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서 론
ऀઌઅ ґࠒҀפֳણઅ ़ीહ ௗݑਁ ઔৰࣳ ࠒҀґ
ीࠃࣼ੭ґीࠒҀ੭୲ࠃ൙ৗ੭୲Ҏഥ࠾
ઊࡽࠤടҲઍৰ֥د1ઊਁെથґࠒҀפֳણઅઍୱહઌ
़ीહௗݑؘ5)8֢ބઊ౸ބઊ३&00&ݴઊੋടؘ
ࣼ੭ૂीઊ१രٻӋઔ੶֢ࠒേਉӘ೩ਁࣳઅࠒ
़Ә٩ഡਉӘݴ౿ഡસӘસ੶ܾઌഡޏޅ
࠾ਉӘ೩ਐӘֳਐڢઅഥ࠾ઊࠋࣥഢ़ઔ੶ઊ
ؘણԞऀӖݬۅৰ۱ݿ़ઔد2ഡٳߜӘ࣏ஔӴ ݴ౿നࠒ़੭ਁસധઍ੶ౄؘࡘؘࣼ੭અ॓ܭ Ӛાࡘਭ॓ܭӚઅֳௐ࠸੶্ܾܱઔد34மԕघґټ
7UDEHFWRPH®ઊੋഡֳௐાԕࣼ੭ґीࣼ੭ਭ
॓ܭӚઅֳௐ࠸ކࣷહ੶ܾૂңടӋઊ਼અ॓ܭӚઅ਼
ௐ࠸ଙҿӚࠃࠒ़ીޔԪીࣛહઌ੭ܾݴமفഡࡂ
ടؘ ़ीࠩ੶ܾ Ԟઅ ਉӘ़ीࡂدؘ ِ ।હઊӋ
ਉӘ೩ݴࣥऀഢചѿ৺Ԟਁഥ࠾ઊࡂدહҫ੶ܾ
্ܱઔد5ઊਁ7UDEHFWRPH®Әઊݴઊੋഡࣼ੭ґी
ਁفനघґടԓ൭ੋऀӘऀਁفനߚവӋ୵౿
ന্ৈࡂӋઘഡد
본 론
5SBCFDUPNF䛬ীೠࣗѐ
7UDEHFWRPH®ࣼ੭ਭ॓ܭӚઅֳௐ࠸ކࣷહ੶ܾૂ
ңടؘԞӴܾ195Ҳઊઅઍ൦ੋKDQGSLHFHWLSਁӚݩࠃ
ඛ ણௗਭ Ԟघઙણௗѿ ણ୲ٻৰ ઔৰ ґ ౿ന
KDQGSLHFHWLSࣘടӋࠒҀܫଊݴࡂࣳࣼ੭ਭ॓
ܮӚઅֳௐ࠸Ԟघઙ੶ܾૂңഢ़ઔد+DQGSLHFHWLS
800×230×110 PఽԞઊӋࣼ੭ݴ౿ന॓ܭӚਁા
ԕઊॕ٩ܿӋټIRRWSODWHѿشܱઔد)RRWSODWHؘࣼ੭
ݴࣔଠڝৰਣݼӋ࠹ଓ੶ܾઊനৌ٩ܿടؘ
ࡂفਊഢടਉࣷહ੶ܾࣼ੭ކԞघઙ१ే़ઔ ಡଙ1HZ+RUL]RQRI*ODXFRPD6XUJHU\
7UDEHFWRPH
®ઊੋഡࣼ੭ґी
ઊ੍
ᱽᯝᦩŝᄲᬱ
Fig. 1.7UDEHFWRPH®GHYLFH
Fig. 2.5HPRYDORIDQJOHWLVVXHEDUULHUUHVWDEOLVKLQJQDXWUDORXWIORZRI
DTXHRXVKXPRU
Journal of The Korean Glaucoma Society
JOURNAL OF THE KOREAN GLAUCOMA SOCIETY 14
٩ܿഡدԞघઙ$UJRQ%RYLH6W3HWHUVEXUJ)/86$ 800(8ݴઊੋടਉ550N+]અࡽ٩ܾ0110:DWWԪ
ന࣏ࣳੋઊѿ؟ട03PPਗਁඛણௗѿઔৰघઙ१ౄ
֢ࣳਠؘಶૂңടӋ3PPਗਁӚݩણௗѿ२ ඥӋࠒ੭ട٩ܿણ୲ٻৰઔد)LJ12
ࢻਬѐࣿࣻࣿߑߨ
़ीࠒࠩ Ӵઽބ൲ ઊௐ੶ܾ1617PPಉ
Ҁޅґ १ര ൲ ઽߜଖ ࣘടӋ ࠒҀܫଊݴ Ҁ ޅ ਁ ਣݾد ґ ౿ന KDQGSLHFH WLS ࡻௐ੶ܾ
ࣘഡ ൲ Ӛݩ ࠃ ඛ ടࣳ ࡻௐઅ ࣼ੭ݴ ࡂࣳ
KDQGSLHFHWLSાԕ१ౄӋIRRWSODWHݴࣼ੭ݴ౿ന॓ܭ ӚԪࣘഡ൲ࠋܾೖشࠎ੶ࣼ੭ਭ॓ܭӚઅֳ
ௐ࠸ઊԞघઙ੶ܾૂңټد१ӆࠒലઊ֢ࠉ१ӆࠒല੶
ܾ٭ৈѿKDQGSLHFHWLSଓઍ़ઔӋട֢અґ
౿നࡂ౿৩ࠒല੶ܾ90120°Ԫાԕઊѿ؟ടدઊ
൲ KDQGSLHFH WLS ૂңടӋ ಉҀޅґ ࡊഥഡد )LJ350LQFNOHUHWDO67UDEHFWRPH®ઊੋഡࣼ੭
ґी൲१രഡଓҩ࣏घҽਁࣳଓ࠾ݼഠહ੶ܾࣼ੭
ઊ ૂңٻӋ ࠹ ଓ੶ܾ ߸ंछࣛઊ ֢ౌ֢ ৌ
੶ଙഥӚӘ॓ܭӚઅ਼ௐ࠸ીࣛહ੶ܾ੭ٻৼ
ࡂӋടਔد)LJ4
Fig. 4.7UDEHFWRPH®UHPRYDORIPHVKZRUNFHOOVYLVLEOHRQRXWHUZDOORI
6FKOHPP±VFDQDOKXPDQDXWRSV\H\HFRXUWHV\RI'RXJ-RKQVRQ
Fig. 3.7UDEHFWRPH®VXUJLFDOVWHSV
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9ROXPH_1XPEHU
ࢻਬѐࣿബਊࢿ
)UDQFLVHWDO7ࠕֳણӘפֳણଔزࠊ൝ઘ304
فࣛ੶ܾഡӴਁ़ࣳीઊ200±63PP+J़ी
3ґਖ਼൲149±37PP+J़ी6ґਖ਼൲148±35PP+J
़ी12ґਖ਼൲155±29PP+J़ी21ґਖ਼൲167±35
PP+JܾࡂӋടਔدԓݼӋी൲3ґਖ਼ઊ൲ਁઊ21
PP+Jઊࣛઊٻң֢12ґਖ਼ઊֳஷѿહפֳણ़ी१ര ഡӄੌݴ५ೂ܅Ӌીઅടਔڹ6ґਖ਼ପऀӖݬ84ࠕֳ
ણ़ीҎઊഡӄੌ6ґਖ਼Ә12ґਖ਼ପऀӖݬ78ਭ64
ܾࡂӋടਔد
0LQFNOHUHWDO8ٻৌؘґࠒҀפֳણ൝ઘ1127
فࣛ੶ܾഡӴਁࣳࣼ੭ґीކ१രഡ൝ઘ738
فࣛ੶ܾѿഡҿӘ़ीઊ257±77
PP+J़ी3ґਖ਼൲165±47PP+J़ी6ґਖ਼൲165
±42PP+J़ी12ґਖ਼൲161±30PP+J़ी24ґਖ਼
൲166±40PP+JܾࡂӋടਔد़ी൲ઊ21PP+J
ઊࣛ੶ܾࣛ०ടӋ2൲ԪౌਉӘ़ी৺ઊी
અ20ઊࣛ҆घടৌӄੌݴ५ೂ܅Ӌીઅടਔڹ
24ґਖ਼ପ़ीऀӖݬ61ਔدۙഡࣼ੭ґीӘ़ી
ஔ੭൛ीҎઊ१രഡ366فࣛ੶ܾѿഡҿ Ә़ीઊ200±62PP+J़ी3ґਖ਼൲147±
37PP+J़ी6ґਖ਼൲148±32PP+J़ी12ґਖ਼൲
159±33PP+J़ी24ґਖ਼൲149±31PP+JܾࡂӋട ਔد
)HUUDULHWDO9ৢߜܾٻৌؘґࠒҀפֳણ൝ઘ֢
ѿऀࡻؙפֳણ൝ઘ11فࣛ੶ܾ१രഡӴਁ़ࣳी
ઊ250PP+J़ी1ґਖ਼൲158PP+J़ी3ґ ਖ਼൲154PP+J़ी6ґਖ਼൲154PP+J़ी12ґਖ਼൲
152PP+J़ी24ґਖ਼൲150PP+JܾࡂӋടਔد
ӵֳਁؘࣳ&KXQJHWDO10ઊԞਉӘ़ीਉܟୱܺ१ രടਔਁ٩ௗݑਁৰܱઊઔৼَ֥ௗऀ൝ઘ1ف
ࣛ੶ܾࣼ੭ґी१രടਉ़ीઊ26PP+J
़ी1ઍ൲14PP+J़ी7ઍ൲15PP+J़ी1ґਖ਼൲
24PP+J़ी3ґਖ਼൲20PP+JܾࡂӋടਔدी൲ઍ१ હઌࣛ०ઊઔৼ੶ടҋૂੋܞઊؘ߆യ
੶֢֥ௗऀ൝ઘݴी൲ࣛઊ֢સڢઅഥ࠾
৺ઊ3ґਖ਼Ԫ21PP+Jઊടઅౖࣛݴ੭ഢ़ઔৼ دӋࡂӋടਔد
ࢻਬѐࣿউࢿ
ਉܟӴਁࣳ7UDEHFWRPH®ઊੋഡࣼ੭ґी൲ࠋࣥ
ഢ़ઔؘഥ࠾੶ؘܾࠒേસઍ१હઌ
ࣛ०़ીஔ֮छࣛࣛഗҿछٙफ़ެޅേࠃࠆݼৗࠒ Ҁ੭୲ڢઊࠋࣥഢ़ઔدӋടਔ੶)UDQFLVHWDO7304
فࣛ੶ܾഡӴਁࣳࠒേ784ਁࣳ൜ઌടਔ
੶֢ઍֳٻৼ੶5PP+J߸ކઅસ13
़ીஔ֮छࣛ13ܾࡂӋടਔد0LQFNOHUHWDO8൝ઘ
1127فࣛ੶ܾഡӴਁ़ࣳी1ઍ൲5PP+J߸ކઅ
સ15़ी1ઍ൲10PP+JઊࣛԚࣛ०અӄ
ੌѿ58ࠒ़੭ઊ01ࠋࣥടਔدӋࡂӋടਔدԓݼ Ӌ&KXQJHWDO10અܺਁࣳ٩ઍ१હઌࠒേઊઔৼ੶֢
7ઍઊֳਁघ५ٻৼ੶ԓ਼અഥ࠾Ӛ୵ٻৌد
)UDQFLVHWDO11ࣼ੭ૂीࠃ़ીஔ੭൛ी१രഡ൝ ઘӶӘ7UDEHFWRPH®ઊੋഡࣼ੭ґीࠃ़ીஔ੭൛ी
ഡ൝ઘӶ੶ܾ֢ৰഥ࠾ࡻӯടਔڹࣼ੭
ૂी१രഡӶਁؘࣳ1ґਖ਼ઊࣛङٻؘસ17
ઍ१હસ13ࠒ़੭4ޔ܆ޅࠆݼ9ޔ܆ޅ ੭4અഥ࠾ઊӚ୵ٻৼ੶֢ࣼ੭ґी१രഡӶ
ਁؘࣳഥ࠾ઊӚ୵ٻৌدӋࡂӋടਔد
ਉܟӴਁࣳࡂӋടਔڡઊ7UDEHFWRPH®ઊੋഡࣼ੭
ґीਉӘ೩ݴކڝৌԞڹߚਁਉӘ೩ܾઌനࠋࣥഢ
़ઔؘഥ࠾ࠒഢ़ઔ੶ࠒ़અ੭ઊࣛӖޅേ
Ӛ౿ടҲٻܾ߳ઊ݀હ੶ؘܾઊࣛӖޅીޔࡂد
़֯৺ৰસਁઅഡޔ܆ޅࠆݼࠃേӘൠࠉ࠾
અസഗഢ़ઔد12ۙഡҿޅࡂടܾ߳ी൲
ઊઊݗৰৌң֢१ৡҿछઊଔരٻؘӄੌஷѿܾ
ࣼ੭ૂीઊ֢ࠒ़੭ણௗࣘीӘҎԞઅפֳ
ણ़ीઊѿ؟ടدؘણઽઊઔد13
결 론
7UDEHFWRPH®ઊੋഡࣼ੭ґीԞઅ़ीࡂدी
Ԟѿҁزട७Ҁഡഥ࠾ઍ़ઔؘણઽѿӋ
ઔدऀӖݬਁઔৰധف࣏ߜଖ࣏ੋഡࣼ੭ૂीࡂد
دघ֯੶ടҋ൭Әۙഡدघৢഡઽઊઔ੶֢ҿޅ
ࡂഢ़ઔৰஷѿહઌਉӘ़ीઊѿ؟ടدؘઽਁࣳ
ґࠒҀפֳણ൝ઘਁࣳӋܱനࡆ़ઔ़ؘीહࠒࠩ੶ܾࣥ
Ҁټد
참고문헌
1. Luntz MH, Livingston DG. Trabeculotome ab externo and
Journal of The Korean Glaucoma Society
JOURNAL OF THE KOREAN GLAUCOMA SOCIETY 16
trabeculectomy in congenital and adult-onset glaucoma.
Am J Ophthalmol 1977;83:174-9.
2. Kobayashi H, Kobayashi K, Okinami S. A comparison of the intraocular pressure-lowering effect and safety of viscocanalostomy and trabeculotomy with mitomycin C in bilateral open-angle glaucoma. Arch Clin Exp Oph- thalmol 2003;241:359-66.
3. Brubaker RF. Targeting outfl ow facility in glaucoma man- agement. Surv Ophthalmol 2003;48(suppl):S17-20.
4. Lutjen-Drecoll E. Functional morphology of the tra- becular meshwork in primate eyes. Prog Retin Eye Res 1999;18:91-119.
5. Nguyen QH. Trabectome: A novel approach to angle sur- gery in the treatment of glaucoma. Int Ophthalmol Clin 2008;48:65-72.
6. Minckler DS, Mosaed S, Dustin L, et al. Trabectome (trabeculectomyinternal approach): additional experi- ence and extended follow-up. Trans Am Ophthalmol Soc 2008;106:149-60.
7. Francis BA, Minckler D, Dustin L, et al. Combined cata- ract extraction and trabeculotomy by internal approach for coexisting cataract and open-angle glaucoma. J
Cataract Refract Surg 2008;34:1096-103.
8. Minckler DS, Mosaed S, Dustin L, et al. Trabectome (trabeculectomyinternal approach): additional experi- ence and extended follow-up. Trans Am Ophthalmol Soc 2008;106:149-60.
9. Ferrari E, Bandello F, Roman-Poqnuz D, et al. Combined clear corneal phacoemulsification and ab interno tra- beculectomy: three-year case series. J Cataract Refract Surg 2005;31:1783-8.
10. HY Chung, JW Choi, JY Choi, et al. Ab interno trabecu- lotomy with Trabectome® for refractory primary open angle glaucoma: a case report. J Korean Ophthalmol Soc 2011;52:502-6.
11. Francis BA, Winarko J. Combined trabectome and cata- ract surgery versus combined trabeculectomy and cata- ract surgery in open angle glaucoma. Clin Surg Ophthal- mol 2011;29:4-10.
12. Mosaed S. Ab interno trabeculotomy with the trabectome surgical device. Techniq in Opthalmol 2007;5:63-6.
13. Godfrey DG, Fellman RL, Neelakantan A. Canal surgery in adult glaucoma. Curr Opin Ophthalmol 2009;20:116-21.