후방유수정체 안내렌즈삽입술의 장기간 임상성적
Long-term Clinical Outcomes of Implantable Collamer Lens
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목적: 근시 환자를 대상으로 한 후방유수정체 안내렌즈삽입술(implantable collamer lens, ICL)의 장기적 임상 결과에 대하여 알아보고자 하였다. 대상과 방법: 근시 교정을 위해 ICL 삽입술을 시행 받고 10년간 경과 관찰하였던 68명, 129안을 대상으로 후향적 연구를 시행하였다. 결과: 수술 후 10년째 평균 나안시력(LogMAR) 0.03 ± 0.13, 평균 최대교정시력(LogMAR) -0.07 ± 0.06이었고, 구면렌즈대응치가 ±0.5 diopters (D) 이하인 경우는 52.7%, ±1.0 D 이하인 경우는 84.5%였다. 평균 효율성 지수는 0.91 ± 0.22, 안전성 지수는 1.07 ± 0.19였다. 수술 후 10년째 평균 안압은 13.59 ± 3.55 mmHg로 수술 전 평균 안압인 13.52 ± 2.88 mmHg에 비하여 유의한 차이를 보이지 않았다. 각막내피세포 수는 수술 전 3,074 ± 365 cells/mm2에서 수술 후 10년째 2,812 ± 406 cells/mm2로 변화하였고(p=0.011), 평균 감소는 8.5 ± 10.8%였다. 수술 후 백내장은 8안(6.2%)에서 발생하였는데 이 중 3안(2.3%)에서 백내장수술을 시행하였으며, 1안(0.8%)에서는 열공망막박리가 발생하여 유리체절제술을 시행하였다. 결론: 근시의 수술적 교정에 있어 ICL 삽입술은 10년의 장기적 임상결과에서 높은 효율성과 안전성을 보였다. 그러나 백내장, 각막내피세포 저하, 망막박리 등의 합병증이 발생할 수 있음을 유념하면서 잘 경과 관찰해야 하리라 사료된다.
Abstract
Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients. Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up. Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy. Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.
참고문헌 (25)
- Moya T, "Implantable collamer lens for myopia : assessment 12 years after implantation", J Refract Surg, 31, pp.548~556 (2015)
- Guber I, "Clinical outcomes and cataract formation rates in eyes 10 years after posterior phakic lens implantation for myopia", JAMA Ophthalmol, 134, pp.487~494 (2016)
- Nakamura T, "Posterior chamber phakic intraocular lens implantation for the correction of myopia and myopic astigmatism : a retrospective 10-year follow-up study", Am J Ophthalmol, 206, pp.1~10 (2019)
- Choi JH, "Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia", J Cataract Refract Surg, 45, pp.1555~1561 (2019)
- Gonvers M, "Implantable contact lens for moderate to high myopia : relationship of vaulting to cataract formation", J Cataract Refract Surg, 29, pp.918~924 (2003)
- Rodríguez-Una I, "Intraocular pressure after implantation of a phakic collamer intraocular lens with a central hole", J Refract Surg, 33, pp.244~249 (2017)
- Alfonso JF, "Objective vs subjective vault measurement after myopic implantable collamer lens implantation", Am J Ophthalmol, 147, pp.978~983 (2009)
- Sanders D, "Comparison of implantable collamer lens(ICL)and laser-assisted in situ keratomileusis(LASIK)for low myopia", Cornea, 25, pp.1139~1146 (2006)
- 한상엽, "고도근시 환자에서 안내후방콘택트렌즈삽입술의 중장기간 임상결과", 대한안과학회지, 48(4), pp.465~472 (2007), 대한안과학회
- Kamiya K, "Factors influencing long-term regression after posterior chamber phakic intraocular lens implantation for moderate to high myopia", Am J Ophthalmol, 158, pp.179~184 (2014)
- Igarashi A, "Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia", Am J Ophthalmol, 157, pp.532~539 (2014)
- Kamiya K, "Changes in vaulting and the effect on refraction after phakic posterior chamber intraocular lens implantation", J Cataract Refract Surg, 35, pp.1582~1586 (2009)
- Du GP, "Changes in objective vault and effect on vision outcomes after implantable collamer lens implantation : 1-year follow-up", Eur J Ophthalmol, 22, pp.153~160 (2012)
- Lackner B, "Long-term results of implantation of phakic posterior chamber intraocular lenses", J Cataract Refract Surg, 30, pp.2269~2276 (2004)
- Sanders DR, "Anterior subcapsular opacities and cataracts 5 years after surgery in the visian implantable collamer lens FDA trial", J Refract Surg, 24, pp.566~570 (2008)
- Chung TY, "Changes in iridocorneal angle structure and trabecular pigmentation with STAAR implantable collamer lens during 2 years", J Refract Surg, 25, pp.251~258 (2009)
- Jiménez-Alfaro I, "Safety of posterior chamber phakic intraocular lenses for the correction of high myopia : anterior segment changes after posterior chamber phakic intraocular lens implantation", Ophthalmology, 108, pp.90~99 (2001)
- Lee J, "Long-term clinical results of posterior chamber phakic intraocular lens implantation to correct myopia", Clin Exp Ophthalmol, 44, pp.481~487 (2016)
- Alfonso JF, "Long-term evaluation of the central vault after phakic Collamer® lens(ICL)implantation using OCT", Graefes Arch Clin Exp Ophthalmol, 250, pp.1807~1812 (2012)
- Choi KH, "Ultrasound biomicroscopy for determining visian implantable contact lens length in phakic IOL implantation", J Refract Surg, 23, pp.362~367 (2007)
- Kojima T, "Posterior chamber phakic implantable collamer lens : changes in vault during 1 year", J Refract Surg, 26, pp.327~332 (2010)
- Kohnen T, "Phakic intraocular lenses : part 2 : results and complications", J Cataract Refract Surg, 36, pp.2168~2194 (2010)
- Edelhauser HF, "Corneal endothelial assessment after ICL implantation", J Cataract Refract Surg, 30, pp.576~583 (2004)
- Sultan ZN, "Rhegmatogenous retinal detachment : a review of current practice in diagnosis and management", BMJ Open Ophthalmol, 5, pp.e000474~ (2020)
- Lam DS, "Prevalence and characteristics of peripheral retinal degeneration in Chinese adults with high myopia : a cross-sectional prevalence survey", Optom Vis Sci, 82, pp.235~238 (2005)