고도근시와 난시 치료를 위해 시행한 ICL 및 반대안 토릭 ICL 삽입술의 임상결과

목적: 단안 ICL (Implantable Contact Lens) 삽입술 시행 후 반대안 Toric ICL 삽입술을 시행받은 환자에 있어 양안의 임상결과를 비교하였다. 대상과 방법: 양안에 난시차가 있는 고도근시 환자 중 ICL 및 Toric ICL 삽입술을 병용하여 시행받은 14명 28안에 대해 후향적으로 연구하였다. 술 전과 술 후 1주, 1, 2, 6개월째 시력 및 굴절검사, 안압검사, 세극등검사, 만족도조사 등을 시행하였다. 결과: ICL군과 Toric ICL군의 평균구면렌즈대응치는 술 전 각각 -7.83D, -5.55D에서 술 후 6개월째 0.13D, 0.20D로, 난시는 술 전 0.92D, 2.60D에서 0.42D, 0.27D로 교정되었다. 술 후 ICL 안에서는 근시가, Toric ICL안에서는 근시 및 난시가 효과적으로 교정되었다. 두 군에서 술 후 6개월째 나안시력은 1.02, 1.05였고, 높은 안전성, 효율성, 예측성을 보였다. 술 후 안압, Vault, 합병증 및 만족도에서 유의한 차이가 없었다. 결론: 양안의 난시차이를 보이는 고도근시 교정에 있어 난시정도에 따라 후방안내렌즈의 종류를 선택하여 삽입하는 것이 효과적인 방법이라 생각된다. Purpose: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. Methods: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. Results: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group) to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D, respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. Conclusions: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism. J Korean Ophthalmol Soc 2010;51(6):802-808