펨토초레이저 상피투과 활모양각막절개 시 절개부 개방이 난시교정에 미치는 영향
Astigmatism Correction during Femtosecond Laser-assisted Transepithelial Arcuate Keratotomy Using the Wound Open Method
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목적: 각막난시교정을 위한 펨토초레이저 상피투과 활모양각막절개 시 절개부를 그대로 유지하는 방법에 비해 절개부를 개방하는 방법에서의 난시교정 효과를 살펴보고자 하였다. 대상과 방법: 2016년 4월부터 2018년 12월까지 삼성서울병원 안과에서 펨토초레이저 백내장수술을 받을 환자를 대상으로 후향적으로 조사하였다. 절개부 개방군, 절개부 유지군에 대해 수술 전후로 각막난시의 크기 비교 및 벡터분석을 시행하였다. 결과: 절개부 개방군과 절개부 유지군에서 target induced astigmatism (TIA)가 각각 1.28 ± 0.55, 1.26 ± 0.29디옵터, surgically induced astigmatism (SIA)가 각각 0.80 ± 0.52, 0.53 ± 0.32디옵터, correction index (CI)가 각각 0.63 ± 0.28, 0.43 ± 0.26으로, 절개부 유지군보다 절개부 개방군에서 난시교정 효과가 더 큰 것으로 나타났다(p=0.048, p=0.025). TIA가 1.2디옵터 미만인 하위집단에서는 두 군의 SIA 및 CI가 유의한 차이가 없었으나, TIA가 1.2디옵터 이상인 하위집단에서는 SIA가 절개부 개방군, 유지군에서 각각 1.09 ± 0.59, 0.54 ± 0.37디옵터, CI는 0.60 ± 0.28, 0.36 ± 0.23으로 절개부 개방군에서 난시교정 효과가 큰 것으로 나타났다(p=0.022, p=0.047). 결론: 펨토초레이저 상피투과 활모양각막절개 시 절개부를 개방하는 방식이 절개부를 유지하는 방식보다 더 큰 난시교정 효과를 보였다.
Abstract
Purpose: The purpose of this study was to compare corneal astigmatism correction between “wound open” and “wound intact” methods during femtosecond laser-assisted transepithelial arcuate keratotomy. Methods: From April 2016 to December 2018, a retrospective survey was conducted on patients undergoing femtosecond laser cataract surgery at the Ophthalmology Department of Samsung Medical Center. Size comparison and vector analysis of corneal astigmatism before and after surgery were performed in the wound open and wound intact groups. Results: In the wound open and wound intact groups, the target-induced astigmatism (TIA) was 1.28 ± 0.55; and 1.26 ± 0.29 diopters, the surgically induced astigmatism (SIA) was 0.80 ± 0.52; and 0.53 ± 0.32 diopters, and the correction index (CI) was 0.63 ± 0.28; and 0.43 ± 0.26, respectively. The astigmatism correction was superior in the wound open group (p = 0.048, p = 0.025). In a subgroup with TIA < 1.2 diopters, there were no significant differences in SIA or CI between the two groups; however, in the subgroup with a TIA > 1.2 diopters, the SIA was 1.09 ± 0.59; and 0.54 ± 0.37 diopters and the CI was 0.60 ± 0.28; and 0.36 ± 0.23 in the wound open and wound intact groups, respectively (p = 0.022, p = 0.047). Thus, astigmatism correction was superior in the wound open group. Conclusions: The wound open method during femtosecond laser-assisted transepithelial arcuate keratotomy was superior for astigmatism correction compared to the wound intact method.
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