2.8 mm 이하의 절개창 크기의 동축 백내장수술에서 난시 유발과 각막 고위수차 비교
Induced Astigmatism and High-Order Aberrations after 1.8-mm, 2.2-mm and 3.0-mm Coaxial Phacoemulsification Incisions
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목적: 동축 미세절개 백내장수술(절개창: 1.8 mm)과 소절개 백내장수술(절개창: 2.2 mm, 2.8 mm) 후 난시 유발과 각막 전면과 후면의 고위수차를 비교 분석하였다. 대상과 방법: 100눈에서 32눈은 1.8 mm, 38눈은 2.2 mm, 30눈은 2.8 mm 크기로 이측에 투명각막절개를 통한 백내장 수술을 하였다. 전향적으로 술 전에 각막곡률계로 각막난시, 각막난시를 측정하였고, 술 후 1개월에 각막난시, 각막 수차, 3개월에 각막난시를 측정하 여수술 유발 난시를 계측하였다. 결과: 수술 유발 난시량은 1.8 mm 절개에서 0.41 ± 0.30, 2.2 mm 절개에서 0.47 ± 0.21, 2.8 mm 절개에서 0.71 ± 0.50디옵터로 1.8 mm 절개에서 가장 적은 난시가 유발되었다(p=0.002). 절개에 따른 각막 전면의 코마수차, 구면수차와 후면의 트레포일수차, 구면수차의 변화량은 세 군간에 차이가 없었다. 결론: 백내장수술 1개월 후 각막 전면과 후면의 고위수차의 변화는 각막절개의 크기와 연관이 없으나 각막절개의 크기에 따른 수술 유발 난시는 2.8 mm 절개보다 1.8 mm와 2.2 mm 절개에서 유의하게 작았다.
Abstract
Purpose: To study theeffect of micro incision (1.8 mm) and small incision (2.2 mm and 2.8 mm) coaxial phacoemulsification on surgically induced astigmatism (SIA) and high-order aberrations (HOA) of anterior and posterior corneal surface. Methods: The present randomized clinical study included 32 eyes having a 1.8-mm, 38 eyes having a 2.2-mm, and 30 eyes having a 2.8-mm corneal incision. SIAs were measured at 1 and 3 months postoperatively. HOAs included coma, trefoil, and spherical aberration. The coma–root mean square (RMS) and trefoil-RMS were evaluated at 1 month after the cataract operation. Results: Surgically induced astigmatisms were 0.41 ± 0.30 diopter (D) in the 1.8-mm incision group, 0.47 ± 0.21 D in 2.2-mm group and 0.71 ± 0.50 D in the 2.8-mm group. The SIA of the 1.8-mm group was smaller than the other groups (p = 0.002). There was no statistically significant difference in coma, spherical aberration of the corneal anterior surface and trefoil, or spherical aberration of the posterior surface among the 3 groups at 1 month after surgery. Conclusions: Incision size contributes to postoperative corneal astigmatism. Phacoemulsification cataract surgery with less than 2.8-mm incision does not significantly influence the corneal aberrationsof anterior and posterior corneal surfaces.
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