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섬유주절제술 후 발생한 안검하수에 관여하는 인자에 대한 분석

Incidence and Risk Factors for the Ptosis after Trabeculectomy

대한안과학회지 2020년 61권 6호 p.645 ~ 649
박형준 ( Park Hyung-Jun ) - Gachon University College of Medicine Gachon University Gil Medical Center Department of Ophthalmology

김성현 ( Kim Sung-Hyun ) - Gachon University College of Medicine Gachon University Gil Medical Center Department of Ophthalmology
지미정 ( Chi Mi-Jung ) - Gachon University College of Medicine Gachon University Gil Medical Center Department of Ophthalmology
이종연 ( Lee jong-Yeon ) - Gachon University College of Medicine Gachon University Gil Medical Center Department of Ophthalmology

Abstract


Purpose: To investigate the incidence and risk factors for the ptosis after trabeculectomy.

Methods: We retrospectively analyzed the medical records of 94 patients who underwent trabeculectomy by a single surgeon. Patients with previous eyelid surgery and ophthalmic surgery, as well as those with systemic disease affecting the eyelid, were excluded from the study. Ptosis was defined as higher eyelid crease compared with contralateral eyelid or a ≥2 mm reduction of margin reflex distance-1 after the surgery. Age, sex, bleb location, conjunctival incision site, mitomycin C concentration, range of mitomycin C contact area, and soaking time were analyzed.

Results: The incidence of ptosis was 19.1% (18/94) at 6 months after trabeculectomy. There were no statistically significant relationships between postoperative ptosis and the following factors: age, sex, surgical site, bleb site, and conjunctival incision site. The incidence of ptosis was significantly higher in the 0.04% mitomycin C group than in the 0.02% mitomycin C group (40.0% vs 11.6%, p = 0.002). The incidence of ptosis was significantly higher in eyes with a large contact area of mitomycin C to the posterior part of the eye, compared to eyes with a smaller contact area (44.4% vs 9.0%, p < 0.001). Logistic regression analysis showed that the range of mitomycin C contact area remained statistically significant.

Conclusions: The large contact area of mitomycin C to the posterior part of the eye during trabeculectomy was found to be a risk factor for postoperative ptosis.

키워드

Glaucoma; Mitomycin C; Ptosis; Trabeculectomy
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