수술 전 안축장 구간에 따른 백내장수술 후 유효수정체위치 예측 = Prediction of Effective Lens Position by Reference to the Preoperative Axial Length

국문 초록 (Abstract)

목적: 부분결합간섭검사로 측정되는 안구 생체계측치를 매개변수로 하는 백내장수술 후 유효수정체위치 예측 공식을 수술 전 안축장 구간별로 탐구해보고자 한다. 대상과 방법: 수술 전에 부분결합간섭검사를 시행하여 안축장;각막굴절력;전방깊이를 성공적으로 측정하였고;통상적인 백내장수술이 합병증 없이 이뤄진 736안을 후항적으로 선정;수술 전 안축장 1.0 mm 구간에 따라 7개의 군으로 분류하였다. 다중선형 회귀분석을 통해 수술 전 안축장;각막굴절력;전방깊이를 독립 매개변수로 하여 유효수정체위치를 예측하는 최적의 공식을 각 군에 따라 구해보았다. 결과: 수술 전 안축장이 22.0 mm에서 25.0 mm에 속하는 경우;각막굴절력이 유효수정체위치와 유의하게 연관되어 있었다. 수술 전 안축장이 23.0 mm에서 26.0 mm에 속하는 경우;전방깊이가 유효수정체위치와 유의하게 연관되어 있었다. 수술 전 안축장이 24.0 mm보다 짧고;26.0 mm보다 긴 경우;수술 전 안축장이 유효수정체위치와 강하게 연관되어 있었다. 수술 전 안축장;전방깊이;각막굴절력 세 변수 모두를 고려한 선형 회귀 공식을 통해 대체로 유효수정체위치를 가장 적절하게 예측할 수 있었으나;각 군에 따라 공식의 형태는 변하였다. 결론: 백내장 술 후 유효수정체의 위치는 술 전 안축장의 길이가 25.0 mm 미만인 경우는 안축장과 각막굴절력;24.0 mm에서 26.0 mm인 경우는 안축장과 전방깊이;그리고 26.0 mm 이상인 경우는 특히 안축장과 유의한 연관성이 있었다.

다국어 초록 (Multilingual Abstract)

Purpose: We derived optimal formulae permitting effective lens position (ELP) for patients differing in terms of their preoperative axial lengths as revealed by partial coherence interferometry. Methods: We included 736 eyes from 736 patients who underwent conventional cataract surgery at Yeouido St. Mary’s Hospital. The preoperative axial length (AL);corneal power (CP);and anterior chamber depth (ACD) measured via partial coherence interferometry served as independent variables for ELP prediction. The 736 eyes were divided into seven groups differing by 1.0-mm intervals in terms of the preoperative axial length. We sought correlations between the independent variables and the ELP;and defined the combinations that best predicted the ELPs of the seven groups. Results: The CP correlated significantly with the ELP for eyes with AL between 22.0 and 25.0 mm (all p < 0.01) and the ACD correlated significantly with the ELP for eyes with AL between 23.0 and 26.0 mm (all p < 0.01). Although a regression equation featuring all of the AL;ACD;and CP best predicted the ELP for the total of 736 eyes (p < 0.001);the optimal combination varied by the preoperative AL. Conclusions: The effects of CP;ACD;and AL on ELP vary by the preoperative AL. The optimal combination of preoperative variables predicting ELP thus varies as that parameter changes.

목차 (Table of Contents)

• 대상과 방법 결과 고찰

참고문헌 (Reference)

1 Norrby S, "Sources of error in intraocular lens power calculation" 34 : 368-376, 2008

2 Kohnen T, "Refractive aspects of cataract surgery" 9 : 55-59, 1998

3 Norrby S, "Prediction of the true IOL position" 101 : 1440-1446, 2017

4 Elder MJ, "Predicting the refractive outcome after cataract surgery : the comparison of different IOLs and SRK-II v SRK-T" 86 : 620-622, 2002

5 Drexler W, "Partial coherence interferometry : a novel approach to biometry in cataract surgery" 126 : 524-534, 1998

6 Shammas HJ, "No-history method of intraocular lens power calculation for cataract surgery after myopic laser in situ keratomileusis" 33 : 31-36, 2007

7 Kane JX, "Intraocular lens power formula accuracy : comparison of 7 formulas" 42 : 1490-1500, 2016

8 Gökce SE, "Intraocular lens power calculations in short eyes using 7 formulas" 43 : 892-897, 2017

9 Wang JK, "Intraocular lens power calculation using the IOL Master and various formulas in eyes with long axial length" 34 : 262-267, 2008

10 Gavin EA, "Intraocular lens power calculation in short eyes" 22 : 935-938, 2008

11 Reitblat O, "Intraocular lens power calculation for eyes with high and low average keratometry readings : comparison between various formulas" 43 : 1149-1156, 2017

12 Sheard RM, "Improving the prediction accuracy of the SRK/T formula : the T2 formula" 36 : 1829-1834, 2010

13 Aristodemou P, "Formula choice : Hoffer Q, Holladay 1, or SRK/T and refractive outcomes in 8108 eyes after cataract surgery with biometry by partial coherence interferometry" 37 : 63-71, 2011

14 Yang S, "Effect of anterior chamber depth on the choice of intraocular lens calculation formula" 12 : e0189868-, 2017

15 Haigis W, "Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis" 238 : 765-773, 2000

16 Cooke DL, "Comparison of 9 intraocular lens power calculation formulas" 42 : 1157-1164, 2016

17 Plat J, "Clinical and biometric determinants of actual lens position after cataract surgery" 43 : 195-200, 2017

18 Kershner RM, "Clear corneal cataract surgery and the correction of myopia, hyperopia, and astigmatism" 104 : 381-389, 1997

19 Fyodorov SN, "Calculation of the optical power of intraocular lenses" 14 : 625-628, 1975

20 Olsen T, "C constant : new concept for ray tracing-assisted intraocular lens power calculation" 40 : 764-773, 2014

21 Terzi E, "Accuracy of modern intraocular lens power calculation formulas in refractive lens exchange for high myopia and high hyperopia" 35 : 1181-1189, 2009

22 Narváez J, "Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK/T formulas" 32 : 2050-2053, 2006

23 Bang S, "Accuracy of intraocular lens calculations using the IOLMaster in eyes with long axial length and a comparison of various formulas" 118 : 503-506, 2011

24 Melles RB, "Accuracy of intraocular lens calculation formulas" 125 : 169-178, 2018

25 Gökce SE, "Accuracy of 8 intraocular lens calculation formulas in relation to anterior chamber depth in patients with normal axial lengths" 44 : 362-368, 2018