두 가지 다른 절개 방법의 Nd:YAG 레이저 후낭절개술이 시기능에 미치는 영향
The Effect of Two Different Opening Patterns of Neodymium:YAG Laser Posterior Capsulotomy on Visual Function
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목적: 후발백내장 환자에서 두 가지 다른 절개 방법의 Nd:YAG 레이저 후낭절개술이 시기능에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 본원 안과에서 후발백내장으로 진단받은 환자 50명, 62안을 대상으로 레이저 후낭절개술을 십자절개법 또는 변형 원형절개법으로 절개 방법을 달리하여 시행하였고 시술 전과 후의 대비감도, 눈부심감도 그리고 시술 후 인공수정체 패임을 분석하였다. 결과: 십자절개법을 시행 받은 환자 군에서 인공수정체 중심으로부터 1.5 mm 안에 3개 이상의 패임이 발생한 수가 변형 원형절개법을 시행 받은 환자 군보다 유의하게 많았다(p=0.047). 또한 십자절개법을 시행 받은 환자 군에서 인공수정체 중심으로부터 1.5 mm 안에 3개 이상의 패임이 발생한 경우 대비감도(p=0.023 in 1.6cpd)와 눈부심감도(p=0.043 in 1.6cpd)가 2개 이하의 패임이 발생한 경우보다 유의하게 작았다. 결론: 후발백내장에 대한 변형 원형절개법을 이용한 레이저 후낭절개술은 인공수정체 중심부의 패임을 줄이는데 효율적인 방법으로 생각된다.
Abstract
Purpose: To investigate the effects of two different opening patterns in neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy on visual function. Methods: A randomized prospective study was conducted on 62 pseudophakic eyes from 50 patients with posterior capsular opacification (PCO). Groups A and B underwent laser posterior capsulotomy with a cruciate opening and a modified circular opening, respectively. The best corrected visual acuity (BCVA), contrast sensitivity, and glare sensitivity were measured before and after laser posterior capsulotomy in both groups. The occurrences of intraocular lens (IOL) pittings were investigated and compared between the two groups. Results: After laser capsulotomy, there were significant increases in BCVA, contrast and glare sensitivity in both groups and no significant differences between the two groups. However, group A had significantly more patients with three or more IOL pittings within a 1.5-mm radius from the IOL center (p = 0.047). In group A, these patients had significantly less contrast sensitivity (p = 0.023 in 1.6 cpd) and glare sensitivity (p = 0.043 in 1.6 cpd) than did patients with two or fewer IOL pittings. Conclusions: Nd:YAG laser posterior capsulotomy using a modified circular opening can be considered an effective method to manage PCO.
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