양막이 라섹(LASEK) 수술 후 상피 치유와 임상적 결과에 미치는 영향 = Effect of Amniotic Membrane after LASEK on Epithelial Healing, Clinical and Refractive Outcomes

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the effect of amniotic membrane (AM) on the outcome of laser subepithelial keratomileusis (LASEK).
Methods: One hundred fifty-two eyes of 84 patients with myopia or myopic astigmatism were evaluated. Following LASEK, AM was placed on the inferior limbus as a strip in 94 eyes of 54 patients. Fifty eight eyes of 30 patients served as control. Postoperative epithelial healing time, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction and corneal haze were examined in both groups.
Results: AM-treated group showed shorter reepithelialization time (2.40±0.94 days vs 3.90±0.97 days, p<0.001) after LASEK. At 6 months, 48 eyes (82.8%) and 53 eyes (91.4%) of control group had a UCVA of 20/25 and 20/40 or better respectively. In AM-treated group, 86 eyes (91.5%) had 20/25 or better and 90 eyes (95.7%) had 20/40 or better. Mean spherical equivalents (SE) was 0.480.54 diopter (D) vs -0.94±0.60D (p<0.001). The corneal haze was significantly less in the AM-treated group than in the control group (p<0.001).
Conclusions: The use of AM after LASEK induced rapid epithelial healing with more favorable visual and refractive outcome and reduced score in corneal haze, compared with conventional LASEK.

국문 초록 (Abstract)

목적 : 근시교정을 위한 LASEK 후에 각막상피세포 치유, 각막 혼탁, 술 후 시력 및 굴절 상태에 양막이 미치는 영향을 알아보고자 하였다.
대상과 방법 : 84명의 근시 혹은 근시성 난시 환자의 154안을 대상으로 LASEK 시행 후 6개월 간 전향적으로 관찰하였다. 두 군으로 나누어 54명의 94안은 양막 이식을 하부 각막 윤부에 시행하였고, 30명의 58안은 대조군으로 하여, 술 후 각막상피 치유 시간, 나안시력, 교정시력, 굴절검사 및 각막 혼탁 정도를 조사하였다.
결과 : 양막 이식군에서 LASEK 후 상피재생 시간이 짧았고(2.400.94 days vs 3.90±0.97 days, p<0.001), 술 후 6개월 후 대조군에서는 48안(82.8%)과 53안(91.4%)에서 각각 나안시력 20/25, 20/40이상이었고, 양막 이식군에서는 86안(91.5%)과 90안(95.7%)에서 각각 나안시력 20/25, 20/40이상이었다. 평균 구면대응치는 양막 이식군에서 -0.48±0.54 Diopter (D), 대조군에서 -0.94±0.60 D였으며, 각막 혼탁은 양막 이식군에서 유의하게 낮았다(p<0.001).
결론 : LASEK 수술 후 양막 이식은 각막상피 재생을 촉진하며, 더 나은 시력 및 굴절 결과를 보여주었고, 각막 혼탁도 감소하는 것을 알 수 있었다.

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