PurposeTo assess the relationship between eye position and anesthesia depth using the bispectral index (BIS) value, a parameter derived from electroencephalography data.MethodsWe investigated the relationship between BIS value and eye position in 32 children who underwent surgery for epiblepharon under general anesthesia. BIS values were recorded continuously throughout the procedure (from induction to awakening). Eye positions were video-recorded and analyzed after surgery. The vertical position of each eye was scored according to its height in relation to the medial canthus. An eye position in which the upper eyelid covered one-third of the cornea was defined as a significant ocular elevation.ResultsThe BIS value correlated inversely with the end-tidal concentration of each anesthetic agent, whereas it correlated positively with the eye elevation score (eye position = 0.014 × BIS + 0.699, p = 0.011). The mean eye position score was significantly greater in patients whose BIS values were over 65. Eleven patients (34.4%) had significant ocular elevation; their mean concurrent BIS value was 61.6. Two of these patients had elevation during surgery and 9 had elevation during emergence from anesthesia.ConclusionsWe found that high BIS values were correlated with low levels of anesthetic concentration and high eye position, suggesting that BIS monitoring may be useful for predicting eye position during anesthesia. Particular attention must be given to eye position during ophthalmic surgery. Anesthesia depth can be maintained by assuring that the BIS value remains below 65.

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목적: 정상군과 녹내장군에서 수술 전 인자가 백내장 수술 후 안압하강 정도를 예측하는데 도움이 되는지를 알아보고자 하였다. 대상과 방법: 정상군 30명, 개방각녹내장군 24명, 폐쇄각녹내장군 31명을 대상으로 수술 전과 수술 후 3개월의 안압을 측정하였다. 각 군별로 수술 전 안압, 전방 깊이, 안축장 길이, 수술 전 안압을 전방 깊이로 나눈 Pressure/Depth ratio (PD ratio), 수술 전 안압을 안축장으로 나눈 Pressure/Length ratio (PL ratio)와 안압하강 정도와의 관계를 분석하였다. 결과: 안압하강 정도와 수술 전 안압은 세 군에서 모두 유의한 상관관계를 보였다(p＜0.001). PD ratio는 개방각녹내장군에서만 안압하 강 정도와 유의한 상관관계를 보였으나(p＜0.001) PL ratio는 세 군 모두에서 유의한 상관관계를 보였고(p＜0.05), 술 후 안압하강을 예측하는 데 PL ratio가 PD ratio보다 나은 민감도와 특이도를 보였다. 결론: PL ratio는 백내장수술 후 안압하강을 예측하는 데 유용한 지표이며, 다른 대상군에 비해 개방각녹내장군에서의 예측력이 더 좋은 경향을 보였다.Purpose: To investigate the relationships between preoperative factors and intraocular pressure (IOP) reduction after phacoemulsification in normal, open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) patients. Methods: IOP was measured before and 3 months after cataract surgery in 30 normal, 24 OAG and 31 ACG patients. The relationship between IOP reduction after cataract surgery and preoperative parameters including anterior chamber depth (ACD), axial length (AL), preoperative IOP/ACD ratio (PD ratio), preoperative IOP/AL ratio (PL ratio) were investigated in the 3 groups. Results: Significant IOP reduction was observed in all 3 groups after surgery (paired sample t-test; p < 0.05), and IOP reduction was correlated with preoperative IOP level in all 3 groups (Pearson's correlation; p < 0.05). Other preoperative parameters such as ACD and AL were not correlated with IOP reduction, and PD ratio was significantly correlated with IOP reduction only in the OAG group (Pearson's correlation; p < 0.001). PL ratio was significantly correlated with IOP reduction in all 3 groups (Pearson's correlation; p < 0.05) and showed the best sensitivity and specificity to predict significant reduction in IOP after cataract surgery among parameters including preoperative IOP, PD ratio and PL ratio. Conclusions: PL ratio was significantly correlated with IOP reduction after cataract surgery in all 3 groups and showed a higher predictive value for IOP reduction in the OAG group than in the other groups.