각막절개 위치와 크기에 따른 난시교정인공수정체의 난시교정의 정확성
Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 각막절개 방법에 따른 난시교정인공수정체 삽입 후의 잔여난시를 비교하여 그 방법에 따른 정확성을 비교하였다. 대상과방법: 2014년 1월부터 2017년 3월까지 수정체초음파유화술 및 난시교정인공수정체삽입수술을 받은 98명의 환자, 98안을 대상으로 후향적 연구를 하였다. 각막절개창은 모두 가파른 난시 축에 내었고, 각막 상측에 절개창을 낸 직난시 군을 1군(n=54), 각막의 이측에 절개창을 낸 도난시 군을 2군(n=44)으로 나누었다. 각 군에서 2.75 mm 블레이드를 이용하여 절개창을 낸 군(소그룹 1)과 2.2mm 블레이드를 사용한 군(소그룹 2)의 두 소집단으로 나누었다. 수술 전 굴절률 및 자동각막곡률을 측정하였고, 술 후 잔여난시값과 난시값의 감소량을 계산하였다. 결과: 술 후 나안시력, 최대교정시력, 굴절난시, 각막난시는 두 군 모두 유의한 호전을 보였다. 각막난시값 감소량은 1군과(0.38 ±0.30D), 2군에서(0.48 ± 0.38D) 유의한 차이를 보이지 않았다(p=0.244).술 후 잔여난시는 두 군 간 유의한 차이는 없었다. 1군과 2군 모두 2.75 mm 각막절개(각각 0.46 ± 0.31D, 0.61 ± 0.36D)는 2.2 mm (각각 0.25 ± 0.25D, 0.23 ± 0.29D)에 비해 각막난시값 감소량이 유의하게 많았다. 결론: 난시교정인공수정체 삽입 시 각막절개의 위치와 크기에 따른 난시 유발의 크기를 정확하게 적용하여 계산하면 술 후 난시를 정확하게 예측할 수 있을 것으로 사료된다.
Abstract
Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.
참고문헌 (21)
- Hoffmann PC, "Analysis of biometry and prevalence data for corneal astigmatism in 23, 239 eyes", J Cataract Refract Surg, 36, pp.1479~1485 (2010)
- He W, "Clinical efficacy of implantation of toric intraocular lenses with different incision positions : a comparative study of steep-axis incision and non-steep-axis incision", BMC Ophthalmol, 17, pp.132~ (2017)
- Shimizu K, "Toric intraocular lenses : correcting astigmatism while controlling axis shift", J Cataract Refract Surg, 20, pp.523~526 (1994)
- Ahmed, II, "Visual function and patient experience after bilateral implantation of toric intraocular lenses", J Cataract Refract Surg, 36, pp.609~616 (2010)
- Bauer NJ, "Astigmatism management in cataract surgery with the AcrySof toric intraocular lens", J Cataract Refract Surg, 34, pp.1483~1488 (2008)
- De Silva DJ, "Evaluation of a toric intraocular lens with a Z-haptic", J Cataract Refract Surg, 32, pp.1492~1498 (2006)
- Entabi M, "Injectable 1-piece hydrophilic acrylic toric intraocular lens for cataract surgery : efficacy and stability", J Cataract Refract Surg, 37, pp.235~240 (2011)
- Mendicute J, "Foldable toric intraocular lens for astigmatism correction in cataract patients", J Cataract Refract Surg, 34, pp.601~607 (2008)
- Poll JT, "Correction of astigmatism during cataract surgery : toric intraocular lens compared to peripheral corneal relaxing incisions", J Refract Surg, 27, pp.165~171 (2011)
- Till JS, "Toric intraocular lens implantation : 100 consecutive cases", J Cataract Refract Surg, 28, pp.295~301 (2002)
- Hill W, "Expected effects of surgically induced astigmatism on AcrySof toric intraocular lens results", J Cataract Refract Surg, 34, pp.364~367 (2008)
- Grosvenor T, "Etiology of astigmatism", Am J Optom Physiol Opt, 55, pp.214~218 (1978)
- Saunders H, "Age-dependence of human refractive errors", Ophthalmic Physiol Opt, 4, pp.107~ (1984)
- Howland HC, "Photokeratometric and photorefractive measurements of astigmatism in infants and young children", Vision Res, 25, pp.73~81 (1985)
- Hayashi K, "Topographic analysis of the changes in corneal shape due to aging", Cornea, 14, pp.527~532 (1995)
- Hayashi K, "Corneal shape changes of the total and posterior cornea after temporal versus nasal clear corneal incision cataract surgery", Br J Ophthalmol, 103, pp.181~185 (2019)
- Kim YJ, "Change in anterior and posterior curvature after cataract surgery", J Refract Surg, 32, pp.754~759 (2016)
- Kohnen T, "Comparison of the induced astigmatism after temporal clear corneal tunnel incisions of different sizes", J Cataract Refract Surg, 21, pp.417~424 (1995)
- Hirnschall N, "Evaluation of factors influencing the remaining astigmatism after toric intraocular lens implantation", J Refract Surg, 30, pp.394~400 (2014)
- Cornut T, "Refractive outcomes and precision in toric intraocular lens alignment using an automated alignment system", J Fr Ophtalmol, 41, pp.291~301 (2018)
- Raucau M, "Toric lens implantation in cataract surgery : automatic versus manual horizontal axis marking, analysis of 50 cases", J Fr Ophtalmol, 41, pp.136~144 (2018)