반복각막미란에서 앞기질천자술과 술 후 장기간 5% NaCl 안약 병용치료의 효과
Efficacy of Anterior Stromal Puncture Using 5% NaCl Eye Drops for Prolonged Time in Recurrent Corneal Erosion Syndrome
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목적: 본 연구에서는 반복각막미란에서 앞기질천자술과 술 후 5% NaCl 안약을 최소 6개월간 장기 병용치료한 효과를 알아보고자 한다. 대상과 방법: 2012년도 1월부터 2016년도 4월 사이에 가톨릭대학교 서울성모병원에서 반복각막미란을 진단받은 환자에서 앞기질천자술을 시행하고 시술 후 5% NaCl 안약을 6개월간 4회 유지하도록 한 환자 21명(21안)을 대상으로 치료결과의 의무기록을 후향적으로 분석하였다. 환자들의 나이, 성별, 각막 외상, 안과적 수술병력의 여부, 시술 후 재발 여부와 재발 시 추가 치료 필요 여부, 술 후 합병증 발생에 대해 조사하였다. 결과: 총 21명의 환자 평균 나이는 42.05 ± 13.83세(19-68세)였고, 성별의 비율에 차이는 없었으며 평균 관찰 기간은 8.48 ± 2.76개월(6-15개월)이었다. 21명 환자의 21안 중 14안(66.7%)에서 각막 외상, 2안(9.52%)에서 굴절수술을 받은 과거력이 있었고 각막이상증이 있는 경우가 1안(4.8%), 당뇨가 있었던 환자가 2안(9.5%)이었고 원인을 알 수 없는 경우가 5안(28.81%)이었다. 21안 중 치료 후 재발한 환자는 3안(14.3%)이었고 2안은 보존적 치료 후 증상 소실되었으며 1안에서만 재시술이 필요하였다. 재시술을 받은 환자에서도 1회 추가 시술 후에는 재발하지 않았다. 앞기질천자술로 인한 각막혼탁 외에는 감염, 염증 등의 부작용은 없었으며 1명에서 각막혼탁으로 인한 눈부심을 호소하였다. 결론: 반복각막미란 환자에서 앞기질천자술과 술 후 5% NaCl의 장기간 병용 요법은 보존적 치료에 반응하지 않는 난치성 반복각막미란환자의 재발을 예방하는 효과적인 치료법임을 알 수 있었다.
Abstract
Purpose: The purpose of this study is to evaluate the efficacy of the combined treatment of anterior stromal puncture with the concurrent use of 5% NaCl eye drops for 6 months for recurrent corneal erosion syndrome. Methods: A retrospective chart review was conducted for 21 patients (21 eyes) who underwent the combined treatment of anterior stromal puncture with 5% NaCl eye drops qid for 6 months to treat recurrent corneal erosion syndromes. The patients’ age, gender, history of corneal trauma, history of ocular surgery, recurrence rate, need for additional treatments after recurrence and complication were analyzed. Results: The mean age was 42.05 ± 13.83 years (19-68 years) with no significant difference in gender, and the mean follow up period was 8.48 ± 2.76 months (6-15 months). Among the 21 eyes 14 eyes (66.7%) had a previous history of corneal trauma, 2 eyes (9.52%) had previous refractive surgery, 1 eye (4.8%) had corneal dystrophy, 2 eyes (9.5%) had diabetic mellitus and 5 eyes (28.81%) had an unknown origin. Furthermore, 3 eyes (14.3%) developed recurrences and 2 eyes were resolved with conservative treatment while 1 eye needed additional anterior stroma puncture. There was no recurrence after retreatment with anterior stroma puncture. No significant complications such as infection or inflammation developed with the exception of corneal opacity in which one patient developed glare due to corneal opacity. Conclusions: The combined treatment of anterior stromal puncture with 5% NaCl eye drops for a prolonged time might be effective at preventing the recurrence of refractory recurrent corneal erosion syndrome with conservative treatments.
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