전층각막이식술 후 각막 고위수차의 변화 양상
Changes in Higher-Order Aberrations after Penetrating Keratoplasty
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목적: 전층각막이식술 후 각막 고위수차의 변화 양상과 이에 영향을 미치는 인자를 분석하였다. 대상과 방법: 전층각막이식술을 시행 받고 1년 이상 경과 관찰이 가능하였던 48명 48안을 대상으로, 술 후 각막 고위수차의 변화 양상을알아보았다. 성별, 원인질환, 봉합방법, 공여각막 크기에 따른 차이를 비교하였고, 수술 후 봉합사 제거에 따른 고위수차의 변화 양상을알아보았다. 결과: 전층각막이식술 후 총 고위수차는 술 후 1개월, 3개월, 6개월, 12개월, 18개월째 각각 1.67 ± 0.49 μm, 1.63 ± 0.49 μm, 1.64± 0.51 μm, 1.61 ± 0.50 μm 그리고 1.79 ± 0.40 μm로 대조안보다 지속적으로 높았다(p＜0.01). 성별, 공여각막의 크기 및 봉합방법에 따른 각막 고위수차의 차이는 없었으며, 술 전 원인질환이 원추각막이었던 군은 각막혼탁군과 수포각막병증군에 비교하였을 때높았다. 술 후 18개월째, 봉합사가 완전히 제거된 군은 봉합사가 남아있는 군에 비하여 높은 각막 고위수차를 보였다. 결론: 각막 고위수차는 전층각막이식술 후 지속적으로 증가되어 있으며, 봉합사가 완전히 제거 된 경우와 원인질환이 원추각막인 경우더 높은 값을 갖는다.
Abstract
Purpose: To evaluate the changes in corneal higher-order aberrations (HOAs) after penetrating keratoplasty (PKP) and to investigate the factors affecting the changes in corneal HOAs. Methods: Forty-eight eyes of 48 patients with three different underlying diseases who underwent PKP were retrospectively reviewed. The changes in corneal higher-order aberrations (total root mean square (RMS), coma, trefoil, and spherical aberration) were evaluated with Pentacam (Oculus Inc., Dutenhofen, Germany) at 1, 3, 6, 12, and 18 months postoperatively. Sex, age, underlying disease, suturing method, trephine size of donor, and suture state were analyzed as factors affecting the HOAs changes. Results: Total RMS values in the PKP eyes were 1.67 ± 0.49 μm at 1 month, 1.63 ± 0.49 μm at 3 months, 1.64 ± 0.51 μm at 6 months, 1.61 ± 0.50 μm at 12 months, and 1.79 ± 0.40 μm at 18 months after surgery (p < 0.01). The values were higher compared with those in the control eyes. Sex, donor trephine size and suture method did not correlate with the HOAs changes. The HOAs in the keratoconus group were higher than those in the corneal opacity group or bullous keratopathy group. At 18 months, HOAs in the suture removed group were higher than those in the suture-remaining group. Conclusions: Corneal HOAs after PKP were persistently higher than those in the control eyes. The HOAs were higher in patients with keratoconus and in the suture-removed group.
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