소아백내장 수술 후 녹내장 빈도 및 위험 인자
Glaucoma Following Pediatric Cataract Surgery: Incidence and Risk Factors
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목적: 소아백내장 수술 후 녹내장 발생률 및 영향을 주는 인자에 대해 알아보고자 한다. 대상과 방법: 1998년 6월부터 2009년 12월까지 소아백내장으로 본원에서 수술 받은 173안을 대상으로 후향적으로 의무기록을 검토하여 술후 녹내장의 발생률과 영향을 줄 수 있는 인자에 대해 조사하였다. 인자들로는 성별, 양안유무, 진단 시 나이, 수술 시 나이, 백내장 형태, 수술방법 차이, 인공 수정체 삽입유무 및 삽입위치, 인공수정체 포획, 안축장의 길이, 각막곡률 측정치, 추적 관찰기간 등이다. 결과: 녹내장 발생률은 8.6%이며 남녀 차이, 단안 양안 차이, 진단 시 나이, 안축장 길이, 각막곡률 측정치에 따른 녹내장 발생률의차이는 통계적으로 유의하지 않았다(p＞0.05). 하지만 무수정체 안에서, 수술 시 나이가 어릴수록, 인공수정체 포획을 하지 않은 경우,평면부 수정체 절제술, 공막고랑에 인공수정체 삽입한 경우, 핵백내장에서 술후 녹내장의 발생이 유의하게 증가하였다(p＜0.05). 결론: 소아 백내장에서 술후 시력에 상당한 영향을 줄 수 있는 녹내장 발생의 위험인자를 가진 경우 의료진이 인지하여 주기적이고철저한 검사가 필요할 것이다.
Abstract
Purpose: To evaluate the incidence and risk factors of glaucoma after pediatric cataract surgery. Methods: We retrospectively reviewed 173 eyes which underwent pediatric cataract surgery from June 1998 to December 2009. The following parameters were ascertained: sex, laterality of cataract, age at diagnosis, age at surgery, cataract type, operation methods, optic capture, axial length (AXL), keratometry, follow-up period, and association of general abnormality. Results: Out of the 173 eyes reviewed, 8.6% were diagnosed with glaucoma. The factors not significantly different in the glaucoma group compared to the non-glaucoma group were sex, laterality of cataract, age at diagnosis, AXL, and keratometry (p > 0.05). The incidence of glaucoma was significantly higher in the aphakic group compared to the pseudophakic group. Young age at surgery, no optic capture, pars plana lensectomy, sulcus IOL implantation, and nuclear type cataract were significantly associated with increased risk of postoperative glaucoma (p < 0.05). Conclusions: Patients with several predictors of postoperative glaucoma which may affect visual acuity may require extensive postoperative care after pediatric cataract surgery.
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