외상으로 인한 각막혼탁 환자에서 RGP렌즈의 시력교정 효과
Vision-Correction Effect of RGP Contact Lens in Patients With Corneal Opacity Following Repaired Corneal Perforations
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목적: 외상으로 인해 각막혼탁이 발생한 환자에서 RGP (rigid gas permeable)렌즈의 시력교정 효과를 알아보고자 하였다. 대상과 방법: 외상 후 각막열상으로 일차 봉합술 시행 후 RGP렌즈를 착용한 환자 10명의 수술 후 평균 3개월의 나안시력, 굴절검사, 각막지형도, 각막곡률의 만곡도, 안경교정시력과 RGP렌즈 착용 시 최대 교정시력을 검사하였다. 결과: 8명의 환자는 각막중심부에, 2명은 각막주변부에 혼탁이 있었으며, 4명의 환자는 위수정체 소견을 보였다. 수술 후 평균 3개월 후의 LogMAR 나안시력은 1.14 ± 0.53이었으며, 각막지형도 검사에서 모두 부정난시소견을 보였고, 평균각막난시는 4.03 ± 4.06D이 었다. 안경교정시 LogMAR 최대교정시력은 0.91 ± 0.64, RGP렌즈 착용 시 시력은 0.25 ± 0.35이었다. RGP렌즈 착용 시 시력은 안경 교정시력보다 통계학적으로 유의한 호전을 보였다(p = 0.005). 환자들은 하루 평균 6시간 이상 렌즈를 추적관찰 기간(12.10 ± 7.80개 월) 동안 착용하였다. 결론: 각막열상 후 각막혼탁 및 부정난시로 인한 시력저하가 있는 환자에서 RGP렌즈의 착용을 시행하는 것이 유용할 것으로 생각한다.
Abstract
Purpose: To investigate the effect of rigid gas permeable (RGP) contact lenses in patients with corneal scar and opacity following repair of corneal perforations. Methods: A total of 10 eyes from 10 patients undergoing repair of corneal perforating injuries and fitted with RGP contact lenses were examined in the present study. The mean postoperative 3-month visual acuities, refraction, corneal topography, keratometry, best corrected visual acuities with spectacles and RGP lenses at an average of postoperative 3 months were evaluated. Results: Eight eyes had corneal opacities at the central and 2 eyes at the peripheral portion. Four patients had previous cataract surgery or cataract surgery with intraocular lens insertion due to traumatic cataract. The mean postoperative 3-month LogMAR visual acuity was 1.14 ± 0.53. Corneal topography showed irregular astigmatism in all patients and the mean keratometric astigmatism was 4.03 ± 4.06 diopters. The mean best corrected LogMAR visual acuities with spectacles was 0.91 ± 0.64 and with the RGP contact lens was 0.25 ± 0.35. A comparative analysis of improvement in visual acuity with the RGP contact lens over spectacle correction was found to be statistically significant (p = 0.005). Patients wore the lenses for more than 6 hours daily for the mean follow-up period (12.10 ± 7.80 months). Conclusions: In patients with corneal scar and opacity following repair of corneal perforations, RGP contact lens fitting should be considered first before surgical corrections such as keratoplasty.
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