소아 윤부유피종 환자에서 수술 전후 난시의 변화에 대한 연구
Changes in Astigmatism after Surgery in Pediatric Patients with Limbal Dermoid
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목적: 소아 윤부유피종 환자에서 수술 전후 시력 및 난시의 변화에 대해 분석하고자 하였다. 대상과 방법: 윤부유피종으로 진단받은 소아 환자 25명을 대상으로 수술 전후 최대교정시력을 측정하고 조절마비굴절검사, 자동굴절검사 및 각막지형도를 이용하여 난시에 대해 분석하였다. 결과: 조절마비 후 현성굴절검사 및 자동굴절검사를 통한 난시의 변화는 통계적으로 유의하지 않았다(p=0.53, p=0.38). 하지만 각막지형도를 이용하여 측정한 각막난시의 변화는 3.6 ± 2.8 diopters (D)에서 2.7 ± 1.8 D로, 불규칙난시는 3.7 ± 2.2 D에서 2.5 ± 1.5 D로 유의한 감소가 있었다(p<0.05, p<0.001). 각막 불규칙 지표는 0.14 ± 0.10에서 0.08 ± 0.47로, 각막표면분산지수는 60.56 ± 41.02에서 35.00 ± 16.00으로 유의미한 감소가 있었다(p<0.001, p<0.001). 최대교정시력은 logarithm of minimal angle of resolution (logMAR) 0.18에서 logMAR 0.07로 통계적으로 유의한 시력 개선이 있었다(p<0.05). 결론: 소아 윤부유피종 수술 후 유의하게 불규칙난시가 줄어들고 최대교정시력이 향상됨을 확인할 수 있었으며 수술 후 적극적인 약시 치료를 통해 시력 발달을 이루는 것이 중요하겠다.
Abstract
Purpose: To analyze changes in astigmatism and visual acuity in pediatric patients with limbal dermoid before and after surgery. Methods: Twenty-five pediatric patients (7 male, 18 female) diagnosed with limbal dermoid from March 2018 to February 2022 were included. We analyzed best corrected visual acuity and astigmatism using cycloplegic refraction, automated keratometry, and topography before and after surgery. Results: In cycloplegic refraction and automated keratometry, postoperative astigmatism did not decrease significantly (p = 0.53 and p = 0.38, respectively). Topography showed a significant decrease in corneal astigmatism from 3.6 ± 2.8 diopters (D) to 2.7 ± 1.8 D (p < 0.05) and in irregular astigmatism from 3.7 ± 2.2 D to 2.5 ± 1.5 D (p < 0.001). Significant decreases were observed in the corneal irregularity index from 0.14 ± 0.10 mm to 0.08 ± 0.47 mm (p < 0.001) and in the index of surface variance from 60.56 ± 41.02 to 35.00 ± 16.00 (p < 0.001). There was a statistically significant improvement in best corrected visual acuity from logarithm of minimal angle of resolution (logMAR) 0.18 to logMAR 0.07 (p < 0.05). Conclusions: Surgery for limbal dermoid significantly reduced irregular astigmatism and improved best-corrected visual acuity. It is suggested that achieving visual development through active amblyopia treatment after surgery is important.
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