노안이 동반된 근시 환자에서 비구면 미세단안시 라식을 이용한 노안 교정수술의 임상결과
LASIK for Myopia with Presbyopia Using the Aspheric Micro-Monovision Technique
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목적: 노안이 동반된 근시 환자에서 비구면 미세단안시를 이용한 노안 교정수술의 효능과 안전성 및 만족도를 알아보고자 한다. 대상과 방법: 후향적 비대조 연구로서 엑시머레이저를 이용한 비구면 미세단안시 노안 교정수술을 받은 환자 중 근시환자 20명, 40안을 대상으로 하였다. 술 전과 술 후 3개월에 원거리, 중간거리와 근거리 나안 및 교정시력변화를 단안과 양안 모두에서 측정하였다. 입체시, 초점심도, 구면 수차, 환자의 만족도 또한 측정하였다. 결과: 평균나이 48.7세였다. 술 후 3개월에 94%의 우세안에서 0.8 이상의 유용한 원거리 나안시력을, 94%의 비우세안에서 J3 이상의유용한 근거리 나안시력을 얻었다. 술 후 환자의 100%는 양안 원거리 나안시력이 1.0 이상이었으며, 94%는 근거리 시력이 J2 이상이었다. 우세안에서는 수술 후 초점심도가 호전되고 구면수차가 증가하였으나, 비우세안에서는 통계적으로 유의하지 않았다. 입체시 기능 및 대비감도의 변화는 수술 후 관찰되지 않았으며 환자들의 전반적인 만족도는 좋았다. 결론: 노안이 동반된 근시 환자에서 비구면 미세단안시를 이용한 노안 교정수술은 효과적이고 안전한 수술임을 확인하였다.
Abstract
Purpose: To evaluate the efficacy, safety, and satisfaction of patients who underwent the aspheric micro-monovision protocol for the correction of myopia with presbyopia. Methods: A retrospective, noncomparative study included 40 eyes of 20 consecutive patients with myopia and presbyopia who were treated with LASIK-induced micro-monovision. Monocular and binocular visual outcomes of uncorrected and best-corrected distance, intermediate, and near visual acuity were measured. Depth of focus, spherical aberration, stereopsis and satisfaction were evaluated before surgery and 3 months after surgery. Results: Mean patient age was 48.7 years. Monocular uncorrected distance visual acuity was 0.8 in 94% of dominant eyes, and monocular uncorrected near visual acuity was J3 in 94% in non-dominant eyes. Binocular uncorrected near visual acuity was J2 in 94% and J5 in 100% of dominant and non-dominant patient eyes, respectively. Binocular uncorrected distance visual acuity was 1.0 in 100% of patients, and binocular uncorrected near visual acuity was J2 in 94% of patients. Our results showed a significant improvement in depth of focus and a positive shift in spherical aberration in dominant eyes; however, there were no significant changes in the non-dominant eyes. There was no change in stereopsis or contrast sensitivity at any of the tested spatial frequencies. Satisfactory scores were achieved in all eyes. Conclusions: The aspheric myopic micro-monovision protocol was well-tolerated, stable, and effective for treating patients with presbyopia in myopic astigmatism.
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