각막굴절교정 술 후 비접촉성 안압계로 측정한 안압의 저평가 정도
Analysis of Postoperative Intraocular Pressure Underestimation Measured with Non Contact Tonometry after Corneal Refractive Surgery
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목적: 각막굴절교정술 후 비접촉안압계로 측정한 안압의 저평가 정도가 어느 정도인지를 알아보고자 하였다. 대상과 방법: 본원에서 2011년 1월에서 2월까지 라식을 시행한 253명과 라섹을 시행한 281명을 대상으로 비접촉안압계로 측정한 수술전 후의 안압의 차이를 술 후 안압의 저평가로 간주하여 그 정도를 알아보았으며 안압 감소에 영향을 주는 술 전 인자들을 다중회귀방법으로 분석하였다. 결과: 술 후 비접촉안압계를 이용한 안압 감소는 수술 시 나이(r=-0.0420, p=0.03), 각막절제량(r=0.0466, p＜0.01), 그리고 수술방법(라식 혹은 라섹)에 따라(r=0.6006, p＜0.01) 유의한 차이를 보였다. 라식 후 100 μm의 각막두께가 감소할 때, 26세 미만에서 안압이6.29 ± 2.40 mmHg가 감소하였고 26세 이상에서 6.12 ± 2.53 mmHg가 감소하였다(p=0.05). 라섹 후 100 μm의 각막두께가 감소할때, 26세 미만에서 안압이 5.77 ± 2.37 mmHg가 감소하였고, 26세 이상에서 5.44 ± 2.62 mmHg 감소하였다(p=0.05). 결론: 각막굴절교정술 후 비접촉안압계로 측정한 안압은 각막절제량이 증가할수록, 나이가 어릴수록, 라식을 받은 경우 더욱 감소하는경향이 있다.
Abstract
Purpose: To analyze the postoperative intraocular pressure (IOP) underestimation measured with non-contact tonometryafter corneal refractive surgery. Methods: The postoperative IOP decrease measured with non-contact tonometry (NCT), regarded as IOP underestimation,was calculated in 253 LASIK patients and 281 LASEK patients. Multiple regression analysis was performed todetermine the preoperative factors which affect postoperative IOP underestimation. The right eye results were reported inthis paper. Results: The postoperative IOP decrease was affected by age (r = -0.0420, p = 0.03), corneal ablation depth (r = 0.0466,p < 0.01), and operation method (LASIK or LASEK) (r = 0.6006, p < 0.01). For every 100 μm decrease of corneal thicknessby LASIK, the IOP decreased 6.29 ± 2.40 mm Hg in patients under 26 years of age and 6.12 ± 2.53 mm Hg in patientsabove 26 years of age (p = 0.05). For every 100 μm decrease of corneal thickness by LASEK, the IOP decreased 5.77 ±2.37 mm Hg in patients under 26 years of age and 5.44 ± 2.62 mm Hg in patients above 26 years of age (p = 0.05). Conclusions: The postoperative IOP underestimation measured with NCT was more prominent in younger-aged patientsafter LASIK than LASEK with deeper ablation depth.
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