Advanced Surface Ablation-Photorefractive Keratectomy (ASA-PRK): 각막두께가 얇은 경중등도 근시안에서의 수술 효과 및 안전성

• 영문명: Advanced Surface Ablation-Photorefractive Keratectomy (ASA-PRK): Safety and Clinical Outcome for the Correction of Mild to Moderate Myopia with a Thin Cornea
• 발행기관: 대한안과학회
• 저자명: 이상범 정민수,Sang Bumm Lee, M.D., Ph.D., Min Su Chung, M.D.
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume47,number8, 1274~1286쪽, 전체 13쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2006.08.31

영문 초록

Purpose: To evaluate the safety, clinical outcome, and change in higher-order wavefront aberrations (HOAs) of Advanced Surface Ablation-Photorefractive Keratectomy (ASA-PRK) for the correction of mild to moderate myopia in cases with a thin cornea. Methods: ASA-PRK was performed, using a rotary epithelial scrubber, post-laser chilled BSS? irrigation, and bandage contact lens, in 127 eyes of 70 patients who had a preoperative spherical equivalent within -7.0 D and who were followed-up for more than six months. The patients were divided into two groups, according to their central corneal thickness (CCT), by ultrasonic pachymetry (Group Ⅰ: CCT≤520 ?m, 32 eyes, mean 506.6±8.6 ?m; Group Ⅱ: CCT>520 ?m, 95 eyes, mean 552.3±24.8 ?m). The clinical outcomes of Group Ⅰ and Ⅱ were compared. Results: At six months, 100% of Group I (32/32 eyes) and 93.7% of Group II (89/95 eyes) had an UCVA of 1.0 or better (p>0.05). At six months, a spherical equivalent within 0.5 D of emmetropia was observed in 100% (32/32) of the eyes in Group I and in 94.7% (90/95) of the eyes in Group II (p>0.05). At the 12-month follow-up, all eyes showed good stability of the refractive errors, and none showed corneal haze of grade 1 or more, loss of two or more lines of BSCVA, or serious iatrogenic keratectasia. The magnitude of total HOAs, spherical ablation, and coma were significantly higher six and 12 months after surgery in both groups (p<0.05). The postoperative changes in the HOAs at six and 12 months were similar in both groups (p>0.05). Conclusions: ASA-PRK performed on patients with mild to moderate myopia and a thin cornea (≥ 490 ?m) showed a high level of efficacy, predictability, stability, and safety. There was no statistically significant difference in surgically induced HOAs between Groups I and II. The authors suggest that ASA-PRK be used for the correction of mild to moderate myopia, especially in cases with a thin cornea. Further study will be needed to determine the safety of this procedure for thinner corneas in surface keratorefractive surgery.

키워드

Advanced surface ablation-photorefractive keratectomy, Central corneal thickness, Post-laser chilled BSS? irrigation, Rotary epithelial scrubber, Thin cornea