인공수정체 망막박리에서 기체망막유착술의 결과
A Result of Pneumatic Retinopexy for Pseudophakic Retinal Detachment
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목적: 인공수정체 망막박리에서 기체망막유착술을 시행하는 경우 성공률이 37-67%로 보고된 바 있고, 국내 결과에 대해 분석하여 인공수정체 망막박리에서 기체망막유착술의 유용성에 대해 보고하고자 한다. 대상과 방법: 2003년 1월부터 2011년 12월까지 인공수정체 망막박리가 발생하여 SF6 가스를 이용하여 기체망막유착술을 시행한 환자 중 최소 6개월 이상 경과관찰된 38명 38안을 대상으로 후향적 고찰을 통해 1회 수술 후 해부학적 성공률 및 최종 성공률, 최종 시력을 분석하였다. 1차 성공은 추가적인 수술 없이 최종 방문 시 망막이 유착된 것으로 정의하였고, 최종 성공은 추가적인 수술과 관계없이 최종 방문 시 망막이 재유착된 것으로 정의하였다. 결과: 평균연령은 58.47 ± 17.00세로 평균 18개월 동안 경과관찰하였다. 열공의 위치는 상부망막(8-4시)에 위치하였으며 수술 전 logMAR 시력은 평균 1.17 ± 1.00이었고 수술 후 logMAR 시력은 평균 0.42 ± 0.48이었다. 황반부 박리가 동반된 경우는 23명(59%)이었다. 일차 성공은 23명(61%)으로 경과기간 동안 망막의 재유착 및 시력호전을 보였다. 망막이 재박리된 환자는 공막돌륭술 또는 유리체절제술을 시행하여 모든 환자에서 망막이 재유착되었다. 결론: 인공수정체 망막박리에서 일차 수술로 기체망막유착술을 시행하는 경우 안구운동이상, 굴절이상의 위험이 없으며 최종성공률은 66%로 인공수정체 망막박리에서 환자상태 및 상황에 따라 유용한 치료법으로 고려될 수 있다.
Abstract
Purpose: To evaluate the clinical effectiveness of pneumatic retinopexy as a treatment method for pseudophakic retinal detachment. Methods: A retrospective chart review was conducted of medical records of 38 patients who underwent pneumatic retinopexy using SF6 gas from January 2003 to December 2011 and who were observed during a follow-up period longer than 6 months. Primary and final success rates and final visual acuity were analyzed. Primary success was defined as retinal attachment at the last visit without additional surgery. Final success was defined as retinal reattachment at the last visit regardless of additional surgery. Results: The mean patient age was 58.47 ± 17.00 years. All retinal tears were located in the upper retina (from 8 to 4 o’clock). Preoperative mean visual acuity was 1.17 ± 1.00 log MAR, and postoperative mean visual acuity was 0.42 ± 0.48 log MAR. The primary success rate was 61%, and patients with re-detached retina underwent repeat pneumatic retinopexy or other surgery such as scleral buckling or pars plana vitrectomy. At the final visit, all of the patients demonstrated successful results. Conclusions: Pneumatic retinopexy does not result in strabismus or refractive error, and the final success rate was 66% in our study. Therefore, pneumatic retinopexy can be considered as an effective management technique for some pseudophakic retinal detachment patients.
참고문헌 (36)
- The Retina Society Terminology Committee, "The classification of retinal detachment with proliferative vitreoretinopathy", Ophthalmology, 90, pp.121~125 (1983)
- Schepens CL, "Retinal detachment and aphakia", AMA Arch Ophthalmol, 45, pp.1~17 (1951)
- Norton EW, "Retinal detachment in aphakia", Trans Am Ophthalmol Soc, 61, pp.770~789 (1963)
- Haimann MH., "Epidemiology of retinal detachment", Arch Ophthalmol, 100, pp.289~292 (1982)
- Yoshida A., "Retinal detachment after cataract surgery. Predisposing factors", Ophthalmology, 99, pp.453~459 (1992)
- Yoshida A., "Retinal detachment after cataract surgery. Surgical results", Ophthalmology, 99, pp.460~465 (1992)
- Freeman HM., "Pseudophakic retinal detachment", Mal Probl Ophthalmol, 20, pp.345~353 (1979)
- Javitt JC., "National outcomes of cataract extraction. Retinal detachment and endophthalmitis after outpatient cataract surgery. Cataract Patient Outcomes Research Team", Ophthalmology, 101, pp.100~105 (1994)
- Ninn-Pedersen K., "Cataract patients in a defined Swedish population., 1986 to 1990. V. Postoperative retinal detachments", Arch Ophthalmol, 114, pp.382~386 (1996)
- Wegener M., "Outcome of 1000 consecutive clinic-and hospital-based cataract surgeries in a Danish county", J Cataract Refract Surg, 24, pp.1152~1160 (1998)
- Olsen G., "Update on a long-term, prospective study of capsulotomy and retinal detachment rates after cataract surgery", J Cataract Refract Surg, 26, pp.1017~1021 (2000)
- Bobrow JC, "Visual outcomes after anterior vitrectomy : comparison of ECCE and phacoemulsification", Trans Am Ophthalmol Soc, 97, pp.281~ (1999)
- Yap EY., "Visual outcome and complications after posterior capsule rupture during phacoemulsification surgery", Int Ophthalmol, 23, pp.57~60 (1999)
- Ho PC., "Pseudophakic retinal detachment. Surgical success rate with various types of IOLs", Ophthalmology, 91, pp.847~852 (1984)
- Wilkinson CP, "Pseudophakic retinal detachments", Retina, 5, pp.1~4 (1986)
- Han DP., "Comparison of pneumatic retinopexy and scleral buckling in the management of primary rhegmatogenous retinal detachment. Southern Wisconsin Pneumatic Retinopexy Study Group", Am J Ophthalmol, 126, pp.658~668 (1998)
- Chen JC., "Results and complications of pneumatic retinopexy", Ophthalmology, 95, pp.601~606 (1988)
- Tornambe PE., "Pneumatic retinopexy. A multicenter randomized controlled clinical trial comparing pneumatic retinopexy with scleral buckling. The Retinal Detachment Study Group", Ophthalmology, 96, pp.772~783 (1989)
- 이승은, "기체망막유착술의 결과 및 성공에 영향을 미치는 인자", 대한안과학회지, 54(8), pp.1241~1247 (2013), 대한안과학회
- Hilton GF., "Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision", Ophthalmology, 93, pp.626~641 (1986)
- Poliner LS., "Pneumatic Retinopexy: A Clinical Symposium" (1989), Greenwood Publishing
- Dominguez DA., "Repeated insufflation of expansive gas", Highlights Ophthalmol Lett, 14, pp.1~14 (1986)
- 조우형, "1시간이상 떨어진 다발성 망막열공에 의한 망막박리 환자에서 기체망막유착술을 시행한 3예", 대한안과학회지, 46(12), pp.2110~2114 (2005), 대한안과학회
- Brinton DA., "Retina" (2001), Mosby Inc
- Hilton GF., "Pneumatic retinopexy : principles and practice", Indian J Ophthalmol, 44, pp.131~143 (1996)
- Kleinmann G., "Pneumatic retinopexy : results in eyes with classic vs relative indications", Arch Ophthalmol, 120, pp.1455~1459 (2002)
- Bartz-Schmidt KU., "Primary vitrectomy for pseudophakic retinal detachment", Br J Ophthalmol, 80, pp.346~349 (1996)
- Brazitikos PD., "Primary pars plana vitrectomy versus scleral buckle surgery for the treatment of pseudophakic retinal detachment : a randomized clinical trial", Retina, 25, pp.957~964 (2005)
- Brazitikos PD., "Primary vitrectomy with perfluoro-n-octane use in the treatment of pseudophakic retinal detachment with undetected retinal breaks", Retina, 19, pp.103~109 (1999)
- Campo RV., "Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments", Ophthalmology, 106, pp.1811~1815 (1999)
- Weichel ED., "Pars plana vitrectomy versus combined pars plana vitrectomy-scleral buckle for primary repair of pseudophakic retinal detachment", Ophthalmology, 113, pp.2033~2040 (2006)
- Speicher MA., "Primary vitrectomy alone for repair of retinal detachments following cataract surgery", Retina, 20, pp.459~464 (2000)
- Martínez-Castillo V., "Pars plana vitrectomy alone for the management of inferior breaks in pseudophakic retinal detachment without facedown position", Ophthalmology, 112, pp.1222~1226 (2005)
- Heimann H., "Primary vitrectomy for rhegmatogenous retinal detachment : an analysis of 512 cases", Graefes Arch Clin Exp Ophthalmol, 244, pp.69~78 (2006)
- Devenyi RG., "Combined scleral buckle and pars plana vitrectomy as a primary procedure for pseudophakic retinal detachments", Ophthalmic Surg Lasers, 30, pp.615~618 (1999)
- Brazitikos PD, "The expanding role of primary pars plana vitrectomy in the treatment of rhegmatogenous noncomplicated retinal detachment", Semin Ophthalmol, 15, pp.65~77 (2000)