인공수정체 공막봉합고정술과 무봉합공막고정술(야마네 기법)에서 굴절력 예측의 정확성
The Refractive Outcomes of Sutured and Sutureless Scleral Fixation (the Yamane Technique)
9
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 인공수정체 공막봉합고정술과 비교하여 무봉합공막고정술(야마네 기법)에서 술 전 예상한 굴절력과 술 후 측정한 굴절력의 정확성을 알아보고자 한다. 대상과 방법: 본원에서 인공수정체 탈구 또는 수정체떨림으로 인공수정체 공막봉합고정술(20안) 또는 무봉합공막고정술(12안)을 시행받은환자들을 대상으로 의무기록을 후향적으로 분석하였다. 수술 전 예측구면렌즈대응치는 IOL master® (Zeiss, Carl Zeiss Meditec, Jena, Germany) 측정값과 A-scan biometry (AL-100; Tomey, Nagoya, Japan) 초음파로 측정한 안축장에 각막형태검사로 측정한 각막곡률반경값을 대응하여 계산하였다. 수술 후 1개월째 구면렌즈대응치는 자동굴절각막곡률계를 이용하여 측정하였고, 수술 전 예측구면렌즈대응치와 술 후 1개월째 구면렌즈대응치의 일치 정도를 비교 분석하였다. 결과: 술 전 인공수정체 공막봉합고정술을 시행한 군의 예측구면렌즈대응치는 -0.158 ± 0.577 diopters (D) (A-scan), -0.143 ± 0.617 D (IOL master®)로 1개월째 구면렌즈대응치 -0.400 ± 0.923 D와 각각의 일치도를 비교한 상관계수는 유의하게 나타나지 않았다(p=0.903, 0.563). 반면 무봉합공막고정술을 시행한 군의 예측구면렌즈대응치는 -0.340 ± 0.368 D (A-scan), -0.183 ± 0.251 D (IOL master®)로1개월째 구면렌즈대응치 -0.313 ± 1.129 D와 각각 유의한 상관관계를 보였다(p=0.038, 0.005). 결론: 무봉합공막고정술군에서 술 전 목표로 한 굴절력과 술 후 측정된 굴절력이 유의하게 일치되는 상관관계를 보였다. 삽입된 인공수정체 도수의 굴절력 예측에 있어서 무봉합공막고정술이 공막봉합고정술과 비교하여 그 정확성이 떨어지지 않으면서, 안전하게 시행 가능한 수술 방법임을 확인할 수 있었다.
Abstract
Purpose: To evaluate the pre- and post-operative refractive powers of patients undergoing sutured and sutureless scleral fixation (the latter: the Yamane technique). Methods: Patients who had undergone sutured or sutureless scleral fixation to treat intraocular lens (IOL) dislocation or phacodonesis at Dong-A University Hospital from January 2017 to December 2021 were retrospectively investigated. The preoperatively predicted spherical equivalents (derived using the radii of corneal curvature) were measured via optical coherence topography and the axial lengths were determined using an IOL master ® (Zeiss, Carl Zeiss Meditec, Jena, Germany) device and A-scan biometry (AL-100; Tomey, Nagoya, Japan) ultrasound. The spherical equivalent was measured 1 month after surgery employing an automatic refractive keratometer. The extent of agreement between the predicted and actual spherical equivalents were compared between the sutured and sutureless scleral fixation groups. Results: The sutured scleral fixation group included 20 eyes and the sutureless group 12 eyes. The preoperatively predicted spherical equivalent of the sutured group was -0.158 ± 0.577 diopters (D) on A-scan (Tomey) ultrasound and -0.143 ± 0.617 D employing the IOL master ® (Carl Zeiss Meditec); both correlated poorly with the postoperatively measured spherical equivalent of -0.400 ± 0.923 D (p = 0.903, 0.563). However, the predicted spherical equivalent of the group undergoing sutureless fixation was -0.340 ± 0.368 D on A-scan ultrasound and -0.183 ± 0.251 D using the IOL master ® (Carl Zeiss Meditec); both correlated significantly with the postoperatively measured spherical equivalent of -0.313 ± 1.129 D (p = 0.038, 0.005). Conclusions: The preoperatively predicted refractive power correlated significantly with the postoperative refractive power after sutureless but not sutured scleral fixation. Sutureless fixation was safe and the postoperative refractive power was comparable to that of sutured fixation.
참고문헌 (30)
- Por YM, "Techniques of intraocular lens suspension in the absence of capsular", zonular support, 2005, pp.50, 429~462
- Zandian M, "Ab externo iris fixation of posterior chamber intraocular lens through small incision", J Cataract Refract Surg, 36, pp.2032~2034 (2010)
- Stark WJ, "Posterior chamber intraocular lens implantation in the absence of posterior capsular support", Ophthalmic Surg, 19, pp.240~243 (1988)
- Moschos MM, "The correction of aphakia using anterior chamber intraocular lens", In Vivo, 30, pp.733~738 (2016)
- Hannush SB, "Sutured posterior chamber intraocular lenses : indications and procedure", Curr Opin Ophthalmol, 11, pp.233~240 (2000)
- Brunin G, "Secondary intraocular lens implantation : complication rates, visual acuity, and refractive outcomes", J Cataract Refract Surg, 43, pp.369~376 (2017)
- Vote BJ, "Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation", Am J Ophthalmol, 141, pp.308~312 (2006)
- Gabor SG, "Sutureless intrascleral posterior chamber intraocular lens fixation", J Cataract Refract Surg, 33, pp.1851~1854 (2007)
- Matsui Y, "Exposure of haptic of posterior chamber intraocular lens after sutureless intrascleral fixation", BMC Ophthalmol, 15, pp.104~ (2015)
- Kumar DA, "Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules", J Cataract Refract Surg, 39, pp.1211~1218 (2013)
- Scharioth GB, "Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation", J Cataract Refract Surg, 36, pp.254~259 (2010)
- Yamane S, "Flanged intrascleral intraocular lens fixation with double-needle technique", Ophthalmology, 124, pp.1136~1142 (2017)
- Olsen T, "Prediction of the effective postoperative(intraocular lens)anterior chamber depth", J Cataract Refract Surg, 32, pp.419~424 (2006)
- Jacob S, "Scleral fixation of intraocular lenses", Curr Opin Ophthalmol, 31, pp.50~60 (2020)
- Botsford BW, "Scleral fixation of intraocular lenses with gore-tex suture : refractive outcomes and comparison of lens power formulas", Ophthalmol Retina, 3, pp.468~472 (2019)
- Abbey AM, "Sutureless scleral fixation of intraocular lenses: outcomes of two approaches. The 2014Yasuo Tano Memorial Lecture", Graefes Arch Clin Exp Ophthalmol, 253, pp.1~5 (2015)
- Kane JX, "Intraocular lens power formula accuracy : comparison of 7 formulas", J Cataract Refract Surg, 42, pp.1490~1500 (2016)
- Kane JX, "Intraocular lens power formulas, biometry, and intraoperative aberrometry : a review", Ophthalmology, 128, pp.e94~114 (2021)
- Kelkar AS, "Comparison of flanged intrascleral intraocular lens fixation versus iris claw intraocular lens fixation : a retrospective study", Indian J Ophthalmol, 67, pp.1838~1842 (2019)
- 김주영, "무수정체안에서 인공수정체공막고정술 및 홍채 후방고정 안내렌즈삽입술 비교", 대한안과학회지, 60(7), pp.643~653 (2019), 대한안과학회
- MustafiD, "Outcomes of sutureless secondary intraocular lens fixation with haptic flanging in a cohort of surgically complex eyes", Graefes Arch Clin Exp Ophthalmol, 259, pp.1357~1363 (2021)
- 최윤아, "유리체절제술 및 인공수정체 경공막섬모체고랑고정술에서 예측구면대응값과 술 후 구면대응값의 차이 분석", Journal of Retina, 5(2), pp.143~148 (2020), 한국망막학회[DOI]
- Li Z, "Accuracy of intraocular lens calculation formulas for eyes with insufficient capsular support", Ann Transl Med, 9, pp.324~ (2021)
- Steinert RF, "Intraocular lens power calculation" (2010), Elseiver Inc
- Knox Cartwright NE, "Adjustment of intraocular lens power for sulcus implantation", J Cataract Refract Surg, 37, pp.798~800 (2011)
- Eom Y, "Modified haigis formula effective lens position equation for ciliary sulcus-implanted intraocular lenses", Am J Ophthalmol, 161, pp.142~149 (2016)
- Dubey R, "Improved refractive outcome for ciliary sulcus-implanted intraocular lenses", Ophthalmology, 119, pp.261~265 (2012)
- Randerson EL, "Clinical outcomes and lens constant optimization of the Zeiss CT Lucia 602 lens using a modified Yamane technique", Clin Ophthalmol, 14, pp.3903~3912 (2020)
- Rocke JR, "Refractive outcomes of the yamane flanged intrascleral haptic fixation technique", Ophthalmology, 127, pp.1429~1431 (2020)
- McMillin J, "Accuracy of intraocular lens calculation formulas for flanged intrascleral intraocular lens fixation with double-needle technique", J Cataract Refract Surg, 47, pp.855~858 (2021)