비측 투명각막절개를 이용한 백내장수술의 임상결과: 안전성과 효용성
Clinical Outcomes of Cataract Surgery Using Nasal Clear Corneal Incision: Safety and Efficacy
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목적: 한국인에서 비측 투명각막절개 백내장수술의 안전성과 효용성을 상측 또는 이측 투명각막절개 백내장수술과 비교하여 평가하였다. 대상과 방법: 투명각막절개 백내장수술을 받은 환자들을 대상으로 연구를 시행하였다. 환자들은 투명각막절개의 방향에 따라 비측(그룹1), 상측(그룹2), 이측(그룹3)의 3 그룹으로 나누었다. 수술의 효용성을 평가하기 위해서 수술유발난시, 교정시력, 안압, 각막곡률치(keratometry reading), 굴절이상을 수술 전과 수술 후 3달 뒤에 시행하여 비교하였고, 수술 소요 시간을 각 군별로 평가하였다. 안전성을 평가하기 위해, 수술 중의 합병증 발생 여부 및 수술 시간과 술 후 창상의 안정성을 비교하였다. 결과: 전체 1,374안이 포함되었고, 그중 그룹 1은 283안, 그룹 2는 587안, 그룹 3은 504안이 포함되었다. 세 그룹 사이에서 수술유발난시는 유의한 차이가 없었다. 수술 후의 평균 교정시력, 안압, 각막곡률치, 구면렌즈대응치, 수술 시간 또한 세 그룹 간에 유의한 차이가 없었다(14.04 ± 3.79 vs. 13.80 ± 3.27 vs. 13.80 ± 3.70; p=0.473). 수술 중 합병증 발생률이나 각막 창상의 봉합률은 세 그룹 간에 차이가 없었다(1.7% vs. 3.2% vs. 2.3%; p=0.378). 결론: 비측 투명각막절개 백내장수술의 안전성과 효용성은 이측이나 상측 투명각막절개 수술과 차이를 보이지 않았다. 본 연구의 결과는 한국인에서 비측 투명각막절개를 이용하여 백내장수술을 안전하게 시행할 수 있음을 보여주었다.
Abstract
Purpose: To compare the safety and efficacy of cataract surgery using nasal clear corneal incision (CCI) versus superior or temporal CCIs in Korean patients. Methods: A retrospective comparative study was conducted. Patients underwent cataract surgery using CCI performed by 3 surgeons between January 2012 and December 2013.The patients were divided into the following 3 groups based on CCI direction: nasal CCIs (group I), superior CCIs (Group II), and temporal CCIs (Group III). To assess usability, surgically induced astigmatism (SIA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), keratometry reading, and refractive errors at baseline and 1 month after surgery were compared. Operation times were compared between groups. To assess safety, intraoperative complications and wound stability were compared. Results: A total of 1,374 eyes (Group I, 283 eyes; Group II, 587 eyes; Group III, 504 eyes) were included in the present study. The SIA was not significantly different among the 3 groups. The postoperative mean BCVA, IOP, keratometry reading and spherical equivalent as well as the mean operation times were not significantly different between the 3 groups (14.04 ± 3.79 vs. 13.80 ± 3.27 vs. 13.80 ± 3.70; p = 0.473). The rate of intraocular complications and incidence of corneal wound suture were not significantly different between the 3 groups (1.7% vs. 3.2% vs. 2.3%; p = 0.378). Conclusions: The safety and efficacy of cataract surgery using nasal CCI were not significantly different compared with the use of temporal or superior CCI. Our results showed that cataract surgery using nasal CCI can be performed safely and conveniently in Korean patients.
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