생체계측치와 각막 곡률의 차이에 따른 인공수정체 삽입 후 굴절 오차의 경향
Comparison of the Refractive Outcomes According to the Differences of Biometry and Keratometry Reading
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목적: 일반적인 백내장 수술에서 안축장과 전방 깊이, PentacamⓇ과 자동각막곡률계의 기기별 각막곡률의 차이에 따른 인공수정체삽입 후 굴절 오차의 경향에 미치는 각각의 영향을 비교하고자 하였다. 대상과 방법: 84명 110안을 대상으로 수술 전 초음파 생체계측계를 통해 안축장과 전방 깊이를 측정하고 자동각막곡률계와 PentacamⓇ을이용하여 각막곡률을 측정하였다. 수술 전 SRK/T 공식으로 도출한 예측 굴절력의 구면렌즈 대응치와 수술 2개월 후 현성 굴절 검사상굴절력의 구면렌즈 대응치 사이의 차이를 실제오차로 간주하였고 이의 절대값을 절대오차로 간주하여 각 기기의 각막곡률을 대입하여도출한 계산값을 비교하였다. 결과: 안축장과 전방깊이에 따른 굴절 오차는 유의한 차이가 없었고, 기기별로 측정된 각막 곡률로 계산된 평균절대 오차는 차이가없었으나 각막 곡률의 기기간의 차이의 절대치가 1.00D 이상 차이가 날 때 인공수정체의 도수 측정의 오차가 커지는 경향을 보였다. 결론: 안축장과 전방깊이에 따른 술 후 굴절 오차는 유의한 상관관계가 없었고, 자동각막곡률계와 PentacamⓇ으로 측정된 각막곡률은양기계간의 수치의 차이가 1.00D 이상일 때에는 인공수정체 도수 예측도의 정확성이 낮으므로 술 후 굴절 오차를 유발할 수 있어인공 수정체 도수 결정 시 양 기기간의 수치의 차이에 유의해야 한다.
Abstract
Purpose: The purpose of this study was to investigate the error tendency between preoperative expected refraction and postoperative manifest refraction based on axial length, anterior chamber depth, and keratometric data obtained by an automated keratometer and Pentacam® in cataract surgery cases and to report how their differences affect determination of intraocular lens (IOL) power. Methods: The authors retrospectively reviewed the medical records of 110 eyes of 84 patients who underwent cataract surgery. Axial length and anterior chamber depth were measured by A scan ultrasound biometry, while keratometric values were obtained by an automated keratometer and Pentacam®. IOL power was calculated using the SRK/T formula. Patients were divided into 3 groups based on the axial length, anterior chamber depth, and the difference of keratometric values between the 2 devices. Refractive error was analyzed 2 months after surgery. Results: There were no statistically significant differences between axial length and anterior chamber depth among the groups; however, the K reading differences were statistically significant. Although the mean absolute error (MAE) of each group showed no statistical significance among the groups, the MAE was more pronounced in the group in which the keratometeric value measured by Pentacam® differed more than 1.00 diopter from the automated keratometer measurements. Conclusions: There was no statistically significant difference between axial length and anterior chamber depth among the groups. A difference of 1.00 diopter or more between the keratometric values obtained by an automated keratometer and Pentacam® significantly affects the postoperative refractive error; therefore, these factors should be considered when determining IOL power.
참고문헌 (27)
- Holladay JT, "Improving the predictability of intraocular lens power calculations", Arch Ophthalmol, 104, pp.539~541 (1986)
- Mamalis N, "Complications of foldable intraocular lenses requiring explanation or secondary intervention--1998 survey", J Cataract Refract Surg, 26, pp.766~772 (2000)
- Olsen T, "Sources of error in intraocular lens power calculation", J Cataract Refract Surg, 18, pp.125~129 (1992)
- Koranyi G, "Anterior chamber depth measurement: a-scan versus optical methods", J Cataract Refract Surg, 28, pp.243~247 (2002)
- Hosny M, "Relationship between anterior chamber depth, refractive state, corneal diameter, and axial length", J Refract Surg, 16, pp.336~340 (2000)
- Olsen T, "Prediction of the effective postoperative (intraocular lens) anterior chamber depth", J Cataract Refract Surg, 32, pp.419~424 (2006)
- Norrby S, "Sources of error in intraocular lens power calculation", J Cataract Refract Surg, 34, pp.368~376 (2008)
- Speicher L, "Intra-ocular lens calculation status after corneal refractive surgery", Curr Opin Ophthalmol, 12, pp.17~29 (2001)
- Gonen T, "Comparison of keratometric data obtained by automated keratometer, dicon ct200, allegro topolyzer, and pentacam", J Refract Surg, 28, pp.557~561 (2012)
- Salouti R, "Comparison of anterior chamber depth measurements using Galilei, HR Pentacam, and Orbscan II", Optometry, 81, pp.35~39 (2010)
- Shammas HJ, "Scheimpflug photography keratometry readings for routine intraocular lens power calculation", J Cataract Refract Surg, 35, pp.330~334 (2009)
- 장민욱, "Which Keratometer is Most Reliable for Correcting Astigmatism with Toric Intraocular Lenses?", Korean Journal of Ophthalmology, 26(1), pp.10~14 (2012), 대한안과학회
- Savini G, "Accuracy of Scheimpflug corneal power measurements for intraocular lens power calculation", J Cataract Refract Surg, 35, pp.1193~1197 (2009)
- Módis L Jr, "Keratometry evaluations with the Pentacam high resolution in comparison with the automated keratometry and conventional corneal topography", Cornea, 31, pp.36~41 (2012)
- 맹효성, "전방깊이와 안축장에 따른 인공수정체 삽입 후 굴절 오차의 경향", 대한안과학회지, 51(2), pp.195~202 (2010), 대한안과학회
- Weissman JL, "Enlarged anterior chamber: CT finding of a ruptured globe", AJNR Am J Neuroradiol, 16(4 Suppl), pp.936~938 (1995)
- Masket S, "Alcon Restor multifocal-clinical pearls. In Mastering refractive IOLs: The art and science", pp.38~ (2008), SLACK Incorporated
- Gale RP, "Benchmark standards for refractive outcomes after NHS cataract surgery", Eye, 23, pp.149~152 (2009)
- 조동현, "각막굴절교정수술 후 인공수정체 도수 결정시 Orbscan II 비디오각막경의 유용성", 대한안과학회지, 50(11), pp.1730~1734 (2009), 대한안과학회
- Tang Q, "Accuracy of Scheimpflug Holladay equivalent keratometry readings after corneal refractive surgery", J Cataract Refract Surg, 35, pp.1198~1203 (2009)
- Kim SW, "Use of the pentacam true net corneal power for intraocular lens calculation in eyes after refractive corneal surgery", J Refract Surg, 25, pp.285~289 (2009)
- Symes RJ, "Automated keratometry in routine cataract surgery: comparison of Scheimpflug and conventional values", J Cataract Refract Surg, 37, pp.295~301 (2011)
- Retzlaff JA, "Development of the SRK", T intraocular lens implant power calculation formula, 1990, pp.16, 333~340
- Cho YT, "Evaluation for the accuracy of the SRK", T Formula in PCL Implanted Patients(I), 1991, pp.32, 752~760
- Aristodemou P, "Formula choice: Hoffer Q, Holladay 1, or SRK", T and refractive outcomes in 8108 eyes after cataract surgery with biometry by partial coherence interferometry, 2011, pp.37, 63~71
- Narváez J, "Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK", T formulas, 2006, pp.32, 2050~2053
- Sanders DR, "Comparison of the SRK", T formula and other theoretical and regression formulas, 1990, pp.16, 341~346