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[논문] 아이리움안과 6번째 스마일라식 SCI 논문 발표

2018.07.17 7325

스마일라식 수술의 정확성을 높인

트리플 센트레이션(Triple Centration) 연구논문이

SCI 학술지 JRS(Journal of Refractive Surgery)에

등재됐습니다.

아이리움안과는 '스마일라식 SCI 논문 6편 발표'라는

독보적인 성과를 기록하며 안과학계의

큰 관심을 받고 있습니다.


ORIGINAL ARTICLE

Comparison of the Distribution of Lenticule Decentration Following SMILE by Subjective Patient Fixation or Triple Marking Centration

David Sung Yong Kang, MD; Hun Lee, MD; Dan Z. Reinstein, MD, MA(Cantab), FRCSC; Cynthia J. Roberts, PhD; Samuel Arba-Mosquera, PhD; Timothy J. Archer, PhD; Eung Kweon Kim, MD, PhD; Kyoung Yul Seo, MD, PhD; Tae-im Kim, MD, PhD

ABSTRACT

PURPOSE
To investigate lenticule decentration following small incision lenticule extraction (SMILE) via the subjective patient fixation method or triple marking centration method and compare inductions of corneal higher order aberrations (HOAs) between the two methods.
METHODS
This study analyzed decentration values obtained from the Keratron Scout (Optikon, Rome, Italy) tangential topography difference map of 110 eyes (110 patients) undergoing SMILE with the subjective patient fixation method (n = 55) or triple marking centration method (n = 55). Root mean square values of total HOAs, 3rd order coma aberration, and 4th order spherical aberration, as well as individual coefficients for vertical and horizontal coma, were measured preoperatively and 3 months postoperatively. Relationships between the magnitudes of decentration and induced corneal HOAs were assessed.
RESULTS
There were significant differences in horizontal decentered displacement (P = .048), vertical decentered displacement (P = .002), and total decentered displacement (P = .001) between the two groups. Total HOAs, coma, vertical coma, and spherical aberration significantly increased in the subjective patient fixation method (all P < .001), whereas total HOAs (P = .002) and vertical coma (P = .005) increased in the triple marking centration method. Induction of total HOAs (mean values: 0.13 vs 0.07; P = .026), coma (0.09 vs 0.05; P = .004), and vertical coma (0.08 vs 0.04; P = .001) was significantly lower in the triple marking centration method than in the subjective patient fixation method. Total decentered displacement was significantly correlated with induced total HOAs (r = 0.496, P < .001) and coma (r = 0.501, P < .001).

Accurate centration of the treatment zone during corneal refractive procedures plays an important role in achieving good visual outcomes.1-3 Visual axis, pupil center, and corneal vertex have been the suggested treatment centers for refractive procedures. The corneal intercept of the visual axis would be the most ideal reference, but it is difficult to center the crossing point. Corneal vertex centration has been reported to be better than entrance pupil centration regarding the induced ocular aberrations and asphericity.4-6 Moreover, it is well known that the pupil center shifts with changes in pupil size.7

Small incision lenticule extraction (SMILE) using only a femtosecond laser is a new technique for the correction of myopia and myopic astigmatism.8 This procedure extracts the

From Eyereum Eye Clinic, Seoul, South Korea (DSYK); the Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea (HL); The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea (HL, EKK, KYS, TK); London Vision Clinic, London, United Kingdom (DZR, TJA); the Department of Ophthalmology, Columbia University Medical Center, New York (DZR); Centre Hospitalier National d'Ophtalmologie, Paris, France (DZR); the Department of Ophthalmology & Visual Science and Department of Biomedical Engineering, The Ohio State University, Ohio (CJR); Schwind eye-tech-solutions, Kleinostheim, Germany (SA-M); and Corneal Dystrophy Research Institute, Severance Biomechanical Science Institute, Yonsei University College of Medicine, Seoul, South Korea (EKK).

Submitted: November 16, 2017; Accepted: May 7, 2018

Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2017R1A2B4009565).


트리플 센트레이션은 아이리움안과가 고안한

독자적인 수술법으로 사람마다 다른

각막정점(시력의 중심)에 레이저를 정확하게

조사해 스마일라식의 완성도를 높입니다.

JRS 논문에 따르면 스마일라식 수술에

트리플 센트레이션을 적용한 결과,

근난시교정의 정확성이 높아지고

광학적 부작용을 유발해 시력의 질을 떨어뜨리는

고위수차인 코마, 구면수차 발생이

감소하는 것으로 나타났습니다.

헤럴드경제

스마일라식 SCI 논문 6편, 국내 의료진 독보적 성과 주목

기사입력 2018-07-17

국내 의료진의 스마일라식(ReLEx SMILE) 연구 논문이 잇달아 SCI 학술지에 등재돼 국내외 학계의 관심을 받고 있다. 강남 아이리움안과 의료진은 스마일라식의 정확성을 높인 ‘트리플 센트레이션(Triple Centration)’ 수술법에 대한 우수한 임상 결과를 입증해 JRS(Journal of Refractive Surgery)에 논문이 등재됐다. 이로써 아이리움안과의 스마일라식 SCI 논문은 총 6편으로, 국내에서 독보적인 성과를 기록하고 있다.

스마일라식의 완성도를 좌우하는 트리플 센트레이션 수술법

기사원문보기 클릭


아이리움안과의 트리플 센트레이션 연구는

세계 최대 안과학회인, 2018 미국백내장굴절수술학회에서

최우수 연구(BEST PAPER)를 수상하고

글로벌 의학전문 매체에서 메인 이슈로 소개돼

스마일라식의 중요한 연구 성과로 평가받았습니다.



아이리움안과

THE SURGEON'S GUIDE TO SMILE: Small Incision Lenticule Extraction

Glenn I. Carp

The final step in fine-tuning the energy and spot spacing settings was to modify the lenticule/stromal bed and cap/cap interface settings independently for the lenticule and cap interface. Once I have set these individual fine parameters as shown in Figure 10, I then the energy settings constant for all of interfaces, but the spot and track distance was adjusted to suit each interface. It is important to note that these settings apply specifically to the VisuMax laser, but the principles behind the methodology can be applied to other platforms with appropriate adjustments.

Key considerations for energy and spot spacing:

  • Cap interface: We set a spot and track distance of 4.5 µm for the cap interface, which provides a balance between ease of separation and treatment time. In combination with the low energy, we have seen the best results.
  • Lenticule interface: We set a spot and track distance of 4.5 µm for the lenticule interface, which provides a balance between ease of separation and treatment time. In combination with the low energy, we have seen the best results.
  • Lenticule side cut: We set a spot and track distance of 2.0 µm for the lenticule side cut, which provides a balance between ease of separation and treatment time. In combination with the low energy, we have seen the best results.

아이리움안과, 국내 의료진 중 유일하게

'안과 전공의를 위한 스마일라식 가이드 북' 공동 집필

(로우에너지 스마일라식, 트리플 센트레이션 수록)

아이리움안과는

로우에너지 스마일(Low Energy SMILE)을

국내에 도입해 '맞춤형 저에너지' 수술의

중요성을 알리고

트리플 센트레이션 수술법을 고안해

스마일라식의 혁신을 이끌고 있습니다.


시력교정술의 새로운 미래를 만드는 연구!

아이리움안과는 앞으로도

시력교정술의 안전성과 시력의 질 향상을 위한

연구활동에 최선을 다하겠습니다.