군날개의 크기에 따른 수술 전후의 각막 고위수차의 변화
The Changes of Corneal Higher-Order Aberrations after Surgery According to Pterygium Size
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목적: 군날개의 크기에 따른 수술 전 후 각막 난시와 각막 고위수차의 변화를 알아보고자 하였다. 대상과 방법: 46명(50안)을 대상으로 군날개의 크기가 작은 군(2.0 mm 이하)과 큰 군(2.0 mm 초과)으로 나누어 수술 전과 수술 후1주, 1개월, 3개월에 각막지형도(Orbscan II®)와 고위수차계(KR‐1W®)를 측정하였다. 결과: 작은 군은 14명(16안)이었고 큰 군은 32명(34안)이었다. 작은 군에서는 수술 전과 수술 3개월 후 나안시력 및 교정시력, 구면대응치, Sim K 난시의 차이를 보이지 않았으나 큰 군에서는 교정시력의 변화 없이 나안시력 증가와 구면대응치 및 Sim K 난시의 감소를보였다. 수술 전 Sim K 난시와 각막 고위수차 값은 크기가 증가할수록 유의하게 증가하는 모습을 보였고, 큰 군이 작은 군에 비해각막중심 4 mm 구역 총구면수차(p=0.501)를 제외한 모든 고위수차에서 통계학적으로 유의하게 증가되어 있었다(p＜0.05). 수술 전후의 각막고위수차 값의 변화 또한 군날개의 크기가 작은 군에서는 통계학적으로 유의한 차이를 보이지 않았으나, 큰 군에서는 수술후 1주, 1개월, 3개월에 각막중심 4 mm와 6 mm 구역에서의 총고위수차, 총코마수차, 총트레포일수차에서 통계학적으로 유의한 감소를 보였다(p＜0.05). 결론: 군날개의 크기가 클수록 각막 난시 및 각막 고위수차는 증가하고, 2.0 mm가 초과하는 경우, 수술 후 나안시력 회복과 시력질향상에 도움이 될 정도로 유의하게 감소하므로 군날개의 크기가 수술시기 결정의 유용한 지표로 이용될 수 있을 것이다.
Abstract
Purpose: To investigate the effects of pterygium size on the change of corneal astigmatism and corneal higher-order aberrations(HOAs) after surgery. Methods: Fifty eyes of 46 patients who underwent pterygium surgery were included in the present study and divided into 2groups according to pterygium size (small group: size ≤ 2.0 mm, large group: size > 2.0 mm). Corneal HOAs using wavefrontaberrometer (KR-1W®) and corneal astigmatism using topography (Orbscan II®) were evaluated before surgery andtheir changes monitored after surgery at postoperative 1 week, 1 month, and 3 months. Results: The small group was comprised of 16 eyes and 34 eyes were included in the large group. In the small group, uncorrectedvisual acuity (UCVA), best corrected visual acuity (BVCA), and spherical equivalent (SE) were not statisticallysignificantly different after surgery at postoperative 3 months. In the large group, BVCA was not statistically significantlydifferent, but UCVA increase and SE decrease were statistically significant after surgery at postoperative 3 months. Preoperative simulated keratometric (Sim K) astigmatism and corneal HOAs increase were statistically significant accordingto the pterygium size. Preoperative corneal HOAs of the large group were significantly higher than the small group exceptfor spherical aberration in the central 4 mm optical zone (p = 0.501). In the small group, there was no statistically significantdifference in corneal HOAs before and after surgery. In the large group, corneal total HOAs, trefoil and coma in thecentral 4 mm and 6 mm zone were statistically significantly decreased at postoperative 1 week, 1 month, and 3 months, respectively(p < 0.05). Conclusions: The corneal HOAs and the corneal astigmatism were increased according to pterygium size. In cases withpterygium greater than 2.0 mm in size, the corneal HOAs and the corneal astigmatism were decreased after pterygium surgerywhich can improve visual acuity and quality. Therefore, the pterygium size can be a useful factor in deciding when toperform pterygium surgery.
참고문헌 (15)
- Qais A, "Ophthalmology", pp.248~250 (2008), Mosby Elsevier
- Hansen A, "Astigmatism and surface phenomena in pterygium", Acta Ophthalmol (Copenh), 58, pp.174~181 (1980)
- Lin A, "Correlation between pterygium size and induced corneal astigmatism", Cornea, 17, pp.28~30 (1998)
- Fong KS, "Refractive change following pterygium surgery", CLAO J, 24, pp.115~117 (1998)
- Tomidokoro A, "Quantitative analysis of regular and irregular astigmatism induced by pterygium", Cornea, 18, pp.412~415 (1999)
- Tomidokoro A, "Effects of pterygium on corneal spherical power and astigmatism", Ophthalmology, 107, pp.1568~1571 (2000)
- Bedrossian RH, "The effects of pterygium surgery on refraction and corneal curvature", Arch Ophthalmol, 64, pp.553~557 (1960)
- Pesudovs K, "Corneal first surface wavefront aberrations before and after pterygium surgery", J Refract Surg, 22, pp.921~925 (2006)
- Gumus K, "Effect of pterygia on refractive indices, corneal topography, and ocular aberrations", Cornea, 30, pp.24~29 (2011)
- Gumus K, "The change in ocular higher-order aberrations after pterygium excision with conjunctival autograft:a 1-year prospective clinical trial", Cornea, 31, pp.1428~1431 (2012)
- Yagmur M, "Visual acuity and corneal topographic changes related with pterygium surgery", J Refract Surg, 21, pp.166~170 (2005)
- Yilmaz S, "Corneal topographic changes after four types of pterygium surgery", J Refract Surg, 24, pp.160~165 (2008)
- Cinal A, "The effect of pterygium surgery on corneal topography", Ophthalmic Surg Lasers, 32, pp.35~40 (2001)
- Bahar I, "Effect of pterygium surgery on corneal topography: a prospective study", Cornea, 23, pp.113~117 (2004)
- Maheshwari S, "Pterygium-induced corneal refractive changes", Indian J Ophthalmol, 55, pp.383~386 (2007)