건성안 환자에서 두 종류의 실리콘 눈물점마개의 효과, 유지, 합병증 분석

Efficacy, Retention, and Complications of Two Types of Silicone Punctal Plugs in Dry Eye Patients

목적: 건성안 환자에서 두 종류의 실리콘 눈물점마개를 삽입한 후 건성안 임상 효과, 유지율과 합병증에 대해 비교해보고자 하였다. 대상과 방법: SuperEagle Punctum Plug™ 또는 Parasol Punctum Plug™를 눈물점에 삽입한 73명(133안)을 대상으로 의무기록을 분석하였다. 건성안 치료 효과를 기존의 건성안 지표와 빛간섭단층촬영으로 측정한 눈물띠 높이로 알아보았고, 눈물점마개의 전체적인 유지율, 합병증을 조사하고, 첫 6개월 유지율, 합병증을 군 간 비교 분석하였다. 결과: 평균연령은 52.52 ± 13.66세(13-82세)이고, A군은 79안, B군은 54안이었다. 눈물띠 높이가 눈물점마개의 탈락이나 제거 여부와 상관없이 6개월 이후 증가하는 경향을 보였고, 각 피험자에서 시술 전과 6개월 후 눈물띠 높이 변화와 쉬르머Ⅰ검사 수치 변화는 양의 상관관계를 보였다(p=0.007). 합병증은 두 군 모두 눈물점마개 탈락이 가장 많았다. 유지율은 Parasol plug (44.4%)가 SuperEagle (24.1%)보다 높았으며(p=0.012), 두 군에서 중간 크기 눈물점마개의 유지율이 작은 크기 눈물점마개의 유지율보다 높았다(p=0.027). 나이가 많을수록 6개월 유지율이 낮았다(p=0.032). 결론: 눈물점마개의 종류나 합병증 여부에 상관없이 건조증 치료 효과가 있었으며, Parasol Plug의 유지율이 더 우수하였다.

Purpose: We analyzed the clinical efficacy, retention rates, and complications after inserting two types of silicone plugs in dry eye patients. Methods: The medical records of 73 patients (133 eyes) whose lacrimal puncta were occluded with the SuperEagle Punctum Plug™ (EagleVision, Denville, NJ, USA) or the Parasol Punctum Plug™ (Beaver-Visitec International, Inc. Waltham, MA, USA) were analyzed. Conventional indices for dry eye disease and tear meniscus height (TMH) using optical coherence tomography were used to determine the clinical efficacy. The overall retention rates and complications were investigated and those of each plug were compared between the two groups during the first 6 months after insertion. Results: The average age was 52.52 ± 13.66 years (13-82 years). Group A included 79 eyes and group B included 54 eyes. TMH tended to increase after 6 months regardless of plug loss or removal due to complications. Schirmer Ⅰ test value differences before and 6 months after plug insertion were positively correlated with the TMH differences in study subjects (p = 0.007). Plug loss was the most frequent complication in both groups. The retention rate of the Parasol plug was higher than the SuperEagle plug (44.4% and 24.1% respectively) (p = 0.012) and the retention rate of medium-sized plugs was higher than small-sized plugs (p = 0.027). Also, the plug retention rate decreased with age at 6 months (p = 0.032). Conclusions: Punctal occlusion with a silicone punctal plug was effective, regardless of the plug type or complication. The retention rate of the Parasol plug was higher than the SuperEagle plug.