플랜지형 인공수정체 공막내고정술에서 Double-needle Stabilizer의 효과
Effect of Double-needle Stabilizer during Flanged Intrascleral Fixation of Intraocular Lens
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 플랜지형 인공수정체 공막내고정술에서 double-needle stabilizer 사용에 따른 임상 결과 차이를 비교하였다. 대상과 방법: 2019년 6월부터 2021년 6월까지 플랜지형 인공수정체 공막내고정술을 시행받은 후 1년 이상 경과 관찰이 가능했던 44안을 대상으로 후향적 연구를 진행하였다. 수술 시 double-needle stabilizer를 사용하지 않은 군(1군, 18안)과 사용한 군(2군, 26안)으로나누어 최대교정시력, 구면렌즈대응치, 굴절예측오차, 인공수정체 기울어짐과 중심이탈 및 합병증을 관찰하였다. 결과: Double-needle stabilizer 사용에 따라 두 군으로 나누어 비교하였을 때, 술 후 최대교정시력, 구면렌즈대응치 및 굴절예측오차에는 유의한 차이가 없었다(p=0.672, p=0.131, p=0.247). 인공수정체 기울어짐은 1군에서 수평 3.96 ± 2.01°, 수직 4.17 ± 2.07°, 2군에서는 수평 2.59 ± 2.02°, 수직 2.50 ± 1.92°로 2군에서 유의하게 적었고(p=0.038, p=0.015), 인공수정체 중심이탈 또한 1군에서 수평 0.44 ± 0.21 mm, 수직 0.45 ± 0.20 mm, 2군에서 수평 0.25 ± 0.09 mm, 수직 0.27 ± 0.13 mm로 2군에서 유의하게적었다(p=0.001, p=0.004). 결론: 플랜지형 인공수정체 공막내고정술 시 double-needle stabilizer의 사용은 술 후 인공수정체의 기울어짐과 중심이탈을 유의하게감소시켰으며, 술 후 시력의 질을 향상시키는 데 도움이 될 수 있다.
Abstract
Purpose: We evaluated the difference in clinical outcome according to the use of double-needle stabilizer in flanged intrascleral fixation of intraocular lens (IOL). Method: We retrospectively analyzed the medical records of 44 patients (44 eyes) who underwent flanged intrascleral fixation of IOL. Groups 1 and 2 (respectively) underwent surgery that did not and did employ a double-needle stabilizer. We evaluated the best-corrected visual acuity (BCVA), intraocular pressure, spherical equivalent (SE), refractive prediction error (RPE), IOL tilt and decentration, and other complications. Results: The postoperative BCVA, SE, and RPE did not differ between the two groups (p = 0.672, p = 0.131, p = 0.247). IOL tilt was significantly less in group 2 than in group 1 (p = 0.038, p = 0.015 [horizontal and vertical]) (3.96 ± 2.01° horizontally and 4.17 ± 2.07° vertically in group 1; 2.59 ± 2.02° horizontally and 2.50 ± 1.92° vertically in group 2). IOL decentration was also significantly less in group 2 than in group 1 (p = 0.001, p = 0.004 [horizontal and vertical]) (0.44 ± 0.21 mm horizontally and 0.45 ± 0.20 mm vertically in group 1; 0.25 ± 0.09 mm horizontally and 0.27 ± 0.13 mm vertically in group 2). Conclusions: Use of a double-needle stabilizer during flanged intrascleral fixation of IOL significantly reduced postoperative IOL tilt and decentration, and may thus improve postoperative visual quality.
참고문헌 (37)
- Engren AL, "Anterior chamber depth, intraocular lens position, and refractive outcomes after cataract surgery", J Cataract Refract Surg, 39, pp.572~577 (2013)
- asaki K, "Measurement of postoperative intraocular lens tilting and decentration using Scheimpflug images", J Cataract Refract Surg, 15, pp.454~457 (1989)
- Drolsum L, "Long-term follow-up of secondary flexible, open-loop, anterior chamber intraocular lenses", J Cataract Refract Surg, 29, pp.498~503 (2003)
- Biro Z, "Results and complications of secondary intraocular lens implantation", J Cataract Refract Surg, 19, pp.64~67 (1993)
- Downing JE, "Ten-year follow up comparing anterior and posterior chamber intraocular lens implants", Ophthalmic Surg, 23, pp.308~315 (1992)
- Evereklioglu C, "Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses", J Cataract Refract Surg, 29, pp.301~308 (2003)
- Lewis JS, "Ab externo sulcus fixation", Ophthalmic Surg, 22, pp.692~695 (1991)
- Buckley EG, "Safety of transscleral-sutured intraocular lenses in children", J AAPOS, 12, pp.431~439 (2008)
- Price MO, "Late dislocation of scleral-sutured posterior chamber intraocular lenses", J Cataract Refract Surg, 31, pp.1320~1326 (2005)
- Vote BJ, "Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation", Am J Ophthalmol, 141, pp.308~312 (2006)
- 이유림, "탈구된 인공수정체 공막고정 및 홍채고정의 단기 임상결과 비교", 대한안과학회지, 58(10), pp.1131~1137 (2017), 대한안과학회
- 오신엽, "인공수정체 공막고정술에서 난시변화와 임상결과 및 이에 영향을 미치는 인자", 대한안과학회지, 55(10), pp.1452~1459 (2014), 대한안과학회
- Gabor SG, "Sutureless intrascleral posterior chamber intraocular lens fixation", J Cataract Refract Surg, 33, pp.1851~1854 (2007)
- Agarwal A, "Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules", J Cataract Refract Surg, 34, pp.1433~1438 (2008)
- Yamane S, "Flanged intrascleral intraocular lens fixation with double-needle technique", Ophthalmology, 124, pp.1136~1142 (2017)
- Yamane S, "Needle stabilizer for flanged intraocular lens fixation", Retina, 39, pp.801~ (2019)
- Do JR, "A 1-year prospective comparative study of sutureless flanged intraocular lens fixation and conventional sutured scleral fixation in intraocular lens dislocation", Ophthalmologica, 244, pp.68~75 (2021)
- Weikert MP, "Astigmatism induced by intraocular lens tilt evaluated via ray tracing", J Cataract Refract Surg, 44, pp.745~749 (2018)
- Oshika T, "Ocular higher-order wavefront aberration caused by major tilting of intraocular lens", Am J Ophthalmol, 140, pp.744~746 (2005)
- Uozato H, "What is the tolerable limits of the IOL tilt and decentration", Jpn Rev Clin Ophthalmol, 82, pp.2308~2311 (1988)
- Oshika T, "Influence of tilt and decentration of scleral-sutured intraocular lens on ocular higher-order wavefront aberration", Br J Ophthalmol, 91, pp.185~188 (2007)
- Holladay JT, "Evaluating the intraocular lens optic", Surv Ophthalmol, 30, pp.385~390 (1986)
- Howland HC, "A subjective method for the measurement of monochromatic aberrations of the eye", J Opt Soc Am, 67, pp.1508~1518 (1977)
- Chalita MR, "Correlation of aberrations with visual acuity and symptoms", Ophthalmol Clin North Am, 17, pp.135~142 (2004)
- Holladay JT, "A new intraocular lens design to reduce spherical aberration of pseudophakic eyes", J Refract Surg, 18, pp.683~691 (2002)
- Atchison DA, "Design of aspheric intraocular lenses", Ophthalmic Physiol Opt, 11, pp.137~146 (1991)
- Altmann GE, "Optical performance of 3 intraocular lens designs in the presence of decentration", J Cataract Refract Surg, 31, pp.574~585 (2005)
- Kemer Atik B, "The effect of intraocular lens tilt on visual outcomes in scleral-fixated intraocular lens implantation", Int Ophthalmol, 40, pp.717~724 (2020)
- Piers PA, "Theoretical comparison of aberration-correcting customized and aspheric intraocular lenses", J Refract Surg, 23, pp.374~384 (2007)
- Abbey AM, "Sutureless scleral fixation of intraocular lenses: outcomes of two approaches. The 2014Yasuo Tano memorial lecture", Graefes Arch Clin Exp Ophthalmol, 253, pp.1~5 (2015)
- Su D, "Refractive outcomes after pars plana vitrectomy and scleral fixated intraocular lens with Gore-Tex suture", Ophthalmology Retina, 3, pp.548~552 (2019)
- Chandra A, "Prevalence of ectopia lentis and retinal detachment in Marfan syndrome", Acta Ophthalmol, 92, pp.e82~3 (2014)
- Miraldi Utz V, "Surgical management of lens subluxation in Marfan syndrome", J AAPOS, 18, pp.140~146 (2014)
- Barbara R, "Is an iris claw IOL a good option for correcting surgically induced aphakia in children? A review of the literature and illustrative case study", Eye (Lond), 30, pp.1155~1159 (2016)
- Herschler J, "Trabecular damage due to blunt anterior segment injury and its relationship to traumatic glaucoma", Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 83, pp.239~248 (1977)
- Singh H, "Laser iridotomy for pseudophakic reverse pupillary block in patients with pupillary optic capture after sulcus-placed intraocular lenses", J Cataract Refract Surg, 43, pp.299~ (2017)
- Choi SR, "Risk factors for and management of pupillary intraocular lens capture after intraocular lens transscleral fixation", J Cataract Refract Surg, 43, pp.1557~1562 (2017)