원발성군날개 수술 후 베바시주맙 결막하 주사의 효과
The Effect of Subconjunctival Bevacizumab Injection after Primary Pterygium Surgery
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목적: 원발성군날개 수술 직후 bevacizumab 결막하 주사를 시행하여 그 효과 및 안전성에 대해 평가하고자 한다. 대상과 방법: 2010년 10월부터 2011년 6월까지 원발성군날개 환자 54명 54안을 대상으로 공막노출법을 이용한 군날개절제술을 시행하고, Bevacizumab군(27명 27안)에서는 bevacizumab 5 mg (0.2 ml)을, 대조군(27명 27안)에서는 평형염액 0.2 ml를 수술 직후 결막하주사하였다. 수술 후 6개월 동안 경과 관찰하여 두 군에서 섬유혈관조직의 증식 정도, 군날개의 재발률 및 상처회복 정도를 전향적으로비교, 분석하였다. 결과: Bevacizumab군에서 수술 후 1개월까지 섬유혈관조직의 증식이 대조군에 비해 억제되는 양상을 보였으나(p=0.028), 술 후 3개월부터는 차이가 없었으며 군날개의 재발률 및 수술 후 상처회복 양상도 두 군 모두 동일하였다. 결론: 군날개 수술 직후 bevacizumab 결막하 주사는 약 1개월간 섬유혈관조직의 증식을 억제하는 효과가 있었으며, 수술 후 상처회복에도 안전하여 수술 후의 보조요법으로 잠재력이 있다고 생각한다.
Abstract
Purpose: To evaluate the effect and safety of subconjunctival bevacizumab injection immediately after primary pterygium surgery. Methods: From October 2010 to June 2011, 54 patients (54 eyes) with primary pterygium who had received pterygium excision with the bare sclera technique were evaluated. Twenty-seven patients (27 eyes) in the bevacizumab group received a subconjunctival injection of 5 mg (0.2 ml) bevacizumab and 27 patients (27 eyes) in the control group received a subconjunctival injection of 0.2 ml balanced salt solution immediately after surgery. At the 6-month follow-up, the degree of fibrovascular tissue proliferation, the recurrence rate of pterygium and the effect of wound healing were analyzed prospectively. Results: One month after the surgery, the degree of fibrovascular tissue proliferation was inhibited in the bevacizumab group compared to the control group (p = 0.028). However, 3 to 6 months after surgery, there was no significant difference between the 2 groups. In addition, there was no significant difference between the 2 groups in the recurrence rate of pterygium and wound healing after surgery. Conclusions: Subconjunctival bevacizumab injection after primary pterygium surgery inhibited the degree of fibrovascular tissue proliferation for 1 month and safe for wound healing. Subconjunctival bevacizumab injection has the potential for adjunctive therapy after pterygium surgery.
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