연속측정방법으로 분석한 초음파유화술 전후 고위수차의 변화 = Changes of Higher Order Aberration Analyzed by Continuous Measurement after Phacoemulsification

다국어 초록 (Multilingual Abstract)

Purpose: To analyze the changes of higher order aberration (HOA) measured serially by KR-1W<SUP>Ⓡ wavefront at every second for 10 seconds between, before, and after phacoemulsification and to evaluate the relationships between HOA and the ocular surface indicators (Schirmer test, tear break-up time, superficial punctate keratitis). Methods: Corneal HOA was measured in 47 eyes of 30 patients pre- and postoperatively at 2, 4, 6, and 8 weeks by KR-1W<SUP>Ⓡ using the continuous measurement mode. The patients were divided into 2 groups according to their Schirmer test (above 10 mm or under 10 mm), tear break-up time (above 5 seconds or less than 5 seconds), and superficial punctate keratitis (any keratitis, none) for analysis of relationships between HOA and ocular surface indicators, and we also analyzed the correlation coefficient. Results: Short-term follow up after phacoemulsification revealed that corneal HOA rapidly increased at 2 weeks and recovered to the preoperative level 8 weeks after surgery. Corneal HOA values showed increasing tendency depending on time at preop and 8 weeks after phacoemulsification, and the differences were statistically significant (preop: p < 0.001, 8 weeks: p = 0.027). There were no significant differences of HOA between the 2 groups divided according to their ocular surface indicators, and there were no significant correlations between HOA and ocular surface indicators at any time point. Conclusions: The HOA of the cornea was restored to its preoperative values at 8 weeks after surgery. Preoperative ocular surface indicators are not significantly influenced on postoperative corneal HOA. The surgical factors are more significant in postoperative corneal HOA than preoperative ocular surface indicators. J Korean Ophthalmol Soc 2015;56(1):25-32

참고문헌 (Reference)

1 최시환, "웨이브프론트의 연속 측정방법으로 분석한 눈물막의 불안정성에 따른 고위수차 변화" 대한안과학회 53 (53): 1076-1080, 2012

2 Hagyó K., "Variability of higher order wavefront aberrations after blinks" 25 : 59-68, 2009

3 Hagyó K., "Variability of higher order wavefront aberrations after blinks" 25 : 59-68, 2009

4 Mencucci R., "Ultrasound thermal damage to rabbit corneas after simulated phacoemulsification" 31 : 2180-2186, 2005

5 Donnenfeld ED., "The effect of hinge position on corneal sensation and dry eye after LASIK" 110 : 1023-1029, 2003

6 Tervo K., "Recovery of corneal innervation following photorefractive keratoablation" 112 : 1466-1470, 1994

7 Quinto GG., "Postrefractive surgery dry eye" 19 : 335-341, 2008

8 Montés-Micó R., "Postblink changes in total and corneal ocular aberrations" 111 : 758-767, 2004

9 Kelman CD., "Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report" 64 : 23-35, 1967

10 Ram J., "Outcomes of phacoemulsification in patients with dry eye" 28 : 1386-1389, 2002

11 Tutt R., "Optical and visual impact of tear break-up in human eyes" 41 : 4117-4123, 2000

12 박영규, "LASEK, LASIK 후 눈물막의 변화" 대한안과학회 43 (43): 6-1151, 2002

13 Li XM., "Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery" 26 (26): S16-S20, 2007

14 Koh S., "Effect of tear film break-up on higher-order aberrations measured with wavefront sensor" 134 : 115-117, 2002

15 조양경, "Dry Eye After Cataract Surgeryand Associated Intraoperative Risk Factors" 대한안과학회 23 (23): 65-73, 2009

16 Benitez-del-Castillo JM., "Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis" 20 : 30-32, 2001

17 Koenig SB., "Corneal sensitivity after epikeratophakia" 90 : 1213-1218, 1983

18 Thibos LN., "Clinical applications of the Shack-Hartmann aberrometer" 76 : 817-825, 1999

19 Oh T., "Changes in the tear film and ocular surface after cataract surgery" 56 : 113-118, 2012

20 Khanal S., "Changes in corneal sensitivity and tear physiology after phacoemulsification" 28 : 127-134, 2008

21 Hiroko BM., "Cataract Surgery: Technique, Complication and Management" Saunders 2004