다초점 인공수정체 삽입 후 3개월 임상결과 및 만족도 비교연구
Visual Outcome and Patient Satisfaction after Implantation of Multifocal IOLs: Three-Month Follow-Up Results
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목적: 레스토Ⓡ 비구면 다초점 인공수정체 D1 (+3.0D) 및 D3 (+4.0D)를 단안 및 양안에 삽입한 환자들의 시력 및 만족도에 대해 알아보고자 하였다. 대상과 방법: 백내장 수술 후 D1 또는 D3를 삽입한 73명 중 단안 수술을 받은 34명과 양안 수술을 받은 39명의 시력 및 만족도를 각각비교 분석하였다. 단안 수술의 경우 D1과 D3를 삽입한 경우로 나누었고, 양안 수술의 경우 삽입된 인공수정체의 조합에 따라 D1/D1,D1/D3, D3/D3의 세 군으로 나누어 비교하였다. 수술 후 3개월에 나안 근거리(30 cm) 및 중간거리(40 cm, 50 cm) 시력과 나안 및최대교정 원거리시력을 측정하였고, 만족도 설문조사를 시행하였다. 결과: 단안에 D1을 삽입한 경우 D3보다 50 cm 중간거리에서 시력이 좋았으며(p＜0.001), D3를 삽입한 경우 D1보다 근거리에서 시력이좋았다(p＜0.001). 만족도는 D1군이 수술의 전반적 만족도, 중간거리 시력 및 타인에게 추천 여부를 묻는 항목들에서 높은 점수를 얻었다(p=0.027, ＜0.001, 0.026). 양안 수술을 받은 군의 비교에서는 D1/D1군이 50 cm 중간거리 시력이 좋았고(p=0.011), D3/D3군이근거리에서 시력이 좋았다(p=0.004). 만족도 조사에서는 수술의 전반적 만족도, 중간거리 시력 및 타인에게 추천 여부를 평가하는항목들에서 D1/D1군이 나머지에 비해 높은 점수를 얻었다(p=0.008, ＜0.001, 0.006). 결론: 양안 레스토Ⓡ 렌즈 삽입 시 D1을 양안에 삽입하는 경우가 가장 좋은 시력 및 높은 만족도를 기대할 수 있을 것으로 생각한다. 단안 수술 시에도 D3보다 D1을 삽입하는 것이 더 유리할 것으로 생각한다.
Abstract
Purpose: To evaluate the visual outcome and patient satisfaction at three months after implantation of ReSTOR® Aspheric multifocal IOL D1 (+3.0 D) and D3 (+4.0 D) in unilateral and bilateral cataract surgery groups. Methods: Among 73 patients who received cataract surgery and implantation of D1 or D3, visual outcome and satisfaction score of 34 patients in the unilateral surgery group and 39 patients in the bilateral surgery group were analyzed respectively. The unilateral surgery group was divided into 2 sub-groups (D1, D3), and the bilateral surgery group was sub-divided into 3 groups (D1/D1, D1/D3, D3/D3) according to the combination of implanted IOL. Uncorrected near visual acuity (UNVA, 30 cm), uncorrected intermediate visual acuity (UIVA, 40 cm, 50 cm), uncorrected distant visual acuity (UDVA) and best corrected visual acuity (BDVA) were measured at three months postoperatively. Also, all patients answered questionnaires to assess satisfaction. Results: In the unilateral surgery sub-groups, visual acuity of the D1 group was higher than that of the D3 group at 50 cm (p < 0.001), although the D3 group showed better visual outcome at 30 cm (p < 0.001). In satisfaction analysis, the D1group reported significantly higher scores in three categories (general satisfaction with surgery; p = 0.027, intermediate vision;p < 0.001, recommendation to others; p = 0.026). Among the bilateral surgery groups, the D1/D1 group showed the best intermediate visual acuity at 50 cm (p = 0.011), and the D3/D3 group achieved the highest postoperative near visual acuity (p = 0.004). In satisfaction analysis, the scores of the three categories (general satisfaction with surgery; p = 0.008,intermediate vision; p < 0.001, recommendation to others; p = 0.006) showed significant differences among the three groups, with the D1/D1 group reporting the highest scores in all three categories. Conclusions: In bilateral ReSTOR® lens implantation, insertion of D1 in both eyes is expected to achieve the most favorable visual outcome and patient satisfaction. In unilateral ReSTOR® lens implantation, implantation of D1 rather than D3would be more advantageous in general.
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