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당뇨황반부종 환자에서 백내장적출술과 유리체내 베바시주맙주입술 동시 수술의 효과

The Results of a Combination of Cataract Surgery and Intravitreal Bevacizumab Injection for Diabetic Macular Edema

이동욱|안민|조남천|권의용|김부기
대한안과학회 (The Korean Ophthalmological Society)|2010|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제51권 제7호|pp. 954-960

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키워드

Diabetic macular edemaCataract surgeryBevacizumab
주제분류안과학

초록

목적: 당뇨황반부종 환자에서 백내장적출술과 유리체내 베바시주맙주입술 동시 수술의 효과와 안전성을 알아보고자 하였다. 대상과 방법: 수정체초음파유화술과 인공수정체삽입술 시행 후 1.25 mg의 베바시주맙을 유리체 내로 주입하였고, 수술 전, 수술 후1주일, 1개월, 3개월, 6개월에 최대교정시력과 중심황반두께를 측정하였고, 합병증 발생 여부를 조사하였다. 결과: 수술 전 평균 최대교정시력(LogMAR)은 0.84±0.50이었고, 평균 중심황반두께는 333.7±57.50 μm였다. 수술 후 평균 최대교정시력은 1주째 0.52±0.40, 1개월째 0.51±0.42, 3개월째 0.52±0.34, 6개월째 0.46±0.37로 수술 전보다 유의하게 향상되었고, 평균중심황반두께는 1주째 356.4±86.44 μm, 1개월째 338.8±138.4 μm, 3개월째 349.0±122.9 μm, 6개월째 334.2±100.4 μm이었다. 수술 중과 수술 후에 합병증은 관찰되지 않았다. 결론: 백내장적출술과 유리체내 베바시주맙주입술의 동시 수술은 안전한 수술이고, 황반부종을 예방하는 데 있어서 1개월까지는 효과가 좋으나, 3개월째부터는 황반부종의 예방효과가 미미하였다.

Abstract

Purpose: To evaluate the efficacy and safety of the combination of cataract surgery and intravitreal bevacizumab injection in patients with cataract and diabetic macular edema. Methods: Patients received an intravitreal injection of bevacizumab(1.25 mg) combined with phacoemulsification and implantation of a posterior chamber intraocular lens. Best corrected visual acuity (BCVA, LogMAR) and, central macular thickness (CMT) were measured using OCT at baseline and at one week, one, three, and six months after surgery, and adverse events were recorded. Results: The mean baseline LogMAR BCVA was 0.84±0.50 and mean CMT was 337.1±57.50 μm. At one week, one, three, and six months after surgery, the mean BCVAs were 0.52±0.40, 0.51±0.42, 0.52±0.34, and 0.46±0.37, and the mean CMTs were 356.4±86.44 μm, 338.8±138.4 μm, 349.0±122.9 μm, and 334.2±100.4 μm, respectively. No adverse events associated with cataract surgery or intravitreal bevacizumab injection were observed. Conclusions: The short-term results from the present study suggest the combination of cataract surgery and intravitreal bevacizumab injection are safe and effective for the prevention of macular edema aggravation for one month, but has little effect on prevention of macular edema aggravation three months after surgery for diabetic macular edema patients.

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