초음파유화술 중 각막의 건조를 막기 위한 점탄물질도포와 평형염용액 관류의 비교
Comparison of Balanced Salt Solution and Ophthalmic Viscosurgical Device to Maintain Optical Clarity During Phacoemulsification
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목적: 백내장 수술 시 각막표면의 수화를 위해 평형염용액의 관류 대신 점탄물질을 도포하여 수술 결과에 미치는 영향을 비교 분석하고자 한다. 대상과 방법: 백내장 환자를 무작위 배정을 통해 평형염용액군과 점탄물질 도포군으로 분류하여 백내장 수술을 시행하였다. 술 중 인자(VAS 통증 척도, 점상 각막상피 미란 유무), 술 후 인자(시력, 각막 내피세포 수, 중심각막두께 및 각막 세포 부피 변화, Oxford staining score)를 조사하여 두 군간의 차이를 비교하였다. 결과: 평형염용액을 사용한 군은 22안, 점탄물질을 사용한 군은 33안을 대상으로 하였다. 환자의 분포와 술 전 인자들에서 두 군간의차이는 없었다. 술 중 인자 중에서 점상 각막상피 미란이 평형염용액군에서 22안 중 6안(27.2%), 점탄물질군에서 33안 중 2안(6%)으로점탄물질을 사용한 군에서 유의하게 적은 빈도를 보였다(p=0.045). VAS 통증 척도 및 술 후 인자에서 양군의 차이는 없었다. 결론: 백내장 수술 시 각막 표면의 수화를 위해 평형염용액을 사용하는 대신 점탄물질을 각막 표면에 도포하여 시행하는 방법은 추가적인 재료나 비용이 없으며 수술 시야의 방해와 안구 표면의 물리적 손상을 줄여준다.
Abstract
Purpose: To compare the corneal wetting properties of balanced salt solution (BSS) and ophthalmic viscosurgical device (OVD) during cataract surgery. Methods: The patients with senile cataract were randomly assigned to receive either BSS or viscous dispersive OVD for maintaining optical clarity during phacoemulsification. Intraoperative factors (VAS pain score, occurrence of corneal punctate epithelial erosions (PEE)) and postoperative factors (visual acuity, Oxford staining score, changes in endothelial cell counts, corneal thickness and volume) were compared. Results: Twenty-two eyes were assigned to the BSS group and; 33 eyes were assigned to the OVD group. There were no significant differences in demographic variable between the 2 groups. Intraoperative PEE was observed in 6 eyes in the BSS group and in 2 eyes in the OVD group. The incidence of PEE in the OVD group was significantly lower than in the BSS group (p = 0.045). There were no significant differences in other parameters (VAS pain score, postoperative factors). Conclusions: Corneal wetting with OVD (DiscoviscⓇ) provides better surgical view and reduces mechanical damage to the corneal surface without additional material or cost than BSS.
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