라섹 후 잠복조절량 증가로 인한 일시적인 근시 편위
Transient Myopic Shift Due to Increased Latent Accommodation after LASEK
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목적: 라섹 후 이른 시기에 근시를 보이는 환자들의 조절량과 경과를 분석하였다. 대상과 방법: 2012년 2월부터 3월까지 라섹을 받은 41안을 대상으로 했다. 수술 1개월 후 현성 굴절 검사상 -0.25D 초과의 근시 상태에서 특별한 치료 없이 근시 정도가 호전된 군을 1군으로, 나머지를 2군으로 분류하였다. 현성 및 조절 마비 하 굴절 검사 굴절값의 차이(CRSE-MRSE)를 구하여 잠복조절량이라 정의하고 두 군간에 차이를 비교하였다. 결과: 잠복조절량은 수술 전 1군(7안) 0.179 ± 0.426D, 2군(34안) 0.265 ± 0.303D, 수술 1개월 후 1군 1.286 ± 0.664D, 2군 0.368± 0.536D, 수술 2개월 후 1군 0.500 ± 0.520D, 2군 0.489 ± 0.546D로 수술 1개월 후에 1군에서 2군보다 유의하게 컸다. 수술 2개월후 두 군간에 잠복조절량의 차이가 없어지면서 1군의 근시 편위가 감소하는 양상을 보였다. 결론: 라섹 1개월 후 일부 환자들은 잠복조절량의 증가에 따른 일시적인 근시 편위를 나타내었으며 이 경우 자연적으로 근시 편위가감소하였다. 따라서 근시 퇴행 환자의 치료를 계획할 때 조절 마비 하 굴절검사를 함께 시행하는 것이 필요하다.
Abstract
Purpose: To investigate accommodation and progress of patients who showed myopia on manifest refraction in the earlypostoperative period after LASEK. Methods: Forty-one eyes were included in the present study which had undergone LASEK surgery from February to March2012. Seven eyes showed myopia over -0.25 D on manifest refraction at 1 month postoperatively, but showed decreasedamount of myopia at 2 months postoperatively and were classified as group 1. The other 34 eyes were classified as group2. The differences between cycloplegic and manifest refraction (CRSE-MRSE) were defined as the amount of latent accommodationand compared between the 2 groups. Results: Amount of latent accommodation was 0.179 ± 0.426 D in group 1 (7 eyes), 0.265 ± 0.303 D in group 2 (34 eyes)preoperatively, 1.286 ± 0.664 D in group 1, 0.368 ± 0.536 D in group 2 at 1 month postoperatively, and 0.500 ± 0.520 D ingroup 1, and 0.489 ± 0.546 D in group 2 at 2 months postoperatively. The amount of latent accommodation in group 1 wassignificantly greater than that of group 2 one month postoperatively. As the amount of latent accommodation decreased,the amount of myopic shift decreased gradually over 2 months in group 1 after surgery. Conclusions: Transient myopic shift due to increased latent accommodation was observed in several patients one monthpostoperatively and the amount of myopic shift decreased with time without treatment. Thus, surgeons should consider cycloplegicrefraction when planning treatment for patients with myopic regression.
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