전방깊이와 안축장에 따른 인공수정체 삽입 후 굴절 오차의 경향 (Effects of Anterior Chamber Depth and Axial Length on Refractive Error after Intraocular Lens Implantation)

서지정보

· 발행기관 : 대한안과학회
· 수록지 정보 : 대한안과학회지 / 51권 / 2호 / 195 ~ 202페이지
· 저자명 : 맹효성, 류은혜, 정태영, 정의상

초록

목적: 백내장 수술 시 전방깊이와 안축장에 따른 술 전후 예상 굴절력과 실제 굴절력의 오차 경향성을 알아보고 이를 통해 인공수정체도수결정에 미치는 영향을 보고하는 바이다.
대상과 방법: 62명 82안을 대상으로 IOL MasterⓇ로 전방깊이 및 안축장을 측정하였으며, SRK II, SRK/T 공식을 통해 인공수정체 도수를 계산하였다. 환자군을 전방깊이 및 안축장에 따라서 각각 3그룹으로, 총 9그룹으로 나눈 뒤 술 후 1개월 째 굴절 오차의 경향을분석하였다.
결과: 각 그룹의 굴절 오차는 원시화 편위를 보였으며, SRK/T 공식에서만 각 그룹 간에 통계적으로 유의한 차이를 보였다(p<0.05).
SRK/T 공식에서 전방깊이와 안축장을 모두 고려한 평균 실제오차의 변화는 안축장이 길수록 오차 변화가 커졌으며 특히 전방깊이가얕은군(<2.5 mm)에서 큰 오차 변화를 보였다(p>0.05). 전방깊이가 깊을수록 굴절 오차가 커졌으며 특히 안축장이 짧은군(<22.5 mm)에서 큰 오차 변화를 보였다(p<0.05).
결론: 전방깊이 및 안축장을 고려한 술 후 굴절 오차의 경향을 파악하여 인공수정체 도수를 결정하여야 한다.

영어초록

Purpose: To investigate the error tendency between preoperative expected refraction and postoperative manifest refraction based on anterior chamber depth (ACD) and axial length (AXL) in cataract surgery cases and to report how ACD and AXL affect determination of intraocular lens (IOL) power.
Methods: We retrospectively studied 82 eyes of 62 patients who underwent cataract surgery in our hospital between August 2008 and January 2009. Anterior chamber depth and AXL were measured using IOL MasterⓇ, and IOL power was calculated using the SRK II and SRK/T formulae. Patients were divided into three groups based on ACD and into another three based on AXL. Refractive error (RE) was analyzed one month after surgery.
Results: Though the RE of each group showed a tendency for hyperopic shifts, only those obtained with the SRK/T formula showed statistically significant differences between groups (p＜0.05). Using the SRK/T formula, we found that an increasing AXL was associated with an increased hyperopic shift. This was more pronounced in those with shallow ACD (<2.5 mm), though the difference was not statistically significant. Similarly, an increase in ACD was associated with an increased hyperopic shift, and this difference was more pronounced in those with short AXL (＜22.5 mm), and this time the difference was statistically significant.
Conclusions: As ACD and AXL significantly affect RE, both should be considered when investigating postoperative RE tendency and when determining IOL power. Postoperative RE will be greatly affected by a short AXL or a shallow ACD, and therefore these factors should be considered in IOL power determination.

참고자료

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