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경도의 안구건조증 환자에서 굴절교정수술 전후 0.05% 사이클로스포린 사용의 효과

Efficacy of Topical Cyclosporine in Mild Dry Eye Patients Having Refractive Surgery

김홍균|강건욱
대한안과학회 (The Korean Ophthalmological Society)|2014.12|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제55권 제12호|pp. 1752-1757

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키워드

CyclosporineDry eye syndromeLASIKRefractive surgery
주제분류안과학

초록

목적: 경도의 안구건조증 환자를 대상으로 0.05% 사이클로스포린 점안액을 굴절교정수술 2주 전부터 수술 후 8주까지 총 10주간사용하고 임상적 효과를 알아보고자 하였다. 대상과 방법: 본 연구는 무작위 전향적 임상연구로서, 경도의 안구건조증으로 진단된 40명의 라식(Laser in situ keratomileusis) 수술예정인 환자를 각각 시험군과 대조군으로 무작위 배정하였다. 시험군은 무방무제 인공누액과 0.05% 사이클로스포린 점안액을 수술2주 전부터 술 후 8주간 사용하고, 대조군은 무방부제 인공누액만 사용하였다. 술 전, 술 후 1, 4, 8주에 Ocular surface diseaseindex (OSDI), 눈물막 파괴시간, Oxford Stain Score (OSS), 눈물액 삼투압을 측정하였다. 결과: 라식 수술환자에서 눈물막 파괴시간이 술 후 1주와 4주에서 사이클로스포린을 사용하였던 시험군에서 유의하게 길었다(p=0.024, p=0.036). 술 후 1주에 시험군에서 눈물액삼투압이 대조군에 비해 유의하게 낮게 측정되었다(p=0.004). 결론: 경도의 안구건조증 환자에게 굴절교정수술 전후에 10주간 0.05% 사이클로스포린 점안액을 사용하는 것은 수술 후 안구건조증의 악화를 예방하는 좋은 방법이다.

Abstract

Purpose: To evaluate the efficacy of pre- and post-operative use of topical 0.05% cyclosporine A (CsA) in mild dry eye patientshaving refractive surgery. Methods: This randomized prospective study included 40 patients with mild dry eye syndrome who were scheduled for laser insitu keratomileusis (LASIK). All patients were divided into 2 groups. Patients in the CsA group used both 0.1% sodium hyaluronate(HA) and 0.05% CsA from 2 weeks before to 8 weeks after the surgery, while patients in the control group used 0.1% HAonly. Ocular surface disease index (OSDI), tear film break-up time (TF-BUT), Oxford Stain Score (OSS), and tear osmolaritywere evaluated before surgery and 1, 4, and 8 weeks after surgery. Results: TF-BUT was significantly longer in the CsA group at 1 and 4 weeks post-operatively (p = 0.024, p = 0.036) compared tothe control group. Tear osmolarity was significantly lower in the CsA group at 1 week post-operatively (p = 0.004) compared tothe control group. Conclusions: The pre- and post-operative use of topical 0.05% CsA is effective in alleviating dry eye symptom after LASIK in patientswith dry eye syndrome.

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