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소수성 인공수정체와 친수성 인공수정체의 Nd:YAG 레이저 후낭 절개술 시행률 비교

Comparison of Nd:YAG Capsulotomy Rates between Hydrophobic and Hydrophilic Intraocular Lenses

김선영|김수영|이미연|이영춘|최미현
대한안과학회 (The Korean Ophthalmological Society)|2016.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제57권 제7호|pp. 1063-1070

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참고문헌

키워드

Nd:YAG capsulotomyHydrophilic intraocular lensPosterior capsule opacificationHydrophobic intraocular lens
주제분류안과학

초록

목적: 백내장 수술 시 흔히 사용되는 소수성 구면 인공수정체와 친수성 구면 인공수정체의 수술 후 Nd:YAG 레이저 후낭 절개술 시행률을 비교하고자 한다. 대상과 방법: 2006년 7월 1일부터 2009년 12월 31일까지 한 명의 술자에 의해 시행된 노년성 백내장 수술 후 소수성 구면 인공수정체인 SA60AT (Alcon, Fort Worth, TX, USA)를 삽입한 268안과 친수성 구면 인공수정체인 I-FLEX (I-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany)를 삽입한 331안을 수술 후 2년간의 Nd:YAG 레이저 후낭 절개술 시행률 및 레이저 후낭절개술 전후의 최대 교정시력을 후향적으로 비교하였다. 결과: 추적 기간은 SA60AT 인공수정체를 삽입한 군에서 평균 23.5개월, I-FLEX 인공수정체를 삽입한 군에서 평균 22.6개월로SA60AT 인공수정체군에서 더 길었다(p=0.035). 연령은 각각 평균 68.6세와 70.3세로 두 군 사이에 유의한 차이가 없었다(p=0.367). 소수성 인공수정체군은 268안 중 17안(6.3%)에서, 친수성 인공수정체군은 331안 중 37안(11.2%)에서 레이저 후낭절개술을 시행하였으며 통계적으로 유의한 차이를 보였다(p=0.020). 레이저 후낭 절개술 전후의 최대 교정 시력은 두 군 간의 차이를 보이지 않았다. 결론: 친수성 구면 인공수정체에서 소수성 구면 인공수정체보다 Nd:YAG 레이저 후낭절개술 시행률이 높았다. 그 이유는 소수성 아크릴 인공수정체의 생체유착적 성질로 인해 후낭과 인공수정체가 유착함으로써 수정체 상피세포의 이동을 막아 후낭혼탁을 덜 유발하는 것으로 생각된다.

Abstract

Purpose: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. Methods: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. Results: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. Conclusions: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.

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