익상편 수술에서 변형된 결막소판술 후 재발
Recurrence after Modified Mini-Flap Technique for Pterygium Surgery
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목적: 익상편 수술에서 기존에 알려져 있던 결막소판술과 새로이 시행된 변형된 결막소판술 후 임상 결과를 비교 분석하고자 한다. 대상과 방법: 2004년 1월부터 2005년 8월까지 결막소판술을 시행받은 39안과 2008년 9월부터 2010년 12월까지 변형된 결막소판술을시행받은 142안을 대상으로 후향적으로 분석하였다. 수술방법에 따른 재발률과 재발한 군과 재발하지 않은 군의 차이점에 대해서도비교하였다. 결과: 기존의 결막소판술로 수술받은 익상편환자의 재발률은 10.3% (4/39)였다. 변형된 결막소판술의 재발률은 2.1 (3/142)%로 의미있게 낮았으나(p=0.040), 2008년 보고하였던 재발률 6.1% (3/49)와 비교하였을 때는 통계적으로 유의한 차이를 보이지 않았다(p=0.165). 수술방법에 따른 환자군의 나이 및 성별을 재발된 군과 재발되지 않은 군에서 비교해 본 결과, 변형된 결막소판술을 시행받은 환자 중 재발된 군에서 젊은 연령을 보였다(p<0.001). 결론: 새로이 시행된 변형된 결막소판술은 기존의 결막소판술만큼 안전하며 재발률이 낮은 수술방법이며, 원발성 익상편뿐만 아니라재발성 익상편에서의 수술적 방법으로 고려할 수 있는 술식이다.
Abstract
Purpose: To compare and analyze the clinical outcomes after the traditional mini-flap technique and a new modified mini-flap technique for pterygium surgery. Methods: This is a retrospective, clinical outcome study of 39 eyes that received the existing mini-flap technique from January, 2004 to August, 2005, and 142 eyes that received the modified mini-flap technique from September, 2008 to December, 2010. We analyzed the recurrence rate of each mini-flap technique and the difference between the group that experienced recurrence and the group that did not. We also analyzed the difference between the group that received the mini-flap technique and the group that received the modified mini-flap technique. Results: The recurrence rate of pterygium patients who received the mini-flap technique was 10.3% (4/39). The rate of those who received the modified mini-flap technique was 2.1% (3/142), which is statistically lower (p = 0.040). However,compared from the recurrence rate of 6.1% (3/49) that was reported in 2008, the recurrence rate of the modified mini-flap technique did not show any statistical significance (p = 0.165). From the comparison of demographic factors of the patients in each surgical technique group, in both recurred and not recurred group, the patient group in the modified mini-flap technique group whose pterygium was recurrd was the youngest (p < 0.001). Conclusions: The newly applied modified mini-flap technique is not only a safe method with low recurrence rate compared to the traditional mini-flap technique, but also a reliable surgical technique in both primary and recurred pterygium.
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