각막혼탁이 있는 환자에서 스마일수술의 단기간 임상 성적
Short-term Clinical Outcomes of Small Incision Lenticule Extraction for Correction of Myopia Patients with Corneal Opacity
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목적: 수술 전 렌티큘 형성 부위에 각막혼탁이 있는 환자를 대상으로 시행된 스마일수술의 임상 성적을 평가하고자 하였다. 대상과 방법: 스마일수술을 시행받고 3개월 이상 경과 관찰이 가능하였던 환자 중 수술 전 렌티큘 형성 부위에 각막혼탁을 가진 환자 13명 13안을 대상으로 후향적 연구를 시행하였다. 수술 3개월 후 나안시력, 굴절력 등을 측정하였고, 수술 전후 세극등현미경을 이용하여 혼탁의 면적을 측정하고, 샤임플러그 전안부 분석기(Galilei®, Ziemer Ophthalmic System, Port, Switzerland)의 농도계를 이용하여 혼탁의 밀도를 측정하여서 그 값을 비교하였다. 결과: 수술 전 13안 모두에서 렌티큘 형성 부위에 각막혼탁이 존재하였고, 평균 각막혼탁의 면적은 0.72 ± 0.33 mm2, 평균 각막혼탁의 밀도는 52.46 ± 15.74였다. 스마일수술은 특별한 합병증 발생 없이 진행되었고, 수술 후 3개월 동안의 검사상 효율성 지수는 1.01 ± 0.15, 안전성 지수는 1.05 ± 0.10, 평균 구면렌즈대응치는 -0.03 ± 0.25였으며 혼탁의 밀도는 46.85 ± 14.56 (p=0.038)으로 수술 전과 비교해서 유의한 감소를 보였고 혼탁의 크기는 0.70 ± 0.36 mm2 (p=0.776)로 유의한 차이를 보이지 않았다. 스마일수술 중 합병증은 발생하지 않았고, 수술 후 3개월간의 경과 관찰 동안 합병증은 관찰되지 않았다. 결론: 스마일수술은 렌티큘 형성 부위에 각막혼탁을 가진 환자를 대상으로 합병증 없이 안전하게 시행되었고 좋은 초기 임상 성적을 보였다.
Abstract
Purpose: To evaluate the clinical outcomes of small incision lenticule extraction (SMILE) for the treatment of myopia with corneal opacity. Methods: Thirteen eyes of 13 patients with corneal opacities who underwent SMILE were retrospectively studied. Uncorrected distance visual acuity, spherical equivalence, efficacy index, and safety index were noted at 3 months after the procedure. The density and area of the corneal opacities were measured and compared preoperatively and 3 months postoperatively. Results: All eyes had preoperative corneal opacities within the lenticule formation areas. The mean area and density of corneal opacities were 0.72 ± 0.33 mm2 and 52.46 ± 15.74, respectively. All procedures were uneventful and no intraoperative complications were observed. At 3 months after the procedure, the efficacy and safety indices were 1.01 ± 0.15, and 1.05 ± 0.10, respectively, and the mean densities and areas of corneal opacities were 46.85 ± 14.56 (p = 0.038) and 0.70 ± 0.36 mm2 (p = 0.776), respectively. Conclusions: The SMILE procedure was effective and safe for the correction of myopic patients with corneal opacities.
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