경사절개법을 이용한 전층각막절개 난시교정술의 임상성적
Clinical Outcomes of Beveled, Full Thickness Astigmatic Keratotomy
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목적: 경사절개법을 이용한 전층각막절개 난시교정술의 임상성적을 평가하고자 한다. 대상과 방법: 경사절개법을 이용한 전층각막절개 난시교정술을 받고 6개월간 경과관찰이 가능하였던 112명(185안)을 안내렌즈삽입술후 난시교정술을 받은 환자를 A군, 백내장 수술 뒤 난시교정술을 받은 환자를 B군, 난시교정술만을 받은 환자를 C군으로 나누고 술후 1주, 1개월, 3개월, 6개월에 나안시력, 난시도수를 측정하여 술 전과 비교하였고, 효율성, 안전성, 예측성을 평가하였다. 결과: 술 후 6개월째 교정된 난시의 양은 전체적으로 68.9 ± 18.24%, A군에서 69.24 ± 20.76%, B군에서 67.84 ± 17.56%, C군에서67.82 ± 13.97%로 술 전에 비해 유의하게 감소하였고, 잔여난시가 1.0D 이내인 비율은 전체적으로 88.65%, A군에서 91.49%, B군에서 87.5%, C군에서 70.0%였다. 최대교정시력은 평균 0.56줄의 증가를 보였고, 2줄 이상의 감소를 보인 경우는 없었다. 수술 후 합병증은 관찰되지 않았다. 결론: 경사절개법을 이용한 전층각막절개 난시교정술은 효과적이고 안전한 방법으로, 단독으로 시행했을 때뿐만 아니라 안내렌즈삽입술 또는 백내장 수술과 병합하여 시행했을 때도 좋은 결과를 보였다.
Abstract
Purpose: To evaluate the beveled, full thickness astigmatic keratotomy. Methods: This study included 185 eyes of 112 patients treated with beveled, full thickness astigmatic keratotomy. Treated eyes were divided into 3 groups: beveled, full thickness astigmatic keratotomy after implantable collamer lens (ICL) implantation (group A), beveled, full thickness astigmatic keratotomy after cataract surgery (group B) and beveled, full thickness astigmatic keratotomy alone (group C). Follow-up visits were at 1 week, 1 month, 3 months and 6 months. The outcome measures included uncorrected distance visual acuity, astigmatism, efficacy, safety and predictability. Results: At 6 months postoperatively, astigmatism was significantly reduced: 68.9 ± 18.24% in total, 69.24 ± 20.76%, in the group A, 67.84 ± 17.56% in the group B and 67.82 ± 13.97% in the group C. The proportion of eyes with astigmatism 1.0 or less was 88.65% in total, 91.49% in the group A, 87.5% in the group B and 70.0% in the group C. Mean improvement in corrected distance visual acuity (CDVA) was 0.56 lines; no eyes lost 2 lines of CDVA after 6 months postoperatively. Postoperative complications were not observed. Conclusions: This study showed the beveled, full thickness astigmatic keratotomy is effective and safe for correcting astigmatism alone as well as correcting astigmatism after ICL implantation or cataract surgery.
참고문헌 (25)
- Pineda R., "Arcuate keratotomy : an option for astigmatism correction after laser in situ keratomileusis", Cornea, 28, pp.1178~1180 (2009)
- Güell JL., "Correction of high astigmatism with astigmatic keratotomy combined with laser in situ keratomileusis", J Cataract Refract Surg, 26, pp.960~966 (2000)
- 송현범, "전층 각막이식술 후 잔여 고도난시에 대해 각막윤부 이완절개 및 추가 봉합술의 단기 교정효과", 대한안과학회지, 52(10), pp.1142~1149 (2011), 대한안과학회
- Nubile M., "Femtosecond laser arcuate keratotomy for the correction of high astigmatism after keratoplasty", Ophthalmology, 116, pp.1083~1092 (2009)
- Rosecan LR., "Endophthalmitis and cystoid macular edema after astigmatic keratotomy", Ophthalmic Surg, 25, pp.481~482 (1994)
- 윤재문, "난시교정용 후방 유수정체 안내렌즈 삽입술의 단기간 임상성적", 대한안과학회지, 50(6), pp.839~851 (2009), 대한안과학회
- Ivarsen A., "Laser in situ keratomileusis for high astigmatism in myopic and hyperopic eyes", J Cataract Refract Surg, 39, pp.74~80 (2013)
- Binder PS., "Analysis of ectasia after laser in situ keratomileusis : risk factors", J Cataract Refract Surg, 33, pp.1530~1538 (2007)
- Nagy ZZ., "Photorefractive keratectomy using the meditec MEL 70 G-scan laser for hyperopia and hyperopic astigmatism", J Refract Surg, 18, pp.542~550 (2002)
- Holladay JT., "Functional vision and corneal changes after laser in situ keratomileusis determined by contrast sensitivity, glare testing, and corneal topography", J Cataract Refract Surg, 25, pp.663~669 (1999)
- Jiménez-Alfaro I., "Safety of posterior chamber phakic intraocular lenses for the correction of high myopia : anterior segment changes after posterior chamber phakic intraocular lens implantation", Ophthalmology, 108, pp.90~99 (2001)
- Akura J., "Experimental study using pig eyes for realizing ideal astigmatic keratotomy", Cornea, 20, pp.325~328 (2001)
- Duffey RJ., "Paired arcuate keratotomy. A surgical approach to mixed and myopic astigmatism", Arch Ophthalmol, 106, pp.1130~1135 (1988)
- Akura J., "Clinical application of full-arc, depth-dependent, astigmatic keratotomy", Cornea, 20, pp.839~843 (2001)
- Hoffart L., "Mechanized astigmatic arcuate keratotomy with the Hanna arcitome for astigmatism after keratoplasty", J Cataract Refract Surg, 33, pp.862~868 (2007)
- Poole TR., "Astigmatic keratotomy for post-keratoplasty astigmatism", J Cataract Refract Surg, 32, pp.1175~1179 (2006)
- Cleary C., "Beveled femtosecond laser astigmatic keratotomy for the treatment of high astigmatism postpenetrating keratoplasty", Cornea, 32, pp.54~62 (2013)
- Buzzonetti L., "Arcuate keratotomy for high postoperative keratoplasty astigmatism performed with the intralase femtosecond laser", J Refract Surg, 25, pp.709~714 (2009)
- Kumar NL., "IntraLase-enabled astigmatic keratotomy for post-keratoplasty astigmatism : on-axis vector analysis", Ophthalmology, 117, pp.1228~1235 (2010)
- Tsioulias G., "Arcuate relaxing incisions with a 5. 00-mm optical zone for the correction of high postcataract astigmatism", Ophthalmologica, 214, pp.385~389 (2000)
- Guyton DL., "Prescribing cylinders : the problem of distortion", Surv Ophthalmol, 22, pp.177~188 (1977)
- Lindquist TD., "Trapezoidal astigmatic keratotomy. Quantification in human cadaver eyes", Arch Ophthalmol, 104, pp.1534~1539 (1986)
- Akura J., "Clinical application of full-arc, depth-dependent, astigmatic keratotomy", Cornea, 20, pp.839~843 (2001)
- Feldman RM., "Retinal detachment following radial and astigmatic keratotomy", Refract Corneal Surg, 7, pp.252~253 (1991)
- Adrean SD., "Infectious keratitis after astigmatic keratotomy in penetrating keratoplasty : review of three cases", Cornea, 24, pp.626~628 (2005)