양안 근시 환자의 단안백내장 수술 시 만족도 및 목표굴절력
Target Refraction and Satisfaction of Patients with Binocular Myopia and Monocular Cataract
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목적: 양안 근시 환자에서 단안 백내장 수술한 경우 수술 후 목표굴절력 결정에 도움이 되고자 하였다. 대상과 방법: 양안 근시(안축장길이 25 mm 이상)로 단안 백내장 수술을 한 환자 199명의 수술 전후 굴절력 변화조사와 술 후 만족도설문조사를 시행하였다. 결과: 술 전 굴절력은 3단계로 ≤-3D군, -3~-6D군, ＞-6D군으로 구분하였다. 술 후 수술에 대한 전반적인 만족도는 세 군에서 유의한 차이가 없었고, 수술 후 교정상태에 대한 만족도는 ＞-6D군에서만 유의하게 낮았다(p＜0.05). 술 후 부등시 정도가 3D 이하에서교정상태에 대한 만족도가 유의하게 높았으며(p＜0.05), 목표굴절력(-2~-3D 또는 정시)에 따른 만족도는 유의한 차이가 없었다. 술후 교정방법은 안경 119명(60%), 콘택트렌즈 26명(13%), 단안시 14명(7%)으로 교정하고 있었고 모든 교정방법에 만족하지 못한 40명(20%)의 환자들은 반대안 백내장수술을 시행하였으며, 만족도가 콘택트렌즈 군을 뺀 다른 군에 비해 유의하게 낮았다(p＜0.05). 수술전 굴절력에 따라 나눈 세 군에서의 반대안 백내장수술 비율은 세 군에서 각각 유의한 차이가 없었다. 결론: 목표굴절력을 -2~-3D 또는 정시로 설정하는 것은 만족도에 유의한 차이가 없으며, 수술 후 반대안과의 부등시가 3D 미만이되도록 목표굴절력을 설정하는 것이 더 나은 만족도를 보인다.
Abstract
Purpose: To evaluate the target refraction of patients with binocular myopia and monocular cataract after intraocular lens (IOL)implantation. Methods: This study comprised 199 patients with binocular myopia (axial length >25 mm) and monocular cataract after IOL implantationfor the removal of the monocular cataract. The research was conducted using a questionnaire method and by performingstatistical analysis of the refractive outcomes. Results: The patients are grouped into 3 domains (≤-3 D group, -3~-6 D group, >-6 D group). There were no statistically significantdifferences among the 3 groups; whereas the satisfaction of the present corrected state was statistically low in the >-6 Dgroup (p < 0.05). The satisfaction of the corrected state was statistically high in the group of postoperative anisometropia under3 D (p < 0.05). There was no statistical difference between the groups on the satisfaction of target diopter (-2~-3 D or emmetropia). In terms of correction method, glasses were worn in 119 patients (60%), contact lenses were worn in 26 patients (13%),and monovision was used in 14 patients (7%) were used respectively. Forty patients (20%) with implanted IOL in both eyes didnot use any of the correction methods above. Except for the contact lens group, the general satisfaction and the satisfaction ofthe present corrected state were statistically lower than the other group (p < 0.05). There was no statistically significant differenceamong the 3 groups in the percentage of cataract surgery in the fellow eye. Conclusions: There was no statistical difference between the groups in satisfaction of target diopter (-2~-3 D or emmetropia). Setting the target refraction difference between both eyes less than 3 D leads to more satisfactory outcomes.
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