양의 수직코마를 가진 환자에서 상측절개 백내장수술 전후의 고위수차 변화
Changes in Higher-order Aberrations after Superior-incision Cataract Surgery in Patients with Positive Vertical Coma
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목적: 양의 수직코마를 가진 환자에서 직난시 및 도난시에 따른 상측절개 백내장수술 전후의 고위수차 변화량을 비교하고자 하였다. 대상과 방법: 양의 수직코마를 가진 환자에서 2.5 mm 상측 투명각막절개 백내장수술을 시행한 직난시군 37안과 도난시군 33안을 대상으로 수술 전 및 수술 후 1달 뒤 나안시력, 최대교정시력, 각막난시를 측정하였고, 각막 전면, 후면 및 총 수차(사축트레포일, 수평트레포일, 수직코마, 수평코마, 구면수차, 총 고위수차)를 Pentacam으로 측정하여 비교하였다. 결과: 직난시군에서는 수술 후 각막 전면, 후면 및 총 수직코마가 유의하게 감소하였고(p<0.05), 도난시군에서는 후면 수직코마에서 유의한 감소를 보였으나(p=0.008), 총 수직코마에서는 유의한 변화를 보이지 않았다. 사축트레포일은 두 군 모두에서 유의한 증가를 보였고, 수평트레포일은 도난시군에서 유의한 감소를 보였다(p<0.05, respectively). 구면수차는 도난시군의 전면 각막수차에서 유의한 감소를 보였고(p<0.001), 총 고위수차는 직난시군의 전면과 후면, 도난시군의 후면수차에서 유의한 증가를 보였다(p<0.05, p=0.001). 수평코마와 각막난시는 두 군에서 수술 전후로 유의한 변화를 보이지 않았다. 결론: 상측절개 백내장수술에서 수직코마는 난시축에 영향을 받아 직난시군에서 유의한 감소를 보였고, 각막 난시는 수술 전후로 유의한 변화를 보이지 않았다.
Abstract
Purpose: The purpose of this study was to compare changes in higher-order aberrations after superior-incision cataract surgery between eyes with a within-the-rule (WTR) astigmatism and an against-the-rule (ATR) astigmatism in patients with positive vertical coma. Methods: This study included patients who presented with positive vertical coma and who underwent cataract surgery through a 2.5 mm superior clear corneal incision. The eyes included in this study were divided into two groups (37 eyes with WTR astigmatism and 33 eyes with ATR astigmatism), and uncorrected visual acuity, best corrected visual acuity, and corneal astigmatism were measured before and after surgery. In addition, anterior, posterior, and total aberrations (i.e., oblique trefoil, horizontal trefoil, vertical coma, horizontal coma, spherical aberration, and total higher-order aberrations) were measured using a Pentacam. Results: In the WTR astigmatism group, anterior/posterior corneal aberrations and total aberrations were significantly decreased after surgery (p < 0.05). However, in the ATR astigmatism group, a significant decrease in the posterior vertical coma (p = 0.008) was observed, although there was no change in total vertical coma. A significant increase in oblique trefoil was observed in both groups, while a significant decrease in horizontal trefoil was found in the ATR astigmatism group (all p < 0.05). For spherical aberration, the ATR astigmatism group showed a significant decrease in anterior cornea aberrations (p < 0.001). For total higher- order aberrations, the WTR astigmatism group showed a significant increase in anterior and posterior aberrations, while the ATR astigmatism group showed a significant increase in posterior aberrations (p < 0.05, p = 0.001, respectively). In the case of horizontal coma and corneal astigmatism, both groups exhibited no significant changes after surgery. Conclusions: When superior-incision cataract surgery was performed, vertical coma was affected by the axis of astigmatism, resulting in a significant decrease in the WTR astigmatism group. However, no significant changes in corneal astigmatism were observed before and after surgery.
참고문헌 (20)
- Zhu X, "Accuracy of WASCA aberrometer refraction compared to manifest refraction in Chinese adult myopes", J Refract Surg, 25, pp.1026~1033 (2009)
- Applegate RA, "Interaction between aberrations to improve or reduce visual performance", J Cataract Refract Surg, 29, pp.1487~1495 (2003)
- Muñoz G, "Combining zonal refractive and diffractive aspheric multifocal intraocular lenses", J Refract Surg, 28, pp.174~181 (2012)
- 문상정, "2.8 mm 이하의 절개창 크기의 동축 백내장수술에서 난시 유발과 각막 고위수차 비교", 대한안과학회지, 52(4), pp.407~413 (2011), 대한안과학회
- Campbell CE, "A new method for describing the aberrations of the eye using Zernike polynomials", Optom Vis Sci, 80, pp.79~83 (2003)
- Artal P, "Contributions of the cornea and the lens to the aberrations of the human eye", Opt Lett, 23, pp.1713~1715 (1998)
- Williams D, "Visual benefit of correcting higher order aberrations of the eye", J Refract Surg, 16, pp.S554~S559 (2000)
- Lombardo M, "Wave aberration of human eyes and new descriptors of image optical quality and visual performance", J Cataract Refract Surg, 36, pp.313~331 (2010)
- Pantanelli S, "Characterizing the wave aberration in eyes with keratoconus or penetrating keratoplasty using a high-dynamic range wavefront sensor", Ophthalmology, 114, pp.2013~2021 (2007)
- Song IS, "Higher-order aberrations associated with better near visual acuity in eyes with aspheric monofocal IOLs", J Refract Surg, 30, pp.442~446 (2014)
- Nishi T, "Effect of total higher-order aberrations on accommodation in pseudophakic eyes", J Cataract Refract Surg, 32, pp.1643~1649 (2006)
- 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)
- 정현진, "직난시 및 도난시에 따른 동축 소절개 백내장 수술의 난시와 고위수차의 비교분석", 대한안과학회지, 55(2), pp.182~189 (2014), 대한안과학회
- Can İ, "Comparison of corneal aberrations after biaxial microincision and microcoaxial cataract surgeries: a prospective study", Curr Eye Res, 37, pp.18~24 (2012)
- Helbostad JL, "Change in vision, visual disability, and health after cataract surgery", Optom Vis Sci, 90, pp.392~399 (2013)
- 권혁란, "다양한 재질의 인공수정체를 삽입한 인공수정체 안에서 고위수차의 변화", 대한안과학회지, 46(6), pp.954~960 (2005), 대한안과학회
- Guirao A, "Corneal optical aberrations and retinal image quality in patients in whom monofocal intraocular lenses were implanted", Arch Ophthalmol, 120, pp.1143~1151 (2002)
- Ye H, "Changes of corneal higher-order aberrations after cataract surgery", Optom Vis Sci, 91, pp.1244~1250 (2014)
- Oshika T, "Apparent accommodation and corneal wavefront aberration in pseudophakic eyes", Invest Ophthalmol Vis Sci, 43, pp.2882~2886 (2002)
- 최진아, "2.2 mm 동축 소절개 백내장수술의 단기 임상 결과 비교", 대한안과학회지, 49(6), pp.904~910 (2008), 대한안과학회