삼체형과 일체형 비구면 인공수정체 삽입 후 전방부 계측치와 굴절력의 비교
Comparison of Anterior Chamber Parameter and Refractive Change between Three-Piece and Single-Piece Aspheric Intraocular Lenses
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목적: 삼체형과 일체형 비구면 인공수정체의 전방부 계측치와 굴절력을 검사하여 안정성을 비교하고자 하였다. 대상과 방법: 55안의 백내장수술 환자 중 삼체형인 TecnisⓇZA9003 (25안)과 일체형인 TecnisⓇZCB00 삽입군(30안)을 대상으로 수술전, 수술 후 1주일, 1개월에 전안부 분석기를 이용하여 전방 깊이 및 부피, 전방각을 측정하고, 자동굴절검사기를 이용하여 굴절력을검사하였다. 결과: 일체형과 삼체형 인공수정체 모두 수술 전에 비해 전방 깊이, 전방부피, 전방각 모두 유의하게 증가하였으며 수술 1주째 및 1개월째 일체형 인공수정체가 삼체형 인공수정체에 비해 전방의 깊이가 깊게 나타나는 경향을 보였다. 굴절력은 두 군 모두 목표 굴절력에비해 근시화 되는 경향을 보였으나 1주 및 1개월에 유의한 굴절력의 변화를 보이지 않았다. 결론: 두 인공수정체에서 수술 후 전방 깊이, 전방부피, 전방각이 증가하였으며 수술 후 두군 모두 안정적인 굴절력을 보여주었다. 일체형 비구면 인공수정체는 목표 굴절력에 비해 근시로 나타나 상수에 대한 고찰이 필요할 것으로 생각한다.
Abstract
Purpose: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA)and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. Methods: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric TecnisⓇ ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric TecnisⓇ ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1month. Refractive outcomes were evaluated using an autokeratometer. Results: When comparing the 3-piece (TecnisⓇ ZA9003) and 1-piece (TecnisⓇ ZCB00) IOL with the same optic, ACD,ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. Conclusions: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.
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