한국인의 특발성 망막앞막에서 투명각막절개 초음파유화술과 유리체절제술의 병합 및 연속수술
Combined Clear Corneal Phacoemulsification and Vitrectomy Versus Two-Step Surgery in Korean Patients With Idiopathic Epiretinal Membrane
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목적: 한국인의 특발성 망막앞막에서 수정체초음파유화술및 인공수정체삽입술과 유리체절제술의 병합수술을 시행하고 그 임상결과에 대해 연속수술과 비교하여 보고하고자 한다. 대상과 방법: 특발성 망막앞막으로 수정체초음파유화술, 인공수정체삽입술 및 유리체절제술의 병합수술을 받은 19명 20안, 유리체절제 술 후 초음파유화술 및 인공수정체삽입술을 받은 18명 18안을 대상으로 의무기록을 후향적으로 조사하여 두 군의 수술 후 경과 및 합병증에 대해 비교 분석하였다. 결과: 술후 최대교정시력(logMAR)은 병합수술 군에서 0.41 ± 0.42, 연속수술군에서 0.35 ± 0.37로 유의한 차이는 없었고(p=0.675), 술 후 굴절예측이상값은 병합수술 군에서 -0.46 ± 0.88D, 연속수술군에서 -0.06 ± 0.68D로 두 군간의 차이는 유의하지 않았다(p=0.147). 합병증 발생은 술중 경미한 각막부종, 술후 안압상승의 발생, 그리고 수정체낭혼탁이 두 군에서 비슷한 빈도로 나타났다. 결론: 초음파수정체유화술 및 인공수정체삽입술과 유리체절제술의 병합수술은 연속수술과 마찬가지로 효과적이고 안전한 수술이며 특 발성 망막앞막과 백내장이 동반된 환자에서 추천되는 방법이다.
Abstract
Purpose: To evaluate the surgical outcomes on the combined procedures of phacoemulsification, intraocular lens (IOL) implantation, and vitrectomy, and to compare clinical results with sequential surgery results in Korean patients with idiopathic epiretinal membrane. Methods: The present retrospective study included 20 eyes of 19 patients with idiopathic epiretinal membrane who underwent combined phacoemulsification, IOL implantation, and pars plana vitrectomy (combined surgery), and 18 eyes of 18 patients who underwent phacoemulsification and IOL implantation subsequent to vitrectomy (sequential surgery). Postoperative clinical results and intra- and postoperative complications were compared between the 2 groups. Results: Postoperative best corrected visual acuity (BCVA) (logMAR) was 0.41 ± 0.42 in the combined group, and 0.35 ± 0.37 in the sequential group. There was no significant difference in BCVA between the 2 groups (p = 0.675). The mean refractive prediction error was -0.46 ± 0.88 diopters (D) in the combined group, and -0.06 ± 0.68 D in the sequential group, showing no statistically significant difference between the 2 groups (p = 0.147). The present study showed no major differences between the 2 groups in complications such as intraoperative mild corneal edema, postoperative ocular hypertension, and lens capsular opacity. Conclusions: Combined phacoemulsification, IOL implantation, and pars plana vitrectomy as well as the two-step procedure are safe and effective for treating patients with idiopathic epiretinal membrane.
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