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목적 : To analyze the cystoid changes of macula and to evaluate the affecting factors on macular thickness after phacoemulsification and IOL implantation.
방법 : A retrospective chart review was done to patients who underwent uneventful phacoemulsification and IOL implantation in Seoul National University Hospital, from April 2012 to April 2013(n=416). The incidence of cystoid macular changes was evaluated. The patients were divided into groups depending on usage of prednisolone or NSAIDs, the presence of diabetes mellitus(DM), DM Retinopathy, epiretinal memebrane(ERM), age-related macular degeneration(ARMD), and ocular inflammatory diseases. Macular thickness and edema was measured by optical coherence tomography, before and 1 month after operation.
결과 : Cystoid macular changes were developed in 1.7% of the patients. Patients receiving oral aceclofenac showed significant reduction in retinal thickness change in 3mm of the macula (p<0.05, independent t-test), while, the patients receiving oral steroids showed no significant increase. Patients with DMR, ERM or history of uveitis or scleritis showed significant elevation of retinal thickness in the 3mm zone(p<0.05, independent t-test). Logistic regression analysis showed increased probability of 3 standard deviation changes of retinal thickness in patients over 65 (OR 1.601, p=0.090).
결론 : This study suggests that adding postoperative oral aceclofenac can reduce macular edematous changes in phacoemulsification and IOL implantation and also indicates that the patients with concomitant DMR, ocular inflammatory diseases or ERM may have a risk of macular changes in phacoemulsification and IOL implantation.
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