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재발성 군날개 환자에서 미세 다공성 신전된 폴리테트라플루오로에틸렌 삽입의 임상효과

The Clinical Effect of Micro-Multiporous Expanded Polytetrafluoroethylene Insertion for Recurrent Pterygium

김재찬|김경우
대한안과학회 (The Korean Ophthalmological Society)|2013.03|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제54권 제3호|pp. 416-426

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참고문헌

키워드

DiplopiaSymblepharonRecurrent pterygiumMicro-multiporous e-PTFEMotility restriction
주제분류안과학

초록

목적: 검구 유착을 동반한 중증 재발성 군날개 환자에서 미세 다공성 e-PTFE 삽입의 임상효과를 알아보고자 하였다. 대상과 방법: 검구 유착, 안구운동장애와 복시 증상을 동반한 재발성 군날개 환자 13명, 13안에서 미세 다공성 e-PTFE를 삽입하였다. 삽입한 e-PTFE는 수술 후 1개월째 제거했고, 평균 추적 관찰기간 11.92 ± 1.32개월 동안 군날개 및 검구 유착 재발, 안구운동제한,복시 및 충혈 정도를 조사하였다. 결과: 13안 중 12안에서 군날개 재발이 없었고, 재발한 1안(7.7%)은 결막부 재발이었다. 13안 모두에서 검구 유착의 재발은 없었다. 복시및 안구운동제한은 13안 중 11안에서 수술 후 사라졌으며, 나머지 2안도 수술 전에 비해 호전되었다. 모든 환자에서 수술 후 수술 부위충혈 정도의 시각화증상척도 점수가 수술 전에 비해 감소하였다. 결론: 중증 재발성 군날개 환자에서 미세 다공성 e-PTFE의 삽입은 심각한 합병증 없이 수술 후 재발률을 낮추고 환자의 군날개 관련증상들을 호전시킬 수 있는 유용한 수술 방법으로 이용될 수 있다.

Abstract

Purpose: To investigate the clinical effect of micro-multiporous e-PTFE insertion for severe recurrent pterygium with symblepharon. Methods: The present study included a total of 13 cases of recurrent pterygium associated with symblepharon, motility restriction and diplopia which had undergone micro-multiporous e-PTFE insertion after pterygium excision, 0.02% mitomycin C application, human amniotic membrane transplantation (AMT) and/or conjunctivo-limbal autograft (CLAU) between September 2010 and February 2011. One month after surgery, the inserted e-PTFE was removed. Recurrence of pterygium and symblepharon, motility restriction, diplopia and injection of ocular surface were evaluated for 11.92 ± 1.32months of mean follow-up period. Results: Pterygial recurrence was not observed in 12 out of 13 eyes, and the 1 eye which recurred showed conjunctival recurrence. No postoperative symblepharon recurrence was observed in any of the 13 eyes. Diplopia and motility restriction disappeared in 11 out of 13 eyes, and were improved in the other 2 eyes. VAS (Visual Analogue Scale) injection scores in the wound site decreased after surgery in all patients. Conclusions: Micro-multiporous e-PTFE insertion combined with mitomycin C application, AMT and CLAU can be a useful surgical method to lower the postoperative recurrence rate and to improve the pterygium-related symptoms in severe recurrent pterygium.

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