MEL-80으로 라섹수술 시 라식 모드 절삭과 PRK 모드 절삭의 임상적 유용성 비교 = Comparison of LASIK Mode Ablation and PRK Mode Ablation in LASEK Using MEL-80 Excimer Laser

다국어 초록 (Multilingual Abstract)

Purpose: We compared laser assisted in situ keratomileusis (LASIK) mode and photorefractive keratectomy (PRK) mode ablation methods in laser subepithelial keratomileusis (LASEK) surgery using the MEL-80 excimer laser.Methods: All patients were followed up for a minimum of 1 year. The PRK mode group consisted of 46 eyes of 23 patients and the LASIK mode group consisted of 97 eyes of 56 patients. The central corneal thickness (CCT), ablation thickness, manifest refractive error and uncorrected visual acuity were compared preoperatively, 1 month and 1 year postoperatively. Spherical equivalent (SE) of cycloplegic refraction at postoperative 1 month and the uncorrected visual acuity (UCVA) ratios of 1.0 or better at postoperative 1 year were compared between the two groups to evaluate clinical efficacy. Results: The SE of refractive error, CCT and target corneal ablation thickness of the two groups were not significantly different preoperatively. The PRK mode group obtained an actual ablation mean thickness of 82.8% of the target and the LASIK mode group obtained an actual ablation mean thickness of 94.1% of the target at postoperative 1 month. In each group, a statistically significant difference was observed between the actual corneal ablation thickness and target corneal ablation thickness. In the PRK mode group, the mean SE of postoperative 1 month cycloplegic refraction was +0.24 ± 0.47 D and in the LASIK mode group, +0.87 ± 0.54 D, indicating a statistically significant difference between the two groups. One year postoperatively, the UCVA ratios of 1.0 or better were 83% in the PRK mode group and 96% in the LASIK mode group, showing a statistically significant difference between the two groups. However, SE of manifest refractive error and CCT in the two groups were not statistically different at postoperative 1 year. Conclusions: The LASIK mode ablation method showed better results than the PRK mode ablation method in postoperative UCVA prognosis after LASEK surgery using the MEL-80 excimer laser. J Korean Ophthalmol Soc 2014;55(11):1625-1630

참고문헌 (Reference)

1 김현진, "중등도, 고도 근시에서 LASEK (Laser Epithelial Keratomileusis)과 LASIK (Laser in situ Keratomileusis)의 임상성적" 대한안과학회 44 (44): 24-1164, 2003

2 Wilson SE, "The wound healing response after laser in situ keratomileusis and photorefractive keratectomy:elusive control of biological variability and effect on custom laser vision correction" 119 : 889-896, 2001

3 Tae Ho Kim, "The Safety of 250 micrometer Residual Stromal Bed in Preventing Keratectasia after Laser in situ Keratomileusis (LASIK)" 대한의학회 22 (22): 142-145, 2007

4 de Benito-Llopis L, "Ten-year follow-up of excimer laser surface ablation for myopia in thin corneas" 147 : 768-773, 2009

5 Gauthier CA, "Role of epithelial hyperplasia in regression following photorefractive keratectomy" 80 : 545-548, 1996

6 이담호, "MEL-60 엑시머레이저와 Schwind Multiscan 엑시머레이저의 각막절삭량 비교" 대한안과학회 44 (44): 7-1053, 2003

7 Azar DT, "Laser subepithelial keratomileusis:electron microscopy and visual outcomes of flap photorefractive keratectomy" 12 : 323-328, 2001

8 Camellin M, "Laser epithelial keratomileusis for myopia" 19 : 666-670, 2003

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

10 이정혜, "LASEK 후 통증 예측인자에 관한 분석" 대한안과학회 51 (51): 1203-1209, 2010

11 Teus MA, "LASEK versus LASIK for the correction of moderate myopia" 84 : 605-610, 2007

12 Gauthier CA, "Factors affecting epithelial hyperplasia after photorefractive keratectomy" 23 : 1042-1050, 1997

13 Taneri S, "Evolution, techniques, clinical outcomes, and pathophysiology of LASEK: review of the literature" 49 : 576-602, 2004

14 Erie JC, "Corneal wound healing after photorefractive keratectomy:a 3-year confocal microscopy study" 101 : 293-333, 2003

15 Dua HS, "Corneal epithelial wound healing" 78 : 401-408, 1994

16 Reinstein DZ, "Corneal ablation depth readout of the MEL 80 excimer laser compared to Artemis three-dimensional very high-frequency digital ultrasound stromal measurements" 26 : 949-959, 2010

17 Patel SV, "Confocal microscopy changes in epithelial and stromal thickness up to 7 years after LASIK and photorefractive keratectomy for myopia" 23 : 385-392, 2007

18 Ellingsen KL, "Age-related refractive shifts in simple myopia" 13 : 223-228, 1997

19 신광훈, "2007년 한국 굴절수술학회 회원 설문조사 - 한국에서의 굴절수술의 최근 경향 -" 대한안과학회 50 (50): 1468-1474, 2009

20 구면, "2006년 한국 굴절수술학회 회원 설문조사-한국에서의 굴절수술의 최근 경향-" 대한안과학회 50 (50): 182-188, 2009

21 신경환, "2005년 한국 굴절수술학회 회원 설문조사-한국에서의 굴절수술의 최근 경향-" 대한안과학회 49 (49): 570-576, 2008