실리콘관 삽입술에서 관의 고정을 위한 실리콘 시트와 봉합사 사용의 임상적 효과 비교 (Comparison of Clinical Efficacy Between Tie Methods of Silicone Tube Intubation in Nasolacrimal Duct Obstruction)

서지정보

· 발행기관 : 대한안과학회
· 수록지 정보 : 대한안과학회지 / 50권 / 2호 / 177 ~ 181페이지
· 저자명 : 박영민, 구기홍, 이지은, 이종수, 김윤경

초록

목적: 불완전 코눈물관막힘 환자의 실리콘관 삽입술시 관고정을 위해 실리콘시트를 사용한 경우와 봉합사를 사용한 경우의 임상효능을 비교하였다.
대상과 방법: 87명 88안을 실리콘시트를 이용한 59안(1군)과, 봉합사를 이용한 29안(2군)으로 나누어, 수술성공률, 재발율 및 합병증을 비교하였다.
결과: 수술성공률은 1군 83%, 2군 82.7%로 유의한 차이가 없었다. 합병증은 1군에서 눈자극감 5/59안(8.4%), 관빠짐, 결막염, 각막미란 및 눈물주머니염 각각 2/59안(3.4%), 눈물소관열창 1/59안(1.6%) 순으로 발생하였고, 2군은 눈자극감 3/29안(10.3%), 관빠짐, 결막염, 눈물소관열창, 눈물주머니염 각각 2/29안(6.9%), 각막미란, 육아종 각각 1/29안(3.4%)순으로, 2군에서 합병증 발생률이 유의하게 높았다. 관제거후 1군 6안(10%), 2군 3안(10%)에서 눈물흘림이 재발하였다.
결론: 불완전 코눈물관막힘 환자에서 실리콘관 삽입술시 실리콘시트의 사용은 봉합사를 사용한 경우에 비해, 수술성공률 차이가 없고, 합병증이 적으며, 특히 눈물배출로에의 압박이 적어 눈물소관열창 발생을 줄일 수 있는 효과적 치료방안으로 생각된다.

영어초록

Purpose: To compare the clinical outcome of silicone tube intubation according to the tie methods.
Methods: Eighty-eight eyes of 87 patients who underwent silicone tube intubation were divided into two groups based on the tie method: a silicone silastic sheet group (Group 1, n=59) and a nylon 6-0 suture knot group (Group 2, n=29). The two groups were compared according to their success rates, recurrence rates and complications.
Results: No significant difference was found in the success rate between the two groups (83.0% in Group 1 and 82.7% in Group 2). However, Group 2 showed a significantly higher rate of postoperative complications than Group 1. In Group 1, 5/59 (8.4%) eyes had ocular irritation, 2/59 (3.4%) eyes exhibited tube prolapse, conjunctivitis, corneal erosion, and dacryocystitis and 1/69 (1.6%) eyes had a punctal slit after intubation. In Group 2, 3/29 (10.3%) eyes had ocular irritation, 2/29 (6.9%) eyes exhibited tube prolapse, conjunctivitis, a punctal slit, and dacryocystitis, and 1/29 (3.4%) eyes showed corneal erosion, or a granuloma after intubation. A recurrence of symptomatic tearing was found in 6/59 (10%) eyes in Group 1 and 3/29 (10%) in Group 2.
Conclusions: In silicone tube intubation of incomplete NLD obstruction, the usage of silicone silastic sheets to tie both ends of the silicone tube produced a lower complication rate and a higher success rate than that of the suture knot group. Lower tension on the nasolacrimal passage in the silicone silastic sheet group allows for a significantly lower rate of punctal slit development. Therefore, the method of using silicone silasitic sheets can be considered useful in the treatment of NLD obstruction.

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