저간섭성 반사계, 부분 빛간섭계, 접촉식 초음파를 이용한 생체계측과 백내장수술 후 굴절력의 비교
Comparison of Biometric Measurements and Refractive Results among Low-coherence Reflectometry, Partial Interferometry and Applanation Ultrasonography
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목적: 백내장 수술 전 검사로서 OA-2000Ⓡ, IOL MasterⓇ, A-scan을 이용한 생체 계측치를 비교하고, 후낭하백내장 군에서 수술 후 예측 굴절 오차를 비교하고자 한다. 대상과 방법: 백내장수술 대상자를 OA-2000Ⓡ, IOL MasterⓇ, A-scan을 이용하여 전방 깊이, 각막굴절력, 안축장을 측정하였고 SRK/T 공식으로 인공수정체 도수를 결정했다. 예상 굴절력과 백내장수술 3개월 후의 실제 굴절력 간의 오차를 비교하였다. 결과: 80명의 환자, 80안을 대상으로 하였고 이 중 OA-2000Ⓡ, IOL MasterⓇ, A-scan 3가지 장비로 안축장이 측정되었던 눈은 57안(A그룹)이었으며 IOL MasterⓇ로 측정이 되지 않아 OA-2000Ⓡ, A-scan만으로 측정된 눈이 23안(B그룹)이었다. A그룹과 B그룹은 후낭하백내장 정도의 차이가 있었고(p=0.001) 측정된 안축장, 각막굴절력, 전방 깊이는 3가지 장비에서 A그룹, B그룹 모두 통계적으로 유의한 차이는 없었으나 수술 3개월 후 측정한 굴절력 예측 오차는 B그룹에서는 OA-2000Ⓡ이 더 정확한 굴절력 예측치를 보였다(p=0.041). 결론: 후낭하백내장이 심하지 않은 경우에는 OA-2000Ⓡ, IOL MasterⓇ, A-scan으로 계산한 굴절력 예측 오차의 차이가 없었으나, 심한 후낭하백내장에서는 OA-2000Ⓡ이 A-scan보다 더 정확하게 예측 굴절치를 계산하였다.
Abstract
Purpose: To compare the measurement results and the accuracy of the predicted refractive error after cataract surgery among 3 ocular biometry devices; OA-2000®, IOL Master® and A-scan ultrasound in posterior subscapular cataracts. Methods: Biometry measurements including axial length, anterior chamber depth and the keratometry of 80 cataractous eyes were measured using ultrasonography, OA-2000® and IOL Master®. To calculate the intraocular lens (IOL) power, the SRK/T formula was used and 3 months after cataract surgery, the refractive outcome was compared to the preoperatively predicted refractive error. Results: The number of eyes measured by the 3 devices (A-scan, IOL Master® and OA-2000®) was 57 (group A) and the number of eyes measured by 2 devices (A-scan and OA-2000®) was 22 (group B). When cataract grading was performed based on the Lens Opacity Classification system Ⅲ, the severity of posterior subscapular opacity was significantly different between the 2 groups (p = 0.001). Although no difference was observed in the measured biometry values including axial length, anterior chamber depth and keratometry in groups A and B, the predicted refractive error was significantly different in group B; OA-2000® showed a significantly higher accuracy in predicting IOL power than A-scan. Conclusions: In cataract patients whose posterior subscapular opacity is not severe, the accuracy for predicting refractive error after cataract surgery was not significantly different among the 3 devices included in our study (A-scan, IOL Master® and OA-2000®). However, in patients with severe posterior subscapular opacity, OA-2000®, that provides a Fourier domain light source-calculated predicted refractive error of IOL may be more accurate.
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