단안시요법을 통한 인공수정체 삽입술의 1년 후 결과
Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery
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목적: 단안시요법을 이용한 백내장 수술 후 1년째 임상적 결과 및 환자만족도를 살펴보고, 수술 후 2개월째 결과와 비교하였다. 대상과 방법: 2010년 2월부터 2014년 1월까지 단안시요법으로 백내장 수술을 시행 받고 1년 이상 추적관찰이 가능했던 30명을 대상으로 하였다. 수술은 양안 중 백내장이 심하여 먼저 수술 받은 눈을 정시에 맞추었고, 2-4주 후 반대 눈을 환자의 근거리 작업과 굴절이상을 고려하여 -1.50~-2.50D 근시에 맞추어 수술했다. 수술 전, 수술 후 2개월과 1년째 양안 원거리와 근거리 나안시력, 구면렌즈대응치, 부등시, 입체시를 측정하였고, 원거리와 근거리 시력 만족도, 안경 의존도를 조사하였다. 결과: 환자 평균 나이는 71.9세였고, 수술 2개월째와 1년째 양안 원거리 나안시력(logMAR)은 각각 0.03 ± 0.10, 0.08 ± 0.14, 양안근거리 나안시력은 0.21 ± 0.15, 0.25 ± 0.14였고, 부등시는 1.28 ± 0.68, 1.29 ± 0.76 diopter, 입체시는 301.67 ± 296.61, 251.67 ± 269.28 arcsec였다. 수술 후 1년째 만족도는 원거리 시력에서 27명(90%)이, 근거리 시력에서는 22명(73.3%)이 ʻ호전되었다ʼ 혹은 ʻ매우 호전되었다ʼ고 답했다. ʻ안경을 전혀 쓰지 않는다ʼ는 환자는 11명(36.7%)이었다. 결론: 단안시요법은 백내장 수술 후 발생하는 노안을 줄이는 효과적인 방법으로, 시력과 환자 만족도 등에서 양안 수술 후 1년째 결과가 수술 후 2개월째 결과와 크게 다르지 않았다.
Abstract
Purpose: In this study, the visual performance and patient satisfaction one year after monovision cataract surgery and the results after 2 months. Methods: Thirty patients who had bilateral cataract surgery between February 2010 and January 2014 treated with monovision therapy and received postoperative examinations for at least one year after surgery were enrolled in the present study. The eye with the more severe cataract had the surgery first and was corrected for distance vision targeted at emmetropia. The fellow eye was operated for near vision targeted to -1.50~-2.50 diopter (D) range considering the patient’s need for near task and preoperative refractive errors 2-4 weeks after the first operation. Binocular uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), spherical equivalent, anisometropia, stereopsis, patient satisfaction for far and near distance, and spectacle dependence were evaluated preoperatively and two months and one year postoperatively. Results: The mean age of patients was 71.9 years. Two months and one year after the surgery, the binocular UCDVA (log MAR) were 0.03 ± 0.10 and 0.08 ± 0.14, UCNVA were 0.21 ± 0.15 and 0.25 ± 0.14, anisometropia were 1.28 ± 0.68 and 1.29 ± 0.76 D, and stereopsis were 301.67 ± 251.28 and 251.67 ± 269.28 arcsec, respectively. One year after the surgery, the number of patients answering ‘Better’ or ‘Much better’ for distant vision was 27 (90%) and for near vision 22 (73.3%); 11 patients (36.7%) answered ‘Not dependent on spectacles at all’. Conclusions: Monovision is an effective method to correct presbyopia after bilateral cataract surgery. Visual performances and patient satisfaction at one year after cataract surgery were not different compared with those at two months.
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