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소아에서 저간섭성반사계, 자동각막곡률측정계, 각막지형도로 측정한 각막곡률측정치의 비교

Comparision of Corneal Refractive Power Measured with Opitcal Low-coherence Reflectometry, Autokeratometer, and Topography in Children

대한안과학회지 2016년 57권 10호 p.1535 ~ 1541
정재균 ( Jeung Jae-Gyun ) - 삼육서울병원 안과

배지현 ( Bae Gi-Hyun ) - 삼육서울병원 안과

Abstract

목적: 소아에서 저간섭성반사계(Lenstar LS900 ⓡ ), 자동각막곡률측정계(KR-8100 ⓡ ), 각막지형도(Medmont E300 ⓡ )로 측정한 각막곡률측정 치를 비교하고자 한다.

대상과 방법: 160명 316안을 대상으로 Lenstar LS900 ⓡ ,KR-8100 ⓡ ,Medmont E300 ⓡ 을 이용하여 flat K, steep K, mean K, astigmatism을 측정하였다. 10세 미만을 1군, 10세 이상 18세 미만을 2군, 18세 이상을 3군으로 나누어 측정치를 비교하였고, Bland-Altman plot을 이용하 여 각 기기 간의 일치도를 분석하였다.

결과: 세 군 모두에서 대부분의 각막곡률측정치가 기기 간의 의미있는 차이를 보였다(p<0.05).1군과 2군에서는 Lenstar LS900 ⓡ 와 KR-8100 ⓡ 의 일치도가 가장 높았고, Medmont E300 ⓡ 와 다른 두 기기 간의 일치도는 비교적 낮았다. 3군에서 flat K, astigmatism에서는 Lenstar LS900 ⓡ 와 KR-8100 ⓡ 의 일치도가 높고, Medmont E300 ⓡ 의 일치도가 상대적으로 낮았다. 그러나 steep K와 mean K에서는 Medmont E300 ⓡ 의 일치도가 높고, Lenstar LS900 ⓡ 와 KR-8100 ⓡ 의 일치도가 낮았다.

결론: 소아에서는 Medmont E300 ⓡ 이 Lenstar LS900 ⓡ ,KR-8100 ⓡ 과 비교하여 낮은 일치도를 보인 반면, 성인에서는 기기 간의 일치도가 일관되지 않고 각막곡률측정치 지표에 따라 다양한 결과를 보였다.

Purpose: To compare the keratometry obtained from optical low-coherence reflectometry (Lenstar LS900ⓡ), autokeratometer (KR-8100ⓡ), and topography (Medmont E300ⓡ) in children.

Methods: A retrospective study was performed in 316 eyes of 160 subjects. Subjects were divided into 3 groups according to age. Group 1 was younger than 10 years, group 2 was older than 10 years and younger than 18 years, and group 3 was older than 18 years. Subjects were tested using the Lenstar LS900ⓡ, KR-8100ⓡ, and Medmont E300ⓡ. Comparisons were made for steep K, flat K, mean K, and astigmatism among three groups. Agreement among the 3 devices was examined using the Bland-Altman method.

Results: The keratometry measured by Medmont E300ⓡ was highest, followed by that of Lenstar LS900ⓡ and KR-8100ⓡ in all 3 groups. Almost all keratometry was significantly different among the 3 devices except for the flat K measured by LS900ⓡ and KR-8100ⓡ in all 3 groups and flat K measured by KR-8100ⓡ and Medmont E300ⓡ in Group 3 (p < 0.05). With regard to mean K, the agreement between Lenstar LS900ⓡ and KR-8100ⓡ was better than that between the other two pairs in both Groups 1 and 2, while agreement between Lenstar LS900ⓡ and Medmont E300ⓡ was better in Group 3. The agreement between KR-8100ⓡ and Medmont E300ⓡ was worse than that between the other two pairs in Groups 1 and 3, while the agreement between Lenstar LS900ⓡ and Medmont E300ⓡ was worse in Group 2.

Conclusions: There were significant differences in keratometry among the 3 devices in all 3 groups. In children, Medmont E300ⓡ showed relatively less agreement compared with the other two devices. In adults, however, the agreement between 2 devices showed variable results. Consideration of the keratometry measurement from Lenstar LS900ⓡ, KR-8100ⓡ, and Medmont E300ⓡ might be helpful to estimate accurate corneal keratometry in children.

키워드

Autokeratometer; Children; Keratometry; Lenstar; Topography
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