< D30322D303828B1E8C5C2C0D32DB9E8C7FCBFF8292D E687770>

Size: px

Start display at page:

Download "< D30322D303828B1E8C5C2C0D32DB9E8C7FCBFF8292D E687770>"

미선 교
5 years ago
Views:

1 대한안과학회지 2009 년제 50 권제 11 호 J Korean Ophthalmol Soc 2009;50(11): DOI : /jkos = 증례보고 = 접수번호 : 세종류의비구면인공수정체간의술후구면수차, 대비감도및초점심도정도의비교 배형원 김응권 김태임 연세대학교의과대학안과학교실, 시기능개발연구소 목적 : 세가지종류의비구면인공수정체삽입후구면수차, 대비감도및초점심도를평가하고자하였다. 대상과방법 : Akreos adapt Advanced Optics (AO) (18 안 ), AcrySof IQ SN60WF (20 안 ), Tecnis Acrylic IOL ZA9003 (18 안 ), 총 48 명 56 안을대상으로술후 3 개월째고위수차및구면수차를포함한안구전체및안구내수차와대비감도를측정하고, 원거리시력을교정한상태에서 33 cm 및 1 m 시력을이용한초점심도를평가하였다. 결과 : 전체구면수차및안구내구면수차에있어 AO 를삽입받은군이다른두군에비해다소높은구면수차값을보였으나, 결과적으로대비감도및초점심도정도에있어서는세군간에있어유의한차이는발견되지않았다. 결론 : 세군간대비감도및초점심도에유의한차이를보이지못한것은세군간구면수차의차이가크지않고구면수차를제외한다른요인들간에차이가없어대비감도및초점심도에큰영향을주지못한것으로생각된다. < 대한안과학회지 2009:50(11): > 현대사회에서삶의질이점차중요시됨에따라백내장수술또한수술기법과인공수정체의발전을통해일차적인백내장의제거수준에서시력의질향상까지고려하는방향으로발전하고있다. 1 수술받지않은눈에있어서양의구면수차값을가진각막에대해젊었을때는수정체가음의값을가짐으로써구면수차가서로상쇄되어비교적좋은시력의질을유지할수있으나, 나이가듦에따라수정체가양의구면수차값으로증가하게됨으로써시력의질이떨어지게된다. 2-6 따라서양의구면수차값을갖는기존의구면인공수정체는백내장수술후에도구면수차의증가가그대로유지되어눈부심, 빛번짐등의증상을야기하는반면에, 7-9 최근의비구면인공수정체는백내장수술후구면수차값을상쇄시켜시기능을향상시키는효과를나타내고있다. 10 반면구면수차의감소는망막에명확한상을맺게함으로써원거리시력의질적향상을가져올수는있으나, 초점 접수일 : 2009 년 2 월 10 일 심사통과일 : 2009 년 7 월 21 일 책임저자 : 김태임서울시서대문구신촌동 134 연세대학교의과대학연세의료원안과 Tel: , Fax: tikim@yuhs.ac * 본논문의요지는 2008 년대한안과학회제 99 회춘계학술대회에서구연으로발표되었음. * This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No.M1AQ19, ) 심도 (depth of focus) 는오히려낮아져근거리시력은더욱나빠진다는여러보고들도제기되고있다. 11,12,22,30,31 백내장수술을받은환자라할지라도동공및각막, 또는삽입된인공수정체의구면수차등에의해어느정도의근거리시력을유지할수있는데, 구면수차가낮아지면초점심도 (depth of focus) 가얕아지기때문에근거리시력은더욱저하된다는것이다. 따라서구면수차의감소가원거리시력의질을향상시키긴하지만근거리시력의저하를함께유발할수도있기때문에비구면인공수정체로인한보다전반적인시기능평가를위해서는수차및대비감도와함께초점심도를아울러비교하는것이필요할것으로여겨진다. Akreos adapt Advanced Optics (AO) (Bausch & Lomb, Inc., Rochester, NY) 인공수정체는일체형형태의친수성아크릴재질의인공수정체로서인공수정체의전면과후면모두를비구면화함으로써 0 μm의구면수차값을갖도록고안된인공수정체이고, AcrySof IQ SN60WF (Alcon, Inc., Forth Worth, TX) 인공수정체는일체형형태의소수성아크릴재질로서후면비구면표면을가짐으로써 -0.2 μm의음의구면수차값을가진인공수정체이다. 3-piece 형태의 Tecnis Acrylic IOL ZA9003 (AMO, Inc., Santa Ana, CA) 인공수정체는소수성아크릴재질로서전면부표면을변형하여 μm의음의구면수차값을가진다 (Table 1). 본연구는세종류의비구면인공수정체간의술후고위수차와구면수차를비롯한수차및대비감도를비교하고, 구면수차차이로인한초점심도의차이를비교하고자하였다

2 - 대한안과학회지 2009 년제 50 권제 11 호 - Table 1. Optical characteristics of the aspherical IOLs * used in the study Charateristics Akreos adapt AO AcrySof IQ SN60WF Tecnis ZA9003 Optic type Monofocal Monofocal Monofocal Lens 1-piece 1-piece 3-piece Optical material Hydrophilic acrylic Hydrophobic acrylic Hydrophobic acrylic Refractive index Optic size (mm) Overall length (mm) 10.5~ Design Prolate anterior and posterior surfaces Prolate posterior surface Prolate anterior surface Haptic angulation Haptic material Hydrophilic acrylic Hydrophobic acrylic PMMA monofilament Sph A (μm) * IOLs=intraocular lens; PMMA=polymethylmethacrylate; Sph A=spherical aberration. 대상과방법 2007년 8월부터 2007년 12월까지본원에서백내장초음파유화술및인공수정체안내삽입술을시행받은환자 48명 56안을대상으로무작위할당을통하여 Akreos adapt Advanced Optics (AO) 를삽입받은군 (I 군 ), AcrySof IQ SN60WF 를삽입받은군 (II 군 ), Tecnis Acrylic IOL ZA9003 를삽입받은군 (III 군 ) 의세군으로구분하고전향적인연구를진행하였다. 각막난시가 2D가넘지않는노인성백내장환자를대상으로, 각막혼탁, 약시, 녹내장, 망막질환등눈에다른질환을가진사람과이전에굴절교정수술받은사람및수술과정에서후낭파열이발생한경우, 그리고수술후경과관찰시인공수정체이탈소견이보이는경우는연구대상에서제외하였다. 수술은단일술자에의해시행되었고, 점안마취후이측또는비측투명각막절개를통해전방내점탄물질을주입한후 26 gauge의주사침을이용하여약 5.5 mm 크기의수정체낭원형절개를시행하였다. 평형염액을사용하여수력분리술및수력분층술을시행한후초음파를이용한수정체유화술로수정체핵을제거하였으며관류흡입기로남아있는수정체피질을제거하였다. 그후카트리지를이용하여인공수정체를수정체낭내에삽입하였으며남아있던점탄물질을관류흡입기로제거하고평형염액을사용하여안구의긴장도를유지하였다. 모든환자는술후 3개월째수차및대비감도를측정하였으며, 초점심도를비교하기위하여원거리시력및원거리교정된상태에서의중간거리, 근거리시력이측정되었다. 수차검사는산동된상태에서동공중심부 6 mm 영역에대하여시행되었다. itrace (Tracey Tech., Houston, TX) 를사용하여 RMS (Root mean square) 총합, 고위수차, 구면수차, 코마수차, 트레포일수차를각각측정하였고, 안구전체의수차 (total ocular aberration) 와각막수차를제외한안 구내수차 (internal ocular aberration) 를나누어분석하였다. 대비감도는 FACT 차트방식의 Optec 6500 (Stereo Optical Co, Inc., Chicago, IL) 을이용하여굴절이상을교정한상태로시행하였으며, 명소시 (photopic condition, 85 cd/m 2 ) 와박명시 (mesopic condition, 3 cd/m 2 ) 조건하에서각각 1.5, 3, 6, 12,18 cpd (cycle perdegree) 의주파수에대해서측정하였다. 초점심도는원거리시력을교정한상태 (distance-corrected) 에서의중간거리시력과근거리시력의평균을비교함으로써판단하였다. 11 초점심도에영향을줄수있는인자인동공크기및각막난시도함께고려하였으며, 동공크기는명소시 (85 cd/m 2 ) 와박명시 (3 cd/m 2 ) 상태에서각각측정하였고, 각막난시는 Auto Ref-keratometer RK-3 (Canon, Inc., Tokyo, Japan) 를사용하여측정하였다. 원거리시력은교정된상태에서 4 m에서 ETDRS 시력표를사용하여측정하였고, 중간거리시력은원거리시력이교정된상태에서 ETDRS 1 m 시력측정법으로측정하였다. 이경우중간거리시력이 ETDRS 1 m 시력측정법으로측정가능한최대값인 0.5 이상으로측정되면 1 m 거리에서로젠바움 (Rosenbaum, Cleveland, OH) 근거리시력표를이용하여측정한값의 3배값을중간거리시력으로하였다. 근거리시력역시원거리시력이교정된상태로 33 cm 거리에서로젠바움근거리시력표를사용하여측정하였다. 통계학적분석은통계프로그램 SPSS 12.0 for Windows (SPSS Inc., Chicago, IL) 를사용하였으며, 통계학적유의성의기준은 p<0.05 로하였다. 결과 환자군은총 48명 56안이었고, I 군은 18안, II 군은 20 안, III 군은 18안이었다. 연령, 성별및술후 3개월째최대교정시력에있어서세군간의유의한차이는보이지않았

3 - 배형원외 : 비구면인공수정체간의수차및시기능 - Table 2. Demographics of study groups No * of eyes (%) OD:OS Gender (M:F) Mean Age (±SD ) BCVA (±SD) Akreos adapt AO AcrySof IQ SN60WF Tecnis ZA9003 p-value 18 9:9 6: (±8.89) (±0.12) 20 10:10 10: (±8.85) 0.04 (±0.06) All values are displayed as logmar visual acuity. * No=number; SD=standard deviation; BCVA=best corrected visual acuity. 18 9:9 10: (±13.43) 0.03 (±0.05) Table 3. Total ocular aberrations (μm) of three groups measured by itrace (Mean±Standard deviation) IOL groups RMS * total HO A Sph A Coma 7A Coma 8A Trefoil 6A Trefoil 9A AO 1.46± ± ± ± ± ± ±0.28 IQ 1.46± ± ± ± ± ± ±0.25 Tecnis 1.09± ± ± ± ± ± ±0.21 p-value * RMS=root mean square; HO A=higher-order aberration; Sph A=spherical aberration; Statistically significant (p<0.05). Table 4. Internal aberrations (μm) of three groups measured by itrace (Mean±Standard deviation) IOL groups RMS * total HO A Sph A Coma 7A Coma 8A Trefoil 6A Trefoil 9A AO 1.54± ± ± ± ± ± ±0.31 IQ 1.69± ± ± ± ± ± ±0.27 Tecnis 1.44± ± ± ± ± ± ±0.25 p-value * RMS=root mean square; HO A=higher-order aberration; Sph A=spherical aberration; Statistically significant (p<0.05). Table 5. Visual acuities and depth of focus (Mean±Standard deviation) Far * Intermediate Near Depth of focus AO IQ Tecnis p-value -0.02± ± ± ± ± ± ± ± ± ± ± ± All values are displayed as logmar visual acuity. * Best corrected visual acuity; Distance-corrected visual acuity; Mean of intermediate visual acuity and near visual acuity. 다 (Table 2). 술후 3개월째 6 mm 동공크기로산동된상태에서 itrace 로측정한수차를살펴볼때 RMS 총합, 고위수차, 코마수차, 트레포일수차의경우에있어서는안구전체수차 (total ocular aberration) 및안구내수차 (internal ocular aberration) 모두에서세군간에유의한차이가발견되지않았지만, 구면수차에있어서는 I 군이다른두군에비해통계적으로유의하게다소높은값을나타냈다 (p<0.000)(table 3, 4). Optec 6500 으로측정된대비감도에서는명소시와박명시모두모든주파수영역에서세군간에유의한차이가관찰되지않았다 (Fig. 1). 또한세군간에동공크기및각막난시는유의한차이를보이지않은상태에서세군간에원거리교정된상태의중간거리및근거리시력의평균은통계적으로유의한차이 를보이지않아, 세군간초점심도에서도유의한차이를관찰할수없었다 (Table 5). 고찰 최근백내장수술의목표는백내장치료의목적외에도수술을통해굴절이상의교정및시력의질을향상시키는개념으로점차발전하고있다. 1,14,15 즉, 시력의회복뿐만아니라시기능의향상이백내장수술에있어중요한요소가되고있으며, 대비감도검사와수차분석은이러한시기능을수치화하여분석하는데수단으로사용되고있다. 7,9,16,17 비구면인공수정체는백내장수술에있어구면인공수정체삽입시발생할수있는구면수차의증가를감소시킴으로써구면인공수정체에비해보다나은대비감도를얻을수

4 - 대한안과학회지 2009 년제 50 권제 11 호 - Figure 1. Contrast sensitivity test of three groups at photopic condition (A) and mesopic condition (B). There was no statistically significant difference among three groups. 있다는것이이미기존의국내외많은연구에서입증된바있으며, 16,18-19 각회사들은이러한연구들을기반으로더좋은시력의질을얻기위해다양한비구면인공수정체를양산해내고있다. 본연구는이렇게서로다른비구면인공수정체간에술후결과의차이가존재하는지에대해알아보고자하였다. 본연구에서는세종류의비구면인공수정체를대상으로하였다. Akreos adapt Advanced Optics (AO) 인공수정체는전면과후면모두에비구면처리를함으로써인공수정체자체의구면수차를없앴으며, 이는기존의구면인공수정체로인해발생할수있는구면수차의증가를막을수있는동시에, 인공수정체중심부이탈등의상황에서인공수정체자체로인해발생할수있는수차의유발가능성을줄이는장점을갖는다. 23,24 실제로 Altmann et al 23 의연구에서인공수정체중심부이탈시구면수차값이없는비구면렌즈는음의구면수차값을갖는비구면인공수정체에비해더나은시기능을보이는것이보고되었으나, 본연구에서는인공수정체가중심부이탈된경우연구에서제외하였기때문에이에대한분석은시행하지않았다. AcrySof IQ SN60WF 인공수정체는후면비구면표면을가짐으로써 -0.2 μm의음의구면수차값을가진비구면인공수정체로써평균각막의구면수차값을 +0.27~0.28 μm 정도라고할때 시력이좋은젊은사람눈의평균구면수차를 +0.1 μm 정도로보고술후안구전체의구면수차를이와유사하게유지하는것을목표로한다. 27 반면전면부비구면표면을갖는 Tecnis Acrylic IOL ZA9003 인공수정체는 μm의인공수정체구면수차를갖고백내장수술후눈전체구면수차를 0 μm으로만들고자계획 되었다. 본연구에서, 안구내구면수차, 즉인공수정체의구면수차는각회사가계획했던것과유사한값 (I 군 -0.02±0.17 μm, II 군 -0.22±0.16 μm, III 군 -0.28±0.10 μm) 을나타내었다 (Table 4). 그러나안구전체의구면수차에있어서는 I 군및 III 군에는의도된값과유사한반면, II 군은기대했던 +0.1 μm 보다약간낮은 0.00±0.14 μm의구면수차값을보였다. AcrySof IQ SN60WF 인공수정체삽입후구면수차를측정한기존의여러다른연구들을살펴볼때, μm 부터 μm 까지다양한구면수차값을나타냈지만전반적으로예상값보다낮은구면수차값을보였는데, 18,28,29 AcrySof IQ SN60WF 인공수정체삽입시눈전체구면수차가기대했던값보다조금낮게측정되는이유에대해서는추가적인연구가필요할것으로생각된다. 구면수차의감소는시력의질의향상을가져오게되고, 이는대비감도의증가로나타나게된다. 16,18,19,28 즉, 구면수차가낮을수록대비감도가증가해야하나본연구에서는구면수차가높은 I 군의대비감도는다른두군에비해서통계적차이가없었다. 이는 Johansson et al 30 이연구한 AO 인공수정체와 Tecnis Z9000 비구면인공수정체간의비교연구에서도유사한결과를보였는데, 비록기존의여러다른연구에서구면수차가낮은비구면수정체는구면수정체에비하여우수한시기능을보였지만, AO 인공수정체또한다른구면수정체에비해더좋은시기능을보이는비구면인공수정체이기때문에비구면인공수정체군간의크지않은구면수차의차이는전체적인대비감도의결과에유의한영향을끼치지못하는것으로생각된다. 게다가 Dietze and

5 - 배형원외 : 비구면인공수정체간의수차및시기능 - Cox 31 의연구에의하면구면수차자체가전체수차에미치는영향또한크지않을수있기때문에이러한비구면인공수정체간의작은구면수차의차이는결과적으로시력의질의차이에큰영향을미치지못할가능성이있다고하겠다. 한편많은연구에서비구면인공수정체는구면수차가낮기때문에원거리시력의질은향상되지만, 초점심도 (depth of focus) 가낮아져근거리시력은더욱나빠진다는단점이제기되고있다. 11,12,22,30,31 즉, 초점심도는구면수차가클수록깊어지는데, 초점심도가깊을수록상대적으로우수한근거리시력을가질수있기때문이다. 초점심도에영향을줄수있는요인으로는구면수차이외에도동공크기, 각막난시, 인공수정체이탈등이있으나, 본연구에서는인공수정체가이탈된경우에는연구대상에서제외하였으며, 동공크기및각막난시에있어서도세군간에유의한차이는보이지않았다. 따라서다른요인들이배제된상태에서원거리시력이교정된상태 (distance-corrected) 의중간거리 (1 m) 및근거리 (33 cm) 시력의평균을측정함으로써세비구면인공수정체간의초점심도를비교할수있었다. 11 앞서언급한대로상대적으로구면수차가높았던 I 군에서다른두군에비해초점심도가높을수있을것으로기대할수있으나, 본연구의결과에서는세군간의초점심도에있어유의한차이가관찰되지않았다 (Table 5). 이것역시대비감도의경우와마찬가지로비구면인공수정체간의크지않은구면수차의차이는결과적으로초점심도의유의한차이를가져오지못한것으로생각해볼수있겠다. 그동안비구면인공수정체의기능에관한연구는국내외에서많이발표되었지만, 비구면인공수정체간의비교연구는그수가상대적으로적었으며, 특히초점심도를함께고려한비구면인공수정체간의기능비교연구는아직까지국내에서보고된바없었다. 따라서본연구는비구면인공수정체간의초점심도까지고려한국내연구라는점에서일차적인의미를둘수있을것이다. 또한본연구의결과를살펴보면기존에국외에서보고된결과들과크게다른점을보이지않았는데, 이는최근국내의백내장수술경향이거의선진국수준에이르렀기때문이라고미루어판단해볼수가있겠다. 32 결론적으로세종류의비구면인공수정체는서로목표로하는구면수차에는다소차이가있지만그차이가크지않아결과적으로대비감도및초점심도에대해유의한영향을끼치지못하는것으로여겨지며, 따라서세종류의비구면인공수정체간에술후대비감도및초점심도의차이는없는것으로판단할수있겠다. 참고문헌 1) Werner L, Olson RJ, Mamalis N. New Technology IOL Optics. Ophthalmol Clin North Am 2006;19: ) Guirao A, Redondo M, Artal P. Optical aberrations of the human cornea as a function of age. J Opt Soc Am A Opt Image Sci Vis 2000;17: ) McLellan JS, Marcos S, Burns SA. Age-related changes in monochromatic wave aberrations of the human eye. Invest Ophthalmol Vis Sci 2001;42: ) Oshika T, Klyce SD, Applegate RA, Howland HC. Changes in corneal wavefront aberrations with aging. Invest Ophthalmol Vis Sci 1999;40: ) Artal P, Berrio E, Guirao A, Navarro R. Contribution of the cornea and internal surface to the change of ocular aberrations with age. J Opt Soc Am A Opt Image Sci Vis 2002;19: ) Artal P, Guirao A, Berrio E, Williams DR. Compensation of corneal aberrations by the internal optics in the human eye. J Vis 2001;1:1-8. 7) Rawer R, Stork W, Spraul CW, Lingenfelder C. Imaging quality of intraocular lenses. J Cataract Refract Surg 2005;31: ) Chalita MR, Krueger RR. Correlation of aberrations with visual acuity and symptoms. Ophthalmol Clin North Am 2004;17: ) Guirao A, Redondo M, Geraghty E, et al. Corneal optical aberrations and retinal image quality in patients in whom monofocal intraocular lenses were implanted. Arch Ophthalmol 2002;120: ) Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg 2002;18: ) Rocha KM, Soriano ES, Chamon W, et al. Spherical Aberration and Depth of Focus in Eyes Implanted with Aspheric and Spherical Intraocular Lenses. Ophthalmology 2007;114: ) Elder MJ, Murphy C, Sanderson GF. Apparent accommodation and depth of field in pseudophakia. J Cataract Refract Surg 1996; 22: ) Sawusch MR, Guyton DL. Optimal astigmatism to enhance depth of focus after cataract surgery. Ophthalmology 1991;98: ) Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg 2002;18: ) Olson RJ, Werner L, Mamalis N, Cionni R. New intraocular lens technology. Am J Ophthalmol 2005;140: ) Caporossi A, Martone G, Casprini F, Rapisarda L. Prospective randomized study of clinical performance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes. J Refract Surg 2007;23: ) Mester U, Dillinger P, Anterist N. Impact of a modified optic design on visual function: clinical comparative study. J Cataract Refract Surg 2003;29: ) Rocha K, Soriano E, Chalita M, et al. Wavefront Analysis and Contrast Sensitivity of Aspheric and Spherical Intraocular Lenses. Am J Opthalmol 2006;142: ) Tzelikis P, Akaishi L, Trindade F, Boteon JE. Spherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study. Am J Ophthalmol 2008;145: ) Ahn H, Kim SW, Kim EK, Kim TI. Wavefront and Visual Function Analysis After Aspherical and Spherical Intraocular Lenses Implantation. J Korean Ophthalmol Soc 2008;49:

6 - 대한안과학회지 2009 년제 50 권제 11 호 - 21) Kim HS, Kim SW, Ha BJ, et al. Ocular Aberrations and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses. J Korean Ophthalmol Soc 2008;49: ) Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J Cataract Refract Surg 2007;33: ) Altmann GE, Nichamin LD, Lane SS, Pepose JS. Optical performance of 3 intraocular lens designs in the presence of decentration. J Cataract Refract Surg 2005;31: ) Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg 2002;18: ) Wang L, Dai E, Koch DD, Nathoo A. Optical aberrations of the human anterior cornea. J Cataract Refract Surg 2003;29: ) Beiko GH, Haigis W, Steinmueller A. Distribution of corneal spherical aberration in a comprehensive ophthalmology practice and whether keratometry can predict aberration values. J Cataract Refract Surg 2007;33: ) Levy Y, Segal O, Avni I, Zadok D. Ocular higher-order aberrations in eyes with supernormal vision. Am J Ophthalmol 2005;139: ) Tzelikis P, Akaishi L, Trindade F, Boteon J. Ocular aberrations and contrast sensitivity after cataract surgery with AcrySof IQ intraocular lens implantation. J Cataract Refract Surg 2007;33: ) Awwad ST, Lehmann JD, McCulley JP, Bowman RW. A comparison of higher order aberrations in eyes implanted with AcrySof IQ SN60WF and AcrySof SN60AT intraocular lenses. Eur J Ophthalmol 2007;17: ) Johansson B, Sundelin S, Wikberg-Matsson A, et al. Visual and optical performance of the Akreos Adapt Advanced Optics and Tecnis Z9000 intraocular lenses: Swedish multicenter study. J Cataract Refract Surg 2007;33: ) Dietze HH, Cox MJ. Limitations of correcting spherical aberration with aspheric intraocular lenses. J Refract Surg 2005;21:S ) Lee DY, Roh JH, Shyn KH survey for KSCRS members. J Korean Ophthalmol Soc 2007;48: =ABSTRACT= Spherical Aberration, Contrast Sensitivity and Depth of Focus With Three Aspherical Intraocular Lenses Hyoung Won Bae, MD, Eung Kweon Kim, MD, PhD, Tae-Im Kim, MD Vision Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea Purpose: To evaluate postoperative spherical aberration, contrast sensitivity and depth of focus after implanting 3 different aspheric intraocular lenses. Methods: Fifty-six eyes (18 eyes for Akreos adapt Advanced Optics (AO), 20 eyes for AcrySof IQ SN60WF and 18 eyes for Tecnis Acrylic IOL ZA9003) of 48 patients were evaluated. Internal ocular aberration including spherical aberration and higher-order aberration and contrast sensitivity were evaluated 3 months after lens implantation. In addition, visual acuities at 33 cm and 1 m distance were measured with the far vision corrected state to calculate depth of focus. Results: The total and internal ocular spherical aberration of the AO implanted group was slightly higher than the other groups with statistical significance. However, there was no statistically significant difference of contrast sensitivity and depth of focus among the 3 groups. Conclusions: A subtle difference of spherical aberration among the 3 groups without a statistically significant difference in other factors may not induce the differences of contrast sensitivities and depths of focus in each group. J Korean Ophthalmol Soc 2009;50(11): Key Words: Aspheric intraocular lens, Contrast sensitivity, Depth of focus, Spherical aberration Address reprint requests to Tae-Im Kim, MD Vision Research Institute, Department of Ophthalmology, Yonsei University College of Medicine #134 Sinchon-dong, Seodaemun-gu, Seoul , Korea Tel: , Fax: , tikim@yuhs.ac

<30362D30322D303628B1E8C5C2C0D32DC0CCC1D8BFF D34382E687770>

<30362D30322D303628B1E8C5C2C0D32DC0CCC1D8BFF D34382E687770> = 증례보고 = 두종류의삼체형비구면인공수정체삽입후임상결과의비교 대한안과학회지 2012 년제 53 권제 1 호 J Korean Ophthalmol Soc 2012;53(1):43-48 pissn: 0378-6471 eissn: 2092-9374 http://dx.doi.org/10.3341/jkos.2012.53.1.43 이준원 김재훈 김응권 김태임 연세대학교의과대학안과학교실,