유리체절제술 및 백내장수술을 시행한 군과 백내장수술만 시행한 군의 장기 수술 유발 난시도 비교
Long-term Analysis of Surgically Induced Astigmatism after Combined Vitrectomy and Cataract Surgery versus Cataract Surgery Alone
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 유리체절제술 및 백내장수술을 함께 시행한 환자와 백내장수술만 시행한 환자에서 수술 유발 난시의 장기 변화를 비교해 보았다. 대상과 방법: 백내장수술만 받은 군(1군)과 23게이지 무봉합 유리체절제술 및 백내장수술을 함께 시행 받은 군(2군)에서 술 후 1년간 수술 유발 난시의 변화를 후향적으로 비교하였다. 수술 전과 수술 후 1, 3, 6, 12개월 각각 자동각막곡률계검사를 이용하여 편평한 축 및 가파른 축의 각막곡률과 난시축을 측정하였다. 벡터분석법을 이용하여 수술 후 수술 유발 난시를 계산한 후 각 경과 관찰 시점별 값이 두 군 간 차이가 있는지 알아보았다. 결과: 총 86명 86안이 본 연구에 포함되었고 1군은 45안, 2군은 41안이었다. 수술 후 1, 3, 6, 12개월 경과 관찰 시의 수술 유발 난시 평균 값(diopter)은 1군에서 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, 0.59 ± 0.33이었고, 2군에서 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, 0.61 ± 0.30이었으며 시간 경과에 따라 수술 유발 난시는 두 군 모두에서 감소하는 추세를 보였다(모두 p<0.001). 각 경과 관찰 시점마다 두 군의 수술 유발 난시는 서로 유의한 차이를 보이지 않았다(모두 p>0.05). 결론: 유리체절제술 및 백내장수술을 함께 시행한 경우의 수술 유발 난시는 백내장수술만 시행한 군과 차이가 없었고, 이를 통해 23게이지 무봉합 유리체절제술이 각막난시에 유의한 영향을 주지 않음을 알 수 있었다.
Abstract
Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only. Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups. Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively). Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.
참고문헌 (24)
- Machemer R, "A new concept for vitreous surgery. I. Instrumentation", Am J Ophthalmol, 73, pp.1~7 (1972)
- de Paula AC, "Alterations in the corneal topography after pars plana vitrectomy with the standard system of 20-gauge and the 25-gauge transconjunctival sutureless vitrectomy", Semin Ophthalmol, 27, pp.11~14 (2012)
- Alió J, "Outcomes of microincision cataract surgery versus coaxial phacoemulsification", Ophthalmology, 112, pp.1997~2003 (2005)
- Yao K, "Corneal astigmatism, high order aberrations, and optical quality after cataract surgery: microincision versus small incision", J Refract Surg, 22(9 Suppl), pp.S1079~S1082 (2006)
- Kim EC, "Microincision versus small-incision coaxial cataract surgery using different power modes for hard nuclear cataract", J Cataract Refract Surg, 37, pp.1799~1805 (2011)
- Wang J, "The effect of micro-incision and small-incision coaxial phaco-emulsification on corneal astigmatism", Clin Exp Ophthalmol, 37, pp.664~669 (2009)
- Masket S, "Induced astigmatism with 2.2- and 3.0-mm coaxial phacoemulsification incisions", J Refract Surg, 25, pp.21~24 (2009)
- 김용규, "Comparison of Surgically-induced Astigmatism after Combined Phacoemulsification and 23-Gauge Vitrectomy: 2.2-mm vs. 2.75-mm Cataract Surgery", Korean Journal of Ophthalmology, 28(2), pp.130~137 (2014), 대한안과학회
- Czajka MP, "Comparison of 1.8-mm incision versus 2.75-mm incision cataract surgery in combined phacoemulsification and 23-gauge vitrectomy", Acta Ophthalmol, 94, pp.507~513 (2016)
- Galway G, "A comparison of induced astigmatism in 20-vs 25-gauge vitrectomy procedures", Eye(Lond), 24, pp.315~317 (2010)
- Park DH, "Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy", Graefes Arch Clin Exp Ophthalmol, 247, pp.1331~1337 (2009)
- Shao Y, "Surgical induced astigmatism correlated with corneal pachymetry and intraocular pressure : transconjunctival sutureless 23-gauge versus 20-gauge sutured vitrectomy in diabetes mellitus", Int J Ophthalmol, 8, pp.528~533 (2015)
- Kim YK, "Surgically induced astigmatism after 23-gauge transconjunctival sutureless vitrectomy", Eye(Lond), 24, pp.799~804 (2010)
- Drews RC, "Five year study of astigmatic stability after cataract surgery with intraocular lens implantation : comparison of wound sizes", J Cataract Refract Surg, 26, pp.250~253 (2000)
- Holladay JT, "Analysis of aggregate surgically induced refractive change, prediction error, and intraocular astigmatism", J Cataract Refract Surg, 27, pp.61~79 (2001)
- 문상정, "2.8 mm 이하의 절개창 크기의 동축 백내장수술에서 난시 유발과 각막 고위수차 비교", 대한안과학회지, 52(4), pp.407~413 (2011), 대한안과학회
- Sušić N, "Analysis of postoperative corneal astigmatism after phacoemulsification through a clear corneal incision", Acta Clinica Croatica, 46, pp.37~40 (2007)
- 황상조, "미세 절개 및 고전적 백내장 수술에서의 수술 유발 난시 및 각막 고위 수차 비교", 대한안과학회지, 49(10), pp.1597~1602 (2008), 대한안과학회
- 박영민, "20게이지와 23게이지 평면부 유리체절제술 후 각막지형도 변화의 비교", 대한안과학회지, 50(3), pp.353~358 (2009), 대한안과학회
- Wilczynski M, "Evaluation of surgically induced astigmatism after coaxial phacoemulsification through 1.8mm microincision and standard phacoemulsification through 2.75mm incision", Klin Oczna, 113, pp.314~320 (2011)
- Zhang ZH, "Transconjunctival sutureless vitrectomy versus 20-gauge vitrectomy for vitreoretinal surgery : a meta-analysis of randomized controlled trials", Graefes Arch Clin Exp Ophthalmol, 251, pp.681~688 (2013)
- Sonmez S, "The effect of tunnel length and position on postoperative corneal astigmatism : an optical coherence tomographic study", Eur J Ophthalmol, 30, pp.104~111 (2020)
- Roman SJ, "Surgically induced astigmatism with superior and temporal incisions in cases of with-the-rule preoperative astigmatism", J Cataract Refract Surg, 24, pp.1636~1641 (1998)
- 조형석, "23게이지 경결막 유리체절제술 후 각막지형도의 변화", 대한안과학회지, 53(12), pp.1801~1806 (2012), 대한안과학회