안구 길이와 전방 깊이에 따른 Haigis 공식의 정확성
Accuracy of the Haigis Formula Based on Axial Length and Anterior Chamber Depth
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목적: 안구 길이와 전방 깊이에 따른 Haigis 공식의 정확성을 알아보고자 한다. 대상과 방법: 백내장수술을 받은 137안을 대상으로 술 전 IOL Master^Ⓡ를 이용하여 안구 길이 및 전방 깊이를 측정하였고, 인공수정체 도수계산공식으로 Haigis, SRK/T, Hoffer Q, Holladay 1 공식을 이용하였다. 전방 깊이는 Pentacam을 이용하여서도 측정하였다. 환자 군을 안구 길이 및 전방 깊이에 따라 각각 3군으로 나눈 뒤 수술 한달 후 평균 실제오차와 평균 절대오차를 알아보았다. 결과: 안구 길이에 따른 3군에서 공식들 사이의 굴절 오차에 유의한 차이가 없었다. 전방 깊이가 얕은 군에서 공식들 사이의 평균 절대 오차에 유의한 차이가 있었으며 Haigis 공식의 평균 실제오차가 술 후 원시 편위를 보였고, IOL Master^Ⓡ로 측정한 전방 깊이가 Pentacam으로 측정한 전방 깊이보다 유의하게 작았다. 전방 깊이에 따른 나머지 군에서는 공식들 사이의 굴절 오차 및 측정기구에 따른 전방 깊이의 차이가 없었다. 결론: Haigis 공식의 정확성은 다른 공식들보다 전방 깊이에 영향을 받으므로, 정확한 전방 깊이 측정이 필요하며, 전방 깊이에 따른 굴절 오차의 경향을 고려하여 인공수정체 도수 결정이 필요하다.
Abstract
Purpose: To evaluate the effect of axial length (AXL) and anterior chamber depth (ACD) on the accuracy of the Haigis formula in comparison to its effect on other 3rd generation IOL power calculations. The possibility of measurement error in ACD using either method was also investigated. Methods: A study was performed on 137 eyes of 98 patients who underwent cataract surgery in our hospital. AXL and ACD were measured using IOL Master, and IOL power was calculated using the Haigis, SRK/T, Hoffer Q, and Holladay 1 formulas. ACD was also measured using Pentacam. Patients were divided into 3 groups based on ACD and AXL. Mean numeric error and mean absolute error were analyzed 1 month after surgery. Results: Five formulae showed no significant difference in refractive error in the 3 groups based on AXL. In contrast, the Haigis formula showed statistically significant differences in the group with shallow ACD, in which hyperopic shift was also demonstrated. The difference in ACD between using IOL Master and using Pentacam was significant in the shallow ACD group, with IOL Master showing more shallow measurement. However, the other groups based on ACD showed no significant difference in the refractive error from the Haigis formula, and in the difference in ACD between measurements. Conclusions: Errors in ACD measurement should be taken into consideration for discrepancy between the Haigis formula measurement and other formula measurements. The authors of the present study suggest that ACD-driven refractive error should be considered in determination of IOL.
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