단순열공망막박리에서 눈속공기충전을 이용한 23게이지 경결막무봉합 일차유리체절제술의 임상결과
Primary 23 Gauge Transconjunctival Sutureless Vitrectomy With Air Tamponade for Simple Rhegmatogenous Retinal Detachment
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목적: 단순열공망막박리 환자에서 눈속공기충전을 이용한 23게이지 경결막 무봉합 일차유리체절제술의 임상결과를 알아보고자 하였다. 대상과 방법: 2009년 9월부터 2010년 3월까지 본원에서 단순열공망막박리로 23게이지 경결막 무봉합 유리체절제술 및 눈속공기충전술 을 시행받은 환자들 중, 수술 후 3개월 이상 추적관찰이 가능하였던 38명 38안을 대상으로 후향적으로 조사하였다. 결과: 38안 중 2안에서 망막박리가 재발하여 일차수술성공률은 94.7%이었다. 평균 logMAR 최대교정시력은 수술 전 0.81 ± 0.13에서 수술 후 3개월에 0.48 ± 0.37로 통계적으로 유의한 시력의 호전을 보였다(p＜0.05). 눈속공기는 수술 후 1주일에 평균 21.3% 남아 있었으며, 2주째에는 모두 흡수되었다. 합병증은 수술 종료 시 공막절개창누출 1안, 백내장 3안, 유리체출혈 1안, 망막전막 2안 및 안압 상승 3안이 있었다. 결론: 단순열공망막박리 환자에서 눈속공기충전을 이용한 23게이지 경결막 무봉합 일차유리체절제술은 수술 후 일상생활로의 빠른 복귀를 가능하게 하면서 성공적인 망막유착을 유도할 수 있는 효과적인 수술방법이 될 수 있다.
Abstract
Purpose: To evaluate the surgical outcomes of primary 23-gauge (23G) transconjunctival sutureless vitrectomy (TSV) with air tamponade in patients with idiopathic simple rhegmatogenous retinal detachment (RRD). Methods: A chart review of 38 eyes with idiopathic simple RRD which underwent primary 23G TSV with air tamponade and without prone positioning by a single vitreoretinal surgeon was retrospectively performed. All cases were followed up for a minimum of 3 months after the operation. Results: The primary anatomical success rate was 94.7% (36/38 eyes). Preoperative mean logMAR (Snellen) best corrected visual acuity (BCVA) was 0.81 ± 0.13 and improved to 0.63 ± 0.37 and 0.48 ± 0.37 at postoperative 1 week and 3 months (p < 0.05), respectively. The mean 21.35% amount of air bubble remained in the vitreous cavity at postoperative 1 week and the residual air bubble was completely absorbed at postoperative 2 weeks. Complications were sclerotomy site leakage (1 eye), cataract (3 eyes), vitreous hemorrhage (1 eye), epiretinal membrane (2 eyes) and increased intraocular pressure (3 eyes). Conclusions: The use of 23G TSV with air tamponade in cases with idiopathic simple RRD may be an effective and safe surgical technique.
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