한국인 진행성 원추각막 환자에서 각막 교차결합술의 임상 효과
Clinical Results of Riboflavin and Ultraviolet-A -induced Corneal Cross-linking for Progressive Keratoconus in Korean Patients
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목적: 한국인 진행성 원추각막 환자에서 각막 교차결합술의 임상 효과에 대해 알아보고 원추각막의 진행 정도를 반대편 눈과 비교해 보고자 하였다. 대상과 방법: 양안 진행성 원추각막 환자 10명 10안을 대상으로 각막 교차결합술을 시행하였다. 술 전과 술 후 1, 3, 6, 9, 12개월에 최대교정시력, 최대각막곡률치, 평균각막곡률치, 각막두께, 각막난시, 각막내피세포수를 측정하였다. 결과: 각막 교차결합술 12개월 후, 최대교정시력은 0.60 ± 0.39에서 0.52 ± 0.38로 호전되었으며 최대각막곡률치와 평균각막곡률치는 62.39 ± 8.82D, 51.59 ± 5.86D에서 60.21 ± 9.21D, 50.04 ± 6.21D로 감소하였다. 가장 얇은 부위와 첨부의 각막 두께는 술 전 433.60 ± 44.31 μm, 444.90 ± 53.06 μm에서 12개월 후 403.40 ± 38.95 μm와 422.70 ± 42.85 μm로 두께가 감소하였다. 각막내피세포 수 는 술 전과 술 후 12개월에 유의한 차이를 보이지 않았다(p=0.731). 결론: 한국인 진행성 원추각막 환자를 대상으로 각막 교차결합술을 시행하고 1년 경과 관찰한 결과, 각막곡률치의 감소를 보였으며 원추각막의 진행이 억제되었다.
Abstract
Purpose: To report the clinical results of 10 progressive keratoconic eyes in Korean patients treated by corneal cross-linking and compare the progression of keratoconus in the fellow eyes. Methods: This present retrospective case series was comprised of 10 progressive keratoconic eyes (10 patients) that had corneal cross-linking. Patients were examined before corneal cross-linking as well as 1, 3, 6, 9, and 12 months postoperatively. The main outcome measures were best corrected visual acuity, maximum keratometry, mean keratometry, corneal thickness, corneal astigmatism and endothelial cell count. Results: The best corrected visual acuity (logMAR) improved from 0.60 ± 0.39 to 0.52 ± 0.38 at 12 months postoperatively. The maximum keratometry decreased from 62.39 ± 8.82 D preoperatively to 60.21 ± 9.21 D at 12 months postoperatively and the mean keratometry decreased from 51.59 ± 5.86 D to 50.04 ± 6.21 D at 12 months. In addition, the corneal thickness (at the thinnest area) decreased from 433.60 ± 44.31 μm to 403.40 ± 38.95 μm at 12 months. There was no statistically significant difference between the preoperative and 12 months postoperative endothelial cell count (p = 0.731). Conclusions: This present 1-year follow-up study of Korean keratoconus patients showed corneal cross-linking appeared to be effective in the stabilizing progression of keratoconus and improving best corrective visual acuity and keratometry.
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