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두 가지 토릭 인공수정체 삽입 후 임상결과 분석

Comparison of the Clinical Outcomes of Two Types of Toric Intraocular Lens

이재훈|임성아|정소향|양순원
대한안과학회 (The Korean Ophthalmological Society)|2016.02|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제57권 제2호|pp. 200-207

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참고문헌

키워드

AstigmatismIntraocular lensToricAT TORBITecnis
주제분류안과학

초록

목적: TECNIS Toric 인공수정체(Abbott Medical Optics Inc., Santa Ana, CA, USA)와 AT TORBI Toric 인공수정체(Carl Zeiss Meditec AG, Jena, Germany) 삽입술을 시행한 환자들의 임상결과 및 고위수차를 비교하고자 하였다. 대상과 방법: 본 연구는 1.25D 이상 및 4.5D 이하의 각막난시를 동반한 백내장으로 난시교정용 인공수정체를 삽입한 26명의 32안을 대상으로 후향적으로 고찰하였다. 백내장 수술은 동일한 술자에 의해 2.2 mm 이측 절개로 시행하였다. 수술 후 3개월까지 나안 및 교정시력, 굴절력, 잔여난시, 인공수정체 축 회전 및 고위수차를 관찰하였다. 난시는 Cartesian astigmatism (J0) 및 oblique astigmatism (J45)을 이용한 power vector 분석을 이용하였다. 결과: 수술 3개월째 최대교정시력 및 잔여난시는 두 군 간에 통계적으로 유의한 차이는 없었다(p＞0.05). TECNIS Toric 삽입군에서 J0는 수술 전 0.71 ± 0.84D에서 수술 후 0.05 ± 0.39D로 유의하게 감소하였고(p=0.029), AT TORBI Toric 삽입군에서 J0는 수술 전 0.88 ± 1.27D에서 수술 후 –0.02 ± 0.16D로 유의하게 감소하였다(p=0.032). 고위수차 분석에서 구면수차를 제외하고는 두 군 간에 통계적으로 유의한 차이는 없었으며, AT TORBI Toric 삽입군에서 높은 구면수차를 보였다(p=0.047). 결론: 난시를 동반한 백내장 환자에서 두 가지 난시교정용 인공수정체 삽입술은 우수한 난시교정 및 시력교정 효과를 보였으며 결과는 3개월까지 안정적이었다.

Abstract

Purpose: In this study evaluated clinical outcomes and higher-order aberrations in patients with implanted Tecnis ZCT toric intraocular lens (IOL) (Abbott Medical Optics Inc., Santa Ana, CA, USA) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG, Jena, Germany) in eyes with low to moderate corneal astigmatism. Methods: We conducted a retrospective study of 32 consecutive eyes of 26 patients with a visually significant cataract and moderate corneal astigmatism (higher than 1.25 diopter [D] and lower than 4.5 D) undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics Inc.) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG). Phacoemulsification was performed by the same experienced surgeon using 2.2 mm temporal incision. Visual, refractive and aberrometric changes were evaluated during a 3-month follow-up. Power vector analysis of Cartesian astigmatism (J0) and oblique astigmatism (J45) was performed. Results: At the 3-month follow-up, corrected distance visual acuity (CDVA) and residual astigmatism showed no statistically significant differences between groups (p = 0.203 and p = 0.364, respectively). Pre- and postoperative J0 were 0.71 ± 0.84 and 0.05 ± 0.39 in the Tecnis Toric group and, 0.88 ± 1.27 and -0.02 ± 0.16 in the AT TORBI group, respectively, which showed statistically significant differences (p = 0.029 and p = 0.032, respectively). Pre- and post-operative differences of J0 and J45 were not statistically significant (p = 0.234 and p = 0.603, respectively). No eye had IOL rotation ≥10°. Ocular aberrometry values were statistically significantly differenct between the groups, except for spherical aberration, which was higher in the AT TORBI group (p = 0.0047). Conclusions: Both IOLs showed good postoperative uncorrected distance visual acuity, CDVA and refractive results in this study. Rotational stability was excellent for both IOLs until the 3-month follow-up.

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