안축장이 짧은 안에서 인공수정체도수 산출 공식과 전방 깊이에 따른 정확성 분석
Accuracy of Intraocular Lens Power Calculations According to the Formulas and Anterior Chamber Depth in Short Eyes
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목적: 안축장이 짧은 환자에서 백내장으로 수정체유화술을 받은 경우 인공수정체도수 산출 공식과 전방 깊이에 따른 정확성을 비교 분석하고자 하였다. 대상과 방법: 백내장수술을 받은 환자 중 안축장이 짧은 환자(안축장＜22.0 mm, 50명 57안)와 안축장이 정상인 환자(22.0 mm≤안축장 ＜25.0 mm, 36명 42안)를 대상으로 SRK II, SRK/T, Binkhorst, Holladay I, Hoffer Q 공식을 이용하여 계산한 예상굴절력과 술 후 실제굴절력과의 오차를 비교하였고 안축장이 짧은 군을 전방 깊이에 따라 두 군으로 나누어 그 정확성을 분석하였다. 결과: 안축장이 짧은 군에서 Binkhorst, Holladay I, Hoffer Q, SRK/T로 술 후 굴절력을 예측 시 비슷한 수준의 정확도를 보였고 모든 공식에서 원시화되는 경향을 보였으며 Hoffer Q와 Holladay I이 비교적 정확한 예측도를 보였다. SRK II에서는 낮은 정확도를 보였고 SRK II, SRK/T에서는 안축장이 짧을수록 원시화 경향이 커지는 상관성을 보였으며 안축장이 짧은 군 내에서는 전방 깊이가 깊은 군이 상대적으로 원시화되는 경향이 컸다. 결론: 안축장이 짧은 환자에서 Hoffer Q와 Holladay I 공식의 정확도가 우수하였고 술 전 전방 깊이와 안축장이 굴절오차에 영향을 미쳤다.
Abstract
Purpose: To evaluate the accuracy of intraocular lens (IOL) power calculations according to the chosen formulas and anterior chamber depths in eyes with short axial lengths. Methods: A retrospective analysis was performed on 57 eyes of 50 patients (axial length < 22.0 mm) and 42 eyes of 36 patients (22.0 mm ≤ axial length < 25.0 mm) who underwent cataract surgery. IOL power was calculated with the SRK II, SRK/T, Binkhorst, Holladay I, and Hoffer Q formulas. The differences between the predicted refraction and the actual refraction were compared and analyzed. The errors according to the anterior chamber depth were also evaluated. Results: The SRK II formula showed a lower predictive accuracy, and the other formulas showed similar accuracies in eyes with short axial lengths. The Holladay 1 and Hoffer Q formulas showed good predictive accuracies in eyes with short axial lengths. Hyperopic shift tended to occur with all formulas in eyes with short axial lengths. When using SRK II and SRK/T formulas, a correlation between axial length and hyperopic shift was observed, with shorter axial length patients shifting to more hyperopic conditions. In eyes with short axial lengths, larger hyperopic shifts tended to occur in eyes with relatively deeper anterior chambers. Conclusions: In eyes with short axial lengths, preoperative predicted IOL power showed good accuracies with Holladay 1 and Hoffer Q formulas. Preoperative anterior chamber depth and axial length had a strong influence on the accuracies of predicted IOL power.
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