토포라이저 바리오를 이용한 각막굴절력검사의 신뢰도 연구
Clinical Reliability of the Topolyzer Vario Instrument for Measurement of Corneal Refractive Power
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목적: Topolyzer Vario (WaveLight, Erlangen, Germany)의 임상적 신뢰도에 대하여 평가하기 위하여 각막지형도를 검사하는 세 기기의 각막굴절력 측정값을 비교하였다. 대상과 방법: 각막굴절교정술을 위해 본원에 내원한 환자들의 의무기록을 후향적으로 분석하여, Pentacam HR (Oculus, Wetzlar, Germany), ORBscan II (Bausch & Lomb, Rochester, New York, USA), Topolyzer Vario를 동일한 날에 시행한 환자들의 각막계측치를 분석하였다. 각 기기로부터 편평각막곡률(Kf), 가파른각막곡률(Ks), 평균각막곡률(Km)과 난시값(Kastig), 카티지언 난시(J0), 경사난시(J45)를 계산하여 비교하였다. 결과: 80안의 각막계측치를 분석하였으며, 세 기기들은 모든 각막굴절력값에서 높은 상관성과 일치도를 보였다. Pentacam HR은 ORBscan II보다 Kf, Km을 유의하게 낮게 측정하였고, Topolyzer Vario보다 Kf, Km, Ks, J45를 유의하게 낮은 수준으로 측정하였으나, ORBscan II와 Topolyzer Vario 간에는 모든 측정값에서 유의한 차이가 관찰되지 않았다. Topolyzer Vario와 Pentacam HR 간 측정된 각막굴절력값의 차이는 임상적 의미가 크지 않았다. 결론: 굴절이상 외 다른 안과적 과거력이 없는 환자의 각막굴절력 측정시, Topolyzer Vario는 ORBscan II 및 Pentacam HR과 호환이 가능하므로 임상적으로 신뢰할 만한 검사기기이다.
Abstract
Purpose: To evaluate the clinical reliability of the Topolyzer Vario (Wavelight-Alcon, Erlangen, Germany), we compared three different corneal topographers in terms of corneal refractive power. Methods: The medical records of patients who visited Severance Hospital for corneal refractive surgery were retrospectively reviewed. Keratometric data of patients who underwent evaluations using the Pentacam HR (Oculus, Wetzlar, Germany), ORBscan II (Bausch & Lomb, Rochester, NY, USA), and Topolyzer Vario instruments on the same day were obtained. Flat keratometry (Kf), steep keratometry (Ks), mean keratometry (Km), astigmatism keratometry (Kastig), Cartesian astigmatism (J0), and oblique astigmatism (J45) values were calculated. The measurement values of the three devices were subjected to Pearson’s correlation analysis and repeated measures analysis of variance (with Bonferroni correction); a Bland-Altman plot was also created. Results: The keratometric data of 80 eyes were included in the analysis and all of the keratometric measurements obtained by the three devices showed significant correlations, i.e., good agreement. The Kf and Km measurements of the Pentacam HR were flatter than those of the ORBscan II, and the Kf, Km, Ks, and J45 measurements were flatter than those of the Topolyzer Vario. However, there was no significant difference in keratometric values between the ORBscan II and Topolyzer Vario. Furthermore, the difference in corneal refractive power between the Pentacam HR and Topolyzer Vario was not clinically significant. Conclusions: When measuring the corneal refractive power of patients without any history of corneal disorder or ocular surgery, the Topolyzer Vario is a clinically reliable device that shows similar performance to the ORBscan II and Pentacam HR.
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