짧은 안축장의 환자에서 각막곡률의 정도에 따른 인공수정체도수산출 공식의 정확성 분석
Accuracy of Intraocular Lens Power Calculations According to Corneal Curvature in Short Eyes
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목적: 짧은 안축장에서 백내장 수술 시 각막곡률에 따라 정확도에 차이가 나는지 Hoffer Q 공식과 다른 공식들의 산출값을 수술 후결과와 비교하여 정확성을 알아보고자 하였다. 대상과 방법: 2012년 1월 1일부터 6월 12일까지 한 명의 술자에게 백내장 수술을 받은 대상 중에서 안축장 23.0 mm 미만인 환자 77명(90안)을 대상으로 평균 각막굴절력을 기준으로 44.0D 이하와 45.0D 이상의 두 군으로 분류 취합하여 후향적 연구를 하였으며, SRKII, SRK-T, Holladay I과 Hoffer Q 공식을 통해 인공수정체도수 결정 후 예상굴절력과 수술 후 실제굴절력 간 오차를 분석하여 정확성을 분석하였다. 결과: 짧은 안축장 눈에서 각막곡률과 무관하게 Hoffer Q가 SRK II, SRK-T, Holladay I보다 정확한 예측치를 보였으며(p＜0.001,p=0.023), 각막곡률이 가파른 경우보다 편평한 경우 SRK II, SRK-T, Holladay I 공식이 Hoffer Q 공식보다 실제굴절력과 비교해 더부정확한 결과를 나타내었다(p＜0.001, p=0.215). 결론: 짧은 안축장을 가진 환자에서 인공수정체 도수계산 시 Hoffer Q가 다른 공식보다 정확하였고, 편평한 각막에서는 SRK II,SRK-T, Holladay I 공식이 Hoffer Q 공식보다 유효한 렌즈 위치(Effective lens position, ELP)를 저평가하여 산정함으로써 원시화하는 경향이 커서, 오차가 더 나타나므로, 이러한 경우에는 Hoffer Q 공식이 더 정확한 것으로 생각한다.
Abstract
Purpose: To evaluate the accuracy of intraocular lens (IOL) power calculations between Hoffer Q and other formulas accordingto corneal curvature by comparing the results of cataract surgery and calculation of chosen formulas in short axial lengths. Methods: We performed a retrospective analysis of patients who underwent cataract surgery from January 1st, 2012 to June12th, 2012. The patients were selected if their axial length was below 23.00 mm and 77 patients (90 eyes) were included in thepresent study. The patients were divided into 2 groups according to mean corneal curvature below 44.0 D and over 45.0 D. IOLpower was calculated using the Hoffer Q and SRK II, SRK-T and Holladay I formulas and the error between the calculations andrefractive outcome of cataract surgery were measured. The accuracy of each formula was evaluated by comparing the error betweenthe 2 groups. Results: Hoffer Q formula showed a higher predictive accuracy than other formulas regardless of corneal curvature in eyes withshort axial lengths (p < 0.001, p = 0.023). Particularly, SRK II, SRK-T and Holladay I showed a lower predictive accuracy in eyeswith flat corneal curvature than Hoffer Q (p < 0.001, p = 0.215). Conclusions: In eyes with short axial lengths, preoperative predicted IOL power calculations showed better accuracy with HofferQ formula than SRK II, SRK-T and Holladay I formulas. SRK II, SRK-T and Holladay I formulas showed a lower predictive accuracyin flat corneal curvature eyes than steep corneal curvature eyes with short axial lengths. We hypothesize that SRK II, SRK-Tand Holladay I tend to underestimate effective lens position in eyes with short axial lengths indicating Hoffer Q formula is moreaccurate.
참고문헌 (24)
- Holladay JT, "Improving the predictability of intraocular lens power calculations", Arch Ophthalmol, 104, pp.539~541 (1986)
- Drexler W, "Partial coherence interferometry:a novel approach to biometry in cataract surgery", Am J Ophthalmol, 126, pp.524~534 (1998)
- Holladay I JT, "Achieving emmetropia in extremely short eyes with two piggyback posterior chamber intraocular lenses", Ophthalmology, 103, pp.1118~1123 (1996)
- Olsen T, "Intraocular lens power calculation with an improved anterior chamber depth prediction algorithm", J Cataract Refract Surg, 21, pp.313~319 (1995)
- Drews RC, "Reliability of lens implant power formulas in hyperopes and myopes", Ophthalmic Surg, 19, pp.11~15 (1988)
- 신정아, "짧은 안축장에서 백내장수술 후 굴절오차 분석과 각막굴절력 및 전방깊이에 따른 정확성 분석", 대한안과학회지, 54(1), pp.65~71 (2013), 대한안과학회
- MacLaren RE, "Biometry accuracy using zero- and negative-powered intraocular lenses", J Cataract Refract Surg, 31, pp.280~290 (2005)
- Hoffer KJ, "The Hoffer Q formula: a comparison of theoretic and regression formulas", J Cataract Refract Surg, 19, pp.700~712 (1993)
- Hitzenberger CK, "Optical measurement of the axial eye length by laser Doppler interferometry", Invest Ophthalmol Vis Sci, 32, pp.616~624 (1991)
- Drexler W, "Dual beam optical coherence tomography: signal identification for ophthalmologic diagnosis", J Biomed Opt, 3, pp.55~65 (1998)
- Fedorov SN, "A method of calculating the optical power of the intraocular lens", Vestn Oftalmol, 80, pp.27~31 (1967)
- Holladay JT, "A three-part system for refining intraocular lens power calculations", J Cataract Refract Surg, 14, pp.17~24 (1988)
- Retzlaff JA, "Development of the SRK", T intraocular lens implant power calculation formula, 1990, pp.16, 333~340
- Hoffer KJ, "The Hoffer Q formula: a comparison of theoretic and regression formulas", J Cataract Refract Surg, 19, pp.700~712 (1993)
- Lam AK, "The repeatability and accuracy of axial length and anterior chamber depth measurements from the IOLMaster", Ophthalmic Physiol Opt, 21, pp.477~483 (2001)
- 김효진, "IOL Master, A-scan과 Orbscan Ⅱ를 이용한 안축장과 전방깊이의 비교", 대한안과학회지, 44(7), pp.8~1527 (2003), 대한안과학회
- McEwan JR, "Effect of keratometer and axial length measurement errors on primary implant power calculations", J Cataract Refract Surg, 16, pp.61~70 (1990)
- Drexler W, "Dual beam optical coherence tomography: signal identification for ophthalmologic diagnosis", J Biomed Opt, 3, pp.55~65 (1998)
- Olsen T, "Sources of error in intraocular lens power calculation", J Cataract Refract Surg, 18, pp.125~129 (1992)
- Haigis W, "Intraocular lens power calculations", pp.5~ (2004), SLACK Incorporated
- Olsen T, "Prediction of postoperative intraocular lens chamber depth", J Cataract Refract Surg, 16, pp.587~590 (1990)
- Olsen T, "Intraocular lens power calculation with an improved anterior chamber depth prediction algorithm", J Cataract Refract Surg, 21, pp.313~319 (1995)
- 맹효성, "전방깊이와 안축장에 따른 인공수정체 삽입 후 굴절 오차의 경향", 대한안과학회지, 51(2), pp.195~202 (2010), 대한안과학회
- 이영은, "안축장이 짧은 안에서 인공수정체도수 산출 공식과 전방 깊이에 따른 정확성 분석", 대한안과학회지, 51(10), pp.1338~1344 (2010), 대한안과학회