LASIK 시술후의 부족교정에 대한 Reablation의 효과

Abstract

We evaluated the effect of the reablation on the undercorrected eye after the Laser in-situ keratomileusis(LASIK). The subjects were 21 eyes of 19 patients, who showed undercorrection after the LASIK. Reablation was done on the stromal bed after lifting the original flap aside. Patients were followed up for 1 to 6 months after the reablation. At the time of first LASIK, the mean spherical equivalent(S/E) was －11.29±2.98D preoperatively, －1.90±1.16D at postoperative 3 months, the mean amount of correction was －9 . 6 0±1.90D. At the time of reablation, the mean(S/E) was －3 . 2 6±1.08D, and the mean amount of correction was －3.31±1.11D. Reablation was done only after the refractive error stabilized and did not change over 3 months. One month after the reablation, the mean(S/E) was ＋0.15±0.98D and 85.7% of the eyes were within ±1.0D. Six months after the reablation, the mean(S/E) was －0.10±0.66D and 84.6% were within ±1.0D. The uncorrected visual acuity of 0.6 or more was achieved in 76.2% of eyes at 1 month, and 84.6% at 6 months. The best spectacle-corrected visual acuity(BSCVA) was lost 2 lines or more in 14.3% at 1 month, but none at 6 months after surgery. The BSCVA did not change or gain 1 line or more in 76.2% at 1 month, and 92.3% at 6 months after surgery. There was no problem when lifting the original corneal flap. In conclusion, reablation using the original flaps without new cuts seems to be a predictable, safe method for retreatment.

L A S I K수술 후 부족교정이 나타난 환자 1 9명 2 1안을 대상으로 기존의 각막절편을 젖히고 reablation을 시행한 후 그 효과를 1개월부터 6개월까지 추적 관찰하였다. 처음 LASIK 시술시의 술 전 평균구면렌즈대응치는 -11.29±2.98D, 술 후 3개월에 -1.90±1.16D였으며,평균교정량은 －9.60±1.90D였다. 재시술전의 평균구면렌즈대응치는 －3.26±1.08D, 평균교정량은－3.31±1.11D였고, 재시술은 3개월 이상 변화 없이 굴절력이 안정된 이후에 시행하였다. 술 후 1개월에 평균구면렌즈대응치는 + 0.15±0.98 D로, ±1.0D 이내로 교정된 경우는 8 5 . 7 %였으며, 술 후 6개월에는 평균구면렌즈대응치가 －0.10±0.66D로, 100%에서 ±1.0D 이내였다. 술 후 나안 시력의 변화는 0.6 이상이 술 후 1개월에 76.2%, 6개월에 84.6%였다. 최대교정시력이 두 줄 이상 감소한 경우는 술 후 1개월에 14.3%, 술 후 6개월에는 없었으며, 변화가 없거나 한줄 이상 증가한 경우는 술 후 1개월에 76.2%, 술 후 6개월에 92.3%였다. 기존의 각막절편을 젖히는데 어려움이 있었던 경우는 없었다. 이들 결과로 미루어 보아 LASIK 시술후의 부족교정에 대한 기존의 절편을 이용한 reablation 방법은 정확하고 안전한 방법이라고 생각된다.