원발군날개 절제술 후 눈물막의 변화
The Changes in Tear Film after Primary Pterygium Operation
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 원발군날개 절제술 전후 건성안 지표의 변화에 대하여 알아보고자 하였다. 대상과 방법: 원발군날개가 있는 환자에서 한 명의 술자에 의해 군날개 절제술을 시행 받고 3개월째 성공적인 수술결과를 보인 42명,43안을 대상으로 술 전, 술 후의 눈물막의 두께, 눈물막파괴시간, 기본눈물분비량(Schirmer I), 안구표면질환지수(OSDI, Ocular Surface Disease Index)를 조사하였다. 결과: 군날개 절제술을 받은 대상자 43안의 평균 연령은 58.0 ± 11.1세(34-81세)였으며 수술 전 눈물막 두께, 눈물막파괴시간과 기본눈물분비량(Schirmer I)은 각각 21.53 ± 5.93 μm, 4.84 ± 2.21초와 11.67 ± 6.75 mm였다. 수술 전 눈물막 두께는 술 후 3개월째 21.53± 5.93 μm에서 24.23 ± 4.19 μm(p＜0.05)로 눈물막파괴시간은 4.84 ± 2.21초에서 5.81 ± 1.89초(p＜0.05)로 유의한 변화를 보였으나 기본눈물분비량(Schirmer I)은 11.67 ± 6.75 mm에서 13.02 ± 7.54 mm (p=0.094)로 유의한 차이를 보이지 않았다. 주관적인 지표인 안구표면질환지수(OSDI)점수는 술 후 3개월째 호전을 보였다(p=0.015). 결론: 군날개 절제술 시행 후 눈물막의 두께, 눈물막 파괴시간, 그리고 안구표면질환지수(OSDI)가 술 전에 비해 유의한 호전을 보이므로 군날개절제술 후 눈물막의 기능도 부분적으로 회복될 것으로 생각한다.
Abstract
Purpose: In this study we evaluated the changes in tear film after primary pterygium operation in patients with pterygium. Methods: We investigated 43 eyes of 42 subjects who showed successful results 3 months after pterygium operation performed by one surgeon. The changes in tear film thickness, tear break-up time (BUT), Schirmer I test, and ocular surface disease index (OSDI) were evaluated. All values were compared before and after surgery. Results: The mean age was 58.0 ± 11.1 years (34-81 years). Preoperative tear film thickness, tear BUT, and Schirmer I test in eyes which underwent pterygium operation were 21.53 ± 5.93 μm, 4.84 ± 2.21 seconds, and 11.67 ± 6.75 mm,respectively. Three months after the operation, the respective values were 24.23 ± 4.19 μm (p < 0.05), 5.81 ± 1.89 seconds (p < 0.05), and 13.02 ± 7.54 mm (p = 0.094). Tear film thickness and BUT score increased significantly after pterygium operation. There was no statistically significant difference in Schirmer I test, before and 3 months after pterygium operation. The subjective parameter (OSDI) improved 3 months after pterygium operation (p = 0.015). Conclusions: Pterygium operation can partially restore the tear film function into a normal state by improving tear film thickness and tear BUT after pterygium operation.
참고문헌 (23)
- Mutlu FM, "A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin c with conjunctival flap", Ophthalmology, 106, pp.817~821 (1999)
- Ang LP, "Current concepts and techniques in pterygium treatment", Curr Opin Ophthalmol, 18, pp.308~313 (2007)
- Corneo MT, "The pathogenesis of pterygia", Curr Opin Ophthalmol, 10, pp.282~288 (1999)
- Di Girolamo N, "Pathogenesis of pterygia: role of cytokines, growth factor, and matrix metalloproteinase", Prog Retin Eye Res, 23, pp.195~228 (2004)
- Coroneo MT, "Pterygium as an early indicator of ultraviolet insolation: a hypothesis", Br J Opthalmol, 77, pp.734~739 (1993)
- Ergin A, "Study on tear function abnormality in pterygium", Ophthalmologica, 215, pp.204~208 (2001)
- Li M, "Tear function and goblet cell density after pterygium excision", Eye (Lond), 24, pp.224~228 (2007)
- Ischioka M, "Pterygium and dry eye", Ophthalmologica, 215, pp.209~211 (2001)
- Wang S, "Changes of tear film function after pterygium operation", Ophthalmic Res, 45, pp.210~215 (2011)
- 오한진, "검열반과 익상편 환자에서 눈물막과 안구표면의 변화", 대한안과학회지, 47(5), pp.717~724 (2006), 대한안과학회
- Zhuang H, "A novel method for pachymetry mapping of human precorneal tear film using pentacam with fluorescein", Invest Ophthalmol Vis Sci, 51, pp.156~159 (2010)
- Schiffman RM, "Reliability and validity of the Ocular Surface Disease Index", Arch Ophthalmol, 118, pp.615~621 (2000)
- Miller KL, "Minimal clinically important difference for the ocular surface disease index", Arch Ophthalmol, 128, pp.94~101 (2010)
- Goldberg L, "Pterygium and its relationship to the dry eye in the Bantu", Br J Ophthalmol, 60, pp.720~721 (1976)
- Biedner B, "Pterygium and basic tear secretion", Ann Ophthalmol, 11, pp.1235~1236 (1979)
- Kadayifçilar SC, "Tear function in patients with pterygium", Acta Ophthalmol Scand, 76, pp.176~179 (1998)
- Holly FJ, "Physical chemistry of the normal and disordered tear film", Trans Ophthalmol Soc U K, 104(Pt 4), pp.374~380 (1985)
- Marzeta M, "Study of mucin of tear film in patients with pterygium", Klin Oczna, 105, pp.60~62 (2003)
- Nakagami T, "Expression of stem cell factor in pterygium", Jpn J Ophthalmol, 44, pp.193~197 (2000)
- Tseng SC., "Evaluation of the ocular surface in dry-eye conditions", Int Ophthalmol Clin, 34, pp.57~69 (1994)
- Johnson ME, "Changes in the tear film and ocular surface from dry eye syndrome", Prog Retin Eye Res, pp.449~474 (2004)
- Rajiv SM, "Pterygium and dry eye--a clinical correlation", Ind J Ophthalmol, 38, pp.15~16 (1991)
- Marzeta M, "Study of mucin of tear film in patients with pterygium", Klin Oczna, 105, pp.60~62 (2003)