정상인과 퇴행성 아래 눈꺼풀 속말림 및 눈물 흘림 환자에서 안쪽, 가쪽 눈구석 인대 이완의 측정
Medial and Lateral Canthal Tendon Laxity: An Evaluation of Patients with Involutional Entropion and Epiphora
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목적: 정상인 아래 눈꺼풀의 안쪽, 가쪽 눈구석 인대 이완을 성별, 연령별로 알아보고 퇴행성 아래 눈꺼풀 속말림 및 눈물 흘림 환자와비교하였다대상과 방법: 정상 180명 360안과 퇴행성 아래 눈꺼풀 속말림 환자 12명 15안, 눈물 흘림 환자 41명 58안의 아래 눈꺼풀의 안쪽, 가쪽눈구석 인대 이완을 가쪽, 안쪽 당김 검사로 아래 눈물점의 위치에 따른 등급으로 측정하였다. 결과: 눈구석 인대 이완 평균은 각각 1.83/1.08로 성별에 따른 차이는 없고 연령이 증가함에 따라 증가하였다. 퇴행성 아래 눈꺼풀속말림 환자 평균 2.78/2.18, 눈물 흘림 환자 평균 2.28/1.22이었으며, 환자군에서 코경유눈물주머니코안연결술(D), 가쪽눈꺼풀판띠고정술(T), 안쪽방추형결막절제술(M)을 시행하였고 술 전 인대 이완 평균은 D군 1.84/1.04, M군 3.00/1.20, D+T군 2.33/2.00, D+M군3.20/1.40, D+T+M군 3.50/2.00이었다. 고찰: 이번 연구를 통해 퇴행성 아래 눈꺼풀 속말림 환자 및 눈물 흘림 환자의 치료 방법 선택 시 고려해야 할 안쪽, 가쪽 눈구석 인대이완 정도의 지표로 삼을 수 있을 것이다.
Abstract
Purpose: The degree of laxity of the medial and lateral canthal tendon in Korean subjects with and without involutional entropion and epiphora was evaluated in the present study. Methods: The present study included 180 normal subjects (360 eyes), 12 patients (15 eyes) with involutional entropion,and 41 patients (58 eyes) with epiphora. The degree of laxity of the medial and lateral canthal tendon, which grades the position of the inferior punctum, was measured using the lateral and medial distraction test. Results: The mean degree of medial and lateral canthal tendon laxity was 1.83/1.08 in normal subjects. A statistical difference was not observed between sexes, and the mean degree of laxity tended to be higher in older patients. The mean degree of laxity was 2.78/2.18 and 2.28/1.22 in the involutional entropion group and the epiphora group, respectively. The involutional entropion group and the epiphora group underwent endoscopic endonasal dacryocystitis (D), medial spindle procedure (M), and endoscopic endonasal dacryocystitis with the medial spindle procedure and/or the tarsal strip procedure (T). The mean degree of laxity was 1.84/1.04 in group D, 3.00/1.20 in group M, 2.33/2.00 in group D + T, 3.20/1.40 in group D + M and 3.50/2.00 in group D + T + M before surgery. Conclusions: The results from the present study may aid in the selection of a basic treatment plan for Korean patients with involutional entropion or epiphora.
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