회절성 난시교정용 다초점 인공수정체의 임상결과
Clinical Outcomes of Diffractive Multifocal Toric Intraocular Lens Implantation
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목적: 회절성 난시교정용 다초점 인공수정체를 삽입한 환자들의 임상결과를 알아보고자 한다. 대상과 방법: 회절성 난시교정용 다초점 인공수정체 삽입 수술 받은 26명 34안을 대상으로 술 후 1일, 2주, 1 ․ 3 ․ 6개월에 나안 원거리 ․ 중간거리 ․ 근거리시력, 잔여굴절난시를 측정하였고 술 후 3개월째 Optical Quality Analysis System Ⅱ (OQAS II)를 이용한 시기능검사, 고위수차 검사 및 만족도 조사를 시행하였다. 결과: 술 후 6개월째 평균 나안시력은 원거리 0.06 ± 0.07, 중간거리 63 cm 0.18 ± 0.11, 100 cm 0.16 ± 0.12, 근거리 0.03 ±0.06 (logMAR)이었다. 굴절 난시값은 술 전 -1.66 ± 1.04D에서 6개월째 -0.54 ± 0.32D로 유의하게 감소하였다(p<0.01). OQASII 검사상 Objective scatter index는 평균 1.33 ± 0.67, MTF cut-off value는 평균 37.24 ± 9.67 cpd, Strehl ratio는 평균 0.22 ±0.09이었고 위조절력은 평균 3.08 ± 0.53D이었다. 고위수차는 5 mm 0.30 ± 0.09, 6 mm 0.49 ± 0.15이었다. 술 후 82.3%에서만족하였고 79.4%가 추천하였으며 야간시력장애 호소는 14.7%였다. 결론: 난시를 가진 백내장 환자에서 회절성 난시교정용 다초점 인공수정체 삽입은 우수한 원거리, 중간거리 및 근거리 시력을 보였고우수한 시력 질과 높은 만족도를 보였다.
Abstract
Purpose: To evaluate the clinical outcomes of patients with diffractive multifocal toric intraocular lens (IOL) implantation. Methods: Thirty-four eyes of 26 patients underwent diffractive multifocal toric IOL. Uncorrected visual acuity (UCVA) at distant,intermediate and near and residual refractive astigmatism were measured on the first day, at 2 weeks, and 1, 3 and 6 monthspostoperatively. Optical quality obtained using the Optical Quality Analysis System II (OQAS II), high-order aberrations (HOA)and patient satisfaction questionnaire were evaluated 3 months postoperatively. Results: At the 6 month postoperative visit, the mean UCVA at distant, intermediate (63 cm, 100 cm) and near were 0.06 ± 0.07,0.18 ± 0.11, 0.16 ± 0.12 and 0.03 ± 0.06 (log MAR), respectively. The refractive astigmatism decreased significantly from -1.66± 1.04 D to -0.54 ± 0.32 D at 6 months postoperatively (p < 0.01). The means of objective scatter index, modulation transfer function(MTF) cut-off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.33 ± 0.67, 37.24 ± 9.67cdp, 0.22 ± 0.09 and 3.08 ± 0.53 D, respectively. HOA scores for 5 mm and 6 mm were 0.30 ± 0.09 and 0.49 ± 0.15, respectively;82.3% of the patients were satisfied with the postoperative results, 79.4% of the patients reported they would recommend theprocedure to others, and 14.7% of patients reported moderate or severe visual disturbance at night. Conclusions: Implantation of a diffractive multifocal toric IOL in patients with cataract and corneal astigmatism provided excellentdistant, intermediate, and near visual outcomes, good optical quality and high patient satisfaction.
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