ICL 삽입술 후 안축장 측정값의 변화
Axial Length Change after Implantable Collamer Lens Implantation
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목적: 안축장 측정은 백내장 수술의 인공수정체 도수계산에 있어서 중요한 변수이다. implantable collamer lens (ICL)의 유무가 안축장 측정에 어떤 영향을 미치는지 알아보고자 하였다. 대상과 방법: 76명 141안의 고도근시 환자를 대상으로 ICL 삽입술 전과 수술 후 1개월째 안축장을 압평 A-scan 초음파검사를 이용하여측정하였다. 결과: ICL 삽입술 전과 수술 후 1개월째 안축장은 각각 28.03 ± 1.91 mm, 28.08 ± 1.86 mm로 수술 후 0.05 mm 더 길게 통계학적으로유의하게 측정되었으며(p=0.036), 술 전과 후의 안축장 값은 높은 상관관계를 보였다(R2=0.9829, p＜0.0001). 결론: ICL 삽입술 후에 안축장 값이 의미있게 길게 측정 되었으나 0.05 mm의 안축장 차이는 인공수정체의 도수선택에 영향을 미치지않을 정도의 작은 크기이다. 따라서 ICL 삽입 여부는 백내장 수술 시 인공수정체 도수 선택을 위한 안축장 측정에서 고려할 사항이기는하나, ICL의 유무와 관계없이 백내장 수술 직전에 측정한 안축장을 그대로 인공수정체 도수계산공식에 사용하여도 무방할 것으로 생각한다.
Abstract
Purpose: The axial length measurement is an important variable in calculating the intraocular lens (IOL) power in cataract surgery. In this study, the effects of the implantable collamer lens (ICL) on the axial length measurement were investigated. Methods: The axial lengths of 141 eyes of 76 highly myopic patients were measured before ICL implantation and 1 month postoperatively using applanation A-scan ultrasound. Results: The measured axial lengths before ICL implantation and 1 month after the surgery were 28.03 ± 1.91 mm and 28.08 ± 1.86 mm respectively, with a statistically significant difference of 0.05 mm (p = 0.036). These 2 values showed a high correlation (R2 = 0.9829, p < 0.0001). Conclusions: Even though the axial length after ICL implantation significantly increased, the 0.05 mm change was too small to influence the determination of the IOL diopters in cataract surgery. Therefore, ICL implantation history may be reflected when measuring the axial length for the IOL power calculation in cataract surgery, but the axial length measured immediately before the cataract surgery may be used to calculate the IOL power regardless of the ICL implantation history.
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