새로운 인공수정체를 낭내 삽입한 미세각막절개 백내장 수술의 임상평가
Clinical Outcomes After Microincision Cataract Surgery and In-the-bag Implantation of a New Intraocular Lens
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 미세절개창을 통해 삽입 가능한 Akreos MI-60 인공수정체를 삽입한 군의 임상성적을 일반 인공수정체를 삽입한 군과 비교하였다. 대상과 방법: 동일한 술자가 수정체유화술을 시행한 후 Akreos MI-60 인공수정체를 삽입한 25안과 Akreos Adapt-AO 인공수정체를삽입한 28안을 대상으로 술 후 1주, 1개월, 4개월에 최대교정시력, 고위수차, 대비감도, 수술유발난시 등을 측정하였다. 결과: 최대교정시력은 술 후 1주째 0.09±0.11 (logMAR), 0.11±0.08 (MI-60, Adapt-AO 순), 술 후 1개월째 0.06±0.07, 0.06±0.06,술 후 4개월째 0.05±0.06, 0.06±0.05로 유의한 차이가 없었다(Mann-Whitney U test, p>0.05). 굴절오차는 술 후 1주, 1개월, 4개월째 모두 유의한 차이를 보였다. 두 군간 고위수차, 대비감도에서 유의한 차이는 없었으나, 술 후 1개월, 4개월째 수술유발난시는 MI-60군에서 유의하게 작았다. 결론: Akreos MI-60 인공수정체는 기존의 임상성적이 검증된 비구면 인공수정체와 대등한 구면수차, 대비감도를 보이고, 여기에 미세절개수술의 장점으로 작은 술 후 난시값을 보였다.
Abstract
Purpose: To compare visual performance after microincision cataract surgery (MICS) with the implantation of the Akreos MI-60(MI-60) intraocular lens (IOL) through a 1.8-mm microincision with that after conventional cataract surgery with implantation of the Akreos Adapt-AO IOL (Adapt-AO). Methods: All MICS procedures were performed by the same surgeon. The MI-60 was implanted into 25 eyes, and the Adapt-AO was place in 28 eyes. Best corrected visual acuity (BCVA), total high-order-aberration (HOA), contrast sensitivity, and surgically-induced astigmatism (SIA) were recorded one-week, one-month, and four-months postoperatively. Results: There were no statistically significant differences in BCVA between eyes implanted with the MI-60 or those with the Adapt-AO (MI-60 vs. Adapt-AO, 0.09±0.11 at baseline (logMAR), 0.11±0.08 at one-week, 0.06±0.07, 0.06±0.06 at one-month,0.05±0.06, 0.06±0.05 at four-months according to the Mann-Whitney U test, p>0.05). Refractive errors were significantly less with the Adapt-AO than with the MI-60 (MI-60 vs. Adapt-AO, -0.50±0.43 at baseline (diopter), -0.06±0.39 at one-week,-0.50±0.41, 0.01±0.57 at one-month, -0.46±0.36, 0.08±0.58 at four-months according to the Mann-Whitney U test, p<0.05). There were no statistically significant differences in total HOA or contrast sensitivity between eyes implanted with the MI-60 and those implanted with the Adapt-AO. SIAs were significantly reduced in eyes implanted with the MI-60 than in those with the Adapt-AO at one-month and four-months postoperatively (Mann-Whitney U test, p<0.05). Conclusions: Implantation with either the MI-60 or the Adapt-AO produced clinically acceptable outcomes, including good spherical aberration and contrast sensitivity. Furthermore, implantation with the MI-60 caused less SIA at one- and four-months postoperation, as compared to that with the Adapt-AO.
참고문헌 (23)
- Ginsberg AP, "Contrast sensitivity predicts pilots’ performance in aircraft simulation", Am J Optom Physiol Opt, 59, pp.105~109 (1982)
- Pesudovs K, "The usefulness of Vistech and FACT contrast sensitivity charts for cataract and refractive surgery outcomes research", Br J Ophthalmol, 88, pp.11~16 (2004)
- Applegate RA, "Corneal surface optical aberrations and visual performance", J Refract Surg, 16, pp.507~514 (2000)
- Mierdel P, "Ocular optical aberrometer for clinical use", J Biomed Opt, 6, pp.200~204 (2001)
- Bhattacharjee H, "Visual performance: comparison of foldable intraocular lenses", J Cataract Refract Surg, 32, pp.451~455 (2006)
- Agarwal A, "Phakonit: phacoemulsification through a 0.9 mm corneal incision", J Cataract Refract Surg, 27, pp.1548~1552 (2001)
- Agarwal A, "Phakonit with an AcriTec IOL", J Cataract Refract Surg, 29, pp.854~855 (2003)
- Fine IH, "Optimizing refractive lens exchange with bimanual microincision phacoemulsification", J Cataract Refract Surg, 30, pp.550~554 (2004)
- Braga-Mele R, "Feasibility of sleeveless bimanual phacoemulsification with the Millenium microsurgical system", J Cataract Refract Surg, 29, pp.2199~2203 (2003)
- Mackool RJ, "Temperature during bimanual phacoemulsification", J Cataract Refract Surg, 30, pp.732~ (2004)
- Soscia W, "Bimanual phacoemulsification through 2 stab incision a wound-temperature study", J Cataract Refract Surg, 28, pp.1039~1043 (2002)
- Soscia W, "Microphacoemulsification with WhiteStar. A wound-temperature study", J Cataract Refract Surg, 28, pp.1044~1046 (2002)
- Olson RJ, "Clinical experience with 21-gauge manual microphacoemulsification using Sovereign Whitestar technology in eyes with dense cataract", J Cataract Refract Surg, 30, pp.168~172 (2004)
- Alio JL, "Advances in microincision cataract surgery intraocular lenses", Curr Opin Ophthalmol, 17, pp.80~93 (2006)
- Hill W, "Expected effects of surgically induced astigmatism on AcrySof toric intraocular lens results", J Cataract Refract Surg, 34, pp.364~367 (2008)
- Donnenfeld ED, "Efficacy and woundtemperature gradient of whitestar phacoemulsification through a 1.2mm incision", J Cataract Refract Surg, 29, pp.1097~1100 (2003)
- Steinert RF, "Astigmatism after small incision cataract surgery. A prospective, randomized, multicenter comparison of 4- and 6.5 mm incisions", Ophthalmology, 98, pp.417~423 (1991)
- Alió JL, "Clinical outcomes and postoperative intraocular optical quality with a microincision aberration-free aspheric intraocular lens", J Cataract Refract Surg, 35, pp.1548~1554 (2009)
- Tong N, "Changes in corneal wavefront aberrations in microincision andsmall-incision cataract surgery", J Cataract Refract Surg, 34, pp.2085~2090 (2008)
- Denoyer A, "Intraindividual comparative study of corneal and ocular wavefront aberrations after biaxial microincision versus coaxial small-incision cataract surgery", Br J Ophthalmol, 92, pp.1679~1684 (2008)
- Wilczynski M, "Comparison of surgically induced astigmatism after coaxial phacoemulsification through 1.8 mm microincision and bimanual phacoemulsification through 1.7 mm microincision", J Cataract Refract Surg, 35, pp.1563~1569 (2009)
- Milla E, "Corneal endothelium evaluation after phaocoemulsification with continuous anterior chamber infusion", Cornea, 24, pp.278~282 (2005)
- Choi JA, "Clinical results after implantation of a spherical aberration-free intraocular lens: Effect of contrast sensitivity and wavefront aberration-a clinical comparative study", Ophthalmologica, 223, pp.320~325 (2009)
