유수정체 안내후방렌즈삽입술 후 망막신경섬유층 두께 측정값의 변화
The Change of Retinal Nerve Fiber Layer Thickness after Posterior Chamber Phakic Intraocular Lens Implantation
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목적: 유수정체 안내후방렌즈 삽입술을 시행 받은 환자에서 빛간섭단층촬영(optical coherence tomography, OCT)을 이용하여 수술전후의 망막신경섬유층 두께의 측정값의 변화 양상을 분석하고 이와 관련된 인자에 대해 분석하고자 하였다. 대상과 방법: 유수정체 안내후방렌즈 삽입술을 시행 받고 1개월 이상 경과관찰이 가능하였던 40명 40안에 대하여 의무기록을 후향적으로 분석하였다. 스펙트럼영역 빛간섭단층촬영기를 이용한 군(A군) 20명 20안과 시간영역 빛간섭단층촬영기를 이용한 군(B군) 20명20안에서 수술 전후의 상측, 하측, 비측, 이측 및 평균 망막신경섬유층 두께의 측정값의 변화를 측정하고 그 변화를 알아보고자 하였다. 결과: 두 군의 망막신경섬유층의 평균 두께와 A군의 이측, 하측, 상측, B군의 하측, 상측의 망막신경섬유층 두께의 측정값의 변화는수술 전과 비교하여 수술 후 유의한 증가양상을 보였으나(p＜0.05), 이는 수술 전 구면대응치, 수술 전후의 구면대응치 변화량 및삽입된 렌즈 도수와 유의한 상관관계를 보이지는 않았다. 결론: 유수정체 안내후방렌즈 삽입술 후 빛간섭단층촬영을 이용한 망막신경섬유층 두께의 측정값의 변화를 측정 시 수술 전에 비해두껍게 측정될 수 있어 결과 해석에 주의를 요한다.
Abstract
Purpose: In the present study we evaluated the changes of measured retinal nerve fiber layer (RNFL) thickness using optical coherencetomography (OCT) after phakic intraocular lens (implantable collamer lens, ICL) implantation and analyzed the factorscorrelated with the changes of measured RNFL thickness. Methods: Forty eyes of 40 patients (Group A: 20 patients using spectral domain OCT and Group B: 20 patients using time domainOCT) who underwent ICL implantation were included in this study. RNFL thickness was measured 1 week before surgeryand 1 month postoperatively using OCT. The changes of measured RNFL thickness and the correlation between patients' datawere analyzed. Results: The postoperative measured RNFL thickness of the average, inferior, temporal, and superior quadrants were increasedcompared to preoperative measured RNFL thickness in Group A. Group B had similar results in the average, inferior, and superiorquadrants (p < 0.05). However, the postoperative changes of RNFL measurements were not correlated with the preoperativespherical equivalent, the degree of spherical equivalent change and diopters of implanted lens (p > 0.05). Conclusions: The measured RNFL thickness after ICL implantation may increase compared to the preoperative value. Cautionshould be taken when interpreting the RNFL thickness values measured by OCT in patients with myopia who undergo ICLimplantation.
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