두 가지 절개창 크기와 초음파수정체유화방식이 수술유발난시도와 각막 내피에 미치는 영향
Influences on Astigmatism and Corneal Endothelium Using Two Different Incision Sizes and Mode of Phacoemulsification
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목적: OzilⓇ과 Hyperpulse 방식으로 2.2와 2.8 mm 절개창을 통한 초음파유화술이 수술유발난시도와 각막내피에 미치는 영향을 비교하였다. 대상과 방법: InfinitiⓇ의 OzilⓇ과 Hyperpulse 방식으로 절개창 크기를 달리하여 OzilⓇ 2.2 mm 29안, 2.8 mm 30안, Hyperpulse 2.2mm 29안, 2.8 mm 30안을 대상으로 수술 후 2개월까지 각막곡률을 측정하여 수술유발난시도를 계산, 중심각막두께와 각막내피밀도를측정하였고, 평균초음파사용시간으로 효율성을 비교하였다. 결과: 네 군 사이의 수술유발난시도, 각막두께, 각막내피밀도 및 교정시력과 평균초음파세기에서 유의한 차이가 관찰되지 않았다. CDE (Cumulated dissipated energy)는 핵경화도 1, 2 환자군에서 OzilⓇ방식을 사용한 경우가 더 작은 값을 보였다. 결론: InfinitiⓇ의 OzilⓇ과 Hyperpulse 방식과 2.2, 2.8 mm 절개창을 통한 초음파유화술은 술 후 2개월까지 수술유발난시도, 각막내피세포밀도 변화에서 유의한 차이를 보이지 않았고, 핵경화도가 낮은 백내장에서 OzilⓇ 방식이 보다 효율적이라고 생각한다.
Abstract
Purpose: To compare surgically induced astigmatism and influences on the corneal endothelium in phacoemulsification by OzilⓇ and Hyperpulse mode of InfinitiⓇ using 2 different corneal incision lengths of 2.2 mm and 2.8 mm. Methods: The patients were grouped by the mode of phacoemulsification and incision size as follows: OzilⓇ mode with 2.2mm incision group (n = 29), and 2.8 mm incision group (n = 30); Hyperpulse mode with 2.2 mm incision group (n = 29), and 2.8 mm incision group (n = 30). The surgically induced astigmatism, central corneal thickness and endothelial cell density were measured up to 2 months after surgery and the efficiency of 2 modes compared by measuring average phacoemulsification times. Results: There was no significant difference in the surgically induced astigmatism, central corneal thickness, endothelial cell density, best corrected visual acuity and average phaco power among 4 groups. The cumulated dissipated energy (CDE) using OzilⓇ mode was lower than Hyperpulse mode in the group of nuclear sclerosis grade 1 and 2. Conclusions: Two different modes of phacoemulsification using OzilⓇ and Hyperpulse mode, and different incision sizes of 2.2 mm and 2.8 mm in InfinitiⓇ showed no significant difference in the endothelial cell density or the surgically induced astigmatism up to 2 months after surgery. Phacoemulsification using OzilⓇ mode is considered more efficient in low grade nuclear sclerosis cataract.
참고문헌 (34)
- Kelman CD, "Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report", Am J Ophthalmol, 64, pp.23~35 (1967)
- Colleaux KM, "Effect of prophylactic antibiotics and incision type on the incidence of endophthalmitis after cataract surgery", Can J Ophthalmol, 35, pp.373~378 (2000)
- Taban M, "Ingress of India ink into the anterior chamber through sutureless clear corneal cataract wounds", Arch Ophthalmol, 123, pp.643~648 (2005)
- Kershner RM, "Clear corneal cataract surgery and the correction of myopia, hyperopia, and astigmatism", Ophthalmology, 104, pp.381~389 (1997)
- Cravy TV., "Calculation of the change in corneal astigmatism following cataract extraction", Ophthalmic Surg, 10, pp.38~49 (1979)
- Simşek S, "Effect of superior and temporal clear corneal incisions on astigmatism after sutureless phacoemulsification", J Cataract Refract Surg, 24, pp.515~518 (1998)
- Crema AS, "Comparative study of coaxial phacoemulsification and microincision cataract surgery. One-year follow-up", J Cataract Refract Surg, 33, pp.1014~1018 (2007)
- 구희찬, "소절개창을 이용한 백내장 수술에서 절개창 길이에 따른 술 후 난시 비교", 대한안과학회지, 46(3), pp.5~5 (2005), 대한안과학회
- Vargas LG, "Endothelial cell integrity after phacoemulsification with 2 different handpieces", J Cataract Refract Surg, 30, pp.478~482 (2004)
- O’Brien PD, "Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident", J Cataract Refract Surg, 30, pp.839~843 (2004)
- 노창래, "사용자조절소프트웨어를 이용한 백내장 수술의 임상결과", 대한안과학회지, 47(5), pp.735~739 (2006), 대한안과학회
- Vasavada V, "Intraoperative performance and postoperative outcomes of microcoaxial phacoemulsification. Observational study", J Cataract Refract Surg, 33, pp.1019~1024 (2007)
- Liu Y, "Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study", J Cataract Refract Surg, 33, pp.287~292 (2007)
- Jun B, "Corneal wound architecture and integrity after torsional and mixed phacoemulsification: evaluation of standard and microincisional coaxial techniques", Ophthalmic Surg Lasers Imaging, 41, pp.128~134 (2010)
- Holladay JT, "Calculating the surgically induced refractive change following ocular surgery", J Cataract Refract Surg, 18, pp.429~443 (1992)
- 지동현, "소절개창 크기에 따른 난시변화", 대한안과학회지, 44(3), pp.10~598 (2003), 대한안과학회
- Long DA, "A prospective evaluation of corneal curvature changes with 3.0- to 3.5-mm corneal tunnel phacoemulsification", Ophthalmology, 103, pp.226~232 (1996)
- Alió J, "Outcomes of microincision cataract surgery versus coaxial phacoemulsification", Ophthalmology, 112, pp.1997~2003 (2005)
- Yao K, "Corneal astigmatism, high order aberrations, and optical quality after cataract surgery: microincision versus small incision", J Refract Surg, 22, pp.S1079~S1082 (2006)
- 최진아, "2.2 mm 동축 소절개 백내장수술의 단기 임상 결과 비교", 대한안과학회지, 49(6), pp.904~910 (2008), 대한안과학회
- Kurz S, "Biaxial microincision versus coaxial small-incision clear cornea cataract surgery", Ophthalmology, 113, pp.1818~1826 (2006)
- 황상조, "미세 절개 및 고전적 백내장 수술에서의 수술 유발 난시 및 각막 고위 수차 비교", 대한안과학회지, 49(10), pp.1597~1602 (2008), 대한안과학회
- Masket S, "Induced astigmatism with 2.2-and 3.0-mm coaxial phacoemulsification incisions", J Refract Surg, 25, pp.21~24 (2009)
- Beesley RD, "The effects of prolonged phacoemulsification time on the corneal endothelium", Ann Ophthalmol, 18, pp.216~222 (1986)
- Jacobs PM, "Endothelial cell loss after cataract surgery--the problem of interpretation", Trans Ophthalmol Soc U K, 102(pt 2), pp.291~293 (1982)
- Oki K., "Measuring rectilinear flow within the anterior chamber in phacoemulsification procedures", J Cataract Refract Surg, 30, pp.1759~1767 (2004)
- Davison JA, "Comparison of ultrasonic energy expenditures and corneal endothelial cell density reductions during modulated and non-modulated phacoemulsification", Ophthalmic Surg Lasers Imaging, 38, pp.209~218 (2007)
- Lee KI, "The evaluation of the endothelial cells after cataract extraction and IOL insertion in patients with corneal guttata", J Korean Ophthalmol Soc, 39, pp.2272~2279 (1998)
- Joussen AM, "Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification", J Cataract Refract Surg, 26, pp.392~397 (2000)
- Bourne RR, "Effect of cataract surgery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery", Ophthalmology, 111, pp.679~685 (2004)
- Suzuki H, "Phacoemulsification associated corneal damage evaluated by corneal volume", Am J Ophthalmol, 142, pp.525~528 (2006)
- 정혜진, "회전 진동 방식과 극단속 방식을 이용한수정체유화술 후 임상성적 비교", 대한안과학회지, 50(3), pp.347~352 (2009), 대한안과학회
- Bozkurt E, "Comparison of conventional and torsional mode (OZil) phacoemulsification: randomized prospective clinical study", Eur J Ophthalmol, 19, pp.984~989 (2009)
- Dong-Hyun Kim, "The Comparison between Torsional and Conventional Mode Phacoemulsification in Moderate and Hard Cataracts", Korean Journal of Ophthalmology, 24(6), pp.336~340 (2010), 대한안과학회