수술 전 안축장 구간에 따른 백내장수술 후 유효수정체위치 예측
Prediction of Effective Lens Position by Reference to the Preoperative Axial Length
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목적: 부분결합간섭검사로 측정되는 안구 생체계측치를 매개변수로 하는 백내장수술 후 유효수정체위치 예측 공식을 수술 전 안축장 구간별로 탐구해보고자 한다. 대상과 방법: 수술 전에 부분결합간섭검사를 시행하여 안축장, 각막굴절력, 전방깊이를 성공적으로 측정하였고, 통상적인 백내장수술이 합병증 없이 이뤄진 736안을 후항적으로 선정, 수술 전 안축장 1.0 mm 구간에 따라 7개의 군으로 분류하였다. 다중선형 회귀분석을 통해 수술 전 안축장, 각막굴절력, 전방깊이를 독립 매개변수로 하여 유효수정체위치를 예측하는 최적의 공식을 각 군에 따라 구해보았다. 결과: 수술 전 안축장이 22.0 mm에서 25.0 mm에 속하는 경우, 각막굴절력이 유효수정체위치와 유의하게 연관되어 있었다. 수술 전 안축장이 23.0 mm에서 26.0 mm에 속하는 경우, 전방깊이가 유효수정체위치와 유의하게 연관되어 있었다. 수술 전 안축장이 24.0 mm보다 짧고, 26.0 mm보다 긴 경우, 수술 전 안축장이 유효수정체위치와 강하게 연관되어 있었다. 수술 전 안축장, 전방깊이, 각막굴절력 세 변수 모두를 고려한 선형 회귀 공식을 통해 대체로 유효수정체위치를 가장 적절하게 예측할 수 있었으나, 각 군에 따라 공식의 형태는 변하였다. 결론: 백내장 술 후 유효수정체의 위치는 술 전 안축장의 길이가 25.0 mm 미만인 경우는 안축장과 각막굴절력, 24.0 mm에서 26.0 mm인 경우는 안축장과 전방깊이, 그리고 26.0 mm 이상인 경우는 특히 안축장과 유의한 연관성이 있었다.
Abstract
Purpose: We derived optimal formulae permitting effective lens position (ELP) for patients differing in terms of their preoperative axial lengths as revealed by partial coherence interferometry. Methods: We included 736 eyes from 736 patients who underwent conventional cataract surgery at Yeouido St. Mary’s Hospital. The preoperative axial length (AL), corneal power (CP), and anterior chamber depth (ACD) measured via partial coherence interferometry served as independent variables for ELP prediction. The 736 eyes were divided into seven groups differing by 1.0-mm intervals in terms of the preoperative axial length. We sought correlations between the independent variables and the ELP, and defined the combinations that best predicted the ELPs of the seven groups. Results: The CP correlated significantly with the ELP for eyes with AL between 22.0 and 25.0 mm (all p < 0.01) and the ACD correlated significantly with the ELP for eyes with AL between 23.0 and 26.0 mm (all p < 0.01). Although a regression equation featuring all of the AL, ACD, and CP best predicted the ELP for the total of 736 eyes (p < 0.001), the optimal combination varied by the preoperative AL. Conclusions: The effects of CP, ACD, and AL on ELP vary by the preoperative AL. The optimal combination of preoperative variables predicting ELP thus varies as that parameter changes.
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