각막에 의한 수정체전낭절개의 확대효과

목적: 백내장 수술 중 수정체전낭절개를 위해 전방에 삽입한 ORGC (open ring guided capsulorhexis)를 이용하여 각막에 의한 수정체전낭절개의 확대율을 측정하고 전방깊이와 각막굴절력에 따라 어떻게 변하는지 밝히고자 한다. 대상과 방법: 2011년 12월부터 2012년 4월까지 ORGC를 이용하여 수정체전낭절개술을 시행한 환자 중 각막난시가 0.25 D 이하인 37명40안을 대상으로 하였다. ORGC를 수정체 전낭 위에 올려놓고, 각막의 윤부에 자를 놓은 후 수술용 현미경에 연결된 카메라로 영상을얻었다. ImageJ로 자 5 mm와 ORGC 내경의 pixel 수를 측정하였다. 실제 ORGC의 내경이 5.30 mm인 정보를 이용하여 비례식으로 확대율을 구하였다. 전방 깊이 및 각막굴절력을 조사하여 그에 따른 확대율의 변화를 알아보았다. 결과: 연구에 포함된 37명은 남자 19명, 여자 21명이었으며 평균 나이는 64.8세였다. 전방깊이는 평균 3.28 mm였으며 각막굴절력은평균 43.534 diopters였다. 이 환자들에서 측정된 ORGC 내경은 평균 6.14 mm (표준편차 0.16 mm)였으며 확대율은 평균 115.9% (표준편차 3.1%)였다. 전방깊이가 깊고 각막굴절력이 큰 경우가 전방 깊이가 얕고 각막굴절력이 작은 경우보다 확대율이 크게 나타났다. 결론: 백내장 수술에서 수정체전낭절개의 크기는 각막에 의해 평균 115.9%로 확대되었다. 특히 전방이 깊고 각막굴절력이 클 때에는 확대율이 더욱 크므로 수정체전낭절개 시 고려해야 한다. Purpose: The purpose of this study is to measure the magnification of the capsulorhexis by the cornea using open ring guided capsulorhexis (ORGC) during cataract surgery. The study also investigated the magnification changes according to anterior chamber depth and corneal power. Methods: The subjects comprised 40 eyes from 37 patients whose astigmatism was lower than 0.25 D and who had cataract surgery using ORGC from December 2011 to April 2012. ORGC was set on the anterior capsule and photographs were obtained using a camera connected to a surgical microscope after attaching a ruler around the limbus. The pixel number of 5 mm gradations on a ruler and the inner diameter of ORGC were measured using ImageJ. The inner diameter of ORGC was known to be 5.30 mm and the size of ORGC in the snapshot was therefore calculated by proportional expression. After corneal power and anterior chamber depth were identified, the magnification effect was evaluated. Results: The 37 subjects were composed of 19 males and 21 females, and their average age was 64.8 years. The average depth of the anterior chamber was 3.28 mm, and the average corneal power was 43.534 D. The measured inner diameter of ORGC was 6.14 mm (SD: ±0.16 mm) and the average magnification of the capsulorhexis was 115.9% (SD: ±3.1%). The results showed that in the case of shallow anterior depth and low corneal power, the magnification was low equivalent to 110%. However, when the anterior chamber was deep and the corneal power was high, the magnification was greatly in creasedto 120%. Conclusions: The capsulorhexis was magnified to an average of 115.9% by the cornea during cataract surgery. In particular, it is necessary to consider capsulorhexis s