1.5 디옵터 이상의 각막 난시에서 난시 각막굴절콘택트렌즈의 효과
Effect of Toric Orthokeratology Lenses on Patients with More Than 1.5 Diopter of Corneal Astigmatism
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목적: 1.5 디옵터(D) 이상의 각막난시를 가진 근시 환자에게 난시 각막굴절교정 렌즈의 효과를 알아보고자 하였다. 대상과 방법: 각막난시로 인해 구면 각막굴절교정 렌즈의 처방이 불가능하거나 실패하여 난시 각막굴절교정 렌즈(Toric Ortho-K LKTM, Lucid Korea, Seoul, Korea)를 처방 받아 6개월 이상 착용한 17명 24안을 대상으로 착용 전후 시력, 굴절이상, 각막변화와함께 각막 및 굴절 난시와 렌즈 난시, 그리고 각막난시와 나안시력 호전 정도와의 상관관계를 알아보았다. 결과: 렌즈 착용 후 나안시력(logMAR)은 0.93 ± 0.13에서 0.09 ± 0.07로 의미 있게 호전되었다(p＜0.001). 구면굴절 이상값(p ＜0.001), 원주굴절 이상값(p=0.008), 구면대응값(p＜0.001)은 모두 유의한 감소를 보였다. Simulated K (Sim K) 값은 모두 유의하게편평해진 변화를 보이고(p＜0.001), 편심률은 유의하게 감소되었으나(p＜0.001), 각막난시는 통계적으로 유의한 차이를 보이지 않았다(p=0.803). 렌즈난시는 각막난시와는 유의한 상관관계를 보였으나(r=0.526, p=0.012), 굴절난시와는 상관관계가 없었으며(r=0.218, p=0.329), 각막난시의 정도는 나안시력 호전 정도와는 연관성이 없는 것으로 나타났다(r=0.1804, p=0.399). 결론: 구면 렌즈의 처방이 어려웠던 각막난시 환자에서 난시 각막굴절교정 렌즈는 근시 및 난시 교정에 유용하여 효과적인 치료로생각되며, 렌즈의 난시도는 각막난시도와 관련성이 높았고, 각막난시의 정도가 높더라도 나안시력 호전에는 영향을 끼치지 않았다.
Abstract
Purpose: To report the effect of toric orthokeratology lenses on myopic patients who have more than 1.5 diopter (D) of corneal astigmatism. Methods: Seventeen patients (24 eyes) who wore toric orthokeratology lenses for more than 6 months were recruited for this study. The uncorrected visual acuity (UCVA), refractive error and keratometric changes including eccentricity before and after wearing lenses were compared. The correlations between corneal astigmatism as well as refractive astigmatism and lens toricity and between corneal astigmatism and improvement of UCVA after lens fitting were assessed. Results: After wearing lenses, UCVA (log MAR) was significantly improved from 0.93 ± 0.13 to 0.09 ± 0.07 (p < 0.001). Myopia changed from -4.53 ± 1.55 D to -0.67 ± 0.80 D (p < 0.001), refractive astigmatism from -1.48 ± 0.71 D to -0.99 ± 0.72 (p = 0.008) and spherical equivalent from -5.27 ± 1.56 D to -1.12 ± 0.92 D (p < 0.001). Simulated K (Sim K) tended to be more flat (p < 0.001) and the eccentricity was significantly decreased from 0.45 ± 0.08 to -0.69 ± 0.45 (p < 0.001), but corneal astigmatism was not significantly changed from 2.05 ± 0.41 D to 2.01 ± 0.98 D (p = 0.803). Correlation between corneal astigmatism and lens toricity was statistically significant (r = 0.526, p = 0.012) but not between refractive astigmatism and lens toricity (r = 0.218, p = 0.329). The amount of corneal astigmatism was not correlated with the improvement of uncorrected visual acuity after lens fitting (r = 0.1804, p = 0.399). Conclusions: Toric orthokeratology lenses might be an effective treatment in patients with corneal astigmatism who cannot be fitted with spherical orthokeratology lenses. Lens toricity was correlated with corneal astigmatism and the amount of corneal astigmatism did not affect the improvement of uncorrected visual acuity after lens fitting.
참고문헌 (19)
- Cheung SW., "Subjective and objective assessments of the effect of orthokeratology-a cross-sectional study", Curr Eye Res, 28, pp.121~127 (2004)
- Tahhan N., "Comparison of reverse-geometry lens designs for overnight orthokeratology", Optom Vis Sci, 80, pp.796~804 (2003)
- Chan B., "Orthokeratology practice in children in a university clinic in Hong Kong", Clin Exp Optom, 91, pp.453~460 (2008)
- Cheung SW., "Astigmatic changes in orthokeratology", Optom Vis Sci, 86, pp.1352~1358 (2009)
- Mountford J., "Corneal topography and orthokeratology: post-fit assessment", Contact Lens Spectrum, 17, pp.6~ (2002)
- 박영기, "난시 각막굴절교정학 렌즈를 이용한 가장자리 각막난시 교정", 대한안과학회지, 54(3), pp.502~507 (2013), 대한안과학회
- 최정훈, "역기하렌즈 착용 후 시력, 굴절이상 그리고 각막 난시의 상관성 분석", 대한안과학회지, 47(8), pp.1266~1273 (2006), 대한안과학회
- Nichols JJ., "Overnight orthokeratology", Optom Vis Sci, 77, pp.252~259 (2000)
- Mountford J., "An analysis of the changes in corneal shape and refractive error induced by accelerated orthokeratology", International Contact Lens Clinics, 24, pp.128~143 (1997)
- Fan DS., "Astigmatism in Chinese preschool children : prevalence, change, and effect on refractive development", Br J Ophthalmol, 88, pp.938~941 (2004)
- Kleinstein RN., "Refractive error and ethnicity in children", Arch Ophthalmol, 121, pp.1141~1147 (2003)
- Chen C., "Toric orthokeratology for high myopic and astigmatic subjects for myopic control", Clin Exp Optom, 95, pp.103~108 (2012)
- Chen CC., "Toric orthokeratology for highly astigmatic children", Optom Vis Sci, 89, pp.849~855 (2012)
- Chen C., "Myopia control using toric orthokeratology(TO-SEE study)", Invest Ophthalmol Vis Sci, 54, pp.6510~6517 (2013)
- Soni PS., "Clinical contact lens practice" (1993), JB Lippincott
- Joe JJ., "The relationship between corneal eccentricity and improvement in visual acuity with orthokeratology", J Am Optom Assoc, 67, pp.87~97 (1996)
- 윤여민, "중등도 이하 근시 환자에서 역기하렌즈 착용중지 후 각막 변화 관찰", 대한안과학회지, 46(9), pp.1478~1485 (2005), 대한안과학회
- Davis WR., "Corneal asphericity and apical curvature in children : a cross-sectional and longitudinal evaluation", Invest Ophthalmol Vis Sci, 46, pp.1899~1906 (2005)
- Horner DG., "Longitudinal changes in corneal asphericity in myopia", Optom Vis Sci, 77, pp.198~203 (2000)