친수성 및 소수성 아크릴 재질의 인공수정체 삽입술 후장기간 임상 결과의 비교분석
Comparison of Long-Term Clinical Results after Implantation of Hydrophilic and Hydrophobic Acrylic Intraocular Lens
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목적: 친수성 아크릴 재질인 Akreos AO 인공수정체 삽입 후의 장기간 임상 경과를 소수성 아크릴 재질인 Acrysof IQ 인공수정체삽입 후의 경과와 비교하고, 굴절력 변화와 연관된 요인을 분석하고자 한다. 대상과 방법: 초음파 수정체유화술 후 인공 수정체 후낭 삽입술을 시행한 73명 103안(Akreos AO 84안, Acrysof IQ 19안)에 대해 수술후 2년 이상의 기간 동안 나안 시력과 굴절력을 측정하여 경과관찰 사이의 변화 및 동일 관찰 시기에서 인공수정체 종류에 따른 차이를 비교하였다. Akreos AO를 삽입 받은 군에서 술 후 0.5D 이상의 구면 대응치 여부와 관련된 요인을 구하기 위해 로지스틱 회귀분석을 시행하였다. 결과: Akreos AO를 삽입한 후의 구면 대응치는 수술 후 1개월에서 6개월 사이에 유의한 원시성 변화를 보였으나(+0.15 ± 0.43D,p=0.027), 나안시력과 난시는 유의한 변화가 없었다. Acrysof IQ삽입군에서의 나안시력, 구면 대응치, 난시는 경과관찰 기간 동안유의한 변화를 보이지 않았으며 각 시기마다 양 군 간의 차이도 유의하지 않았다. Akreos AO 삽입군에서 술 후 0.5D 이상의 구면대응치 변화와 관련된 요인은 수술 전 전방 깊이였다(p=0.006). 결론: Akreos AO를 삽입한 경우 수술 후 원시성 변화를 보일 수 있으며, 수술 전 전방 깊이가 작을수록 굴절력 변화가 클 가능성이높아 도수 결정에 있어 이에 대한 고려가 필요하다.
Abstract
Purpose: To assess long-term clinical outcomes and factors influencing refractive change after implantation of hydrophilic(Akreos AO) and hydrophobic (Acrysof IQ) acrylic intraocular lens. Methods: After phacoemulsification, intraocular lens was inserted in the bag (Akreos AO for 84 eyes and Acrysof IQ for 19 eyes). Uncorrected visual acuities (UCVA), refraction in both spherical equivalent (SE) and astigmatism were compared longitudinallyin more than 2 years follow-up. Factors associated with SE change ≥0.5 diopter (D) after Akreos AO implantation were analyzedwith logistic regression. Results: Although Akreos AO showed hyperopic change mainly within 6 months, UCVA and astigmatism change were not statisticallysignificant during follow up (+0.15 ± 0.43 D, p = 0.027). UCVA, SE, astigmatism were not changed after Acrysof IQ implantationand not significantly different between two groups during follow up. Preoperative anterior chamber depth was a solefactor associated with SE change ≥0.5 D after Akreos AO implantation (p = 0.006). Conclusions: Possible hyperopic shift after Akreos AO implantation should be considered in setting target diopter, especially ineye with shallow anterior chamber.
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