안구내 실리콘기름 안내 충전술의 결과와 술 후 시력의 예후인자 분석

• Published in: Daihan angwa haghoi jabji Vol. 50; no. 12; pp. 1809 - 1816
• Main Authors: 김수영, Soo Young Kim, 정중영, Jung Yeong Jeong, 이상준, Sang Joon Lee, 김신동, Shin Dong Kim
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 15.12.2009
• Subjects: Retinal redetachment; Silicone oil; Silicone oil removal; Vitrectomy; 안과학; Vitrectomy; Retinal redetachment; Silicone oil removal; Silicone oil
• ISSN: 0378-6471; 2092-9374

목적: 안구내 실리콘기름 제거술 후의 결과와 시력 예후인자를 살펴보았다. 대상과 방법: 실리콘기름 충전술을 시행한 환자 76명(79안)을 대상으로 임상결과를 후향적으로 분석하였다. 예후인자를 연령, 발병원인, 전신질환 유무, 망막박리의 범위, 유형, 열공 갯수, 황반부 상태, 수정체 상태, 수술의 종류로 설정하고 해부학적 성공률과 시력에 대한 영향을 조사하였다. 결과: 실리콘기름 제거술을 실시한 79안 중, 원인질환은 증식당뇨망막증 32안, 거대망막열공을 포함한 열공성 망막박리 12안, 안내이물과 연관된 망막박리 9안, 외상성 망막박리 8안, 황반원공이 동반된 망막박리 6안, 타 수술 후 발생한 망막박리 6안, 안내염이 동반된 망막박리 3안, 고도근시가 동반된 망막박리 3안이었다. 최종 해부학적 성공은 59안(74.7%), 시력 개선 32안(40.5%), 무변화 28안(35.4%), 악화 19안(24.1%)이었다. 수술 횟수가 2회 이하인 군, 황반열공이나 변성이 없는 군에서 술 후 시력개선 효과가 유의하였다. 결론: 실리콘기름 제거 시기는 예후인자를 고려하여 정하는 것이 안내 실리콘기름 제거술 후의 합병증 및 망막 재박리를 줄이는데 도움이 되리라 생각한다. <대한안과학회지 2009;50(12):1809-1816> Purpose: To evaluate the factors influencing clinical outcome after removal of intraocular silicone oil and the relationship of the factors to the postoperative visual prognosis. Methods: The authors retrospectively analyzed clinical outcomes related to 76 patients (79 eyes) who underwent silicone oil tamponade. Prognostic factors were as follows: age, underlying pathologies, systemic diseases, range and type of retinal detachment (RD), type of RD, number of retinal tears, macular and lens status, and types of operation. The influence of these factors on visual acuity and anatomical success rates were studied. Results: The 79 eyes that underwent silicone oil removal had preoperative diagnoses as follows: proliferative diabetic retinopathy in 32 eyes, primary rhegmatogenous RD in 12 eyes, RD with an intraocular foreign body in nine eyes, traumatic RD in eight eyes, RD with a macular hole in six eyes, RD development after other surgeries in six eyes, RD with endophthalmitis in three eyes, and RD with high myopia in three eyes. Anatomical success was achieved in 59 eyes (74.7%) after silicone oil removal. Thirty-two eyes (40.5%) had an increase in visual acuity, 28 eyes (35.4%) showed no changes and 19 eyes (24.1%) showed deteriorated conditions after silicone oil removal. The number of surgeries was an important factor related to anatomical and functional success rate. Postoperative visual improvement was observed when the number of surgeries was greater than two and in groups with no macular holes or degenerations. Conclusions: When considering prognostic factors for silicone oil removal, reducing complications and retinal redetachment after silicone oil removal may be helpful. J Korean Ophthalmol Soc 2009;50(12):1809-1816