한국안광학회지 (Journal of Korean Ophthalmic Optics Society)

한국안광학회 (The Korean Ophthalmic Optics Society)
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굴절교정수술을 받은 근시안의 각막 비구면도와 광학적 특성 평가

Corneal Asphericity and Optical Performance after Myopic Laser Refractive Surgery

  • 김정미 (을지대학교 대학원 안경광학과) ;
  • 이아영 (을지대학교 대학원 안경광학과) ;
  • 이군자 (을지대학교 대학원 안경광학과)
  • Kim, Jeong-Mee (Graduate School Dept. of Optometry, Eulji University) ;
  • Lee, A-Young (Graduate School Dept. of Optometry, Eulji University) ;
  • Lee, Koon-Ja (Graduate School Dept. of Optometry, Eulji University)
  • 투고 : 2013.04.23
  • 심사 : 2013.06.15
  • 발행 : 2013.06.30
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초록

목적: 엑시머 레이저 근시굴절교정수술을 받은 사람의 각막 비구면도, 시력, 고위수차를 정시안과 비교 평가하였다. 방법: 단안의 나안 시력이 1.0 이상인 근시 굴절교정수술을 받은 23명(나이: $23.0{\pm}2.5$세)과 20명($21.0{\pm}2.6$세)의 정시안을 대상으로 밝은 조명(photopic)과 중등도(mesopic) 조명상태에서 대비도를 가지는 시력표(100% 및 10%)를 이용하여 시력검사를 하였고, wavefront 수차 분석기(KR-1W, Topcon, Japan)를 이용하여 각막의 비구면계수와 4mm와 6 mm의 동공크기에 따른 눈 전체의 고위수차와 각막의 고위수차를 측정하여 비교하였다. 결과: 굴절교정 수술안과 정시안에서 대비도에 따른 시력은 유의한 차이를 보이지 않았다. 안구 수차(ocular aberrations)에서 전체 고위수차, 4차수차, 구면수차는 동공크기 6 mm상태에서 굴절교정 수술안에서 높게 나타났고, 두 그룹 사이에 유의한 차이를 보였다(p=0.045, p<0.001, p<0.001). 각막의 구면 수차(corneal spherical aberrations)는 동공크기 4 mm와 6 mm상태에서 모두 굴절교정 수술 안에서 더 높게 측정되었고 유의한 차이를 보였다(p<0.01, p<0.001). 각막의 전체고위수차와 4차수차는 동공크기 6 mm 상태에서만 굴절교정 수술안에서 더 크게 나타났고 통계적으로 유의하였다(p<0.001, p<0.001). 정시안의 비구면계수와 구면수차는 동공크기 4 mm와 6 mm 상태에서 안구 수차(r=0.442, p=0.004, r=0.519, p<0.001) 와 각막수차(r=0.358, p=0.023, r=0.646, p<0.001) 모두에서 유의한 상관성을 나타내었으나, 굴절교정 수술안에서는 상관성이 없었다. 결론: 각막굴절교정 수술안의 경우 시력은 정상수준을 나타내고 있으나 동공크기가 커지면 수차가 증가하여 동공이 커지는 야간에는 시력의 질에 영향을 줄 수 있을 것으로 사료된다.

Purpose: To compare corneal asphericity, visual acuity (VA), and ocular and corneal higher-order aberrations (HOAs) between myopic refractive surgery and emmetropia groups. Methods: Twenty three subjects ($23.0{\pm}2.5$ years) who underwent myopic refractive surgery and twenty emmetropia ($21.0{\pm}206$ years) were enrolled. The subjects'criteria were best unaided monocular VA of 20/20 or better in both two groups. High and low contrast log MAR visual acuities were measured under photopic and mesopic conditions. Corneal and ocular HOAs were measured using Wavefront Analyzer (KR-1W, Topcon) for 4 mm and 6 mm pupils. Corneal asphericity was taken by topography in KR-1W. Results: There was no significant difference in VA between two groups under either photopic or mesopic conditions. In ocular aberrations, there were significant differences in total HOAs, fourthorder and spherical aberration (SA) for a 6 mm between two groups (p=0.045, p<0.001, and p<0.001, respectively). In corneal aberrations, there was a significant difference in SA for 4 mm (p=0.001) and 6 mm (p<0.001) pupils between two groups and there were statistically significant differences in total HOAs (p<0.001) and fourth-order aberrations (p<0.001) between two groups for a 6 mm pupil. There was a significant correlation in emmetropia between Q-value and SA in ocular aberrations for 4 mm and 6 mm pupils (r=0.442, p=0.004, and r=0.519, p<0.001) and in corneal aberrations for 4 mm and 6 mm pupils (r=0.358, p=0.023, and r=0.646, p<0.001). No significant correlations were found between Q-value and SA in refractive surgery group. Conclusions: VA in myopic refractive surgery is better than or similar to emmetropia. Nevertheless, the more increasing pupil size is, the more increasing aberrations are. Thus, it could have an influence on the quality of vision at night.

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피인용 문헌

  1. Wavefront Higher-order Aberrations in Young Myopic Adults vol.24, pp.3, 2019, https://doi.org/10.14479/jkoos.2019.24.3.315