Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
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Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy

유리체절제술과 수정체유화술 동시 수술 시 백내장수술 후 앞방내 에피네프린 주입과 동공 확대

  • Kim, Sangbum (Department of Ophthalmology, Dongguk University College of Medicine) ;
  • Park, Jongyeop (Goheung Health Center) ;
  • Shin, Jaeryung (Dongguk University College of Medicine) ;
  • Lee, Seungwoo (Department of Ophthalmology, Dongguk University College of Medicine)
  • 김상범 (동국대학교 의과대학 안과학교실) ;
  • 박종엽 (고흥군 보건소) ;
  • 신재령 (동국대학교 의과대학) ;
  • 이승우 (동국대학교 의과대학 안과학교실)
  • Received : 2018.07.19
  • Accepted : 2018.11.23
  • Published : 2018.12.15
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Abstract

Purpose: We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR). Methods: We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes). Results: The PCA ratios of the study group were $0.52{\pm}0.11$ before PE, $0.43{\pm}0.12$ after PE, and $0.51{\pm}0.11$ after PPV, respectively. Changes in pupil size were significant (p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were $0.52{\pm}0.10$ before PE, $0.39{\pm}0.15$ after PE, and $0.43{\pm}0.15$ after PPV, respectively. Changes in pupil size after PE were significant (p = 0.011) but the change after PPV was not (p = 0.056). Conclusions: Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.

목적: 증식당뇨망막병증에서 유리체절제술과 수정체유화술을 동시에 시행한 경우 백내장수술 후 에피네프린 앞방내 주사가 동공 확대에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 증식당뇨망막병증에서 유리체절제술과 수정체유화술을 동시에 시행한 96명(96안)에서 백내장수술 후 0.001% 에프네프린을 앞방내 주사를 한 군(주사군, 46안)과 하지 않은 군(대조군, 50안)에서 수술 전, 백내장수술 후, 유리체절제술이 끝난 후 동공 크기를 비교하였다. 동공 크기는, 저장된 수술 동영상에서 Image J 프로그램(National Institute of Health, Bethesda, MD, USA)을 이용하여 동공면적과 각막면적의 비를 구하여 수술 전-백내장수술 후의 동공 크기의 변화와 백내장수술 후-유리체절제술 후의 동공의 크기 변화를 비교하였다. 결과: 주사 군에서 수술 전 동공/각막면적의 비는 $0.52{\pm}0.11$, 백내장수술 후에는 $0.43{\pm}0.12$, 유리체절제술 후에는 $0.51{\pm}0.11$로 통계학적으로 유의한 동공 크기 변화를 관찰할 수 있었다(p<0.001, p<0.001). 대조군에서 수술 전 동공/각막면적의 비는 $0.52{\pm}0.10$, 백내장수술 후에는 $0.39{\pm}0.15$, 유리체절제술 후에는 $0.43{\pm}0.15$였다. 대조군에서는 백내장수술 후에는 동공 크기가 유의하게 차이가 났으나(p=0.011), 유리체절제술 후에는 유의한 동공 크기의 차이를 관찰할 수가 없었다(p=0.056). 결론: 에피네프린 앞방내 주사는 증식당뇨망막병증 환자에서 유리체절제술과 초음파유화술 병합 수술 시 백내장수술 후 동공을 다시 빠르게 산동시킬 수 있는 간단한 처치 방법으로 생각된다.

Keywords

References

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