두 종류 비구면 인공수정체 삽입 후 Double-pass 원리를 이용한 시력의 질 비교
Comparison of Optical Quality Between Two Intraocular Lenses Using Double-Pass Based Optical Quality Analysis System
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목적: 두 종류의 일체형 비구면 인공수정체를 삽입한 백내장 수술 환자를 대상으로 Double pass 원리를 적용한 분석기를 이용하여임상결과를 비교하고자 하였다. 대상과 방법: 본원에서 2009년 10월에서 2011년 2월까지 백내장 수술을 시행 받은 25안의 Tecnis® ZCB00 (AMO, Inc., Santa Ana,CA, USA) 삽입 군과 16안의 Acrysof® IQ SN60WF (Alcon, Inc., Fort Worth, TX, USA) 삽입 군을 대상으로 술 후 6개월째 나안시력및 최대교정시력, 구면 대응치를 측정하고 Double pass 원리를 적용한 Optical quality analysis system (OQAS, Visiometrics SL,Spain)을 이용하여 변조전달기능(MTF cutoff), Strehl 비율(Strehl ratio), 객관적 산란지수(OSI) 값을 측정하고 차이를 비교해 보았다. 결과: ZCB00 삽입 군과 SN60WF삽입 군에서의 수술 후 나안시력, 최대교정시력, 구면 대응치, Double pass 이미지 분석에 따른 객관적 산란지수(1.60 ± 0.70 vs 2.76 ± 2.33, p=0.27) 값은 통계적으로 유의한 차이를 보이지 않았다. 반면, 두 군 간의 Double pass 이미지 분석에 따른 변조전달기능(28.0 ± 7.79 vs 20.4 ± 9.51 c/deg, p=0.025)과 Strehl 비율(0.14 ± 0.04 vs 0.12 ± 0.05, p=0.042)은 통계적으로 유의한 차이를 보였다. 결론: 백내장 수술시 삽입되는 렌즈의 종류 및 특성에 따라 수술 후 환자의 시력의 질에 영향을 미치는 것으로 생각되며, OQAS는백내장 수술 후 단순 시력측정으로는 설명이 어려운 실제 망막에 맺히는 상의 질에 대한 보다 객관적인 지표를 제공해주어 진료에도움이 될 것으로 생각한다.
Abstract
Purpose: To compare postoperative optical qualities between two types of 1-piece aspheric intraocular lenses using the double-pass technique. Methods: Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and spherical equivalent were evaluated in the subject groups; the first which included 25 eyes implanted with Tecnis® ZCB00 and the second which included 16eyes implanted with Acrysof® IQ SN60WF. In addition, modulation transfer function (MTF) cut-off, Strehl ratio, and objective scattering index (OSI) were measured 6 months after cataract surgery in the 2 subject groups using Optical Quality Analysis System (OQAS, Visiometrics S.L., Terrasa, Barcelona, Spain) which is based on the double-pass technique. Results: There were no significant differences in the spherical equivalent, UCVA, BCVA, and OSI between the 2 groups. However, both the MTF cut-off, and Strehl ratio showed statistically significant differences. The MTF cut-off (28.0 ± 7.79vs. 20.4 ± 9.51 c/deg, p = 0.025) and Strehl ratio (0.14 ± 0.04 vs. 0.12 ± 0.05, p = 0.042) were higher in the Tecnis® ZCB00-implanted group. Conclusions: The difference in characteristics of intraocular lenses subtly affects the vision quality as measured by values such as MTF cut-off and Strehl ratio after cataract surgery. OQAS based on the double-pass technique is considered useful in more objective estimates of the real retinal image quality after cataract surgery which is difficult to explain simply by measuring visual acuity.
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