저간섭성 반사계와 기존 장비 간의 안구생체계측 및 백내장 수술 후 굴절오차의 비교
Comparison of Ocular Biometry Using Low-Coherence Reflectometry with Other Devices for Intraocular Lens Power Calculation
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목적: 백내장이 있는 눈에서 저간섭성반사계(Lenstar LS900®, Haag-Streit, Bern, Switzerland)를 이용해 측정한 안축장과 각막곡률을 기존 장비로 측정한 값과 비교하고, 술 후 굴절예측의 정확도를 평가하였다. 대상과 방법: 백내장 수술이 예정된 39명 50안에서 저간섭성반사계, 부분결합간섭계(IOL Master®), 초음파(Eyecubed), 자동각막곡률계(KR-7100)를 이용하여 안축장과 각막곡률을 측정하였다. 예측 오차는 술 후 4주와 12주의 최종 굴절오차에서 예상 굴절오차를 뺀차이로 계산하였다. 결과: 저간섭성반사계, 부분결합간섭계, 초음파로 측정한 안축장의 평균은 각각 23.63 ± 0.71, 23.58 ± 0.68, 23.60 ± 0.70 mm로, 장비 간 비교에서 유의한 차이는 없었다(p=0.946). 각막곡률의 비교에서도 유의한 차이를 보이지 않았다(p=0.062). 각 장비로 측정한안축장과 각막곡률로 계산된 술 후 12주의 평균 예측 오차는 Lenstar LS900®, A-scan에서 각각 0.22D, 0.01D 근시로, IOL Master® (Carl Zeiss, Jena, Germany)에서 0.08D 원시로 나타났으며(analysis of variance [ANOVA], p=0.006), 예측 오차가 ±0.5D 이내의비율은 IOL Master®에서 가장 높았고, 그 뒤로 A-scan, Lenstar LS900® 순서였다. 굴절예측 오차의 절대값은 유의한 차이를 보이지않았다(p=0.684). 결론: 저간섭성반사계를 이용한 안구생체계측 시, 안축장 및 각막곡률은 기존 장비와 의미 있는 차이를 보이지 않았으나 술 후 굴절예측 오차는 차이를 보여 임상적용 시 고려해야 할 것이다.
Abstract
Purpose: To compare axial length (AL) and keratometry (K) using optical low-coherence reflectometry (OLCR, Lenstar LS900®, Haag- Streit, Bern, Switzerland) with current ocular biometry devices and evaluate the accuracy of intraocular lens (IOL) power calculation. Methods: In this prospective, comparative observational study of eyes with cataracts, AL and K were measured using an OLCR device (Lenstar LS900®, Haag-Streit), partial coherence interferometry (PCI, IOL Master®, Carl Zeiss, Jena, Germany), A-scan (Eyecubed) and automated keratometry (KR-7100, Topcon, Tokyo, Japan). IOL power calculation was performed using the Sanders-Retzlaff-Kraff (SRK/T) formula. The IOL prediction error (PE) was calculated by subtracting the predicted IOL power from the postoperative (PO) IOL power (PO 4 weeks, PO 12 weeks). Results: A total of 50 eyes of 39 patients with cataracts (mean age 67.12 ± 8.51 years) were evaluated in this study. AL and K were not significantly different between the OLCR device and other devices (analysis of variance [ANOVA], p = 0.946, 0.062, respectively). The mean PE in IOL power calculation was -0.22 ± 0.50D with the OLCR device, 0.08 ± 0.45D with the PCI device and -0.01 ± 0.48D with A-scan and automated keratometry (ANOVA, p = 0.006). The highest percentage of eyes with PE smaller than ± 0.5D was IOL Master® followed by Eyecubed and then Lenstar LS900®. The mean absolute PE was not statistically significant among the 3 devices (ANOVA, p = 0.684). Conclusions: Ocular biometry measurements were comparable between the OLCR device and the PCI ultrasound device. However, the IOL power prediction showed significant differences among the 3 devices. Therefore, the differences in application of these devices should be considered.
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