난시동반 위수정체안에서 경도의 근시가 근거리시력 및 원거리시력에 미치는 영향
Effect of Low Myopia on Near and Distance Vision in Astigmatic Pseudophakic Eyes
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목적: 단초점인공수정체 삽입 위수정체안에서 술 후 난시와 구면렌즈대응치가 원·근거리 나안시력에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 2020년 1월부터 2021년 9월까지 단초점인공수정체를 이용한 백내장수술을 시행받았으며, 수술 후 난시가 1.5 diopters (D) 이하, 구면렌즈대응치가 -0.75 D 이상 +0.25 D 미만인 눈이 연구에 포함되었다. 난시교정인공수정체가 삽입된 눈과 수술 후 최대교정시력<0.8인 눈은 분석에서 제외하였다. 연구는 단면 연구로 진행되어 수술 1개월째의 구면렌즈대응치·난시와 원·근거리 나안시력의 상관관계가 후향적으로 분석되었다. 대상안들을 구면렌즈대응치에 따라 최소근시군(-0.75 D≤구면렌즈대응치<-0.25 D)과 정시군(-0.25 D≤구면렌즈대응치<+0.25 D)으로 나누어 분석하였다. 결과: 총 118안(86명)이 연구에 포함되었으며, 근거리 나안시력은 최소근시군에서 우수하였으나(p=0.009), 원거리 나안시력은 유의한차이가 없었다. 난시의 정도를 0.5 D 단위로 나누어 보았을 때, 난시가 1.0 D 이하인 눈에서는 두 군 사이 원·근거리 나안시력 모두유의미한 차이를 보이지 않았다. 하지만 난시가 1.0 D 초과, 1.5 D 이하인 눈에서는 최소근시군에서 근거리 나안시력이 우수하였고(p=0.03), 원거리 나안시력에는 유의미한 차이를 보이지 않았다. 결론: 난시교정용이 아닌 단초점인공수정체 삽입 위수정체안에서 수술 후 잔여 난시가 1.5 D 이하, 특히 1.0 D 초과 1.5 D 이하였던경우, 최소근시군에서 정시군에 비하여 근거리 나안시력이 유의하게 좋았지만 원거리 나안시력에는 유의한 차이가 없었다.
Abstract
Purpose: To investigate the effect of the postoperative spherical equivalent (SE) and astigmatism on the uncorrected near/distance visual acuity (UNVA/UDVA) in monofocal intraocular lens (IOL)-implanted pseudophakic eyes. Methods: Of the eyes that underwent successful cataract surgery and monofocal IOL implantation from January 2020 to September 2021 by a single surgeon, eyes with postoperative astigmatism ≤ 1.5 diopters (D) and -0.75 D ≤ SE < +0.25 D were included. Eyes implanted with a toric IOL or with a best corrected visual acuity under 20/25 were excluded. This was a cross-sectional study, and the correlation of SE/astigmatism and UNVA/UDVA at 1 month postoperatively was analyzed retrospectively. The eyes were divided into mini-myopia (-0.75 D ≤ SE < -0.25 D) and emmetropia (-0.25 D ≤ SE < 0.25 D) groups according to the SE. Results: This study included 118 eyes (86 patients). The UNVA was significantly better in the mini-myopia group than in the emmetropia group (p = 0.009), without a significant difference in UDVA (p = 0.412). Dividing the range into 0.5 D units according to the degree of astigmatism, no significant difference was observed in UNVA/UDVA between the mini-myopia and emmetropia groups in eyes with astigmatism ≤ 1.0 D. However, the mini-myopia group had a significantly better UNVA (p = 0.03), without a significant difference in UDVA (p = 0.879) in eyes with astigmatism > 1.0 D or ≤ 1.5 D. Conclusions: In non-toric monofocal IOL-implanted pseudophakic eyes with postoperative residual astigmatism of ≤ 1.5 D, especially in eyes with astigmatism > 1.0 D and ≤ 1.5 D, the mini-myopia group had a significantly better UNVA compared to the emmetropia group, without a significant difference in UDVA.
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