미세각막절개 백내장 수술 후 낭내 삽입한 일체형 비구면 인공수정체의 임상 결과
Clinical Outcome of in-the-Bag Single-Piece Aspheric Intraocular Lens Implantation after Microincision Cataract Surgery
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목적: 새로운 설계의 광학부를 가지는 비구면 인공수정체 HOYA AF-1 iSert (HOYA, Tokyo, Japan)와 HOYA AF-1 iMics (HOYA,Tokyo, Japan)를 Akreos MI60 (Bausch & Lomb, Inc., Rochester, NY, USA)의 임상 결과와 비교하여 안정성 및 광학 기능을 평가하고자 하였다. 대상과 방법: iSert, iMics, MI60를 삽입한 55안, 50안, 60안을 대상으로, 최대교정시력, 구면대응치, 전방 깊이, 수차, 대비감도를 측정하여 기능적 안정성, 낭내 전후 위치 안정성, 시력의 질, 수술유발난시 등을 비교하였다. 결과: 수술 전후 최대교정시력은 세 인공수정체 간 차이가 없었다. 술후 구면대응치는 MI60 군에서 유의한 근시화 경향을 보였으나,인공수정체 전후 위치 변화는 통계적으로 유의한 차이를 보이지 않았다. 전체고위수차, 고위수차, 코마수차, 대비감도는 유의한 차이가없었으나 구면수차는 MI60가 술후 6개월에 iSert, iMics보다 유의하게 높은 수치를 보였다. 결론: iSert와 iMics는 술후 6개월 경과 관찰에서 MI60와 대등한 안정성 및 시기능 향상을 보였다.
Abstract
Purpose: To evaluate the stability and optical performance of the newly developed single-piece aspheric intraocular lens (IOL) by comparing the clinical outcome of the aspheric IOL with the new optic profile design (HOYA iSert, HOYA iMics)and the aspheric IOL (Akreos MI60), which has been proven effective and safe. Methods: iSert, iMics, and MI60 were inserted into 55 eyes, 60 eyes, and 50 eyes, respectively, after microincision phacoemulsification cataract surgery. Best corrected visual acuity (BCVA), refraction in spherical equivalent, anterior chamber depth (ACD), total higher order aberration (HOA), contrast sensitivity, and surgically induced astigmatism (SIA) were measured and each IOL was evaluated on the functional stability, anterior-posterior stability, centration in the capsular bag, and quality of vision. Results: No statistical differences in preoperative and postoperative BCVA among the 3 IOL groups were observed, however,MI60 showed significant myopic shift postoperatively. Anterior-posterior stability assessed with postoperative change in refractive error and ACD was slightly lower in the MI60 group. In terms of vision quality, while total aberration, total HOA, coma aberration, and contrast sensitivity for the 3 IOLs were not different significantly, spherical aberration of the MI60 group was higher than the other groups at 6 months postoperative. SIA was significantly increased in eyes implanted with iSert than in eyes with iMics or MI60 at 1 month postoperatively, however, the differences were no longer evident after 3 months postoperatively. Conclusions: The new aspheric IOLs, iSert and iMics, showed good stability and visual outcome equal to MI60 at the 6-month postoperative follow-up.
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