초록
목적: 근시성 굴절교정수술안에서 수평경선에 따른 중심부 및 주변부의 굴절력 변화를 정시안과 비교 평가하고자 하였다. 방법: 수술안 120 안(평균: $23.56{\pm}2.54$세, 범위: 20~29세)과 정시안 40 안(평균: $22.50{\pm}1.74$세, 범위: 20~25세)을 대상으로 개방형 자동굴절력계를 사용하여 중심시야를 기준으로 코 쪽과 귀 쪽의 수평방향 $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$의 굴절력을 각각 측정하였다. 수술안은 수술 전 등가구면 굴절이상에 따라 -6.00 D 미만은 수술안 그룹 1, -6.00 D 이상은 수술안 그룹 2로 분류하여 비교 분석하였다. 결과: 수술안 그룹 1의 수술 전 등가구면 굴절이상은 $-4.56{\pm}0.92D$(범위: -2.50 ~ -5.58 D)였고, 수술안 그룹 2는 $-7.09{\pm}0.96D$(범위: -6.00 ~ -9.00 D)로 나타났다. 정시안의 등가구면 M 평균값의 범위는 $-0.20{\pm}0.22D$(중심)에서 $-0.64{\pm}0.83D$(귀 방향 $25^{\circ}$)와 $-0.20{\pm}0.67D$(코 방향 $25^{\circ}$); 수술안 그룹 1의 M 평균값의 범위는 $-0.16{\pm}0.29D$(중심)에서 $-5.29{\pm}1.82D$(귀 방향 $25^{\circ}$)와 $-4.48{\pm}1.88D$(코 방향 $25^{\circ}$); 수술안 그룹 2의 M 범위는 $-0.20{\pm}0.32D$(중심)에서 $-7.98{\pm}2.08D$(귀 방향 $25^{\circ}$)와 $-7.90{\pm}2.26D$(코 방향 $25^{\circ}$)로 나타났고, 세 그룹 사이의 M 굴절력은 중심(p=0.600)과 귀 방향 $5^{\circ}$(p=0.647)에서 통계적으로 유의한 차이가 없었으나, 주변부 방향으로 갈수록 M 굴절력은 큰 차이를 보였다(p=0.000). 결론: 정시안은 망막의 중심부와 주변부에서 상대적으로 일정한 굴절이상을 보였고, 수평경선에서 주변부 근시흐림의 형태가 나타난 반면, 근시 굴절교정수술안에서는 중심부와 주변부 굴절이상이 정시안과는 다르고 중심부와 주변부의 굴절력 차이가 큰 것으로 나타났다.
Purpose: To evaluate changes in central and peripheral refraction along the horizontal visual fields in myopic corneal refractive surgery group compared with emmetropes. Methods: One hundred twenty eyes of 60 subjects ($23.56{\pm}2.54$ years, range: 20 to 29) who underwent myopic refractive surgery and 40 eyes of 20 emmetropes ($22.50{\pm}1.74$ years, range: 20 to 25) were enrolled. The central and peripheral refractions were measured along the horizontal meridianat $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$ in the nasal and temporal areas using an open-field autorefractor. For analysis of post-op group, the group was classified by pre-op spherical equivalents of < -6.00 D and ${\geq}-6.00D$ as two post-op groups. Results: Pre-op spherical equivalent was $-4.56{\pm}0.92D$ (rang: -2.50 to -5.58 D) in post-op group 1, and $-7.09{\pm}0.96D$ (rang: -6.00 to -9.00 D) in post-op group 2. Spherical equivalent (M) in the emmetropes ranged from $-0.20{\pm}0.22D$ at center to $-0.64{\pm}0.83D$ at $25^{\circ}$ in the temporal visual field and to $-0.20{\pm}0.67D$ at $25^{\circ}$ in the nasal visual field; M in post-op group 1 ranged from $-0.16{\pm}0.29D$ at center to $-5.29{\pm}1.82D$ at $25^{\circ}$ in the temporal visual field and to $-4.48{\pm}1.88D$ at $25^{\circ}$ in the nasal visual field; M in post-op group 2 ranged from $-0.20{\pm}0.32D$ at center to $-7.98{\pm}2.08D$ at $25^{\circ}$ in the temporal visual field and to $-7.90{\pm}2.26D$ at $25^{\circ}$ in the nasal visual field. Among the three groups, there was no significant difference in M at central visual field (p=0.600) and at $5^{\circ}$ in the temporal visual field (p=0.647), whereas, there was significant difference in M at paracentral and peripheral visual field (p=0.000). Conclusions: Emmetropes had relatively constant refractive errors throughout the central and peripheral visual field and showed myopic peripheral defocus along the horizontal visual field. On the other hand, in myopic corneal refractive surgery group, there were significant differences in refractive errors between the central and peripheral visual field compared with differences in the central and peripheral refraction patterns of emmetropes.
