2.2 mm 동축 소절개 백내장 수술과 2.85 mm 동축 절개 백내장 수술 후의 후면각막난시변화

Surgically Induced Posterior Corneal Astigmatism in 2.2 mm Microcoaxial Cataract Surgery Versus 2.85 mm Coaxial Conventional Cataract Surgery

목적: 2.2 mm 동축 소절개와 2.85 mm 절개 백내장 수술 후 후면각막난시 변화를 비교하여 전체각막난시의 변화에 미치는 영향을 분석하고자 하였다. 대상과 방법: 2.2 mm 동축 소절개 백내장 수술 26안(Microcoaxial cataract surgery, MCCS군)과 2.85 mm 절개 고식적 백내장 수술 30안(Conventional cataract surgery, CCS군)을 대상으로 술 전후의 전면, 후면, 전체각막난시를 측정하여, 수술유발 후면난시 및 수술유발 전면난시 그리고 수술유발 전체난시를 비교하였다. 각막난시는 Pentacam？？ (Oculus, Wetzlar, Germany)으로 측정하였고, 나안 및 교정시력과 각막 전, 후면의 고위수차를 술 전, 술 후 1일, 1개월, 2개월에 측정하였다. 결과: 수술유발 후면난시는 두 군 간에 차이는 없었고, 수술유발 전면난시와 수술유발 전체난시는 MCCS군이 적었다(p=0.005, p=0.049). CCS군은 수술유발 후면난시와 수술유발 전체난시 간에 유의한 상관관계를 보였으며(p=0.01, r=0.563), 두 군 모두 수술유발 전면난시와 수술유발 전체난시는 유의한 상관관계를 보였다(CCS군: p=0.00, r=0.855; MCCS군: p=0.039, r=0.407). 결론: 수술유발 후면난시는 MCCS군과 CCS군 간에 유의한 차이를 보이지 않았으나, CCS군에서는 수술유발 후면난시가 수술유발 전체난시에 영향을 주는 것으로 나타났다. 전면 및 후면각막난시를 모두 고려할 때, 2.2 mm 동축 소절개 백내장 수술이 수술유발 전체난시에 대해 고식적 백내장 수술보다 영향이 적었다.

Purpose: To compare the surgically induced posterior astigmatism of microcoaxial cataract surgery using a 2.2 mm incision and conventional cataract surgery using a 2.85 mm incision. Methods: This study included 56 eyes that underwent phacoemulsification and intraocular lens insertion. Subjects were divided into 2 groups: 26 eyes receiving a microcoaxial cataract surgery using a 2.2 mm incision (MCCS group) and 30 eyes receiving a conventional cataract surgery using a 2.85 mm incision (CCS group). Anterior, posterior and total corneal astigmatism was measured. The surgically induced anterior astigmatism, surgically induced posterior astigmatism and surgically induced total astigmatism were compared between MCCS and CCS groups. Corneal astigmatism was measured using a Pentacam？？ device (Oculus, Wetzlar, Germany), uncorrected visual acuity, best corrected visual acuity and corneal aberrations of front and rear side was measured preoperatively and at 1 day, 1 month and 2 months postoperatively. Results: There was no difference in surgically induced posterior astigmatism between CCS and MCCS groups, however, surgically induced anterior astigmatism and surgically induced total astigmatism were significantly lower in the MCCS group than in the CCS group (p = 0.005 and, p = 0.036, respectively). There was a significant positive linear correlation between surgically induced posterior astigmatism and surgically induced total astigmatism in the CCS group (p = 0.01, r = 0.563). There was also a significant positive linear correlation between surgically induced anterior astigmatism and surgically induced total astigmatism in both CCS and MCCS groups (CCS group: p = 0.00, r = 0.855; MCCS group: p = 0.039, r = 0.407). Conclusions: There was no significant difference in the surgically induced posterior astigmatism between the MCCS and CCS groups. However, surgically induced posterior astigmatism significantly affected surgically induced total astigmatism in the CCS group but not in the MCCS group. Considering both anterior and posterior astigmatism of the cornea, microcoaxial cataract surgery using a 2.2 mm incision affects surgically induced total astigmatism less than conventional cataract surgery.