Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
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Corneal Asphericity and Optical Performance after Myopic Laser Refractive Surgery

굴절교정수술을 받은 근시안의 각막 비구면도와 광학적 특성 평가

  • Kim, Jeong-Mee (Graduate School Dept. of Optometry, Eulji University) ;
  • Lee, A-Young (Graduate School Dept. of Optometry, Eulji University) ;
  • Lee, Koon-Ja (Graduate School Dept. of Optometry, Eulji University)
  • 김정미 (을지대학교 대학원 안경광학과) ;
  • 이아영 (을지대학교 대학원 안경광학과) ;
  • 이군자 (을지대학교 대학원 안경광학과)
  • Received : 2013.04.23
  • Accepted : 2013.06.15
  • Published : 2013.06.30
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Abstract

Purpose: To compare corneal asphericity, visual acuity (VA), and ocular and corneal higher-order aberrations (HOAs) between myopic refractive surgery and emmetropia groups. Methods: Twenty three subjects ($23.0{\pm}2.5$ years) who underwent myopic refractive surgery and twenty emmetropia ($21.0{\pm}206$ years) were enrolled. The subjects'criteria were best unaided monocular VA of 20/20 or better in both two groups. High and low contrast log MAR visual acuities were measured under photopic and mesopic conditions. Corneal and ocular HOAs were measured using Wavefront Analyzer (KR-1W, Topcon) for 4 mm and 6 mm pupils. Corneal asphericity was taken by topography in KR-1W. Results: There was no significant difference in VA between two groups under either photopic or mesopic conditions. In ocular aberrations, there were significant differences in total HOAs, fourthorder and spherical aberration (SA) for a 6 mm between two groups (p=0.045, p<0.001, and p<0.001, respectively). In corneal aberrations, there was a significant difference in SA for 4 mm (p=0.001) and 6 mm (p<0.001) pupils between two groups and there were statistically significant differences in total HOAs (p<0.001) and fourth-order aberrations (p<0.001) between two groups for a 6 mm pupil. There was a significant correlation in emmetropia between Q-value and SA in ocular aberrations for 4 mm and 6 mm pupils (r=0.442, p=0.004, and r=0.519, p<0.001) and in corneal aberrations for 4 mm and 6 mm pupils (r=0.358, p=0.023, and r=0.646, p<0.001). No significant correlations were found between Q-value and SA in refractive surgery group. Conclusions: VA in myopic refractive surgery is better than or similar to emmetropia. Nevertheless, the more increasing pupil size is, the more increasing aberrations are. Thus, it could have an influence on the quality of vision at night.

목적: 엑시머 레이저 근시굴절교정수술을 받은 사람의 각막 비구면도, 시력, 고위수차를 정시안과 비교 평가하였다. 방법: 단안의 나안 시력이 1.0 이상인 근시 굴절교정수술을 받은 23명(나이: $23.0{\pm}2.5$세)과 20명($21.0{\pm}2.6$세)의 정시안을 대상으로 밝은 조명(photopic)과 중등도(mesopic) 조명상태에서 대비도를 가지는 시력표(100% 및 10%)를 이용하여 시력검사를 하였고, wavefront 수차 분석기(KR-1W, Topcon, Japan)를 이용하여 각막의 비구면계수와 4mm와 6 mm의 동공크기에 따른 눈 전체의 고위수차와 각막의 고위수차를 측정하여 비교하였다. 결과: 굴절교정 수술안과 정시안에서 대비도에 따른 시력은 유의한 차이를 보이지 않았다. 안구 수차(ocular aberrations)에서 전체 고위수차, 4차수차, 구면수차는 동공크기 6 mm상태에서 굴절교정 수술안에서 높게 나타났고, 두 그룹 사이에 유의한 차이를 보였다(p=0.045, p<0.001, p<0.001). 각막의 구면 수차(corneal spherical aberrations)는 동공크기 4 mm와 6 mm상태에서 모두 굴절교정 수술 안에서 더 높게 측정되었고 유의한 차이를 보였다(p<0.01, p<0.001). 각막의 전체고위수차와 4차수차는 동공크기 6 mm 상태에서만 굴절교정 수술안에서 더 크게 나타났고 통계적으로 유의하였다(p<0.001, p<0.001). 정시안의 비구면계수와 구면수차는 동공크기 4 mm와 6 mm 상태에서 안구 수차(r=0.442, p=0.004, r=0.519, p<0.001) 와 각막수차(r=0.358, p=0.023, r=0.646, p<0.001) 모두에서 유의한 상관성을 나타내었으나, 굴절교정 수술안에서는 상관성이 없었다. 결론: 각막굴절교정 수술안의 경우 시력은 정상수준을 나타내고 있으나 동공크기가 커지면 수차가 증가하여 동공이 커지는 야간에는 시력의 질에 영향을 줄 수 있을 것으로 사료된다.

Keywords

References

  1. Porter J, Guirao A, Cox IG, Williams DR. Monochromatic aberrations of the human eye in a large population. J Opt Soc Am A Opt Image Sci Vis. 2001;18(8):1793-1803. https://doi.org/10.1364/JOSAA.18.001793
  2. Castejon-Mochón JF, Lopez-Gil N, Benito A, Artal P. Ocular wave-front aberration statistics in a normal young population. Vision Res. 2002;42(13):1611-1617. https://doi.org/10.1016/S0042-6989(02)00085-8
  3. McLellan JS, Marcos S, Burns SA. Age-related changes in monochromatic wave aberrations of the human eye. Invest Ophthalmol Vis Sci. 2001;42(6):1390-1395.
  4. Liang J, Williams DR. Aberrations and retinal image quality of the normal human eye. J Opt Soc Am A. 1997;14(11):2873-2883. https://doi.org/10.1364/JOSAA.14.002873
  5. Salmon TO, van de Pol C. Normal-eye Zernike coefficients and root-mean-square wavefront errors. J Cataract Refract Surg. 2006;32(12):2064-2074. https://doi.org/10.1016/j.jcrs.2006.07.022
  6. Thibos LN, Hong X, Bradley A, Cheng X. Statistical variation of aberration structure and image quality in a normal population of healthy eyes. J Opt Soc Am A Opt Image Sci Vis. 2002;19(12):2329-2348. https://doi.org/10.1364/JOSAA.19.002329
  7. Lindskoog Pettersson A, JarkC, Alvin A, Unsbo P, Brautaset R. Spherical aberration in contact lens wear. Contact Lens & Anterior Eye. 2008;31(4):189-193. https://doi.org/10.1016/j.clae.2008.05.005
  8. Moreno-Barriuso E, Lloves JM, Marcos S, Navarro R, Llorente L, Barbero S. Ocular aberrations before and after myopic corneal refractive surgery: LASIK-induced changes measured with laser ray tracing. Invest Ophthalmol Vis Sci. 2001;42(6):1396-1403.
  9. Kohnen T, Buhren J. Corneal first-surface aberration analysis of the biomechanical effects of astigmatic keratotomy and a microkeratome cut after penetrating keratoplasty. J Cataract Refract Surg. 2005;31(1):185-189. https://doi.org/10.1016/j.jcrs.2004.09.048
  10. Charman WN, Chateau N. The prospects for super-acuity: limits to visual performance after correction of monochromatic ocular aberration. Ophthalmic Physiol Opt. 2003; 23(6):479-493. https://doi.org/10.1046/j.1475-1313.2003.00132.x
  11. Nguyen-Khoa JLD, Gicquel JJ, Lebuisson DAA, Dighiero P, Maille M. Monochromatic ocular aberrations distribution in professional pilots. Invest Ophthalmol Vis Sci. 2005;46(5):E-Abstract 1998.
  12. Gonzalez-Meijome JM, Villa-Collar C, Montes-Mico R, Gomes A. Asphericity of the anterior human cornea with different corneal diameters. J Cataract Refract Surg. 2007;33(3):465-473. https://doi.org/10.1016/j.jcrs.2006.11.004
  13. Yoon JH, Avudainayagam K, Avudainayagam C, Swarbrick HA. Validating a new approach to quantify Posterior corneal curvature in vivo. J Korean Oph Opt Soc. 2012;17(2):223-232.
  14. Tuan KM, Chernyak D. Corneal asphericity and visual function after wavefront-guided LASIK. Optom Vis Sci. 2006;83(8):605-610. https://doi.org/10.1097/01.opx.0000232227.70122.b5
  15. Sharma M, Wachler BS, Chan CC. Higher-order aberrations and relative risk of symptoms after LASIK. J Refract Surg. 2007;23(3):252-256.
  16. Chalita MR, Chavala S, Xu M, Krueger RR. Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction, and topography. Ophthalmology. 2004;111(3):447-453. https://doi.org/10.1016/j.ophtha.2003.06.022
  17. Applegate RA, Marsack JD, Ramos R, Sarver EJ. Interaction between aberrations to improve or reduce visual performance. J Cataract Refract Surg. 2003;29(8):1487-1495. https://doi.org/10.1016/S0886-3350(03)00334-1
  18. Chen L, Singer B, Guirao A, Porter J, Williams DR. Image metrics for predicting subjective image quality. Optom Vis Sci. 2005;82(5):358-369. https://doi.org/10.1097/01.OPX.0000162647.80768.7F
  19. Cheng X, Thibos LN, Bradley A. Estimating visual quality from wavefront aberration measurements. J Refract Surg. 2003;19(5):S579-584.
  20. Buhren J, Nagy L, Yoon G, MacRae S, Kohnen T, Huxlin KR. The effect of the asphericity of myopic laser ablation profiles on the induction of wavefront aberrations. Invest Ophthalmol Vis Sci. 2010;51(5):2805-2812. https://doi.org/10.1167/iovs.09-4604
  21. Mcalinden C, Moore JE. Comparison of higher order aberrations after LASIK and LASEK for myopia. J Refract Surg. 2010;26(1):45-51. https://doi.org/10.3928/1081597X-20101215-07
  22. Marcos S. Aberrations and visual performance following standard laser vision correction. J Refract Surg. 2001;17(5):S596-S601.
  23. Jeon IC, Jeong WJ, Kang JH. Comparison of corneal asphericity with measuring range. J Korean Oph Opt Soc. 2012;17(4):469-476.
  24. Kim HJ, Lee DH. Corneal asphericity of myopia in Korean. J Korean Oph Opt Soc. 2006;11(2):109-114.
  25. Holladay JT, Janes JA. Topographic changes in corneal asphericity and effective optical zone after laser in situ keratomileusis. J Cataract Refract Surg. 2002;28(6):942-947. https://doi.org/10.1016/S0886-3350(02)01324-X
  26. Cox I, Holden BA. Soft contact lens-induced longitudinal spherical aberration and its effect on contrast sensitivity. Optom Vis Sci. 1990;67(9):679-683. https://doi.org/10.1097/00006324-199009000-00004

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