원추각막환자에서 전층각막이식 수술 후 Trephine 차이에 따른 각막곡률 및 굴절값 변화
The Keratometric and Refractive Value Change According to Trephine Size Difference after Keratoplasty in Keratoconus
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목적: 전층각막이식수술을 받은 원추각막 환자에서, 공여각막 및 수여각막의 크기 차이에 따른 술 후 굴절값 및 각막곡률의 변화양상을 알아보고자 한다. 대상과 방법: 2005년 1월부터 2008년 7월까지 원추각막으로 전층각막이식수술을 받은 환자의 의무기록을 후향적으로 연구하였다. 수술 전에 안초음파를 이용한 안축장의 길이, 각막지형도상 White to white diameter, 전방 깊이를 측정하였고, 수술 시 공여각막 및수여각막의trephine size를 조사하였다. Trephine size 차이에 따라 두 군으로 나누고, 각각에 대해서 술 후 6개월, 1년, 2년의 각막곡률 및 굴절값을 비교하였다. 결과: 총 41안의 환자를 대상으로 시행하였으며 수술 시 평균 연령은 26.4세였다. 술 후 전방의 깊이는 감소하여 근시성 변화는 해소되었으나 공여각막과 수여각막의 trephine size 차이가 각막 곡률 및 굴절값에 통계학적으로 의미 있는 영향을 미치지 않았다. 결론: 원추각막환자에서 전층각막이식 수술을 통하여 근시를 줄일 수 있지만, 공여각막과 수여각막의 trephine 크기 차이는 술 후 각막곡률에 의미 있는 영향을 주지 않는다.
Abstract
Purpose: To investigate mean keratometric and refractive value after penetrating keratoplasty according to the difference between donor and recipient cornea size. Methods: In a retrospective study, Keratoconus patients who underwent penetrating keratoplasty for keratoconus from January 2005 to July 2008 were examined. Preoperatively, axial length was measured using applanation ultrasonography and anterior chamber depth, white to white diameter were also measured using the corneal topography. The trephine size of donor and recipient during the surgery were recorded. Preoperatively, 6, 12, and 24 months postoperatively refraction and keratometric value were evaluated in groups divided according to corneal trephine size difference. Results: Among the 41 eyes of 41 patients, there was a mean age at transplant of 26.4 years. After surgery, the decrease of anterior chamber depth could contribute to the decrease of myopic change. However, the differences between donor and recipient cornea size do not have a significant affect on postoperative keratometric or refractive value. Conclusions: There is no significant difference between the postoperative keratometric value and the corneal trephine size difference in keratoconus patients.
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