새로운 인공수정체를 낭내 삽입한 미세각막절개 백내장 수술의 임상평가

목적: 미세절개창을 통해 삽입 가능한 Akreos MI-60 인공수정체를 삽입한 군의 임상성적을 일반 인공수정체를 삽입한 군과 비교하였다. 대상과 방법: 동일한 술자가 수정체유화술을 시행한 후 Akreos MI-60 인공수정체를 삽입한 25안과 Akreos Adapt-AO 인공수정체를 삽입한 28안을 대상으로 술 후 1주, 1개월, 4개월에 최대교정시력, 고위수차, 대비감도, 수술유발난시 등을 측정하였다. 결과: 최대교정시력은 술 후 1주째 0.09±0.11 (logMAR), 0.11±0.08 (MI-60, Adapt-AO 순), 술 후 1개월째 0.06±0.07, 0.06±0.06, 술 후 4개월째 0.05±0.06, 0.06±0.05로 유의한 차이가 없었다(Mann-Whitney U test, p＞0.05). 굴절오차는 술 후 1주, 1개월, 4개월째 모두 유의한 차이를 보였다. 두 군간 고위수차, 대비감도에서 유의한 차이는 없었으나, 술 후 1개월, 4개월째 수술유발난시는 MI-60군에서 유의하게 작았다. 결론: Akreos MI-60 인공수정체는 기존의 임상성적이 검증된 비구면 인공수정체와 대등한 구면수차, 대비감도를 보이고, 여기에 미세절개수술의 장점으로 작은 술 후 난시값을 보였다. Purpose: To compare visual performance after microincision cataract surgery (MICS) with the implantation of the Akreos MI-60 (MI-60) intraocular lens (IOL) through a 1.8-mm microincision with that after conventional cataract surgery with implantation of the Akreos Adapt-AO IOL (Adapt-AO). Methods: All MICS procedures were performed by the same surgeon. The MI-60 was implanted into 25 eyes, and the Adapt-AO was place in 28 eyes. Best corrected visual acuity (BCVA), total high-order-aberration (HOA), contrast sensitivity, and surgically- induced astigmatism (SIA) were recorded one-week, one-month, and four-months postoperatively. Results: There were no statistically significant differences in BCVA between eyes implanted with the MI-60 or those with the Adapt-AO (MI-60 vs. Adapt-AO, 0.09±0.11 at baseline (logMAR), 0.11±0.08 at one-week, 0.06±0.07, 0.06±0.06 at one-month, 0.05±0.06, 0.06±0.05 at four-months according to the Mann-Whitney U test, p＞0.05). Refractive errors were significantly less with the Adapt-AO than with the MI-60 (MI-60 vs. Adapt-AO, -0.50±0.43 at baseline (diopter), -0.06±0.39 at one-week, -0.50±0.41, 0.01±0.57 at one-month, -0.46±0.36, 0.08±0.58 at four-months according to the Mann-Whitney U test, p＜0.05). There were no statistically significant differences in total HOA or contrast sensitivity between eyes implanted with the MI-60 and those implanted with the Adapt-AO. SIAs were significantly reduced in eyes implanted with the MI-60 than in those with the Adapt-AO at one-month and four-months postoperatively (Mann-Whitney U test, p＜0.05). Conclusions: Implantation with either the MI-60 or the Adapt-AO produced clinically acceptable outcomes, including good spherical aberration and contrast sensitivity. Furthermore, implantation with the MI-60 caused less SIA at one- and four-months postoperation, as co