각막절편 두께 측정법의 비교: 초음파 각막두께측정계의 차감법, 직접측정법과 빛간섭단층촬영계
Comparison of Flap Thickness Measured with Ultrasound Subtraction Method, Direct Method, and Optical Coherence Tomography
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목적: 펨토초레이저 라식안에서 각막절편 두께를 초음파 각막두께측정계에 의한 차감법, 직접측정법 및 빛간섭단층촬영계로 측정하여 세 가지 방법에 따른 결과를 비교하고자 하였다. 대상과 방법: 펨토초레이저를 이용하여 라식 수술을 시행한 37명 65안이 연구에 포함되었다. 각막절편 두께를 술 중 초음파 각막두께 측정계를 이용하여 차감법과 직접측정법으로 측정하였고, 술 후에는 빛간섭단층촬영계를 이용하여 측정하였다. 세 가지 측정법에 따 른 결과를 비교 분석하였다 결과: 차감법과 빛간섭단층촬영계에 의한 측정값 사이에 통계적으로 유의한 차이는 없었으며(p=0.511), 상관계수 0.820으로 높은 양적 선형관계를 보였다(p＜0.001). 그러나 직접측정법은 차감법 및 빛간섭단층촬영계와 통계적으로 유의한 차이를 보였으며(p＜0.001), 낮은 일치도를 보였다. 또한 직접측정법은 차감법에 비해 측정 성공률이 낮았다(54% vs 95%). 결론: 차감법과 빛간섭단층촬영계를 이용하여 측정한 각막절편 두께는 직접 측정법에 의한 측정값과 차이를 보였으며, 직접측정법은 차감법과 일치도가 낮고 측정의 어려움이 있어 차감법을 대체하기 어려울 것으로 생각된다.
Abstract
Purpose: To compare the flap thicknesses measured with the ultrasound (US) subtraction method, the direct method, and optical coherence tomography (OCT) in femtosecond laser-assisted LASIK eyes. Methods: The present study included 65 eyes of 37 patients who underwent femtosecond laser-assisted LASIK surgery. Flap thickness was measured intraoperatively using the direct and subtraction methods with US pachymetry and postoperatively using anterior segment OCT. Flap thickness measurements were compared among the three methods. Results: There was no significant difference between the flap thickness measured using the US subtraction method and OCT (p = 0.511). The flap thickness values obtained by these two different methods also correlated well with each other (γ = 0.820, p < 0.001). However, flap thickness measured using the US direct method was significantly different (p < 0.001) with a low agreement value compared to the other two methods. Furthermore, the US direct method showed a lower measurement success rate compared to the US subtraction method (54% vs. 95%). Conclusions: Flap thickness measured using the US subtraction method and OCT showed different values compared to that measured using the US direct method. Because of the lower measurement success rate and agreement value, the US direct method is not capable of being used in substitute for the US subtraction method.
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