양막 콘텍트렌즈의 임상적 효용성
Clinical Benefits of Amniotic Membrane Contact Lens
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목적: MS-Amnion 양막 콘택트렌즈의 임상적 효용성에 대해 알아보고자 하였다. 대상과 방법: 비수술적 치료에 반응하지 않는 심한 점상각막염 또는 각막상피결손 환자를 대상으로 MS-Amnion 양막 콘텍트렌즈를1주일 동안 착용하였다. 3개월 이상 경과 관찰한 18안을 대상으로 시술 전과 시술 후 시력, 눈물막파괴시간, 각막지각과 각막혼탁정도를 비교하였으며, 경과 관찰 기간 중 치료 성공률 및 병변 재발률과 기타 합병증에 대해 분석하였다. 결과: 18안 중 15안(83.3%)은 2주 이내에 병변이 호전되어 추가 양막 치료 없이 회복하였고, 3안(16.7%)은 치료 이후에도 병변이 지속되어 추가적인 양막이식술을 하였다. 회복되었던 15안 중 3안(20%)은 기존 병변이 재발하였다. 양막 콘택트렌즈 착용 기간 동안 5안(27.8%)은 양막이 저절로 탈락했고, 2안(11.1%)은 반으로 접혀 있었다. 최대교정시력은 시술 전 평균 0.89 logarithm of the minimal angle of resolution (logMAR)에서 3개월 후 0.27 logMAR로 호전되었고, 각막혼탁 정도는 시술 전 평균 0.38에서 3개월 후 0.11로감소하였으며 두 수치는 통계적으로 유의한 차이를 보였다. 눈물막파괴시간과 각막지각은 호전되는 양상을 보였으나 통계적으로 유의한 차이는 없었고, 특별한 합병증은 발견되지 않았다. 결론: MS-Amnion 양막 콘택트렌즈는 봉합사를 이용한 일시적 양막이식술과 달리 외래에서 간편하게 적용할 수 있는 장점이 있고, 난치성 안구 표면 질환을 치료하는 데 있어 일시적 양막이식술을 대체할 수 있는 효과적인 방법이 될 수 있을 것이라 기대된다.
Abstract
Purpose: To investigate the clinical efficacy of MS-Amnion amniotic membrane contact lenses. Methods: MS-Amnion amniotic membrane contact lenses were placed for 1 week in patients with severe superficial punctate keratitis or corneal epithelial defects that did not respond to medical treatment. Eighteen eyes followed-up for ≥3 months were evaluated in terms of the best-corrected visual acuity, tear break-up time, and corneal sensation and opacity before and after application of the MS-Amnion amniotic membrane contact lens. The success and recurrence rates, and complications during follow- up, were recorded. Results: Out of 18 eyes, 15 (83.3%) healed within 2 weeks without any treatment other than the amniotic membrane; three eyes (16.7%) were unresponsive, and thus underwent temporary amniotic membrane transplantation. Recurrence developed in three eyes (20%). The amniotic membrane contact lens dropped out in five eyes (27.8%) and folded over in two (11.1%). The mean best-corrected visual acuity improved from 0.89 to 0.27 logarithm of the minimal angle of resolution after 3 months, while the mean corneal opacity decreased from 0.38 to 0.11 after 3 months; the changes were statistically significant. The tear break-up time and corneal sensation also improved, but they were not statistically significant. We encountered no significant complications. Conclusions: The MS-Amnion amniotic membrane contact lenses can heal the amniotic membrane and do not require suturing when applied in the outpatient clinic. This may be beneficial for patients with intractable ocular surface disorders.
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