아메드밸브삽입술 중 발생한 모양체해리 틈에 의한 저안압증 1예
A Case of Cyclodialysis Cleft with Hypotony during Ahmed Valve Implantation Surgery
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목적: 아메드밸브삽입술 중 발생한 모양체해리 틈에 의한 저안압증을 동반한 1예의 경과관찰과 치료경험을 보고하고자 한다. 증례요약: 47세 남자환자로서 1년 전 우안 수상 후 외상성 전방출혈로 경과관찰하던 중 1개월 전 열공성망막박리로 유리체절제술, 백내장초음파유화흡인술 및 인공수정체 삽입술을 시술받았다. 술후 약물치료로 안압이 조절되지 않아 아메드밸브삽입술을 시술받았다. 아메드밸브삽입술 도중 전방은 깊게 형성되었으나 저안압이 관찰되었다. 술후 경과관찰 중 저안압이 계속 되었으며 맥락막 삼출이 발생하였고 전안부 빛간섭단층촬영과 전방각경 검사에서 모양체해리 틈이 관찰되었다. 스테로이드점안제와 조절마비제를 사용하여 모양체삼출이 사라졌으며 안압이 정상으로 회복되었다. 결론: 과거 안외상과 망막박리수술 병력이 있었던 환자에서 아메드밸브삽입술 중 모양체해리 틈에 의한 저안압이 발생할 수 있으며,조절마비제와 스테로이드 점안제로 치료할 수 있다.
Abstract
Purpose: To report a case of cyclodialysis cleft with hypotony during Ahmed valve implantation. Case summary: A 47-year-old male was referred for uncontrolled intraocular pressure (IOP) in the right eye. The patient had ahistory of ocular trauma and traumatic hyphema. He underwent pars plana vitrectomy, phacoemulsification and intraocular lensimplantation 1 month prior due to rhegmatogenous retinal detachment. At the end of the Ahmed valve implantation surgery, theeye was hypotonic despite a deep anterior chamber. The hypotony continued and choroidal effusion developed. Anterior segmentoptical coherence tomography and gonioscopic examinations revealed small cyclodialysis clefts. After medical treatmentwith cycloplegics and steroids, choroidal effusion disappeared and IOP was normalized. Conclusions: Patients with previous ocular trauma or surgery could be prone to developing cyclodialysis cleft with hypotony. Inadvertent cyclodialysis cleft with hypotony can be treated with cycloplegics and steroids.
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