Appeared Changes of Binocular Function after Refractive Surgery

Joong-Gu Kang,Dae-Gwang Wi,Koon-Ja Lee,Ki-Cheul Shin,Hyun-Sung Leem 대한시과학회 2016 대한시과학회지 Vol.18 No.2

목 적: 근시를 가진 굴절교정수술을 받은 환자를 대상으로 수술 전후 나타나는 조절력, 사위도, 입체시 등의 양안시기능 변화를 3개월간 추적 관찰하였다. 방 법: 근시안의 굴절교정수술을 받은 20대 50명(남자 23명, 여자 27명)을 대상으로 굴절교정수술 전과 수술 후(1주일, 1개월, 3개월)의 굴절검사 및 조절력검사(Push-up method), 원근거리 사위도(Howell 시표 에 의한 3 m, 33 cm검사), 입체시검사(Titmus 입체시표) 등을 조사하였다. 결 과: 굴절교정 수술 전의 굴절검사 값은 -4.96±2.17D이었고, 수술 3개월 후 굴절검사 값은 -0.54±0.44D 이었다. 굴절수술 전의 조절력은 9.85±2.29D이었으며, 수술 후 1주일, 1개월, 3개월의 조절 력 값은 각각 7.85±2.05D, 7.99±1.81D, 9.16±2.01D로 측정되었으며, 수술 1주일 후 조절력이 떨어졌다 가 3개월 후 다시 증가하는 양상을 나타내었다(F=21.83, p<0.001). 굴절교정 수술 전 원거리 사위도는 -0.03±1.96△, 수술 3개월 후 사위도는 0.15±1.96△로 측정되었으며, 수술 전 근거리 사위도는 -0.54±1.61△, 수술 3개월 후 사위도는 -0.46±1.60△로 측정되었다. 수술 전과 후의 원, 근거리 사위도 는 수술 전과 비교하여 통계적으로 유의하지 않았다. 입체시 값은 굴절교정 수술 전이 52.40±12.70초, 수 술 후 1주일 값이 63.00±14.74초, 수술 후 1개월 값이 60.00±12.94초, 3개월 값이 52.80±12.13초로 측정 되었다(F=8.06, p<0.001). 결 론: 근시 굴절교정수술을 받은 환자를 대상으로 양안시 변화를 분석한 결과 수술 전과 비교하여 조절 력은 수술 후 1주일, 1개월, 3개월동안 통계적으로 유의하게 감소하였다. 그러나 3개월 이후 조절력은 회복되 는 양상을 보였다. 입체시는 수술 후 1 주일, 1개월은 통계적으로 유의하게 증가 하였고 3개월 후에는 수술 전 상태로 유의하게 회복하였다. Purpose: With myopic refractive surgery patients who received preoperative amplitude of accommodation, phoria degree, binocular stereopsis, and functional changes were followed for 3 months. Methods: Myopic refractive surgery in twenties of 50 people(23 males, 27 females) to target refractive surgery before and after surgery(1week, 1month, 3months) and the amplitude of accommodation test(Push-up method), the phoria test of far and near(Howell by chart for 3 m, 33 cm test), stereo-acuity test(Titmus steropsis chart) were evaluated. Results: Refraction before refractive surgery were the value -4.96±2.17D, three months after surgery refractions were the value -0.54±0.44D. Accommodation before refractive surgery were the 9.85±2.29D after surgery, 1week, 1month and 3months respectively accommodation 7.85±2.05D, 7.99±1.81D, 9.16±2.01D measured, and a week after surgery fell accommodation, the pattern shown to increase again after three months(F=21.83, p<0.001). The far phoria of before refractive surgery were -0.03±1.96△, three months after surgery the far phoria were measured to be 0.15±1.96△, also the near phoria before surgery ranged -0.54±1.61△, the near phoria were measured to be -0.46±1.60△, three months after surgery. Before and after surgery, compared to the surgery before the far and near phoria were not statistically significant. The value of stereo-acuity before refractive surgery were measured to be 52.40±12.70 sec, a week after surgery were 63.00±14.74sec, the value of one month after surgery 60.00±12.94 sec, the values of three month ere measured to 52.80±12.13 sec(F=8.06, p<0.001). Conclusions: With myopic refractive surgery patients who received preoperative analysis of the change of the accommodation and stereo-acuity a week after surgery and then increased again after 3 months to reduce pattern could be observed.

Correlation between Corneal Ablation Amount and Intraocular Pressure after Corneal Refractive Surgery

Mi-A Jung,Eun-Hee Lee 대한시과학회 2018 대한시과학회지 Vol.20 No.4

목적: 각막굴절교정수술 후 각막절삭량에 따른 안압변화와 수술 전 굴절이상도에 따른 수술 후 안압 변화에 대하여 알아보고자 하였다. 방법: 라식 각막굴절교정수술을 받은 평균연령 37.34±7.42세, 성인 남녀 108명(남자 48명, 여자60명)을 대상으로 선정하였다. 자동굴절검사기, 비접촉형안압계, 엑시머레이저를 이용하여 굴절이상도, 안압, 각막 절삭량을 측정하였으며, p<0.05일 때 통계적으로 유의하다고 판단하였다. 결과: 각막굴절교정수술 전 안압은 남자가 15.08±2.60mmHg, 여자가 14.16±2.67mmHg로 남자가 여자보다 높게 나타났으며, 각막굴절교정수술 후 안압 감소량은 남자가 4.22mmHg, 여자가 3.61mmHg로 나타났다. 등가구면 굴절력은 각막굴절교정 수술 전 남자 –3.89±2.17D, 여자 –4.45± 2.92D에서, 각막굴절교정 수술 후 남자 -0.10±0.46D, 여자 –0.04±0.46D로 나타났다. 각막굴절교정수술 후 각막절삭량은 남자 53.95㎛, 여자 61.26㎛로 통계적으로 유의한 차이가 있었으며, 각막절삭량과 안압의 감소량에는 유의한 상관성(r=0.2299, p<0.001)을 보였다. 성별로는 남자의 각막절삭량이 많아질수록 안압의 감소량은 유의하게 증가하는 것으로 나타났다. 굴절이상도가 증가할수록 안압의 감소량도 커져 경도의 굴절이상도에서는 3.04±2.18mmHg, 중등도의 굴절이상에서는 4.10±2.16mmHg, 고도의 굴절이상도에서는 4.65 ±3.29mmHg가 감소하는 것으로 나타났다. 결론: 각막굴절교정수술 후 비접촉식 안압계로 측정한 안압은 감소하는 것을 알 수 있었으며, 안압측정은 녹내장 판단에 영향을 줄 수 있으므로 안압 측정시 각막굴절교정수술 여부에 대한 사전설문이 필요할 것으로 생각된다. Purpose : The purposes of this study were to evaluate the changes of intraocular pressure according to corneal ablation amount after corneal refractive surgery and the changes of intraocular pressure according to refractive errors before corneal refractive surgery. Methods : The mean age of adults who underwent LASIK corneal refractive surgery were 37.34 ± 7.42 years, and 108 adults(48 males, 60 females) were participated in this study. Refractive errors, intraocular pressure, and corneal ablation amount were measured using an autorefractor, a noncontact tonometer, and an excimer laser. All test values were considered statistically significant when p<0.05. Results : The mean intraocular pressure before corneal refractive surgery was 15.08 ± 2.60mmHg in males and 14.16 ± 2.67mmHg in females. The decrease of intraocular pressure after corneal refractive surgery were 4.22mmHg in males and 3.61mmHg in females. Spherical equivalent power were -3.89 ± 2.17D in males and -4.45 ± 2.92D in females before corneal refractive surgery, and -0.10 ± 0.46D in males and -0.04 ± 0.46D in females after corneal refractive surgery. The corneal ablation amount after corneal refractive surgery were statistically significant, with 53.95㎛ in males and 61.26㎛ in females. There was significant correlation between corneal ablation amount and decrease of intaocluar pressure(r=0.2299, p<0.001). As the growth of corneal ablation amount in males, the decrease of intraocular pressure was significantly increased. As the growth of refractive error, the amount of decrease in intraocular pressure was also significant. The decrease of intraocualr pressure were 3.04 ± 2.18mmHg in low refractive error, 4.10 ± 2.16 mmHg in middle refractive error, and 4.65 ± 3.29 mmHg in high refractive error. Conclusion : We found that intraocular pressure decreased after corneal refractive surgery by noncontact tonometer and the change of intraocular pressure which is an important index for glaucoma diagnosis, may affect the judgment of eye disease. We think that a preliminary questionnaire whether corneal refractive surgery is necessary for the measurement of intraocular pressure.

각막굴절교정수술 후 각막절삭량과 안압변화의 상관관계

정미아,이은희 대한시과학회 2018 대한시과학회지 Vol.20 No.4

Purpose : The purposes of this study were to evaluate the changes of intraocular pressureaccording to corneal ablation amount after corneal refractive surgery and the changes of intraocular pressure according to refractive errors before corneal refractive surgery. Methods : The mean age of adults who underwent LASIK corneal refractive surgery were 37.34 ±7.42 years, and 108 adults(48 males, 60 females) were participated in this study. Refractive errors, intraocular pressure, and corneal ablation amount were measured using an autorefractor, a noncontact tonometer, and an excimer laser. All test values were considered statistically significant when p<0.05. Results : The mean intraocular pressure before corneal refractive surgery was 15.08 ± 2.60mmHg in males and 14.16 ± 2.67mmHg in females. The decrease of intraocular pressure after corneal refractive surgery were 4.22mmHg in males and 3.61mmHg in females. Spherical equivalent power were -3.89 ± 2.17D in males and -4.45 ± 2.92D in females before corneal refractive surgery, and -0.10 ± 0.46D in males and -0.04 ± 0.46D in females after corneal refractive surgery. The corneal ablation amount after corneal refractive surgery were statistically significant, with 53.95㎛ in males and 61.26㎛ in females. There was significant correlation between corneal ablation amount and decrease of intaocluar pressure(r=0.2299, p<0.001). As the growth of corneal ablation amount in males, the decrease of intraocular pressure was significantly increased. As the growth of refractive error, the amount of decrease in intraocular pressure was also significant. The decrease of intraocualr pressure were 3.04 ± 2.18mmHg in low refractive error, 4.10 ± 2.16 mmHg in middle refractive error, and 4.65 ± 3.29 mmHg in high refractive error. Conclusion : We found that intraocular pressure decreased after corneal refractive surgery bynoncontact tonometer and the change of intraocular pressure which is an important index for glaucoma diagnosis, may affect the judgment of eye disease. We think that a preliminary questionnaire whether corneal refractive surgery is necessary for the measurement of intraocular pressure. 목적: 각막굴절교정수술 후 각막절삭량에 따른 안압변화와 수술 전 굴절이상도에 따른 수술 후 안압 변화에 대하여 알아보고자 하였다. 방법: 라식 각막굴절교정수술을 받은 평균연령 37.34±7.42세, 성인 남녀 108명(남자 48명, 여자60명)을 대상으로 선정하였다. 자동굴절검사기, 비접촉형안압계, 엑시머레이저를 이용하여 굴절이상도, 안압, 각막 절삭량을 측정하였으며, p<0.05일 때 통계적으로 유의하다고 판단하였다. 결과: 각막굴절교정수술 전 안압은 남자가 15.08±2.60mmHg, 여자가 14.16±2.67mmHg로 남자가 여자보다 높게 나타났으며, 각막굴절교정수술 후 안압 감소량은 남자가 4.22mmHg, 여자가 3.61mmHg로 나타났다. 등가구면 굴절력은 각막굴절교정 수술 전 남자 –3.89±2.17D, 여자 –4.45± 2.92D에서, 각막굴절교정 수술 후 남자 -0.10±0.46D, 여자 –0.04±0.46D로 나타났다. 각막굴절교정수술 후 각막절삭량은 남자 53.95㎛, 여자 61.26㎛로 통계적으로 유의한 차이가 있었으며, 각막절삭량과 안압의 감소량에는 유의한 상관성 (r=0.2299, p<0.001)을 보였다. 성별로는 남자의 각막절삭량이 많아질수록 안압의 감소량은 유의하게 증가하는 것으로 나타났다. 굴절이상도가 증가할수록 안압의 감소량도 커져 경도의 굴절이상도에서는 3.04±2.18 mmHg, 중등도의 굴절이상에서는 4.10±2.16mmHg, 고도의 굴절이상도에서는 4.65 ±3.29mmHg가 감소하는 것으로 나타났다. 결론: 각막굴절교정수술 후 비접촉식 안압계로 측정한 안압은 감소하는 것을 알 수 있었으며, 안압측정은 녹내장 판단에 영향을 줄 수 있으므로 안압 측정시 각막굴절교정수술 여부에 대한 사전설문이 필요할 것으로 생각된다.

시력교정술 후 써클콘택트렌즈 착용시 double-pass 원리를 이용한 시력의 질 평가

권기남,김소라,박미정 한국안광학회 2015 한국안광학회지 Vol.20 No.3

Purpose: The study aimed to evaluate the effect of circle contact lens wearing on visual quality of the eyes after a refractive surgery. Methods: The objective visual quality was evaluated for 40 eyes who did not get refractive surgery and 30 eyes who got a refractive surgery after applying plano circle contact lenses on their eyes, respectively. Modulation transfer function (MTF), objective scatter index (OSI) and the focusing ratio on retina (Strehl ratio) were measured by using optical quality analysis system (OQAS) and the correlation between pupil size and objective visual quality was analyzed by measuring the pupil size. Results: When wearing circle contact lens on the eyes after refractive surgery, MTF and Strehl ratio were reduced and OSI was increased compared with the eyes without refractive surgery. The eyes after a refractive surgery showed more significant difference changes in MTF, OSI and Strehl ratio according to the pupil size compared with those without refractive surgery. Conclusions: The results showed that wearing of circle contact lens after the refractive surgery has deteriorated the objective visual quality based on the quality of focused image on the retina. Therefore, we suggest that sufficient understanding and consideration about the deterioration of visual quality is necessary in the case of circle contact lens wearing after refractive surgery. 목적: 본 연구에서는 써클콘택트렌즈의 착용이 시력교정술을 받은 눈에서 시력의 질에 어떠한 영향을 미치는 알아보고자 하였다. 방법: 시력교정술을 받지 않은 40안과 시력교정술을 받은 30안에 무도수의 써클콘택트렌즈를 각각 착용시키고 optical quality analysis system을 이용하여 변조전달기능(modulation transfer function, MTF), 객관적산란지수(objective scatter index, OSI) 및 망막에 맺히는 상의 집속률(Strehl ratio)을 측정하여 객관적인 시력의 질평가를 실시하였으며, 동공크기를 측정하여 객관적인 시력 질과 동공크기의 상관관계를 분석하였다. 결과: 시력교정술을 받은 눈에 써클콘택트렌즈를 착용하였을 경우는 시력교정술을 받지 않은 눈과 비교하여 모두 통계적으로 유의한 수준으로 변조전달기능이 더 저하되었고, 객관적 산란지수는 더 증가하였으며, 망막에 맺히는 상의 집속률은더 감소하였다. 또한, 시력교정술을 받은 눈에서의 써클콘택트렌즈의 착용은 시력교정술을 받지 않은 사람에 비하여 동공크기에 따른 변조전달기능, 객관적 산란지수, 망막에 맺히는 상 집속률의 증감에 미치는 상관관계에 더 크게 영향을 미치는 것을 알 수 있었다. 결론: 본 연구에서 시력교정술 후 써클콘택트렌즈 착용은 실제 망막에 맺히는 상의 질에 근거한 객관적인 시력의 질을 저하시키는 것으로 나타났으므로 시력교정술을 한 경우에는 써클콘택트렌즈 착용하였을 때 시력의 질 저하에 대한 충분한 이해와 고려가 필요함을 제안한다.

각막굴절교정 수술 안에 대한 소프트콘택트렌즈착용 시 Masking 효과

문예림,박형민,추병선 한국안광학회 2016 한국안광학회지 Vol.21 No.2

Purpose: This study investigated the masking effect of the hydrogel lens and silicone hydrogel lens on the cornea with refractive surgery and without surgery. Methods: 24 university students (means age: 23.48±2.89 years) without refractive surgery (12, control group) and with refractive surgery (LASIK: 8, LASEK: 4, experimental group) participated in the study. Mean refractive errors of right eyes were −2.73 D for control group and −0.24 D for experimental group. The differences in the refractive power and corneal topography map between pre- and post-wearing the −3.00 D lenses were compared, and 2 kinds of hydrogel contact lenses (0.89 Mpa, 0.49 Mpa) and 2 kinds of silicone hydrogel lenses (1.5 Mpa, 0.8 Mpa) were used for −3.00 D lenses. NVision-K5001 (Shin nippon, Japan) was used to measure the refractive power and Keratograph 5M (Oculus, Germany) to measure the corneal topography map change. Results: Variations in the refractive power increased to the plus direction in the experimental group after wearing soft contact lenses. The corneal topography map showed significant changes on the both groups after wearing soft contact lenses (p<0.05). However there were no significant differences in the refractive power and corneal topography map variations by lens materials. Conclusions: Wearing soft contact lenses showed corneal topography map changes. Especially wearing soft contact lenses on the flat cornea after corneal refractive surgery showed greater corneal power changes. Therefore, it should pay attention to refractive change in case of prescribing soft contact lenses to patients with corneal refractive surgery. 목적: 본 연구는 각막굴절교정 수술 후 각막과 수술을 한적이 없는 각막 형상에 따른 하이드로겔 렌즈와 실리콘하이드로겔 렌즈 착용시 Masking 효과를 알아보고자 하였다. 방법: 실험에 참여한 2 대상군은 평균 나이가 23.48± 2.89세인 정상적인 각막 형상그룹(12명, 통제그룹)과 각막굴절교정 수술로 인한 편평한 각막 형상그룹(LASIK-8명, LASEK-4명, 실험그룹)으로 구성된 24명의 대학생 이였으며, 오른쪽 눈의 평균 굴절이상은 각각 통제그룹(정상 각막형상)RE: −2.73 D, 실험그룹(편평한 각막형상)RE: −0.24 D이었다. 두 그룹에서 −3.00 D렌즈의 2가지의 하이드로겔 렌즈(0.89 Mpa, 0.49 Mpa)와 실리콘 하이드로겔 렌즈(1.5 Mpa, 0.8 Mpa)를 사용하여 착용 전후의 굴절력 및 각막지형도의 차이를 비교하였다. 측정에 사용된 장비로는 NVision-K5001(Shin-nippon, Japan)로 굴절력을 측정하였으며, 각막지형도 측정을 위하여 Keratograph 5M(Oculus, Germany)을 사용하였다. 결과: 굴절력 변화는 실험그룹에서 + 방향으로 증가하였고, 각막지형도의 변화는 소프트콘택트렌즈 착용 후 두 그룹 모두 유의한 변화를 보였다(p<0.05). 그러나 렌즈 재질별 굴절력 및 각막지형도 변화에서 렌즈 착용 전 후, 두 그룹 모두 유의한 변화를 보이지 않았다. 결론: 소프트콘택트렌즈 착용은 각막지형도의 차이는 있었으며, 특히 각막굴절교정 수술 후 편평한 각막은 소프트콘택트렌즈 착용 시 굴절력 변화가 크게 나타났다. 따라서 각막굴절교정 수술자에게 소프트콘택트렌즈 처방을 할 경우 굴절력 변화에 주의하여야 한다.

2005년 한국 굴절수술학회 회원 설문조사 - 한국에서의 굴절수술의 최근 경향 -

신경환,윤상철,Kyung Hwan Shyn,M,D,Ph,D,Sang Chul Yoon,M,D 대한안과학회 2008 대한안과학회지 Vol.49 No.4

Purpose: This study investigates the current situation and future trends in the field of refractive surgery in Korea. Methods: Since 1995, members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have been surveyed annually on cataract and refractive surgery. The 2005 annual survey, consisting of 63 multiple-choice questions, was mailed in June 2005 to 300 KSCRS members. Fifty-four (18.0%) members responded. Current data were compared with those of previous annual surveys and with data from the USA. Results: The highest percentage of patients were in their forties (37%), and LASIK accounted for the highest percentage of refractive surgeries (81%). Of complications arising after refractive surgery, the degeneration of corrected vision after PRK and dry eye syndrome after LASIK accounted for the high proportions. LASIK was preferred for myopia less than -12 diopter, and phakic IOL was preferred for myopia greater than -12 diopter. Almost all respondents answered that the most promising refractive surgery is LASIK or phakic IOL. Conclusions: This survey summarized the current trends and changes in cataract and refractive surgery in Korea.

2004년 한국 굴절수술 설문조사

신경환,정지웅 대한안과학회 2006 대한안과학회지 Vol.47 No.12

Purpose: This study investigates both the current situation and future trends in the field of refractive surgery in Korea. Methods: Members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have been annually surveyed regarding cataract and refractive surgery since 1995. The 2004 annual survey, which consisted of 58 multiple-choice questions, was mailed in May 2004 to 322 KSCRS members; fifty-four (16.8%) members responded. Data from the 2004 survey was compared with that of previous annual surveys and similar studies from the USA. Results: The respondents indicated that patients in their forties accounted for the highest percentage (57%) of subjects, and LASIK accounted for the highest percentage (82%) of refractive surgeries. Degeneration of corrected vision, night halo, and glare accounted for a high proportion of the complications arising after refractive surgery. LASIK was the preferred method for treating myopia less than -12 diopters, while phakic IOL was preferred for myopia more than -12 diopters. Lastly, more respondents indicated that they had experienced legal problems associated with PRK or LASIK than the previous year. Conclusions: LASIK remains the refractive surgery procedure of choice, although wavefront-guided ablation is gaining in popularity. Approximately half of the respondents indicated they used MMC in their refractive surgeries.

라식 후 백내장 수술을 받은 근시 환자의 술 후 굴절력의 장기 변화

염혜리,김만수,Hae Ri Yum,Man Soo Kim 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To evaluate the long-term change of postoperative refraction after cataract surgery in patients with a history of LASIK. Methods: A retrospective chart review was performed on 40 eyes of 28 patients who had undergone cataract surgery with a history of LASIK, and 40 eyes of 31 patients who had undergone cataract surgery without LASIK. We evaluated preoperative target refraction, and postoperative refraction during the 2-year follow-up period. Results: In the group with a history of LASIK, the target refraction was -1.00 ± 0.98 D, the 2-month postoperative spherical equivalent was -0.53 ± 1.92 D, and the 2-year postoperative spherical equivalent was -1.03 ± 1.84 D. In the group with cataract surgery only, the target refraction was -1.44 ± 1.06 D, the 2-month postoperative spherical equivalent was -1.07 ± 1.27 D, and the 2-year postoperative spherical equivalent was -0.97 ± 1.28 D. The difference in mean spherical equivalent at 2 months postoperatively and at 2 years postoperatively between the 2 groups was statistically significant (p = 0.037). The difference in mean spherical equivalent preoperatively and 2 years postoperatively between the 2 groups was statistically significant (p = 0.002). In the group with cataract surgery only, the postoperative refraction shifted to hyperopic refractive power, and was statistically significant. In the group with a history of LASIK, there were no statistically significant differences between preoperative and postoperative refraction. There were no statistically significant differences according to the cataract type in the group with a history of LASIK. The greater the myopic preoperative spherical equivalent was, the shorter the duration between LASIK and cataract surgery, which was significant in the group with a history of LASIK. Conclusions: The long-term refractive change after cataract surgery was statistically significant between the cataract surgery after LASIK group and the cataract surgery alone group.

4가지 각막곡률측정 시스템을 이용한 굴절교정수술 후 인공수정체도수계산법 비교

이우석,문상정,이경헌,이동준,Woo Seok Lee,Sang Jeong Moon,Kyung Heon Lee,Dong Jun Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.12

Purpose: To report the evaluation and comparison of true corneal power after corneal refractive surgery through ARK, Orbscan II<SUP>®, Pentacam and IOL master. <br /> Methods: Target IOL (Intraocular lens) power calculated with the SRK/T formula using SMK (Sungmo Eye Hospital keratometry), which is a new method for measuring corneal refractive power, was compared with the back-calculated ideal IOL power after cataract surgery for 30 eyes that required cataract surgery and had previously undergone refractive surgery. Target IOL powers calculated using 4 systems were compared with IOL power calculated using the clinical history method for 64 eyes that had undergone refractive surgery. <br /> Results: Using SMK with the SRK/T formula, the actual refraction was within ±0.5 diopter (D) of the intended refraction for 63.8% of eyes and within ±1.0 D for 90.9% of eyes. Compared with target IOL power calculated with the clinical history method, target IOL power calculated by SMK with the SRK/T formula had a difference of 1.95 ± 0.86 D, which was similar to the results calculated by the Haigis-L formula and by TNP with Haigis. <br /> Conclusions: The difference in characteristics of intraocular lenses subtly affects the vision quality as measured by values such as MTF cut-off and Strehl ratio after cataract surgery. OQAS based on the double-pass technique is considered useful in more objective estimates of the real retinal image quality after cataract surgery which is difficult to explain simply by measuring visual acuity.<br /> J Korean Ophthalmol Soc 2013;54(12):1818-1823

Effects of Choroidal Thickness on Refractive Outcome Following Cataract Surgery in Primary Angle Closure

Woo Keun Song,Kyung Rim Sung,Joong Won Shin,Junki Kwon 대한안과학회 2018 Korean Journal of Ophthalmology Vol.32 No.5

Purpose: To identify the preoperative biometric factors, including subfoveal choroidal thickness (CT), associated with refractive outcome after cataract surgery in eyes with primary angle closure (PAC). Methods: This study included 50 eyes of 50 PAC patients who underwent uneventful cataract surgery. Preoperatively, anterior segment parameters including anterior chamber depth (ACD) and lens vault were determined by anterior segment optical coherence tomography. Subfoveal CT was measured by spectral domain optical coherence tomography enhanced depth imaging before and at one month after surgery. Mean refractive error (MRE) was calculated as the difference in spherical equivalent between actual postoperative refraction determined one month postoperatively and that predicted using each of three IOL calculation formulas (SRK/II, SRK/T, and Haigis). Regression analyses were performed to investigate potential associations between MRE and putative factors. Results: Mean ACD was 1.9 ± 0.4 mm, and preoperative subfoveal CT was 250.8 ± 56.9 μm. The SRK/T (MRE, 0.199 ± 0.567 diopters [D]) and Haigis (MRE, 0.190 ± 0.727 D) formulas showed slight hyperopic shift, while the SRK/II formula demonstrated a myopic shift (MRE, -0.077 ± 0.623 D) compared with that expected after cataract surgery. Mean absolute refractive error was not significantly different between formulas. Higher preoperative lens vault and shallower ACD were associated with a hyperopic shift in all formulas, but not in a statistically significant manner. Thicker preoperative subfoveal choroid was associated with a myopic shift after cataract surgery in all formulas (SRK/II: β = -0.511, p < 0.001; SRK/T: β = -0.652, p < 0.001; Haigis: β = -0.671, p < 0.001). Greater postoperative reduction of subfoveal CT was associated with a myopic shift after cataract surgery in all formulas (SRK/II: β = -0.511, p < 0.001; SRK/T: β = -0.652, p < 0.001; Haigis: β = -0.671, p < 0.001). Conclusions: Our results indicate that preoperative subfoveal CT and the difference between pre- and postoperative subfoveal CT are significant factors for predicting refractive error after cataract surgery in PAC patients. These findings should be considered when performing cataract surgery to optimize visual outcomes.