원시 교정 라식수술 후 발생한 합병증 치료 1예
Management of Complication after Hyperopic Laser-assisted in-situ Keratomileusis
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 본 저자들은 원시 교정 라식수술 이후 발생한 교정시력저하를 각막 굴절 수술을 통하여 성공적으로 교정한 증례를 경험하였기에 이를 보고하고자 한다. 증례요약: 12년 전, 원시 교정 라식수술을 받은 환자가 시력저하를 주호소로 내원하였다. 현성 굴절 검사 시 우안 +1.25 +2.00 × 90, 최대 교정시력 0.1, 좌안 -0.25 +2.00 × 80, 최대 교정시력이 0.63이었다. 양안의 직난시와 Zernike 계수를 이용한 각막과 총구면 수차값은 우안의 경우 -1.027 μm와 -0.773 μm, 좌안의 경우 -0.965 μm와 -0.881 μm로 음의 구면수차를 보였다. 세극등 현미경 검사에서 특이 소견은 없었다. 저자들은 각막표면연마굴절수술을 통해 환자 우안의 중심 각막을 편형화하였다. 수술 후 1년 뒤, 우안의 최대 교정시력은 0.63으로 측정되었다. 결론: 중심 각막 편평화를 통한 음의 구면수차를 줄이는 각막굴절 수술은 원시 라식수술 후 발생한 교정시력 저하에 대한 하나의 치료 방법이 될 수 있을 것으로 보인다.
Abstract
Purpose: We present a case of a patient who underwent corneal refractive surgery to improve their corrected visual acuity due to a complication of hyperopic laser-assisted in-situ keratomileusis (LASIK). Case summary: The patient complained of decreased vision after hyperopic LASIK surgery 12 years prior. The corrected distance visual acuity (CDVA) was 20/200 in the right eye and 20/32 in the left, with manifested refractions of +1.25 +2.00 × 90 and -0.25 +2.00 × 80, respectively. The patient had a with-the-rule astigmatism. The values of corneal and total spherical aberration, which can be determined as coefficients of the Zernike polynomials, were respectively -1.027 μm and -0.773 μm in the right eye and -0.965 μm and -0.881 μm in the left eye. Slit lamp biomicroscopy revealed no remarkable findings. We performed surface ablation surgery to flatten the central cornea of the patient’s right eye. At 12 months after surgery, the CDVA of the patient’s right eye was 20/30 and the negative corneal spherical aberration was reduced. Conclusions: Corneal refractive surgery to reduce negative corneal spherical aberration by flattening the central cornea is one of possible treatment options for the reduced corrected distance visual acuity after hyperopic LASIK.
참고문헌 (16)
- Ditzen K, "Laser in situ keratomileusis for hyperopia", J Cataract Refract Surg, 24, pp.42~47 (1998)
- Ditzen K, "Laser in situ keratomileusis for hyperopia and hyperopic astigmatism using the Meditec MEL 70 spot scanner", J Refract Surg, 18, pp.430~434 (2002)
- Spadea L, "Photorefractive keratectomy and LASIK for the correction of hyperopia: 2-year follow-up", J Refract Surg, 22, pp.131~136 (2006)
- Alió J, "Hyperopic LASIK with Esiris", Schwind technology, 2006, pp.22, 772~781
- Varley GA, "LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism: a report by the American Academy of Ophthalmology", Ophthalmology, 111, pp.1604~1617 (2004)
- Argento CJ, "Comparison of optical zones in hyperopic laser in situ keratomileusis: 5.9 mm versus smaller optical zones", J Cataract Refract Surg, 26, pp.1137~1146 (2000)
- Alió JL, "Laser in situ keratomileusis for high hyperopia (>5.0 diopters) using optimized aspheric profiles: efficacy and safety", J Cataract Refract Surg, 39, pp.519~527 (2013)
- Zadok D, "Long-term evaluation of hyperopic laser in situ keratomileusis", J Cataract Refract Surg, 29, pp.2181~2188 (2003)
- Ivarsen A, "Laser in situ keratomileusis for high astigmatism in myopic and hyperopic eyes", J Cataract Refract Surg, 39, pp.74~80 (2013)
- Albarrán-Diego C, "Corneal aberration changes after hyperopic LASIK: a comparison between the VISX Star S2 and the Asclepion-Meditec MEL 70 G Scan excimer lasers", J Refract Surg, 22, pp.34~42 (2006)
- Llorente L, "Total and corneal optical aberrations induced by laser in situ keratomileusis for hyperopia", J Refract Surg, 20, pp.203~216 (2004)
- Tanzer DJ, "Laser in situ keratomileusis in United States Naval aviat", J Cataract Refract Surg, 39, pp.1047~1058 (2013)
- Llovet F, "One-year results of excimer laser in situ keratomileusis for hyperopia", J Cataract Refract Surg, 35, pp.1156~1165 (2009)
- Williams LB, "Correlation of visual outcome and patient satisfaction with preoperative keratometry after hyperopic laser in situ keratomileusis", J Cataract Refract Surg, 34, pp.1083~1088 (2008)
- Alió JL, "Corneal aberrations and objective visual quality after hyperopic laser in situ keratomileusis using the Esiris excimer laser", J Cataract Refract Surg, 34, pp.398~406 (2008)
- Cobo-Soriano R, "Factors that influence outcomes of hyperopic laser in situ keratomileusis", J Cataract Refract Surg, 28, pp.1530~1538 (2002)