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전안부 빛간섭 단층촬영을 이용해 측정한 결막이완증 수술 전후의 결막 및 눈물띠 면적 변화

Changes in Area of Conjunctiva and Tear Meniscus Measured Using Anterior Segment Optical Coherence Tomography after Conjunctivochalasis Surgery

서장원|박우찬|배정범|김종수
대한안과학회 (The Korean Ophthalmological Society)|2015.04|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제56권 제4호|pp. 509-514|DOI http://dx.doi.org/10.3341/jkos.2015.56.4.509

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참고문헌

키워드

Anterior segment optical coherence tomographyConjunctivochalasisAmniotic membrane transplantationTear meniscus
주제분류안과학

초록

목적: Fourier-Domain RTVue-100 전안부 빛간섭 단층촬영을 이용해 결막이완증 수술 전과 후의 결막 면적 및 눈물띠 면적을 측정하여 그 결과를 비교, 분석하고자 하였다. 대상과 방법: 2013년 6월부터 2014년 4월까지 결막이완증 환자 31명 33안을 대상으로 결막이완증 절제술 및 양막이식술을 시행하였다. 수술 전과 수술 후 3개월 경에 RTVue-100 전안부 빛간섭 단층촬영을 시행하였고, 세극등 현미경 검사를 통해 눈물막 파괴시간을측정하였다. 전안부 빛간섭 단층촬영은 중심부(1곳), 비측(3곳), 이측(3곳)에서 시행하여 결막과 눈물띠의 단면적을 측정하였다. 결과: 총 대상자의 평균 나이는 65.8 ± 9.8세였다. 평균 결막의 단면적은 수술 전 0.487 ± 0.42 mm2에서 수술 후 0.007 ± 0.011 mm2(p＜0.001)로 감소하였으며, 모든 방향에서 수술 후에 의미 있는 감소를 보였다(p＜0.05). 수술 전과 후의 눈물띠의 단면적은 통계적으로차이가 없었으며, 눈물막 파괴 시간은 수술 전 2.26 ± 0.69초에서 수술 후 3개월째에 3.81 ± 1.22초로 증가하였다(p＜0.05). 결론: 결막이완증에서 전안부 빛간섭 단층촬영을 이용하여 술 전과 술 후 비교 시 결막의 면적은 효과적으로 감소하였으나 눈물면적에는 유의한 차이가 없었다.

Abstract

Purpose: To evaluate cross-sectional areas of conjunctiva and tear meniscus of conjunctivochalasis using Fourier-DomainRTVue-100 optical coherence tomography (OCT) before and after conjunctivochalasis surgery. Methods: Thirty-one patients (33 eyes) with symptomatic conjunctivochalasis were recruited for this study between June 2013and April 2014. All patients underwent crescent-shaped conjunctiva resection and amniotic membrane transplantation. Anteriorsegment OCT (AS-OCT) imaging was performed and tear break-up time was evaluated prior to and 3 months after the conjunctivochalasissurgery. Cross-sectional areas of conjunctiva and tear meniscus of conjunctivochalasis at 7 locations (1 center,3 nasal and 3 temporal areas) were measured in all patients. Results: The mean age of patients was 66.3 ± 10.8 years. Cross-sectional areas of conjunctivochalasis at all locations significantlydecreased from 0.487 ± 0.42 mm2 to 0.007 ± 0.011 mm2 (p < 0.001), whereas no significant changes in cross-sectionalareas of tear meniscus at all 7 locations were observed after the surgery. Mean tear break-up time significantly increased from2.26 ± 0.69 sec to 3.81 ± 1.22 sec following the surgery. Conclusions: Using AS-OCT, in this study we showed that areas of conjunctiva decreased and areas of tear meniscus were unchangedafter conjunctivochalasis surgery.

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