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24개월 이상 선천 코눈물관막힘 환아의 단계적탐침술을 동반한 단, 상하누소관 실리콘관 효과

Monocanalicular and Bicanalicular Intubation with Sequential Probing for Congenital Nasolacrimal Duct Obstruction in Patients Over the Age of 24 Months

이태수|장민욱|이화|백세현|염지현
대한안과학회 (The Korean Ophthalmological Society)|2013.11|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제54권 제11호|pp. 1635-1640

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키워드

Congenital nasolacrimal duct obstructionBicanalicular intubationMonocanalicular intubationSequential probing
주제분류안과학

초록

목적: 24개월 이상 선천 코눈물관막힘 환아에서 단계적 탐침술을 이용한 단누소관 실리콘관 삽입술과 상하누소관 실리콘관 삽입술의임상효과를 알아보고자 하였다. 대상과 방법: 선천 코눈물관막힘으로 진단 받은 24개월 이상 환아 중 단계적 탐침술 시행 후 아래 눈물점에 단누소관 실리콘관 삽입술을시행 받은 군 19명 20안과 상하누소관 실리콘관 삽입술을 시행 받은 군 22명 22안을 나누어 수술 성공률 및 합병증 등을 비교하였다. 실리콘관은 술 후 6개월에 제거하였고 성공은 유루증상 및 형광 색소 소실 검사상 저류가 없는 것으로 하였다. 결과: 단계적 탐침술 후 단누소관을 삽입한 군은 95.0% (19안/20안)의 성공률을 보였으며 7안에서 실리콘관이 조기 소실되었으나 모두성공하였고 다른 합병증은 관찰되지 않았다. 상하누소관에 삽입한 군은 82.6% (19안/22안)의 성공률을 보였고 누점 열창이 4안, 관의돌출이 3안에서 관찰되었다. 두 군간의 성공률은 유의한 차이가 없었고(p=0.608) 합병증도 유의한 차이가 없었다(p=1.000). 결론: 24개월 이상의 선천 코눈물관막힘 환아에서 단계적 탐침술을 이용한 단누소관 실리콘관 삽입술과 상하누소관 삽입술의 성공률과합병증은 유의한 차이가 없었다. 실리콘관은 단누소관에서는 2개월 상하누소관에서는 3개월 정도 유지해도 좋을 것으로 생각한다.

Abstract

Purpose: The clinical effectiveness of monocanalicular or bicanalicular intubation with sequential probing was evaluated in patients over the age of 24 months with congenital nasolacrimal duct obstruction. Methods: Patients over 24 months of age with congenital nasolacrimal duct obstruction who underwent monocanalicular intubation with sequential probing (19 patients, 20 eyes) or bicanalicular intubation with sequential probing (22 patients, 22eyes) were studied. Success rates and complications were evaluated. Silicone tube was removed 6 months after surgery. Success was defined as no epiphora and no retention on fluorescein dye disappearance test. Results: The success rate was 95.0% (19 eyes / 20 eyes) in the monocanalicular intubation group and complications included 7 cases of early tube dislodgement, which achieved successful outcome. The success rate was 82.6% (19 eyes /22 eyes) in the bicanalicular intubation group and complications included 4 cases of punctal slitting, and 3 cases of tube extrusion. The success and complication rates were not significantly different between the 2 groups (p = 0.608, p = 1.000,respectively). Conclusions: In congenital nasolacrimal duct obstruction, the monocanalicular tube intubation group had similar success and complication rates to the bicanalicular tube intubation group. Silicone tube maintenance for 2 months in the monocanalicular group and for 3 months in the bicanalicular group was sufficient.

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