수술 후 마비성 동공 산대를 유발하는 원인 분석 및 분류

• 영문명: Analysis of the Etiologies and the Classification of Fixed Dilated Pupil after Intraocular Surgery
• 발행기관: 대한안과학회
• 저자명: 김용찬 나종경 김만수,Yong Chan Kim, MD, Jong Kyung Na, MD, Man Soo Kim, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume56,number1, 47~54쪽, 전체 8쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2015.01.15

영문 초록

Purpose: To seek for mechanisms to prevent fixed dilated pupil including Urrets-Zavalia syndrome after intraocular surgery by analyzing and classifying the causes of such cases. Methods: Medical records and anterior segment photographic images of patients with fixed dilated pupil who underwent penetrating keratoplasty, lamellar keratoplasty, or cataract surgery were analyzed in a retrospective manner from April, 1984 to February, 2014. Results: Among 15 cases of postoperative fixed dilated pupil, 8 eyes of keratoconus eyes had received penetrating keratoplasty done and 7 eyes with ocular disorders other than keratoconus underwent intraocular surgeries. In cases 1 and case 2, which received penetrating keratoplasty for keratoconus, dilated pupil with regular pupil border, iris atrophy, and secondary glaucoma occurred; these cases were classified as group 1 and diagnosed as Urrets-Zavalia syndrome. Cases from 3 to 8 which also received penetrating keratoplasties due to keratoconus, irregularly dilated pupil, severe iris atrophy, posterior synechiae after moderate to severe inflammation in the anterior chamber, and fibrotic membrane on the anterior capsule occurred; these cases were classified as group 2. Finally, cases 9 to 15, which had mild inflammation, no fibrotic membrane, and regularly fixed dilated pupil after receiving other intraocular surgeries were classified as group 3. Conclusions: Differences exist between definite Urrets-Zavalia syndrome and postoperative fixed dilated pupil with regards to regularity of pupillary margin, degree of iris atrophy, posterior synechiae, fibrotic membrane, and posterior subcapsular opacity. Therefore, a new classification of fixed dilated pupil after intraocular surgery which addresses these characteristics is required and various trials to prevent the adverse postoperative complications of fixed dilated pupil should be performed. Preventive measures may include careful control of intraocular pressure, restricting atropine use, completely removing of viscoelastics, and minimal air or gas injection. J Korean Ophthalmol Soc 2015;56(1):47-54

키워드

Fixed dilated pupil, Penetrating keratoplasty, Urrets-Zavalia syndrome