were observed. During the follow-up period, pupillary optic capture was repeated without specific causes, such as trauma, or IOL decentration thus, argon laser iridotomy was performed. (Case 2) A 77-year-old man presented with a 3-day history of congestion of the left eye and decreased visual acuity. Best-corrected visual acuity was 0.4 logarithm of the minimum angle of resolution (logMAR) in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed, and no specific findings were observed. During the follow-up period, pupillary optic capture was found, and IOL repositioning and argon laser iridotomy were performed. Conclusions: Laser iridotomy can be used to prevent recurrence of pupillary optic capture in eyes with IOL scleral fixation without decentration or distortion.
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