Mitomycin C를 이용한 섬유주절제술에서 결막편에 따른 수술결과 비교
Outcome of Fornix-Based Versus Limbus-Based Conjunctival Flaps in Trabeculectomy with Mitomycin C
대한안과학회지 2003년 44권 12호 p.2829 ~ 2837
신일호, 형성민,
소속 상세정보
신일호 ( )
Chungbuk National University
형성민 ( )
Chungbuk National University
KMID : 0360220030440122829
Abstract
목적 : Mitomycin C (MMC)를 사용한 섬유주절제술에서 윤부기저결막편과 원개기저결막편을 이용한 후 수술성적을 비교하였다.
대상과 방법 : MMC를 사용하여 섬유주절제술을 시행 받고 6개월이상 추적관찰이 가능했던 42명 46안을 대상으로 하였다. 윤부기저결막편군 21명 23안과 원개기저결막편군 21명 23안의 수술 후 안압 및 시력, 합병증을 비교하였다.
결과 : 안압은 수술 후 18개월에 윤부기저결막편군에서 원개기저결막편군보다 낮았고(10.7±9.5:14.8±11.2 ㎜Hg, p=0.030), 그 외에는 차이가 없었다. 수술 후 합병증은 최종 추적기간까지 지속된 저안압증 만이 윤부기저결막편군에서 많ㅇㅆ다(6:1안, p=0.048) 수술 성공률은 약물을 사용하지 않은 경우 차이가 없었으나, 약물을 추가적으로 사용한 경우는 수술 후 12개월에 원개기저결막편군에서 더 높았고(44.4:77.3%, p=0.033) 누적성공률도 원개기저결막편군에서 더 높았다(p=0.040).
결론 : MMC를 이용한 섬유주절제술에서 결막편에 따른 수술 성공률과 합병증을 비교해 보았을 때 지속적인 저안압증의 빈도가 낮고 수술 성공률이 비교적 높은 원개기저결막편을 이용하는 것이 좋다고 생각한다.
<한안지 44(12):2829-2837, 2003>
Purpose: To compare the surgical outcome of limbus-based group with that of fornix-based group undergone trabeculectomy with mitomycin C (MMC)
Methods: 46 eyes of 42 patients with trabeculectomy with MMC who were observed for 6 months or more were included. A limbus-based conjunctival flap was used for, 23 eyes of 21 patients, and a fornix based conjunctival flap for the other 23 eyes of 21 patients. And the intraocular pressure (lOP), visual acuity and postoperative complications were checked.
Results: In the IOP control, there were no differences between two groups after surgery except 18 months.. The IOP of the limbus-based group at 18 months was lower than that of fornix-based group (10.7±9,5.14.8 ±11.2 mmHg, p=0.030). In the postoperative complications, the number of persistent hypotony in limbus-based group was more than that of fornix-based group (6:1 eyes, p=0.048). There were no differences between two groups in the success rates without additional medication, but the success rates of fornix-based group with additional medication at 12 months were higher than those of limbus-based group (44.4:77.3%, p=0.033). Also the cumulative success rates of fornix-based group with , medication were higher. than those of limbus-based group (p=0.040).
Conclusions: Fornix-based conjunctival flap which has shown lower persistent hypotony and higher success rates than that of limbus-based conjunctival flap is recommendable for trabeculectomy with MMC.
J Korean Ophthalmol Soc 44(12):2829-2837, 2003
키워드
Formix-based conjunctival flap;Limbus-bsed conjunctival flap;Trabeculectomy
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