순차적 백내장수술에서 첫 번째 수술안 예측오차가 두 번째 수술안의 광학적 보정에 미치는 효과
Effect of First Eye Prediction Error on Refractive Adjustment of Second Eye in Delayed Sequential Bilateral Cataract Surgery
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 일주일 간격의 지연된 순차적 양안 백내장수술에서 첫 번째 수술안의 예측오차를 통한 두 번째 수술안의 굴절 보정 효과를 연구하였다. 대상과 방법: 일주일 간격으로 양안 백내장수술을 시행 받은 100명을 대상으로, 의무기록의 후향 분석을 수행하였다. 굴절오차는 술 후 굴절력과 의도된 목표 굴절력과의 차이, 예측오차는 술 후 굴절력과 인공수정체공식(SRK-T, Hoffer-Q,Haigis)별로 계산된 예측굴절력과의 차이로 측정하였다. 술 후 1주와 1달에 굴절력을 측정하였으며, 첫 번째 술 후 1주에 예측오차를 계산하여 크기가 0.25 diopters (D) 이상일 경우 이에 맞추어 두 번째 수술의 인공수정체 도수를 조정하였다. 술 후 1달 굴절오차의 크기를 양안에서 비교하였다. 술 후 1주에 측정한 첫 번째 수술안의 예측오차와 술 후 1달에 측정한 반대안의 예측오차와의 상관 관계를 분석하였다. 결과: 굴절오차의 크기는 두 번째 수술에서 감소하였으나, 통계적으로 유의하지는 않았다. 그러나, 첫 번째 수술안의 굴절 오차가 0.5 D 이상인 경우에는 두 번째 안의 굴절오차가 유의하게 감소하였다(p<0.05). 술 후 1주에 측정한 첫 번째 수술안의 예측오차와 술 후 1달에 측정한 반대안의 예측오차는 유의한 상관 관계를 보여주었다(r=0.483 [SRK-T], r=0.593 [Hoffer-Q], r=0.547 [Haigis]; p<0.001). 결론: 첫 번째 수술안의 굴절오차가 0.5 D보다 높은 경우, 일주일 간격의 지연된 순차적 양안 백내장수술은 두 번째 수술안의 굴절 결과를 보정하는 데 도움을 줄 수 있다.
Abstract
Purpose: We investigated the refractive outcomes of second-operated eyes whose diopters of intraocular lens (IOL) were selected based on the prediction error (PE) of the first-operated eye in 1-week-delayed sequential bilateral cataract surgery. Methods: Medical records of 100 patients who had undergone delayed sequential bilateral cataract surgery with a 1-week interval were reviewed retrospectively. The postoperative subjective refraction was evaluated at 1 week and 1 month after surgery. The refractive error (RE) was determined by comparing postoperative refraction with the intended postoperative refractive target. The PE was determined by comparing postoperative refraction with the predicted postoperative refraction calculated by multiple different formulae (SRK-T, Hoffer Q, and Haigis). When the PE of the first eye was outside the range of ± 0.25 diopters (D) at postoperative 1 week, selection of IOL power was adjusted to reduce the PE of the second eye. Mean numerical and mean absolute errors of RE were calculated. The correlations between PE of the first eye measured at 1 week and PE of the second eye measured at 1 month were analyzed. Results: The mean absolute value of RE was decreased on the second operated eye, but was not significant (p > 0.05). The subgroup whose RE of the first eye was > ± 0.5 D at 1 week showed a significantly decreased mean absolute value of RE in the second eye (p < 0.05). The PE of the first eye measured at 1 week and of the second eye at 1 month showed significant correlation (r = 0.483 [SRK-T], 0.593 [Hoffer Q], 0.547 [Haigis]; p < 0.001). Conclusions: Delayed sequential bilateral cataract surgery with a 1-week interval may enable refinement of the refractive outcome of the second operated eye when the first operated eye shows a RE >0.5 D.
참고문헌 (15)
- 김정희, "양안 백내장 동시수술에 대한 효용성과 안전성", 대한안과학회지, 56(12), pp.1854~1859 (2015), 대한안과학회
- Singh R, "Immediately sequential bilateral cataract surgery : advantages and disadvantages", Curr Opin Ophthalmol, 28, pp.81~86 (2017)
- Norrby S, "Sources of error in intraocular lens power calculation", J Cataract Refract Surg, 34, pp.368~376 (2008)
- Olsen T, "Using the surgical result in the first eye to calculate intraocular lens power for the second eye", J Cataract Refract Surg, 19, pp.36~39 (1993)
- Melles RB, "Accuracy of intraocular lens calculation formulas", Ophthalmology, 125, pp.169~178 (2018)
- "Cataract commisioning guide for Adult Cataract" (2018)[URL]
- Charlesworth E, "When is refraction stable following routine cataract surgery? A systematic review and meta-analysis", Ophthalmic Physiol Opt, 40, pp.531~539 (2020)
- Jivrajka RV, "Improving the secondeye refractive error in patients undergoing bilateral sequential cataract surgery", Ophthalmology, 119, pp.1097~1101 (2012)
- Turnbull AMJ, "Using the first-eye prediction error in cataract surgery to refine the refractive outcome of the second eye", J Cataract Refract Surg, 45, pp.1239~1245 (2019)
- "Cataract surgery: guidelines" (2010)[URL]
- Jabbour J, "Intraocular lens power in bilateral cataract surgery : whether adjusting for error of predicted refraction in the first eye improves prediction in the second eye", J Cataract Refract Surg, 32, pp.2091~2097 (2006)
- Covert DJ, "Intraocular lens power selection in the second eye of patients undergoing bilateral, sequential cataract extraction", Ophthalmology, 117, pp.49~54 (2010)
- Aristodemou P, "First eye prediction error improves second eye refractive outcome results in 2129 patients after bilateral sequential cataract surgery", Ophthalmology, 118, pp.1701~1709 (2011)
- Olsen T, "Use of fellow eye data in the calculation of intraocular lens power for the second eye", Ophthalmology, 118, pp.1710~1715 (2011)
- "Cataracts in adults: management" (2017)[URL]