백내장 수술 후의 건성안에 대한 2% 레바미피드 단독투여와 0.15% 히알루론산 병합투여 비교

Comparison of 2% Rebamipide Monotherapy and 0.15% Hyaluronic Acid Combination Therapy for Dry Eye after Cataract Surgery

목적: 백내장 수술 후 발생한 건성안에서 2% 레바미피드점안액의 단독투여와 2% 레바미피드와 0.15% 히알루론산점안액의 병합투여효과를 비교하고자 한다. 대상과 방법: 백내장 수술 1주일째 건성안증후군으로 선별된 환자들을 무작위로 레바미피드 단독투여군과 병합투여군으로 분류하였다. 두 군에서 수술 1개월 및 2개월째에 strip meniscometry, 눈물막파괴시간, 각막염색점수, 눈물막삼투압, 눈물지질층두께, 안구표면질환지수를 측정하여 치료 효과를 평가했다. 결과: 단독투여군에서 수술 1, 2개월째에 눈물막파괴시간이 유의하게 호전되었고(p = 0.049, < 0.001), 2개월째에는 각막염색점수와안구표면질환지수가 호전되었다(p = 0.010, 0.007). 병합투여군은 1, 2개월째에 눈물막파괴시간(p < 0.001, < 0.001)과 각막염색점수(p = 0.001, < 0.001)가 유의하게 호전되었으나, 2개월째에 strip meniscometry와 안구표면질환지수가 악화되었다(p = 0.004, 0.012). 두 군을 비교한 결과, 1개월째 병합투여군이 단독투여군보다 눈물막파괴시간이 길고 눈물막삼투압이 낮았으나(p = 0.014, 0.028), 안구표면질환지수는 높았고 각막지질두께는 낮았다(p = 0.004, 0.043). 2개월째에는 병합투여군에서 strip meniscometry가 낮고, 안구표면질환지수가 높았다(p = 0.001, < 0.001). 결론: 백내장 수술 후 건성안 치료에 있어 레바미피드 단독투여와 비교하여 레바미피드와 히알루론산의 병합투여가 눈물막파괴시간과 각막염색점수를 개선하는 데 더 효과적이었다.

Purpose: To compare the effects of 2% rebamipide eye drop monotherapy versus in combination with 0.15% hyaluronic acid eye drops on dry eye syndrome following cataract surgery. Methods: One week post-cataract surgery, patients with dry eye syndrome were randomly assigned to receive either rebamipide monotherapy or a combination therapy with hyaluronic acid. Evaluations were conducted at 1 week, 1 month, and 2 months postoperatively, including strip meniscometry, tear breakup time, conjunctival and corneal staining, tear meniscus height, tear lipid layer thickness, and the ocular surface disease index. Results: In the rebamipide monotherapy group, significant improvements in tear breakup time were observed at 1 month (p = 0.049) and 2 months (p < 0.001) post-surgery, with additional improvements in ocular surface staining (p = 0.010) and ocular surface disease index (p = 0.007) at 2 months. In the combination therapy group, significant improvements in tear breakup time and staining were observed at both 1 and 2 months (tear breakup time: p < 0.001, < 0.001; staining: p = 0.001, < 0.001, respectively). However, strip meniscometry and ocular surface disease index scores worsened at 2 months (p = 0.004, 0.012, respectively). Compared to the rebamipide-only group, the combination group demonstrated higher tear breakup time, lower tear meniscus height, a higher ocular surface disease index score, and reduced corneal lipid layer thickness at 1 month (p = 0.014, 0.028, 0.004, 0.043, respectively). By 2 months, the combination group exhibited lower strip meniscometry scores and a higher ocular surface disease index (p = 0.001, < 0.001). Conclusions: The combined use of rebamipide and hyaluronic acid eye drops after cataract surgery showed benefits for dry eye syndrome, particularly with improvements in tear breakup time and corneal staining.