4가지 각막곡률측정 시스템을 이용한 굴절교정수술 후 인공수정체도수계산법 비교
Comparison of Four Systems of IOL Calculation after Keratorefractive Surgery in Eyes Requiring Cataract Surgery
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초록
목적: 자동각막곡률계, Orbscan IIⓇ, PentacamⓇ, IOL masterⓇ의 4가지 시스템을 이용하여 굴절교정수술을 받았던 환자의 각막곡률값을 구한 후 여러가지 인공수정체 도수계산법에 적용하여 가장 적합한 방법을 알아보았다. 대상과 방법: 새로운 각막곡률치 측정 방법인 SMK (Sungmo eye hospital keratometry)를 SRK/T 공식에 대입하여 구한 인공수정체도수의 예측 값과 백내장 수술 후 역으로 구한 이상적인 인공수정체의 값과 비교하였다. 또한 LASIK 수술 전의 각막곡률값과 굴절력을알고 있는 환자를 대상으로 각막곡률산출법으로 구한 인공수정체 도수의 예측 값과 4가지 시스템을 이용하여 구한 인공수정체 도수의예측 값을 비교하였다. 결과: SMK와 SRK/T 공식의 조합은 이상적인 인공수정체의 값과 비교하여 63.8%에서 ±0.5 diopter 범주에 있었으며, 90.9%에서±1.0 diopter 범주에 속하였다. SMK와 SRK/T 공식의 인공수정체 도수 예측 값은 각막곡률산출법으로 구한 값보다 1.95 ± 0.86diopter 높았으나, Haigis-L 공식이나 True net power (TNP)를 Haigis 공식에 대입하여 구한 인공수정체 도수의 예측 값과 통계학적차이를 보이지 않았다. 결론: 굴절교정수술 후 인공수정체 도수 계산시 SMK를 SRK/T 공식에 대입하여 사용하는 것이 예측오차가 가장 적었으며, Haigis-L 공식이나 TNP를 Haigis 공식에 대입한 경우도 비교적 정확한 인공수정체 도수를 얻을 수 있는 것으로 생각한다.
Abstract
Purpose: To report the evaluation and comparison of true corneal power after corneal refractive surgery through ARK,Orbscan II®, Pentacam and IOL master. Methods: Target IOL (Intraocular lens) power calculated with the SRK/T formula using SMK (Sungmo Eye Hospital keratometry),which is a new method for measuring corneal refractive power, was compared with the back-calculated ideal IOL power after cataract surgery for 30 eyes that required cataract surgery and had previously undergone refractive surgery. Target IOL powers calculated using 4 systems were compared with IOL power calculated using the clinical history method for 64 eyes that had undergone refractive surgery. Results: Using SMK with the SRK/T formula, the actual refraction was within ±0.5 diopter (D) of the intended refraction for 63.8% of eyes and within ±1.0 D for 90.9% of eyes. Compared with target IOL power calculated with the clinical history method, target IOL power calculated by SMK with the SRK/T formula had a difference of 1.95 ± 0.86 D, which was similar to the results calculated by the Haigis-L formula and by TNP with Haigis. Conclusions: The method of IOL calculation using SMK with the SRK/T formula showed the best predictability in patients after corneal refractive surgery. Comparatively accurate results were produced in IOL power calculations using the Haigis-L formula, and the TNP with Haigis method.
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