중등도 및 고도근시 환자에서 라식과 각막표면연마굴절수술 후 10년간의 경과 관찰 비교
Comparison of 10-year Clinical Results between Laser in situ Keratomileusis and Surface Ablation for Moderate to High Myopia
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목적: 중등도 및 고도근시 환자에서 라식과 각막표면연마굴절수술의 장기 후향적 관찰 결과를 비교하여 분석한 결과를 보고하고자 한다. 대상과 방법: 1995년부터 2005년까지 라식이나 각막표면연마굴절수술을 시행 받은 근시 환자 44명, 87안을 대상으로 10년간의 후향적 분석을 하였다. 모든 대상군은 -6디옵터(diopter, D)를 기준으로 중등도 근시군과 고도근시군으로 나누어서 평가하였다. 평가 항목은 각 군의 수술 전 나안시력 및 최대 교정시력, 수술 3개월, 1년, 5년, 10년 후 나안시력, 현성 구면렌즈 대응치, 평균 각막곡률, 안정성, 효율성, 예측성, 수술 후 합병증 유무였다. 결과: 술 전 평균 구면렌즈 대응치는 라식안에서 -7.05 ± 2.49D, 각막표면연마굴절수술안에서 -5.25 ± 1.23D였다. 술 후 10년째 평균 구면렌즈 대응치는 라식안에서 -1.78 ± 1.22D, 각막표면연마굴절수술안에서 -1.35 ± 1.09D였으며 두 군 간에 유의한 차이는 없었다. 술 후 10년째 나안시력은 라식안에서 logMAR 0.155 ± 0.161, 각막표면연마굴절수술안에서 logMAR 0.095 ± 0.140이었다. 중증도 및 고도근시군으로 나누어 분석하였을 때, 술 후 10년째의 평균 구면렌즈 대응치, 안정성 및 효율성 척도는 라식 및 각막표면연마굴절수술안에서 다르지 않았다. 술 후 합병증의 발생률에서 수술 종류 간의 유의한 차이는 없었다. 결론: 술 후 10년간의 경과 관찰 결과, 중등도 및 고도근시 환자에서 라식 수술과 각막표면연마굴절수술은 효율성, 안정성, 합병증 등에서 차이가 없었다.
Abstract
Purpose: To compare the long-term prognosis of laser in situ keratomileusis (LASIK) and surface ablation in moderate to high myopia. Methods: A retrospective study including 87 eyes of 44 myopic patients treated with LASIK or surface ablation from 1995 to 2005 was performed. Follow-up visits were performed at 3 months, 1 year, 5 years, and 8 years. All treated eyes were divided into 2 groups according to preoperative spherical equivalent (SE)- moderate myopia (<-6.0 diopters [D]) and high myopia (≥-6.0 D). The main outcome measures were postoperative uncorrected visual acuity (UCVA), best corrected visual acuity, SE, mean keratometry, safety index, efficacy index, predictability, and complications. Results: Mean SE was -7.05 ± 2.49 D in the LASIK group and -5.25 ± 1.23 D in the surface ablation group. The 10-year SE was -1.78 ± 1.22 D in the LASIK group and -1.35 ± 1.09 D in the surface ablation group, and there was no statistical difference between the 2 groups. At 10 years postoperatively, UCVA was log MAR 0.155 ± 0.161 in the LASIK group and log MAR 0.095 ± 0.140 in the surface ablation group. There were no significant differences in postoperative mean SE, safety index, efficacy index, or complications between the LASIK and surface ablation group at 10 years. Conclusions: This 10-year follow-up study shows that LASIK and surface ablation for moderate to high myopia have no statistical differences in mean SE, safety index, efficacy index, or complications.
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