방사상 각막절개술 후 중간거리 시력이 강화된 단초점 인공수정체 삽입을 시행한 1예
A Case of Cataract Surgery after Radial Keratotomy with Enhanced Monofocal Intraocular Lens Implantation
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목적: 방사상 각막절개술 후 발생한 백내장에서 중간거리 시력이 강화된 단초점 인공수정체삽입술을 받고 좋은 시력 결과를 보인 환자 1예를 보고하고자 한다. 증례요약: 녹내장 의증으로 추적관찰 중인 53세 남자가 좌안의 시력저하로 의뢰되었다. 환자는 약 30년 전 근시 교정을 위해 타원에서 양안 방사상 각막절개술을 시행 받았다. 좌안 원거리 시력은 0.5로 교정되지 않았고, NO2NC2C3 (Lens Opacities Classification System Ⅲ 기준)의 백내장이 관찰되었다. 좌안에 수정체유화술 후 중간거리 시력이 강화된 단초점 인공수정체(ICB00; Johnson&Johnson Vision, Santa Ana, CA, USA)를 삽입하였다. 수술 후 1개월 뒤 좌안의 나안 시력은 원거리, 중간거리, 근거리(40 cm) 모두 1.0이었으며, 수술 후 3개월 뒤 좌안의 나안 시력은 원거리 1.0, 중간거리(66 cm) 0.8, 근거리(33 cm) 0.32였다. 결론: 방사상 각막절개술을 받은 환자에서 백내장 수술 시 중간거리 시력이 강화된 단초점 인공수정체의 사용을 고려해볼 수 있겠다.
Abstract
Purpose: To report on a patient who achieved good visual performance following cataract surgery with implantation of an enhanced monofocal intraocular lens (IOL) after a previous radial keratotomy decades earlier. Case summary: A 53-year-old male, previously seen at our medical center as a glaucoma suspect, presented with decreased visual acuity in the left eye. He had radial keratotomy for myopia correction in both eyes 30 years prior at another hospital. Before cataract surgery, the distant visual acuity of his left eye was 0.5, which could not be corrected. Slit-lamp examination revealed an NO2NC2C3 (Lens Opacities Classification System III) cataract. Phacoemulsification with an enhanced monofocal IOL (ICB00; Johnson & Johnson Vision, Santa Ana, CA, USA) was performed on the left eye. One month postoperatively, uncorrected visual acuity in the left eye was 1.0 for all distances: far, intermediate (66 cm), and near (40 cm). At 3 months, uncorrected visual acuity was 1.0 for far, 0.8 for intermediate (66 cm), and 0.32 for near (33 cm). Conclusions: Eyes that have previously undergone radial keratotomy may qualify for the insertion of an enhanced monofocal IOL during cataract surgery.
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