경도 및 중등도 근시환자와 고도근시환자에서의 스마일수술 임상성적 비교
Outcomes of Small Incision Lenticule Extraction: Mild to Moderate Myopia versus High Myopia
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목적: 경도 및 중등도 근시환자와 고도근시환자에서의 스마일수술 임상성적을 비교하고자 한다. 대상과 방법: 스마일수술을 받고 6개월간 경과관찰이 가능했던 166명(332안)을 대상으로 술 전 구면렌즈대응치에 따라 경도 및 중등도 근시군(A군: -6디옵터 미만, 109안), 고도 근시군(B군: -6디옵터 이상, 223안)으로 나누고 술 후 1일, 1주, 1개월, 3개월, 6개월에나안시력, 최대 교정시력, 구면렌즈대응치, 효율성, 안전성, 예측성을 평가 비교하였다. 결과: 술 후 6개월 뒤 나안시력이 20/25 이상인 비율이 A군 98.3%, B군 97.3%였다. 술 전 구면렌즈대응치는 각각 A군 -4.85 ±0.86디옵터, B군 -7.70 ± 1.0디옵터이었고, 술 후 6개월 뒤 A군 -0.04 ± 0.29디옵터, B군 -0.30 ± 0.37디옵터로 두 군 간의 차이는 없었다(p=0.062). 술 후 6개월에서 효율성은 A군 1.02 ± 0.19, B군 0.99 ± 0.18로 두 군 간에 유의한 차이가 없었고(p=0.09),안전성 역시 A군 1.16 ± 0.16, B군 1.14 ± 0.16으로 두 군 간에 유의한 차이는 없었다(p=0.695). 술 후 6개월에 ±0.5디옵터, ±1디옵터 이내 예측성 비율은 A군 97.3%, 100%, B군 91.7%, 96.9%이었다. 결론: 스마일수술은 경도 및 중등도 근시환자와 고도근시환자에서 나안시력, 최대 교정시력, 구면렌즈대응치, 안전성, 효율성, 예측성에서 유의한 차이를 보이지 않아서 경도 및 중등도 근시환자뿐 아니라 고도근시환자에서도 효율적이고 안전한 수술법이다.
Abstract
Purpose: To evaluate the refractive outcomes of small incision lenticule extraction (SMILE) in high myopia patients comparedwith mild to moderate myopia patients. Methods: This study included 332 eyes of 166 myopic patients treated with SMILE using Visumax 500 kHz femtosecond laser. Treated eyes were divided into 2 groups according to preoperative spherical equivalent (SE): mild to moderate myopia (A group,<-6.0 D) and high myopia (B group, ≥-6.0 D). Follow-up visits were at 1 day, 1 week, 1 month, 3 months, and 6 months. The outcomemeasures included uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BDVA), postoperativeSE, efficacy index, safety index and predictability. Results: Preoperative SE was -4.85 ± 0.86 D in the A group and -7.70 ± 1.0 D in the B group. No differences were observed between-0.04 ± 0.29 D in the A group and -0.30 ± 0.37 D in the B group at 6 months postoperatively (p = 0.062). At 6 months postoperatively,98.3% and 97.3% had UDVA of 20/25 or better in the A group and B group, respectively. In the A group, 97.3% and100% were within ±0.5 D and ±1.0 D of intended correction and in the B group, 91.7% and 96.9% were within ±0.5 D and ±1.0 D,respectively. Efficacy indices were 1.02 ± 0.19 in the A group and 0.99 ± 0.18 in the B group. Safety indices were 1.16 ± 0.16 inthe A group and 1.14 ± 0.16 in the B group. The efficacy and safety indices were not significantly different between the A and Bgroups at 6 months postoperatively (p = 0.09, p = 0.695, respectively). Conclusions: This study showed that SMILE is effective and safe for correcting high myopia as well as mild to moderate myopia.
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