20게이지, 23게이지, 25게이지 유리체 망막 수술 기구의 비교

목적: 20, 23, 25게이지 유리체절제기의 직경, 주입률과 흡입률에 대해 알아보고, 관류병의 높이에 따른 이론적, 실제적 안압 변화를 비교해 보고자 하였다. 대상과 방법: 외경과 내경은 유리체 절제기를 분해하여 실제의 외경과 내경을 측정하였다. 40, 60, 80, 100, 120 cm 높이에서 주입률과 100, 200, 300, 400, 500 mmHg의 압력에서 흡입률을 각각 측정하였다. 수술 중 안압은 관류병의 높이에 따르는 안압으로, 실제 안압은 수은 혈압계를 관류관에 연결하여 측정한 값으로 하였다. 결과: 외경은 20, 23, 25게이지 각각 900, 596, 500 μm (오차범위 ± 10 μm)였고, 내경은 각각 670, 450, 380 μm (오차범위 ± 10 μm)였다. 관류액 병의 주입률은 높이에 따라 정비례하여 늘어났고, 흡입률은 압력에 따라 증가하였다. 하지만 각 게이지에서 주입률과 흡입률의 증가량은 20게이지에서 가장 높고 23, 25게이지의 순서로 낮았다. 안압을 40, 60, 80, 100 cm에서 계산하면 29, 44, 59, 74 mmHg였으며, 측정치는 34, 50, 62, 74 mmHg였다. 결론: 케뉼라를 이용한 23, 25게이지 기구들은 20게이지 기구에 비해 주입률과 흡입률이 외경 비율보다 더 적었고, 23, 25게이지간의 차이는 크지 않음을 알 수 있었다. Purpose: To investigate the diameter, the infusion and aspiration rate of 20-, 23- and 25-gauge vitreous cutters, and compare the theoretical and practical intraocular pressure (IOP) change according to the height of the bottle. Methods: A vitreous cutter was disassembled to measure the actual external and internal diameter. The infusion rate was measured at the height of 40, 60, 80, 100 and 120 cm and the suction rate was measured at a pressure of 100, 200, 300, 400 and 500 mm Hg for each gauge. IOP during the operation was calculated according to the bottle height and the actual IOP was measured using a mercury sphygmomanometer. Results: The external diameter of the 20-, 23- and 25-gauge was 900, 596, and 500 mm, respectively, and the internal diameter was 670, 450, and 380 mm, respectively. The infusion rate increased in direct proportion to the bottle height. The aspiration rate increased as the pressure increased. However, the increment of the infusion and aspiration rate in the 20-gauge vitreous cutter was the highest and decreased in the 23- and 25-gauge, in that order. IOP was calculated as 29, 44, 59 and 74 mm Hg when the bottle height was at 40, 60, 80 and 100 cm, respectively, and was measured 34, 50, 62 and 74 mm Hg, respectively. Conclusions: The infusion and aspiration rates per outer diameter in the 23- and 25-gauge vitreous cutters and infusions using cannula were lower than in the 20-gauge vitreous cutter. The difference of the infusion and aspiration rates per diameter between the 23- and 25-gauge vitreous cutters and infusions was not significant. J Korean Ophthalmol Soc 2013;54(8):1236-1240