경한 난시를 보이는 환자의 백내장 수술 후 각막 후면 및 전체 난시의 변화
The Change in Corneal Astigmatism after Cataract Surgery in Patients with Small Amount of Astigmatism
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목적: 각막 전면난시가 1.0D 미만인 환자에서 백내장 수술 후 각막 후면난시 및 전체 난시의 변화를 비교 분석하였다. 대상과 방법: 각막곡률이 가파른 축에 백내장 수술을 시행 받은 1.0D 미만의 각막 전면난시를 가진 환자 52안을 직난시를 보이는33안(1군)과 도난시를 보이는 19안(2군)으로 분류하여 Pentacam®으로 측정한 각막 전면, 후면, 전체 난시를 비교하였다. 결과: 직난시군에서 술 전 전면, 후면, 전체 난시는 0.55 ± 0.44D, 0.31 ± 0.14D, 0.30 ± 0.72D였으며 술 후 2개월 전면, 후면, 전체 난시는 0.51 ± 0.67D, 0.31 ± 0.15D, 0.35 ± 0.81D였다. 도난시군에서는 술 전 전면, 후면, 전체 난시는 -0.48 ± 0.46D, 0.26 ± 0.09D, -0.51 ± 0.65D였으며 술 후 2개월 전면, 후면, 전체 난시는 -0.17 ± 0.68D, 0.25 ± 0.13D, -0.30 ± 0.55D였다. 두 군에서 수술 전후 전면, 후면, 전체 난시에 유의한 차이가 없었다. 수술 2개월 후 수술 후 유발난시량의 vector analysis 시행 시직난시군의 경우 전면난시의 surgically induced astigmatism (SIA)은 0.03D @ 30o, 전체 난시의 SIA가 0.07D @ 74o였으며 도난시군의 경우 전면난시의 SIA는 0.27D @ 100o, 전체 난시의 SIA가 0.36D @ 86o로 측정되었다. 결론: 술 전 전체 각막난시가 1.0D 미만일 경우 후면난시가 수술 후 유발난시량의 예측 및 술 후 전체 난시에 미치는 영향은 적을 것으로 생각된다.
Abstract
Purpose: To analyze the change in posterior corneal astigmatism and total corneal astigmatism in patients with anterior corneal astigmatism less than 1.0 diopter (D). Methods: In the present study we evaluated 52 eyes with anterior corneal astigmatism less than 1.0 D. Patients were divided into 2 groups according to steep axis: Group 1 included 33 eyes with within-the-rule (WTR) astigmatism and Group 2 included 19 eyes with against-the-rule (ATR) astigmatism. Anterior, posterior and total corneal astigmatism were measured using Scheimpflug imaging (Pentacam®). Results: In Group 1, preoperative anterior astigmatism, posterior astigmatism and total astigmatism were 0.55 ± 0.44 D, 0.31 ± 0.14 D and 0.30 ± 0.72 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astigmatism were 0.51 ± 0.67 D, 0.31 ± 0.15 D and 0.35 ± 0.81 D, respectively. There was no statistically significant difference between preoperative and postoperative anterior, posterior and total corneal astigmatism in Group 1. In Group 2, preoperative anterior astigmatism, posterior astigmatism and total astigmatism were -0.48 ± 0.46 D, 0.26 ± 0.09 D and -0.51 ± 0.65 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astigmatism were -0.17 ± 0.68 D, 0.25 ± 0.13 D and -0.30 ± 0.55 D, respectively. There was no statistically significant difference between preoperative and postoperative anterior, posterior and total corneal astigmatism in the 2 groups. There was no statistical correlation between preoperative posterior corneal astigmatism and postoperative 2 months total corneal astigmatism. After vector analysis, surgically induced astigmatism (SIA) of the anterior and total astigmatism in Group 1 were 0.03 D @ 30° and 0.07 D @ 74°, respectively, and in Group 2 were 0.27 D @ 100° and 0.36 D @ 86°, respectively. Conclusions: In patients with preoperative total corneal astigmatism less than 1.0 D, posterior corneal astigmatism had a small effect on postoperative total corneal astigmatism.
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