원시에서 라섹 수술의 단기간 임상 결과 분석
Short-Term Clinical Results of Hyperopic LASEK in Korean Patients
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목적: 원시 환자에서 라섹의 단기 임상성적을 보고하고, 이 중 조절 내사시를 가진 환자의 라섹 임상성적을 포함해 분석하고자 하였다. 대상과 방법: 2005년 5월부터 2013년 3월까지 서울대학교병원 안과에서 원시를 진단 받고 라섹 수술을 받은 환자 중 최소 1개월 이상경과 관찰된 10명 18안을 대상으로 의무기록을 후향적으로 분석하였다. 수술 후 1개월 및 3개월째 나안시력 및 구면렌즈대응치를측정하였으며, 고위수차 및 대비감도는 술 후 3개월째에 측정하였다. 술 전의 안경교정 후 정위의 원거리 사시각 및 근거리 사시각과의 차이를 분석하였다. 결과: 환자들의 평균 연령은 32 ± 11세, 술 전 구면렌즈대응치는 평균 2.95 ± 1.24디옵터(D)였다. 나안시력의 logMAR는 수술 1, 3개월후 각각 +0.17 ± 0.15, +0.14 ± 0.15로 수술 전과 통계적으로 유의한 차이가 없었다. 구면렌즈대응치는 수술 1, 3개월 후 각각 -0.22 ± 1.22D, 0.38 ± 0.91D로 원시가 효과적으로 교정되었다. 수술 전 내사시가 있던 환자 6명에서 수술 전 교정 후 사시각은 7.83 ± 3.60 prism diopter (PD)로 수술 후 나안 시력으로 측정한 사시각인 4.67 ± 5.65 PD와 통계적으로 차이를 보이지 않았다. 합병증으로는 3안(16.7%)에서 지연 창상회복을 보였으며, 이 중 한 안(5.56%)에서 경도 이상의 각막 혼탁이 지속되었으나 시력저하는 없었다. 결론: 라섹도 기존에 보고된 라식에 상응하는 원시 및 사시 교정 효과를 보이나 창상지연에 주의하여야 한다.
Abstract
Purpose: To evaluate short-term clinical outcomes following hyperopic laser-assisted subepithelial keratomileusis (LASEK) in Korean patients. Methods: This retrospective study included 18 eyes of 10 patients who underwent hyperopic LASEK between May 2005 and March 2013 in Seoul National University Hospital. Visual acuity and spherical equivalent were evaluated preoperatively and at 1 and 3 months postoperatively. High order aberrations and contrast sensitivity were measured before and 3 months after the operation. Alternative prism cover test (APCT) was performed both preoperatively with correction and postoperatively without correction. Results: The mean age of patients was 32 ± 11 years and the mean spherical equivalent refractive error was -2.95 ± 1.24 diopters (D). Uncorrected visual acuities were log MAR +0.17 ± 0.15 and log MAR +0.14 ± 0.15 at postoperative 1 month and 3 months, respectively and showed no significant difference in best corrected visual acuity (+0.25 ± 0.30). Spherical equivalent was -0.22 ± 1.22 D at 1 month and 0.38 ± 0.91 D at 3 months postoperatively. In 6 patients who had esotropia before the operation, APCT was 7.83 ± 3.60 prism diopters (PD) esotropia at distance with correction preoperatively and 4.67 ± 5.65 PD at distance without correction postoperatively. Three patients (16.7%) showed delayed wound healing with 1 (5.56 %) having persistent corneal opacity without significant visual loss. Conclusions: The effect of LASEK may be comparable for correcting hyperopia and esotropia when compared with the effect of LASIK in previous reports; however, delayed wound healing may be a concern.
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