소절개창을 이용한 백내장 수술에서 절개창 길이에 따른 술 후 난시 비교

• Published in: Daihan angwa haghoi jabji p. 5
• Main Authors: 구희찬, 김효진, 주천기
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 01.03.2005
• Subjects: 안과학
• ISSN: 0378-6471; 2092-9374

목적 : 백내장수술 시 3.0 mm 절개창을 이용한 경우와 3.2~3.4 mm까지 확장한 절개창을 이용한 경우의 술 후 난시 정도를 비교하였다. 대상과 방법 : 202명 205안을 대상으로 귀쪽에 3.0 mm 투명각막 직선절개 후 주사형 실리콘인공수정체를 삽입한 군을 A군, 같은 인공수정체를 3.2 mm로 확장한 절개창으로 삽입한 군을 B군, 3.4 mm 절개창으로 접힘형 아크릴인공수정체를 삽입한 군을 C군, 3.2 mm 절개창으로 주사형 아크릴인공수정체를 삽입한 군을 D군으로 하였다. 술 전, 술 후 1주, 2개월에 나안시력, 자동굴절계, 각막곡률계를 측정하였다. 결과 : 4군간의 수술 전 난시는 유의한 차이가 없었다. 수술 1주 후 평균 난시는 A군에서 가장 적었고, A와 C, A와 D군간에 유의한 차이를 보였으며(P<.05), 술 후 2개월에는 4군간 유의한 차이가 없었다(P=.945). 한편 수술 1주 후 수술로 유발된 난시도 A군에서 가장 적었고, A와 C, A와 D군간에 유의한 차이를 보였으며(P<.05), 술 후 2개월에는 4군간 유의한 차이가 없었다(P=.985). 결론 : 절개창을 넓히지 않고 3.0 mm 투명각막 직선절개만을 이용할 때 술 후 초기부터 난시를 안정화시켜 수술의 예후에 도움이 될 것으로 보인다. Purpose: To compare surgically-induced corneal astigmatism after 3.0 mm-sized incision and 3.2~3.4 mm-sized extended incision in cataract surgery. Methods: This study included 205 eyes of 202 patients having phacoemulsification with temporal clear corneal incision. The eyes were classified into 4 groups according to IOL type and incision size: Group A, silicone IOL was inserted using the injector through 3.0 mm sized incision; Group B, silicone IOL was inserted using the injector through 3.2 mm sized incision; Group C, acrylic IOL was inserted using the forceps through 3.4 mm sized incision; and Group D, acrylic IOL was inserted using the injector through 3.2 mm sized incision. The uncorrected visual acuity, autorefractometry, and keratometry were taken preoperatively and at 1 week and 2 months postoperatively. Results: Preoperatively, there was no significant difference between the 4 groups in preoperative astigmatism. On the seven operative day, there was significant difference between the 4 groups with one-way ANOVA test (P=.044), and between A and C, and between A and D with post-hoc tests (P<.05). There was no significant difference between the 4 groups at 2 months postoperatively (P=.945). On the seven operative day, there were significant differences between the 4 groups in surgically-induced corneal astigmatism with one-way ANOVA test (P=.009), and between A and C, and between A and D with post-hoc tests (P<.05). There was no significant difference between the 4 groups at 2 months postoperatively (P=.985). Conclusions: The 3.0 mm-sized clear corneal incision without extension induced early stabilization of surgically-induced corneal astigmatism and rapid visual rehabilitation. KCI Citation Count: 7