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상피제거회전솔을 이용한 굴절교정레이저각막절제술과 상피통과굴절교정레이저각막절제술의 임상결과 비교

Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy

최태훈|김세경|최철명|강현승
대한안과학회 (The Korean Ophthalmological Society)|2014.09|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제55권 제9호|pp. 1284-1290

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키워드

Transepithelial photorefractive keratectomyBrush-assisted photorefractive keratectomyEpithelial healing time
주제분류안과학

초록

목적: 상피제거회전솔을 이용한 굴절교정레이저각막절제술(Brush PRK)과 상피통과굴절교정레이저각막절제술(Trans PRK)의 임상성적을 비교하고자 하였다. 대상과 방법: 한 술자에 의해 Brush PRK나 Trans PRK를 받고 1년 이상 추적 관찰이 가능했던 근시 환자 중에서 Brush PRK를 시행받은 38명(73안)과 Trans PRK를 시행 받은 40명(73안)을 대상으로 각막상피 재생시간 및 술 후 1주, 1개월, 3개월, 6개월, 12개월의시력, 굴절력 변화, 합병증 발생 여부에 대해 후향적으로 비교, 분석하였다. 결과: 각막상피재생 시간은 Brush PRK군이 3.67 ± 0.96일, Trans PRK군이 3.27 ± 0.75일로 Trans PRK에서 Brush PRK에 비해상피회복 속도가 빨랐다(p＜0.05). 술 후 나안시력은 술 후 1주일에 Trans PRK군이 0.09 ± 0.08 logMAR, Brush PRK군이 0.13± 0.12 logMAR로 Trans PRK군에서 빠른 시력회복을 보였지만(p＜0.05), 술 후 1, 3, 6, 12개월의 시력은 두 군에서 차이가 없었다. 술 후 12개월째 현성 구면렌즈대응치의 비교 시 Trans PRK군이 -0.14 ± 0.62D, Brush PRK군이 -0.31 ± 0.55D로 통계적으로 유의한 차이는 없었다. 술 후 합병증은 Brush PRK를 시행한 2안(2.7%), Trans PRK를 시행한 군의 1안(1.4%)에서 각막혼탁이 발생하였다. 결론: 근시안의 교정에 있어서 Trans PRK는 Brush PRK와 비교하여 각막상피 재생의 빠른 치유와 시력회복을 보이나, 장기적인 시력예후와 합병증 발생 면에서의 효과는 동등하다.

Abstract

Purpose: To compare the results of transepithelial photorefractive keratectomy (trans PRK) and brush-assisted photorefractivekeratectomy (brush PRK) for the treatment of myopia. Methods: A total of 146 eyes from 78 patients who received brush PRK or trans PRK with the Schwind Amaris laser platformwere included in the present study. Uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent(MRSE) at postoperative 1 week, 1, 3, 6, and 12 months were compared between the 2 groups as well as epithelial healing time. Results: The mean time to complete epithelial healing was 3.27 ± 0.75 days in the trans PRK group and 3.67 ± 0.93 days in thebrush PRK group (p < 0.05). At 1 week after surgery, UDVA recovered more rapidly after trans PRK than brush PRK (brush PRK:0.13 ± 0.12 log MAR units, trans PRK: 0.09 ± 0.08 log MAR units, p < 0.05), however, UDVA was not significantly different at 1,3, 6, and, 12 months postoperatively between the 2 groups. Conclusions: Re-epithelialization and visual recovery were faster in the trans PRK group while visual outcome and postoperativecomplications were equivalent to the brush PRK group.

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