열공망막박리에서 망막 전임의가 시행한 공막돌륭술의 임상결과 = Surgical Outcome of Scleral Buckling for Rhegmatogenous Retinal Detachment Performed by Vitreoretinal Fellow

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the surgical outcome of scleral buckling performed by vitreoretinal fellows compared with that performed by retina specialists.
Methods: Clinical records of patients who underwent scleral buckling due to rhegmatogenous retinal detachment performed by vitreoretinal fellows with less than 2 years of experience were retrospectively reviewed. The same number of surgeries performed by retina specialists with more than 10 years of experience were also reviewed for comparison. Anatomical success was defined by the 1-year reattachment rate without reoperation.
Results: Forty-one eyes of 41 patients treated by fellows and same number of eyes treated by retina specialists were included in this study. Mean patient age was 42.9 ± 18.4 and 31.7 ± 14.5 years, respectively (p = 0.003). Preoperative visual acuity, refractive error, phakic status, and macular detachment rate were not significantly different between the two groups. Inferior retinal breaks were present in 29.3% (12/41) of patients in the fellow group and 56.1% (23/41) of those in the retinal specialist group (p = 0.014). The anatomical success rate in the fellow group was significantly lower than that of the retinal specialist group: 80.5% (33/41) versus 95.1% (39/41), respectively (p = 0.043).
Conclusions: Vitreoretinal fellows performed scleral buckling in older patients and in rhegmatogenous retinal detachment with fewer inferior retinal breaks with an 80.5% anatomical success rate; however, this was significantly lower than the success rate of retina specialists.

국문 초록 (Abstract)

목적: 열공망막박리에서 전임의가 시행한 공막돌륭술의 수술 결과에 대해 알아보고 이를 망막교수의 결과와 비교하고자 한다.
대상과 방법: 2013년부터 2018년까지 의무기록을 후향적으로 분석하여, 2년 이내의 경험을 가진 전임의가 열공망막박리 환자에서 공막돌륭술을 시행한 환자들을 대상으로 환자의 특성 및 해부학적 성공률을 확인하였다. 2018년 1월부터 10년 이상의 경험을 가진 망막 교수가 시행한 같은 수의 공막돌륭술 환자를 순차적으로 확인하여 전임의의 수술 결과와 비교하였다. 해부학적 성공은 1회의 수술로1년째 망막이 재유착된 경우로 정의하였다.
결과: 전임의가 시행한 수술 41명의 41안과 교수가 시행한 수술 41명의 41안이 본 연구에 포함되었다. 평균 연령은 전임의 수술 환자에서 42.9 ± 18.4세, 교수 수술 환자에서 31.7 ± 14.5세로 유의한 차이가 있었다(p = 0.003). 수술 전 시력 및 굴절이상, 수정체 상태, 황반박리 여부 등은 두 군 간에 차이가 없었으며, 하측의 망막열공이 동반된 비율은 전임의 수술은 29.3% (12/41), 교수 수술은56.1% (23/41)로 차이를 보였다(p = 0.014). 해부학적 성공률은 전임의 수술은 80.5% (33/41), 교수 수술은 95.1% (39/41)로 통계적으로 유의한 차이를 보였다(p = 0.043).
결론: 전임의들은 교수에 비하여 고령의 환자와 하측 망막열공이 동반되지 않은 열공망막박리 환자에서도 공막돌륭술을 시행하고 있으며 80.5%의 성공률을 보였으나, 교수의 수술 성공률에 비해서는 낮은 것으로 나타났다.

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