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백내장 수술이 안구박동크기에 미치는 영향

The Effect of Cataract Surgery on Ocular Pulse Amplitude

양홍석|안재홍|이마빈|김민호
대한안과학회 (The Korean Ophthalmological Society)|2012.12|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제53권 제12호|pp. 1828-1834

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키워드

Intraocular pressureCataractCataract surgeryOcular pulse amplitudeDynamic contour tonometry
주제분류안과학

초록

목적: 백내장 수술 후 안압과 안구박동크기(OPA)의 변화를 측정하고, 이에 영향을 미치는 인자에 대해서 알아보고자 한다. 대상과 방법: 단안 백내장 수술을 받은 32명의 환자를 대상으로 하였으며, 수술을 시행하지 않은 반대편 눈을 대조군으로 삼았다. 골드만압평안압계(GAT)를 이용하여 술 전과 술 후 3달째 안압을 측정하였고, 파스칼안압계(DCT)를 이용하여 술 전과 술 후 3달째 안압과OPA를 측정하였다. 술 전 검사로 안축장, 전방 깊이, 중심각막두께를 측정하였다. 결과: 백내장 수술 후 GAT안압, DCT안압, OPA 모두 유의한 감소를 보였으며, 감소량은 각각 1.3 mmHg, 1.6 mmHg, 0.5 mmHg였다. 술 후 GAT 및 DCT 안압과 OPA 감소에 영향을 주는 주요 인자는 술 전 각각의 측정치인 것으로 나타났다. 또한 술 후 OPA 감소는연령과도 유의한 연관성을 보였으나, 안축장이나 전방 깊이, 중심각막두께와는 연관성을 보이지 않았다. 결론: 안압과 OPA 측정치는 백내장 수술 후 감소하며, 백내장 수술은 안압과 OPA 간의 상관관계에도 영향을 주는 것으로 보인다. 또한 OPA 감소는 술 전 OPA값 뿐만 아니라 연령과도 유의한 연관성을 보였는데 이는 연령증가에 따른 안구 경성도 증가와 연관이있을 것으로 생각한다.

Abstract

Purpose: To investigate the change of intraocular pressure (IOP) and ocular pulse amplitude (OPA) measured by dynamic contour tonometry (DCT) after cataract surgery and to identify the influencing factors related with OPA change after cataract extraction. Methods: The present study included 32 patients who underwent unilateral cataract surgery and the non-operated fellow eyes were used as control. IOP was measured by Goldman applanation tonometry (GAT) and Pascal DCT preoperatively,and 3 months postoperatively. Additionally, OPA was measured by Pascal DCT preoperatively, and 3 months postoperatively. Axial length (AL), anterior chamber depth (ACD), and central corneal thickness (CCT) were measured preoperatively. Results: After cataract surgery, IOP by GAT, IOP by DCT, and OPA decreased significantly with a mean decrement of 1.3mm Hg, 1.6 mm Hg, and 0.5 mm Hg, respectively (p < 0.05). OPA was significantly correlated with IOP by GAT (r = 0.497,p = 0.004) and IOP by DCT (r = 0.421, p = 0.016) preoperatively. OPA was correlated with GAT (r = 0.357, p = 0.045) but not with DCT (r = 0.224, p > 0.05) postoperatively. The most important factor influencing the decrement of IOP by GAT,IOP by DCT, and OPA after cataract surgery was the preoperative level of their measurements (r = 0.382, p < 0.05 in GAT,r = 0.807, p < 0.001 in DCT, r = 0.627, p < 0.001 in OPA). In addition, the OPA decrement after cataract surgery was significantly correlated with age (r = -0.370, p = 0.037), and was not correlated with AL, ACD, and CCT. Conclusions: Both IOP and OPA decreased after cataract surgery, which appears to influence the relationship between IOP and OPA. The correlation between OPA decrement and age may be related to increased ocular rigidity with aging.

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