국소마취와 Nadbath-Rehman-Ellis 마취의 백내장 수술 후 안검하수 발생비교

Abstract

목적 : 백내장 수술에서 개검기에 대항하여 안윤근이 수축하는 정도가 수술 후 안검하수 발생에 미치는 영향을 알아보기 위하여, Alcaine�� 점안마취와 Nadbath-Rehman-Ellis마취를 비교 연구 하였다. 대상과 방법 : 한쪽 눈을 점안마취를 이용하여 백내장 수술을 시행 받고 반대편 눈은 Nadbath-Rehman-Ellis마취를 이용하여 수술을 시행 받은 20명(40안)을 대상으로 하였다. 마취 방법에 따라 대상 안을 두그룹으로 나눈 후에 두 그룹간에 수술 Maraginal Reflex Distance 1 과 상안검거근의 기능에 차이가 있는지 알아보았다. 결과 : 수술 전 평균 MRD1은 2.57±0.41mm, 상안 검거근 기능은 9.09±1.12mm로 두 그룹간에 유의한 차이가 없었다. 수술 후 1주와 4주에 점안마취를 시행 받은 눈의 평균 MRD1은 각각 2.07±0.31mm, 2.33±0.38mm로 Nadbath-Rehman-Ellis마취를 시행 받은 눈의 2.31±0.29mm, 2.48±0.47mm와 비교하여 유의하게 작았다. 상안검거근의 기능은 두 그룹간에 유의한 차이가 없었다. 수술 후 1주에 2mm 이상의 MRD1의 감소는 점안마취를 시행한 그룹에서만 20%(4명)에서 나타나서 Nadbath-Rehman-Ellis마취를 시행 받은 그룹과 비교해서 유의하게 많았다. 결론 : 백내장 수술 시 Nadbath-Rehman-Ellis마취는 상안 검거근 근막의 손상을 줄여서 수술 후 안검하수 발생을 최소화 할 수 있다 |Purpose : I had comparative study of Alcaine�� topical anesthesia and Nadbath-Rehman-Ellis akinesia to observe the effect of the limits of the orbicularis oculi against eyelid speculum on the occurrence of post-operative ptosis.

Methods : One eye underwent cataract operation by topical anesthesia and the other eye was done by Nadbath-Rehman-Ellis akinesia in 40 eyes of 20 patients. Depending on the anesthetic method, two groups were evaluated to see the difference on the marginal reflex distance and levator function after the surgery.

Results : There were no significant differences between two groups in the mean pre-operative MRD1 which was 2.57±0.41mm and levator function which was 9.09±1.12mm. After 1 week and 4 weeks, the mean MRD1 on eyes with topical anesthsia were 2.07±0.31mm and 2.33±0.38mm, respectively, and the mean MRD1 on eyes with Nadbath-Rehman-Ellis akinesia were 2.31±0.29mm and 2.48±0.47mm, respectively, which was significantly low. The levator function showed no significant difference. The reduction of MRD1 over 2mm was shown only in group with topical anesthesia which was significantly high in compare to the group with Nadbath-Rehman-Ellis akinesia which was none.

Conclusion : In cataract surgery, Nadbath-Rehman-Ellis akinesia can reduce the damage of levator aponeurosis which drops the occurrence of post-operative ptosis.; Purpose : I had comparative study of Alcaine�� topical anesthesia and Nadbath-Rehman-Ellis akinesia to observe the effect of the limits of the orbicularis oculi against eyelid speculum on the occurrence of post-operative ptosis.

Methods : One eye underwent cataract operation by topical anesthesia and the other eye was done by Nadbath-Rehman-Ellis akinesia in 40 eyes of 20 patients. Depending on the anesthetic method, two groups were evaluated to see the difference on the marginal reflex distance and levator function after the surgery.

Results : There were no significant differences between two groups in the mean pre-operative MRD1 which was 2.57±0.41mm and levator function which was 9.09±1.12mm. After 1 week and 4 weeks, the mean MRD1 on eyes with topical anesthsia were 2.07±0.31mm and 2.33±0.38mm, respectively, and the mean MRD1 on eyes with Nadbath-Rehman-Ellis akinesia were 2.31±0.29mm and 2.48±0.47mm, respectively, which was significantly low. The levator function showed no significant difference. The reduction of MRD1 over 2mm was shown only in group with topical anesthesia which was significantly high in compare to the group with Nadbath-Rehman-Ellis akinesia which was none.

Conclusion : In cataract surgery, Nadbath-Rehman-Ellis akinesia can reduce the damage of levator aponeurosis which drops the occurrence of post-operative ptosis.