펨토초레이저를 이용한 각막이식술과 일반적인 전층각막이식술의 임상결과 비교
Comparison of Outcomes of Femtosecond Laser-assisted Keratoplasty and Conventional Penetrating Keratoplasty
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목적: 펨토초레이저(IntraLaseⓇ)를 이용하여 전층각막이식술을 시행하여 그 임상결과를 일반적인 전층각막이식술과 비교하여 보고하고자 한다. 대상과 방법: 일반적인 전층각막이식술을 받은 18안(17명), 펨토초레이저를 이용한 창상변형 전층각막이식술을 받은 26안(25명)을 대상으로 의무기록을 후향적으로 조사하여 비교하였다. 결과: 펨토초레이저군에서 최대교정시력(logMAR)은 2, 4, 6개월째 0.70, 0.58, 0.61로 일반적인 전층각막이식군의 1.06, 1.01, 0.90과 비교하여 2, 4개월째에 유의한 차이가 있었다. 자동굴절검사상 평균난시는 2, 4, 6개월째 펨토초레이저군에서 4.08, 4.01, 4.44 diopters (D)로 일반적인 전층각막이식군의 5.75, 5.75, 5.21D보다 더 나은 결과를 보여주었으며 2, 4개월째에 유의한 차이가 있었다. 경과관찰 동안 합병증의 발생은 유의한 차이가 없었다. 결론: 펨토초레이저를 이용한 전층각막이식술은 기존의 일반적인 전층각막이식술과 비교하여 시력 호전 및 난시에 있어 비교적 초기에 나은 결과를 보여주었으며 전층각막이식술 시에 고려할 수 있는 하나의 수술방법으로 생각된다.
Abstract
Purpose: To compare the outcomes of IntraLase femtosecond laser-enabled keratoplasty (IEK) versus conventional penetrating keratoplasty (C-PKP). Methods: This retrospective study included 18 eyes of 17 patients who underwent C-PKP and 26 eyes of 25 patients who underwent IEK. Postoperative clinical results were compared between two groups. Results: The mean logMAR best spectacle-corrected visual acuity (BSCVA) was 0.70, 0.58, and 0.61 in the IEK group, and 1.06, 1.01, and 0.90 in the C-PKP group at postoperative 2, 4, and 6 months respectively. The difference between the two groups was statistically significant at 2 and 4 months postoperatively (p=0.033, 0.011). The mean refractive cylinder was 4.08 diopters (D), 4.01D, and 4.44D in the IEK group, while 5.75D, 5.75D, and 5.21D in the C-PKP group for each month, and the difference between the groups was statistically significant at 2 and 4 months postoperatively (p=0.037, 0.027). The complication rate showed no significant differences up to 6 months of follow-up between the two groups. Conclusions: The IEK showed better results in BSCVA and refractive astigmatism in the early postoperative period, in comparison with the C-PKP, and can be considered as a valuable method in penetrating keratoplasty.
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