고도근시와 난시 치료를 위해 시행한 ICL 및 반대안 토릭 ICL 삽입술의 임상결과
Intraindividual Comparison of ICL and Toric ICL Implantation Correction of High Myopia With Astigmatism
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목적: 단안 ICL (Implantable Contact Lens) 삽입술 시행 후 반대안 Toric ICL 삽입술을 시행받은 환자에 있어 양안의 임상결과를 비교하였다. 대상과 방법: 양안에 난시차가 있는 고도근시 환자 중 ICL 및 Toric ICL 삽입술을 병용하여 시행받은 14명 28안에 대해 후향적으로연구하였다. 술 전과 술 후 1주, 1, 2, 6개월째 시력 및 굴절검사, 안압검사, 세극등검사, 만족도조사 등을 시행하였다. 결과: ICL군과 Toric ICL군의 평균구면렌즈대응치는 술 전 각각 -7.83D, -5.55D에서 술 후 6개월째 0.13D, 0.20D로, 난시는 술 전0.92D, 2.60D에서 0.42D, 0.27D로 교정되었다. 술 후 ICL 안에서는 근시가, Toric ICL안에서는 근시 및 난시가 효과적으로 교정되었다. 두 군에서 술 후 6개월째 나안시력은 1.02, 1.05였고, 높은 안전성, 효율성, 예측성을 보였다. 술 후 안압, Vault, 합병증 및 만족도에서유의한 차이가 없었다. 결론: 양안의 난시차이를 보이는 고도근시 교정에 있어 난시정도에 따라 후방안내렌즈의 종류를 선택하여 삽입하는 것이 효과적인방법이라 생각된다.
Abstract
Purpose: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. Methods: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. Results: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group)to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D,respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. Conclusions: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism.
참고문헌 (26)
- Lovisolo CF, "Phakic intraocular lenses", Surv Ophthalmol, 50, pp.549~587 (2005)
- Maloney RK, "Artisan phakic intraocular lens for myopia:short-term results of a prospective, multicenter study", Ophthalmology, 109, pp.1631~1641 (2002)
- Stulting RD, "Three-year results of Artisan", Verisyse phakic intraocular lens implantation. Results of the United States Food And Drug Administration clinical trial, 2008, pp.115, 464~472
- Bartels MC, "The influence of incision-induced astigmatism and axial lens position on the correction of myopic astigmatism with the Artisan toric phakic intraocular lens", Ophthalmology, 113, pp.1110~1117 (2006)
- Coullet J, "Iris-supported phakic lenses (rigid vs foldable version) for treating moderately high myopia: randomized paired eye comparison", Am J Ophthalmol, 142, pp.909~916 (2006)
- 전연숙, "중등도 이상의 근시환자에서 ICL (Implantable Contact Lens) 수술의 임상 결과", 대한안과학회지, 45(3), pp.20~20 (2004), 대한안과학회
- 한상엽, "고도근시 환자에서 안내후방콘택트렌즈삽입술의 중장기간 임상결과", 대한안과학회지, 48(4), pp.465~472 (2007), 대한안과학회
- Sanders DR, "Implantable contact lens for moderate to high myopia: phase I FDA clinical study with 6 month follow-up", J Cataract Refract Surg, 24, pp.607~611 (1998)
- Sanders DR, "U.S. Food and Drug administration clinical trial of the implantable contact lens for moderate to high myopia", Ophthalmology, 110, pp.255~266 (2003)
- Sanders DR, "Toric Implantable Collamer Lens for moderate to high myopic astigmatism", Ophthalmology, 114, pp.54~61 (2007)
- Uusitalo RJ, "Implantable contact lens for high myopia", J Cataract Refract Surg, 28, pp.29~36 (2002)
- Assetto V, "Collamer intraocular contact lens to correct high myopia", J Cataract Refract Surg, 22, pp.551~556 (1996)
- Arne JL, "Phakic posterior chamber lenses for high myopia: functional and anatomical outcomes", J Cataract Refract Surg, 26, pp.369~374 (2000)
- 윤재문, "난시교정용 후방 유수정체 안내렌즈 삽입술의 단기간 임상성적", 대한안과학회지, 50(6), pp.839~851 (2009), 대한안과학회
- Chang J, "Toric Implantable Collamer Lens for high myopic astigmatic Asian eyes", Ophthalmology, 116, pp.2340~2347 (2009)
- Jimenez-Alfaro I, "Safety of posterior chamber phakic intraocular lenses for the correction of high myopia. Anterior segment changes after posterior chamber phakic intraocular lens implantation", Ophthalmology, 108, pp.90~99 (2001)
- Mendicute J, "Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery", J Cataract Refract Surg, 35, pp.451~458 (2009)
- Kamiya K, "Comparison of Collamer toric implantable contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism", J Cataract Refract Surg, 34, pp.1687~1693 (2008)
- Sanders DR, "Comparison of implantable contact lens and laser assisted in situ keratomileusis for moderate to high myopia", Cornea, 22, pp.324~331 (2003)
- Sanders D, "Comparison of implantable collamer lens (ICL) and laser-assisted in situ keratomileusis (LASIK) for low myopia", Cornea, 25, pp.1139~1146 (2006)
- Sanders DR, "Incidence of lens opacities and clinically significant cataracts with the implantable contact lens: comparison of two lens designs", J Refract Surg, 18, pp.673~682 (2002)
- Gonvers M, "Implantable contact lens for moderate to high myopia: relationship of vaulting to cataract formation", J Cataract Refract Surg, 29, pp.918~924 (2003)
- Lackner B, "Long-term results of implantation of phakic posterior chamber intraocular lenses", J Cataract Refract Surg, 30, pp.2269~2276 (2004)
- Sarikkola A-U, "Traumatic cataract and other adverse events with the implantable contact lens", J Cataract Refract Surg, 31, pp.511~524 (2005)
- Lege BA, "Age-related behavior of posterior chamber lenses in myopic phakic eyes during accommodation measured by anterior segment partial coherence interferometry", J Cataract Refract Surg, 32, pp.999~1006 (2006)
- Schallhorn S, "Randomized prospective comparison of Visian Toric Implantable Collamer Lens and conventional photorefractive keratectomy for moderate to high myopic astigmatism", J Refract Surg, 23, pp.853~867 (2007)