인공수정체의 지지부 모양에 따른 백내장수술 후 굴절력의 변화 분석
Analysis of Refractive Error after Cataract Surgery According to the Haptic Shape of Intraocular Lens
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목적: 백내장수술 시 지지부 모양이 다른 인공수정체 삽입 후 굴절력 변화를 분석하여 지지부 모양에 따른 수술 후 굴절력의 정확도를비교하고자 한다. 대상과 방법: 양안 백내장수술 환자의 한 눈에 MBⓇSAL302AC (C형 인공수정체)를, 반대 안에 ZeissⓇCT Asphina509M (판형 인공수정체)를 삽입한 254명, 508안의 의무기록을 후향적으로 분석하였다. Barrett Universal II 공식을 사용하여 술 후 1주, 2주, 1개월, 2개월, 6개월째의 실굴절력과 예상했던 굴절력과의 오차를 비교하였다. 결과: C형군의 굴절력 오차는 술 후 1주째 -0.26 ± 0.42 diopter (D), 2주째 -0.17 ± 0.45 D로, 1주 대비 2주째 근시 정도가 감소되는윈시성 이동이 되었고(p<0.001), 이후 유의미한 변화는 없었다. 판형군의 굴절력 오차는 술 후 1주째 -0.37 ± 0.45 D, 2주째 -0.25 ± 0.44 D, 1개월째 -0.11 ± 0.44 D, 2개월째 -0.04 ± 0.44 D로 술 후 2주(p<0.001), 1개월(p<0.001), 2개월(p=0.02)까지 모두 원시성 이동이 되었으며, 이후 유의미한 변화가 없었다. 술 후 2개월째 관찰된 굴절력의 평균절대오차 및 중앙절대오차는 두 군 간 유의미한 차이는 없었다. 결론: 두 군 모두 술 후 1주째는 근시였으며, C형군은 2주, 판형군은 2개월까지 원시성 이동이 진행되어, 2개월째 C형군에 비해 판형군의 굴절력 오차가 원시화 경향을 보였으나 Barrett Universal II 사용 시 절대오차에 근거한 정확도는 차이가 없었다.
Abstract
Purpose: To analyze and compare changes in refractive error according to different haptic intraocular lenses after cataract surgery. Methods: We retrospectively reviewed the medical records of 508 eyes of 254 patients who underwent cataract surgery in both eyes, with the MBI® SAL302AC (C loop haptic intraocular lens [IOL]) used in one eye and the Zeiss® CT ASPHINA509M (plate haptic IOL) in the other. Using the Barrett Universal II formula, prediction errors were calculated at 1 week, 2 weeks, 1 month, 2 months, and 6 months after surgery. Result: In the C loop group, prediction error was -0.26 ± 0.42 diopter (D) and -0.17 ± 0.45 D at weeks 1 and 2 postoperatively, respectively. Hyperopic shift, which reduced myopia, progressed until 2 weeks postoperatively (p < 0.001), after which there was no significant further shift. In the plate group, prediction error was -0.37 ± 0.45 D at 1 week postoperatively, -0.25 ± 0.44 D at 2 weeks postoperatively, -0.11 ± 0.44 D at 1 month postoperatively, and -0.04 ± 0.44 D at 2 months postoperatively. Hyperopic shift progressed at 2 weeks (p < 0.001), 1 month (p < 0.001), and 2 months (p = 0.02), after which there was no significant further shift. There were no significant differences in the mean or median absolute error at 2 months postoperatively. Conclusions: In both the C loop and plate groups, refraction was myopic at 1 week postoperatively, and then the C loop group progressed to hyperopic shift until 2 weeks postoperatively, and the plate group progressed to hyperopic shift until 2 months postoperatively. At 2 months postoperatively, prediction error of the plate group showed a hyperopic tendency compared to the C loop group, but there was no difference in accuracy based on the absolute error using the Barrett Universal II formula.
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