유리체절제기 파편에 의한 안내이물

목적: 유리체 절단침에 의한 안내이물을 경험하였기에 보고하고자 한다. 증례요약: 과거력상 4개월 전 우안 망막박리로 유리체절제술을 시행 받았던 60세 여자 환자가 내원 2일전부터 발생한 우안 시야흐림 증상으로 내원하였다. 세극등현미경검사상 우안 하측 각막부종이 관찰되었고 우각경검사상 하측 전방각에 금속성 이물이 관찰되어 수술적 제거를 시행하였다. 제거된 금속이물은 유리체 절단침의 말단부위였고 제거 후 각막부종은 소실되었다. 결론: 유리체절제술 중 유리체절단침의 파손가능성에 주의해야 하며 파손시 즉각적인 제거가 필요할 것으로 생각된다. Purpose: To report a case of intraocular foreign body of a vitreous cutter tip fragment. Case summary: A 60-year-old women was referred by her ophthalmologist with a two-day history of visual disturbance in her right eye. She had undergone pars plana vitrectomy, barrier laser and C3F8 gas injection due to pseudophakic rhegmatogenous retinal detachment in our retinal service center four months previously. Slit-lamp biomicroscopy of her right eye showed cornea stromal edema with Descemet membrane folding. Gonioscopic examination revealed a metallic foreign body in the direction of the 6-o`clock anterior chamber angle. Anterior chamber irrigation with successful removal of the metallic foreign body using intraocular foreign body forceps was performed. The removed intraocular foreign body was a vitrectomy cutter tip fragment 20 gauge in size and 3 mm in length. After surgery, the corneal stromal edema disappeared and her visual acuity in the right eye recovered. Conclusions: Intraoperative breakage of vitreous cutter tips can occur and cause toxic ocular tissue reaction. Care should be taken against vitreous cutter tip breakage during vitrectomy. J Korean Ophthalmol Soc 2010;51(1):141-144