수기 수정체낭 원형절개술과 정밀 펄스에너지를 이용한 수정체낭 원형절개술의 임상 결과 비교 연구
The Clinical Outcomes of Manual Continuous Curvilinear Capsulorhexis and Precision Pulse Capsulotomy
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목적: 일반적인 양안 백내장수술 환자에서 단안은 수기로 반대안은 정밀 펄스에너지를 이용한 수정체낭 원형절개를 시행하였을 때안전성 및 일관성을 비교하며 수술 후 임상 결과에 차이를 확인해보고자 하였다. 대상과 방법: 양안 백내장으로 진단받은 환자 101명을 대상으로 동일한 환자에서 양안 백내장수술 진행 시 단안은 정밀 펄스에너지를이용한 수정체낭 원형절개술을 시행하였고 반대안은 수기로 수정체낭 원형절개를 진행하였다. 전낭절개의 소요 시간, 크기 및 원형도를 측정하였고 수술 중 방사상 파열 등의 합병증 여부, 초음파 에너지, 수술 후 시력, 각막내피세포 수를 측정하여 두 군 간 독립표본t검정을 통해 비교하였다. 결과: 펄스에너지군과 수기군에서 전낭절개에 소요된 시간은 통계학적으로 유의한 차이가 없었다. 전낭절개의 크기는 펄스에너지군에서 통계적으로 유의하게 작았고 전낭절개의 원형도는 펄스에너지군에서 통계적으로 유의하게 높았다. 전낭절개 도중 합병증 발생은수기군에서 2건, 펄스에너지군에서는 없었으며 술 후 나안시력, 최대교정시력, 각막내피세포 수에는 두 군 사이에 유의한 차이가 없었다. 결론: 백내장수술 시 동일한 환자에서 양안을 수기 및 정밀 펄스에너지를 이용한 수정체낭 원형절개를 시행하였을 때 정밀 펄스에너지를 이용한 수정체낭 원형절개가 높은 원형도와 작은 수정체낭 원형절개 크기를 보였으며 수술 중 낮은 합병증 발생률을 보였다. 수술 후 임상 결과에서는 두 군 간 유의한 차이를 나타내지 않았다.
Abstract
Purpose: To compare the safety and consistency of manual capsulorhexis and precision pulse capsulotomy performed using pulsed energy during bilateral cataract surgery and to explore the differences in clinical outcomes. Methods: A total of 101 patients with bilateral cataracts were selected. Precision pulse capsulotomy was performed on one eye and manual continuous curvilinear capsulorhexis on the other. The independent-samples t-test was used to compare the duration of continuous curvilinear capsulorhexis, incisional size and roundness, complications such as radial tears, the cumulative dissipated energy, the visual acuity after surgery, and the corneal epithelial cell count. Results: There was no significant difference in the capsulorhexis time between the pulse energy and manual groups. The extent of capsulorhexis was significantly smaller and the circularity of capsulorhexis was higher in the former group. Complications occurred in two manual capsulorhexis patients but in no pulse energy capsulotomy patient. There was no significant between- group difference in any of postoperative visual acuity, best-corrected visual acuity, or the corneal endothelial cell count. Conclusions: During bilateral cataract surgery on the same patients, precision capsulotomy using pulse energy afforded smaller and more circular capsulorhexis and fewer complications than did manual capsulorhexis. However, there was no significant between- group difference in the postoperative clinical outcomes.
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