유리체절제술 시행 후 각막내피세포밀도의 변화

The Change in Corneal Endothelial Cell Density after Pars Plana Vitrectomy

Purpose: To assess the effect of pars plana vitrectomy and gas tamponade on corneal endothelial cell density. Methods: The corneal endothelial cell density in 145 eyes that underwent pars plana vitrectomy was examined with a noncontact specular microscope 3 months pre- and post-operation. The subjects were divided as follows: Group 1 (32 eyes) underwent pars plana vitrectomy, group 2 (26 eyes) underwent pars plana vitrectomy combined with gas tamponade, group 3 (34 eyes) underwent pars plana vitrectomy combined with phacoemulsification and group 4 (48 eyes) underwent pars plana vitrectomy combined with phacoemulsification and gas tamponade. The changes in corneal endothelial cell density between groups was compared. Results: The mean endothelial cell loss was more significant in group 2 than in group 1 (p = 0.012), and there was no difference between groups 3 and 4 (p = 0.063). However, after excluding 6 eyes that had blood in the center of the corneal endothelium as a result of being in the prone position following gas tamponade, the mean endothelial cell loss in group 2 was not less than in group 1. In eyes with blood in the corneal endothelium, endothelial cell loss significantly increased (p < 0.001). Conclusions: The results of this study suggest that ophthalmic surgeons should attempt to carefully control bleeding and sufficiently irrigate the vitreous during pars plana vitrectomy combined with gas tamponade. J Korean Ophthalmol Soc 2011;52(5):544-549