원발성 군날개 환자에서 양막이식술, 자가결막이식술, 자가윤부결막이식술의 재발률 비교 = Recurrence Rates of Amniotic Membrane Transplantation, Conjunctival Autograft and Conjunctivolimbal Autograft in Primary Pterygium

국문 초록 (Abstract)

목적: 원발성 군날개 제거 시 양막이식술(조직접착제군(가군)과 봉합군(나군)), 자가결막이식술(다군), 자가윤부결막이식술(라군)을 각각
시행하고 군날개의 재발률과 합병증을 비교하였다.
대상과 방법: 수술 후 12개월 이상 추적관찰이 가능하였던 원발성 군날개 환자 115명 121안 중, 가군 31명 33안, 나군 28명 29안, 다군 26명
28안, 라군 30명 31안을 대상으로 재발률 및 합병증을 후향적으로 조사하였다.
결과: 술 후 12개월째 가군에서 결막재발 7안(21.2%), 각막재발 1안(3.0%)이 발생하였고, 나군에서 결막재발 6안(20.7%), 각막재발 3안
(10.3%)이 발생하였다. 다, 라군에서는 각막재발이나 결막재발은 관찰되지 않았다. 네 군간에 각막재발률은 통계학적으로 유의한 차이가
없었으나(p=0.089), 결막재발률은 양막이식군에서 유의하게 높았다(p=0.003).
결론: 양막이식술은 상이측결막을 보존할 수 있고 시행하기 쉬운 장점이 있으나, 결막재발률이 높았으며, 전통적인 자가결막이식술과 자가
윤부결막이식술은 술기가 어렵고 시간이 많이 소요되지만 양막이식술에 비해 결막재발률이 낮았다.

다국어 초록 (Multilingual Abstract)

Purpose: To compare the recurrence rates and complications with amniotic membrane transplantation (fibrin glue group and suture
group), conjunctival autograft and conjunctivolimbal autograft in excision of primary pterygium.
Methods: Among 121 eyes of 115 patients with a minimum follow-up period of 12 months, 33 eyes of 31 patients underwent amniotic
membrane transplantation with fibrin glue (Group 1) and 29 eyes of 28 patients underwent amniotic membrane transplantation with
sutures (Group 2). Twenty-eight eyes of 26 patients underwent conjunctival autograft (Group 3), and 31 eyes of 30 patients underwent
conjunctivolimbal autograft (Group 4). Recurrence rates and complications were evaluated retrospectively.
Results: With a minimum of 12 months of follow-up, conjunctival recurrence was noted in seven eyes (21.2%) and six eyes (20.7%)
in Group 1 and Group 2, respectively. Corneal recurrence occurred in one eye (3.0%) in Group 1 and in three eyes (10.3%) in Group
2 and no conjunctival or corneal recurrence were noted in Group 3 or Group 4. There was a statistically significant difference in
conjunctival recurrence rates (p=0.003), but not in corneal recurrence rates (p=0.089) among the four groups.
Conclusions: Although amniotic membrane transplantation preserved the superotemporal conjunctiva and was a technically easy
procedure, it had high conjunctival recurrence rates. Conjunctival autograft and conjunctivolimbal autograft are technically demanding
and time consuming, but they are more effective in preventing conjunctival recurrence compared with amniotic membrane transplantation.

참고문헌 (Reference)

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