목적 : 변형 섬유주절제술의 효과를 알아보았다. 대상과 방법 : 2003년 1월부터 2007년 1월까지 녹내장환자 52명 55안 중, 27명 29안은 기존 섬유주절제술(기본수술군)을, 25명 26안은 변형 섬유주절제술(변형수술군)을 시행받았다. 변형수술군에서 공막편 모서리를 내측으로 1 mm 이동하여 봉합하였고, 과도한 방수유출을 예방하기 위해 공막편 양측에 추가봉합을 시행하였다. 두 군 대부분 0.02 mg/ml mitomycin‐C 0.1 ml를 결막하에 주사하였다. 안압, 합병증, 여과포 형태, 수술성공률 등을 후향적으로 조사하였다. 결과 : 아르곤레이저 봉합사용해를 각 군 절반에서 시행하였다. 술 후 1일과 1주를 제외하고는 변형수술군의 안압이 지속적으로 낮았고, 2개월과 12개월에 통계적으로 유의하게 낮았다(p<0.05). 두 군 간 합병증은 차이가 없었다. 미세낭포가 동반된 미만성 여과포는 변형수술군과 기본수술군이 각각 19안(73%), 17안(59%)으로 변형수술군에서 많았다. Kaplan‐Meier 생존분석을 이용한 누적성공률은 변형수술군에서 높았다(p<0.05). 결론 : 공막편의 봉합위치를 변형시킨 섬유주절제술이 기존 섬유주절제술에 비해 보다 효과적인 안압 조절 효과를 보였다.

Purpose: To evaluate the efficacy of trabeculectomy using modified scleral flap suture technique Methods: We retrospectively reviewed the medical records of 52 patients (55 eyes) who had undergone trabeculectomy from January 2003 to January 2007. Standard trabeculectomy was performed for 29 eyes of 27 patients, modified trabeculectomy for 26 eyes of 25 patients. We changed suture site of scleral flap corner about 1mm medially from original site and added tight suture to both lateral margins of scleral flap to prevent overflow in modified group. In both groups, most of patients were injected 0.1 ml of 0.02 mg/ml mitomycin-C (MMC) subconjunctivally and the others 0.1 ml of 0.04 mg/ml MMC. We evaluated intraocular pressure (IOP), complication, morphology of filtering bleb, cumulative success rates. Results: Argon laser suturelysis was performed postoperatively in about half cases of both groups. The IOPs of modified group were consistently lower than those of standard group for 24 months except postoperative 1 day and 1 week. There was a significant difference of IOP at postoperative 2 months and 12 months (p<0.05). No significant difference of complications was found between two groups. The diffuse bleb with microcyst was found in 19 eyes (73%) of modified group and 17 eyes (59%) of standard group. From Kaplan-Meier survival analysis, cumulative success rates of modified group were higher than those of standard group (p<0.05). Conclusions: Trabeculectomy using modified scleral flap suture appears to give better IOP control than standard trabeculectomy.

Purpose: To evaluate the efficacy of trabeculectomy using modified scleral flap suture technique Methods: We retrospectively reviewed the medical records of 52 patients (55 eyes) who had undergone trabeculectomy from January 2003 to January 2007. Standard trabeculectomy was performed for 29 eyes of 27 patients, modified trabeculectomy for 26 eyes of 25 patients. We changed suture site of scleral flap corner about 1mm medially from original site and added tight suture to both lateral margins of scleral flap to prevent overflow in modified group. In both groups, most of patients were injected 0.1 ml of 0.02 mg/ml mitomycin-C (MMC) subconjunctivally and the others 0.1 ml of 0.04 mg/ml MMC. We evaluated intraocular pressure (IOP), complication, morphology of filtering bleb, cumulative success rates. Results: Argon laser suturelysis was performed postoperatively in about half cases of both groups. The IOPs of modified group were consistently lower than those of standard group for 24 months except postoperative 1 day and 1 week. There was a significant difference of IOP at postoperative 2 months and 12 months (p<0.05). No significant difference of complications was found between two groups. The diffuse bleb with microcyst was found in 19 eyes (73%) of modified group and 17 eyes (59%) of standard group. From Kaplan-Meier survival analysis, cumulative success rates of modified group were higher than those of standard group (p<0.05). Conclusions: Trabeculectomy using modified scleral flap suture appears to give better IOP control than standard trabeculectomy.