시력의 질을 포함한 스마일 수술의 임상 결과 보고
Clinical Outcome of Small Incision Lenticule Extraction including Visual Quality Analysis
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목적: 국내 근시 환자를 대상으로 시행한 스마일 수술(small incision lenticule extraction)에서 시력의 질을 포함한 임상결과를 보고하고자 한다. 대상과 방법: 2014년 5월부터 2015년 2월까지 본원에서 스마일 수술을 시행 받고 이후 3개월간 경과 관찰이 가능했던 116명 228안의 의무기록을 후향적으로 분석하였다. 결과: 술 전 최대 교정 시력은 0.01 ± 0.02였으며(logMAR), 구면 대응치는 평균 –5.03 ± 1.72디옵터, 안압은 평균 15.85 ± 2.85 mmHg, objective scattering index (OSI) 수치는 0.68 ± 0.49였다. 스마일 수술 후 원거리 나안 시력은 술 후 1일, 1주, 1달, 3달째 각각 0.13 ± 0.10, 0.05 ± 0.08, 0.04 ± 0.09, 0.02 ± 0.04였으며, OSI는 각각 2.16 ± 1.89, 1.25 ± 0.64, 1.14 ± 0.69, 0.81 ± 0.36이었다. 안압은 술 후 1주, 1달, 3달째 각각 12.55 ± 3.74 mmHg, 13.03 ± 4.35 mmHg, 11.65 ± 2.49 mmHg였다. 술 후 3개월째, 굴절 수술의 효율성은 0.97 ± 0.11, 안정성은 0.99 ± 0.10, 예측도는 ±0.5디옵터와 ±1.0디옵터의 범위에 대해 각각 99.56%와 100.00%로 관찰되었다. 결론: 국내 환자를 대상으로 한 스마일 수술은 기존의 굴절 수술에 비해 그 효율성과 안전성, 예측도에서 큰 차이가 없었고, 스마일술 후 측정한 안압과 시력의 질은 술 후 3개월에 걸쳐 점진적으로 정상화되었다.
Abstract
Purpose: To present the clinical outcomes of small incision lenticule extraction (SMILE) including visual quality analysis in Korean patients with myopia Methods: The medical records of 228 eyes of 116 patients who underwent SMILE in HanGil Eye Hospital LASIK Center from May 2014 to Feb 2015 and were followed-up for at least 3 months was analyzed retrospectively. The patients were followed up at 1 day, 1 week, 1 month, and 3 months after the operation. Refractive value, visual acuity, intraocular pressure, and visual quality were measured at each visit Results: Preoperatively, uncorrected distant visual acuity was 0.01 ± 0.02 in log MAR, spherical equivalent was -5.03 ± 1.72 diopters, intraocular pressure was 15.85 ± 2.85 mm Hg, and the objective scattering index (OSI) value was 0.68 ± 0.49. The postoperative uncorrected distant visual acuity was 0.13 ± 0.10, 0.05 ± 0.08, 0.04 ± 0.09, and 0.02 ± 0.04 and OSI was 2.16 ± 1.89, 1.25 ± 0.64, 1.14 ± 0.69, and 0.81 ± 0.36 at 1 day, 1 week, 1 month, and 3 months after the operation, respectively. The postoperative intraocular pressure was 12.55 ± 3.74 mm Hg, 13.03 ± 4.35 mm Hg, 11.65 ± 2.49 mm Hg at 1 week, 1 month, and 3 months after the operation. The efficacy of refractive surgery 3 months after the operation was 0.97 ± 0.11, the safety was 0.99 ± 0.10, and predictability was 99.56% and 100.00% at the range of ±0.5 diopters and ± 1.0 diopter, respectively. Conclusions: The SMILE operation showed comparable clinical outcomes with conventional refractive surgery in terms of efficacy, safety, and predictability. Intraocular pressure and visual quality normalized gradually throughout the 3-month postoperative period.
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