유리체절제술 중 광각안저관찰렌즈에 발생하는 김서림 예방 방법의 비교

목적: 유리체절제술 중 광각안저관찰렌즈에 발생하는 김서림을 예방하기 위해 warm saline과 anti-fog solution을 이용한 방법의 효과를 비교하였다. 대상과 방법: 섭씨 36℃, 5 L의 물을 용기에 담고 광각안저관찰렌즈에 발생하는 김서림 영역을 현미경 영상으로 획득하였다. 렌즈를1분간 25℃의 sailne에 담근 군(control), 50℃의 sailne에 담근 군(warm saline), 25℃의 sailne에 담근 후 anti-fog solution을 도포한군(anti-fog)으로 나누었으며 각각 10초, 1분, 3분, 5분의 김서림 영역(%)과 렌즈 중심 영역 침범 유무를 확인하였다. 각 10회의 실험을반복하였다. 결과: Control군은 모든 실험 동안 100% 김서림 영역이 확인되었다. 10초, 1분, 3분, 5분의 평균 김서림 영역은 warm saline군이 4.34 ± 1.28%, 6.30 ± 1.38%, 56.00 ± 25.01%, 93.81 ± 5.88%, anti-fog군이 4.74 ± 0.57%, 7.35 ± 0.96%, 10.13 ± 1.09%, 11.74 ± 1.74%였고, 3분과 5분에서 유의한 차이를 보였다(p=0.029, p=0.012). Warm saline군은 3분과 5분 경과 후 각각 8예, 10예의 렌즈중심 영역 침범이 있었으며 anti-fog군은 관찰되지 않았다. 결론: Anti-fog solution을 광각안저관찰렌즈에 도포하는 방법은 유리체절제술 중 발생하는 김서림을 예방할 수 있다. Purpose: To compare the effectiveness of warm saline and anti-fog solution for preventing fogging of a non-contact wide-field viewing system during vitrectomy. Methods: Five liters of water at 36°C were placed in a transparent container. The fogging areas of wide-field lenses were microscopically measured. We created three groups: lenses soaked in normal saline at 25°C for 1 minute (control), lenses soaked in normal saline at 50°C for 1 minute (warm saline), and lenses that were wiped with a sponge soaked in anti-fog solution (ULTRASTOP pro med. Solution, Sigmapharm, Vienna, Austria) after prior soaking in normal saline at 25°C for 1 minute (anti-fog). Images of fogged areas were acquired at 10 seconds and 1, 3, and 5 minutes. Extent of fogged areas and central lens invasion were determined. All experiments were repeated 10 times. Results: In the control group, the entire areas were always completely fogged. The average fog coverage values were 4.34 ± 1.28, 6.30 ± 1.38, 56.00 ± 25.01, and 93.81 ± 5.88% at 10 seconds and 1, 3, and 5 minutes in the warm saline group and 4.74 ± 0.57, 7.35 ± 0.96, 10.13 ± 1.09, and 11.74 ± 1.74% in the anti-fog group, respectively. There were significant differences at 3 and 5 minutes (p = 0.029, p = 0.012). Fogging of the central lens was detected in 8 tests after 3 minutes and all 10 tests after 5 minutes in the warm saline group, but no fogging was detected in the anti-fog group. Conclusions: Application of an anti-fog solution to a wide-field viewing lens prevents lens fogging during vitrectomy. KCI Citation Count: 0