웨이브프론트 방식을 이용한 라섹 수술 시 수술 전 다양한 굴절 검사의 정확도 비교
Comparison of the Refractive Error Measurement Using Different Methods in Wavefront-Guided LASEK
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목적: Wavefront guided LASEK에서 수술전 시행한 굴절검사의 정확도를 알아보고, 만족스러운 수술 결과를 위한 nomogram을 찾고자 하였다. 대상과 방법: Wavefront guided LASEK을 시행한 30명 57안을 대상으로 절삭량과 수술 후 굴절량을 바탕으로 예측한 이상적 수술량과수술 전 자동굴절검사, 현성굴절검사, 조절마비하 굴절검사, 조절마비회복 후 굴절검사, Wavescan, iTrace 수차계로 검사한 굴절량의상관관계를 분석하였다. 결과: 조절마비회복 후 굴절검사로 측정한 굴절량이 이상적 수술량과 가장 밀접한 상관관계를 보였으며, 이를 기준으로 이상적 수술량을 예측하는 nomogram의 효과가 유의하였다. 그외로 Wavescan을 이용한 굴절량이 다른 기계적 검사법보다 정확하였다. 결론: 수술 직전 정확하게 시행된 현성굴절검사가 굴절수술을 위한 굴절량 결정에 가장 중요할 것으로 생각되며, wavefront guided LASEK을 위해 시행하는 aberrometer인 wavescan을 이용한 굴절량도 유사한 정확도를 보여 이를 기준으로 한 nomogram의 결정이수술의 정확도를 올리는 데 기여할 것이다.
Abstract
Purpose: To predict the accuracy of preoperative refractive error measurement methods in wavefront-guided laser-assisted subepithelial keratectomy (LASEK) surgery and to formulate a nomogram for satisfactory surgical results. Methods: The medical records of 30 patients (57 eyes) who had undergone wavefront-guided LASEK were reviewed. The ideal surgical ablation amount was defined as the sum of the real surgical ablation amount and the remaining refractive errors. Comparison between the ideal surgical ablation amount and preoperative refractive errors was made using autorefraction,manifest refraction, cycloplegic refraction, postcycloplegic refraction, wavescan, and iTrace aberrometer measurements. Results: The refractive errors measured by the postcycloplegic refraction showed the closest relation with the ideal surgical amount, and the nomogram based on this refraction correlated statistically significantly with the ideal surgical ablation amount. The refractive error using the wavescan also showed more accurate refractive measurements than the autorefractor and iTrace aberrometer. Conclusions: Accurate manifest refraction immediately before surgery is the most important in determining the ablation amount. Additionally, the refractive errors measured with the wavescan, which is an aberrometer used for wavefront-guided LASEK, showed a minimal amount of errors. After reviewing the results, the nomogram based on these 2methods can be concluded to possibly contribute to an increase in the accuracy of surgery.
참고문헌 (18)
- Doane JF, "An introduction to wavefront-guided refractive surgery", Int Ophthalmol Clin, 43, pp.101~117 (2003)
- Charman WN, "Wavefront aberration of the eye: a review", Optom Vis Sci, 68, pp.574~583 (1991)
- Wang L, "Evaluation of refractive error measurements of the wavescan wavefront system and the Tracey wavefront aberrometer", J Cataract Refract Surg, 29, pp.970~979 (2003)
- Reinstein DZ, "Accuracy of the WASCA aberrometer refraction compared to manifest refraction in myopia", J Refract Surg, 22, pp.268~274 (2006)
- 박상준, "WaveScan 수차계의 굴절량과 현성굴절검사 및 자동굴절검사의 굴절량의 비교분석", 대한안과학회지, 50(5), pp.684~690 (2009), 대한안과학회
- Elliott M, "Repeatability and accuracy of automated refraction: a comparison of the Nikon NRK-8000, the Nidek AR-1000, and subjective refraction", Optom Vis Sci, 74, pp.434~438 (1997)
- Kinge B, "Clinical evaluation of the Allergan Humphrey 500 autorefractor and the Nidek AR-1000 autorefractor", Br J Ophthalmol, 80, pp.35~39 (1996)
- Mallen EA, "Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults", Ophthalmic Physiol Opt, 21, pp.101~107 (2001)
- Gwiazda J, "Comparison of spherical equivalent refraction and astigmatism measured with three different models of autorefractors", Optom Vis Sci, 81, pp.56~61 (2004)
- Nayak BK, "A comparison of cycloplegic and manifest refractions on the NR-1000F (an objective auto refractometer)", Br J Ophthalmol, 71, pp.73~75 (1987)
- Ghose S, "Critical evaluation of the NR-1000F auto refractometer", Br J Ophthalmol, 70, pp.221~226 (1986)
- Wesemann W, "Automatic infrared refractors-comparative study", Am J Optom Physiol Opt, 64, pp.627~638 (1987)
- Mcbrien NA, "Clinical evaluation of the Canon Autoref R-1", Am J Optom Physiol Opt, 62, pp.786~792 (1985)
- Raj PS, "Comparative evaluation of the Allergan Humphrey 570 and Canon RK-1 autorefractors. I. Objective refraction in normal subjects", Eye, 6, pp.284~286 (1992)
- Jorge J, "The influence of cycloplegia in objective refraction", Ophthalmic Physiol Opt, 25, pp.340~345 (2005)
- Thibos LN, "Principles of Hartmann-Shack aberrometry", J Refract Surg, 16, pp.S563~565 (2000)
- Liang J, "Objective measurement of wave aberrations of the human eye with the use of a Hartmann-Shack wave-front sensor", J Opt Soc Am A Opt Image Sci Vis, 11, pp.1949~1957 (1994)
- 이상목, "고식적인 라섹과 웨이브프론트 방식을 이용한 라섹 전후의 고위수차의 변화 비교", 대한안과학회지, 48(8), pp.1028~1035 (2007), 대한안과학회