샤임플러그 전안부사진기로 측정한 수술 전 백내장 경화도와 초음파유화술 지표들의 관련성
The Relationship between the Nuclear Density Using Scheimpflug Imaging with Phacoemulsification Parameters
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목적: Pentacam® (Oculus Optikgerate GmbH, Wetzlar, Germany)의 샤임플러그 전안부사진기를 이용한 핵경화도와 초음파유화술지표들 간의 상관관계를 알아보고자 하였다. 대상과 방법: Pentacam®을 이용한 ImageJ를 이용한 ‘maximal nuclear density’, Pentacam® nucleus staging (PNS), lens densitometry 에서의 average value, maximal value 등으로 산출한 수술 전 백내장의 핵경화도와 유효초음파시간, 평형염액 사용량과의 상관관계를 조사였다. 또한 각막내피세포밀도의 수술 전후의 변화와 핵경화도와의 상관관계를 알아보았다. 결과: 유효초음파시간과의 관련성은 ImageJ를 이용한 ‘maximal nuclear density’ (r=0.379, p＜0.01)와 PNS (r=0.367, p＜0.01)는 양의 상관관계를 보였으나 나머지 방법들은 유의한 관계를 보이지 않았다. 평형염액 사용량과의 관련성은 ImageJ를 이용한 ‘maximal nuclear density’ (r=0.279, p=0.03)와 PNS (r=0.286, p=0.04)는 양의 상관관계를 보였으나, 나머지 방법들은 유의하지 않았다. 경면현미경검사에서는 핵경화도가 증가할수록 수술 후 각막내피세포밀도가 감소하는 경향을 보였으나, 통계적으로 유의하지는 않았다. 결론: 수술 전 백내장의 경화도를 측정할 때 ImageJ를 이용한 ‘maximal nuclear density’ 또는 PNS 방법을 이용하는 것이 초음파유화술의 지표들과 연관성을 보임을 알 수 있었다.
Abstract
Purpose: To evaluate the correlation between nuclear density measured using the Pentacam® (Oculus Optikgerate GmbH, Wetzlar, Germany) Scheimpflug imaging system and phacoemulsification parameters. Methods: The nuclear density was measured using maximal nuclear density with ImageJ, Pentacam® nucleus staging (PNS), average value and maximal value in lens densitometry. Intraoperatively, effective phaco time (EPT) and balanced salt solution (BSS) used were noted and compared with the nuclear density calculation methods. As an index of corneal endothelial cells, the changes in cell density (CD) were compared with the nuclear density. Results: Regarding EPT, maximal nuclear density with ImageJ (r = 0.379, p < 0.01) and PNS (r = 0.367, p < 0.01) were correlated positively, but the other methods were not correlated. Concerning BSS used, maximal nuclear density with ImageJ (r = 0.279, p = 0.03) and PNS (r = 0.286, p = 0.04) were positively correlated, but the other methods were not correlated. The specular microscopy showed that as the nuclear density increased, the postoperative CD tended to decrease, but without statistical significance. Conclusions: Preoperative nuclear density measurements using maximal nuclear density with ImageJ or PNS were correlated with phacoemulsification parameters.
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