백내장 수술 후 비구면 인공수정체 및 구면인공수정체 삽입안에서 광학적 기능의 비교
Comparison of Optical Performances in Eyes Implanted With Aspheric and Spherical Intraocular Lenses After Cataract Surgery
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초록
목적: 구면 및 비구면 인공수정체(intraocular lens; IOL)를 삽입한 눈의 광학기능을 비교하고자 한다. 대상과 방법: 69명 88안에서 구면(Sensar AR40; Acrysof natural SN60AT) 또는 비구면(Tecnis ZA9003; Acrysof IQ SN60WF) IOL을 22안씩 삽입 후, 술후 1개월에 대비감도, 초점심도, 구면수차를 측정하여 분석하였다. 결과: 대비감도는 명소시에는 12,18 cpd에서, 박명시에는 6,12,18 cpd에서 ZA9003와 SN60WF이 구면 IOL보다 유의하게 높았다. 초점 심도는 ZA9003 1.31D, SN60WF 1.67D, AR40 1.52D, SN60AT 1.49D로 유의한 차이는 없었다. 구면수차는 ZA9003 -0.032 μm, SN60WF 0.022 μm, AR40 0.076 μm, SN60AT 0.072 μm으로, SN60WF이 구면 IOL군보다 유의하게 낮았고, ZA9003은 다른 모든 IOL군보다 유의하게 낮았다. 구면수차와 초점심도는 유의한 상관관계를 보였다. 결론: 비구면 IOL는 박명시 대비감도가 구면 IOL보다 우수하며, 초점심도도 구면 IOL에 필적하는 결과를 보였다. 인공수정체의 선택 시 개인 각막의 수차를 참조하여 선택하는 것이 바람직하다.
Abstract
Purpose: To compare optical performances in eyes implanted with aspheric and spherical intraocular lenses (IOLs) after cataract surgery. Methods: In 88 eyes of 69 patients, spherical (Sensar AR40; Acrysof natural SN60AT) or aspherical (Tecnis ZA9003; Acrysof IQ SN60WF) IOLs were implanted. After one month, contrast sensitivity, depth of focus, and spherical aberration were measured and compared between the groups. Results: Contrast sensitivities of ZA9003 and SN60WF were significantly higher in 12,18 cycles per degree (CPD) under photopic conditions and were also higher in 6,12,18 CPD under mesopic conditions compared to those of respective spherical IOLs. Depths of focus were 1.31 D in ZA9003, 1.67 D in SN60WF, 1.52 D in AR40, and 1.49 in SN60AT, and the differences were not significant. Spherical aberration (Z40) with a 4 mm pupil was -0.032 μm in ZA9003, 0.022 μm in SN60WF, 0.076 μm in AR40, and 0.072 μm in SN60AT. Spherical aberration of SN60WF was significantly lower than spherical IOLs, and that of ZA9003 had the lowest among all IOL groups. Depth of focus significantly correlated with spherical aberration. Conclusions: Aspheric IOLs were superior in mesopic contrast sensitivity and equal in depth of focus to spherical IOLs. Individual corneal spherical aberration should be considered in the choice of IOLs.
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