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홍채고정안내렌즈 삽입술 후 엎드린 자세가 임계거리에 미치는 영향

Effects of Prone Positioning on Critical Distance in Iris-Claw Phakic Intraocular Lens-Implanted Eyes

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초록

목적: 홍채고정안내렌즈(ArtiflexⓇ) 삽입술 후 일시적인 엎드린 자세를 취할 때 렌즈 광학부의 주변부와 각막내피세포 사이의 거리(임계거리)에 변화가 있는지 알아보고자 하였다. 대상과 방법: 홍채고정안내렌즈(ArtiflexⓇ) 삽입술을 시행 받은 20명 40안에 대하여 전안부 빛간섭단층촬영계를 이용하여 앉은 자세와상체를 90도로 구부려 엎드린 자세에서 임계거리를 측정하고 비교하였다. 결과: 비측에서 측정한 임계거리는 앉은 자세에서 1.52 ± 0.15 mm였으며 엎드린 자세에서는 1.49 ± 0.13 mm로 앉은 자세로 측정한값에 비해서 감소하였다(p=0.01). 이측에서 측정한 임계거리는 앉은 자세에서 1.63 ± 0.17 mm였으며 엎드린 자세에서의 1.63 ± 0.16mm와 통계적 차이가 없었다(p=0.67). 비측에서 측정한 임계거리의 변화는 전방부피와 양의 상관관계를(r=0.27; p=0.01) 보였고 동공크기와는 음의 상관관계를(r=-0.23; p<0.01) 보였으며 이는 통계적으로 유의하였다. 결론: 홍채고정안내렌즈(ArtiflexⓇ) 삽입술을 시행 받은 환자에서 일시적인 엎드린 자세를 취하는 것은 비측의 임계거리를 감소시킨다.

Abstract

Purpose: To evaluate the effects of prone positioning on the critical distance (CD) in Artiflex (Ophtec BV) foldable anterior iris-claw phakic intraocular lens (pIOL)-implanted eyes. Methods: Twenty patients with 40 Artiflex-implanted eyes were prospectively enrolled in the present study. The nasal and temporal critical distances (CD) were measured with Visante anterior segment optical coherence tomography (OCT, Carl Zeiss, Dublin, CA) in both the sitting and prone positions. Results: The mean nasal CD was 1.52 ± 0.15 mm in the sitting position and 1.49 ± 0.13 mm in the prone position (p =0.01). The mean temporal CD was 1.63 ± 0.17 mm in the sitting position and 1.63 ± 0.16 mm in the prone position (p =0.67). In a multiple regression analysis, the changes in nasal CD were positively correlated with anterior chamber volume (r = 0.27; p = 0.01) and negatively correlated with pupil size (r = -0.23; p < 0.01). Conclusions: Prone positioning can induce a decrease in the nasal CD in Artiflex-implanted patients, especially in subjects with small pupils and large anterior chamber volumes.

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