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목적 : 생후 1세 이하의 영아기에 시행한 선천백내장 수술 후 단일인공수정체안, 이중인공수정체안의 굴절력 변화 및 합병증 빈도를 알아보고자 하였다. 대상과 방법 : 1999년 1월부터 2002년 12월까지 선천백내장으로 생후 1세 이하에 단일인공수정체삽입술을 받은 6명8안, 임시 이중인공수정체삽입술을 받은 3명 5안을 대상으로 후향적 의무기록 검사를 시행하였다. 결과 : 평균 생후 6.1 개월에 수술을 하였고, 수술 후 외래 관찰은 평균 10개월이었다. 수술 직후 및 마지막 관찰 시 굴절력은 단일인공수정체안의 경우 각각 +7.82디옵터, +4.25디옵터의 현성굴절률과 매달 평균 -0.34디옵터의 굴절률 변화를 보였고, 이중인공수정체안은 각각 평균 +0.32 디옵터와 -3.5디옵터로 매달 평균 -0.45디옵터의 굴절률 변화를 보였다. 합병증 발생률은 단일인공수정체안에서 12.5% (1/8안), 이중인공수정체안에서 20.0% (1/5안)로 나타났다. 재수술을 시행한 경우는 단일인공수정체안, 이중인공수정체안에서 각각 1안씩이었다. 결론 : 1세 이하 환아에서 이중인공수정체안의 합병증과 재수술 빈도가 단일인공수정체안보다 크게 높다고 볼 수 없으며, 대부분 추가적인 교정이 필요하지 않았고, 상대적으로 약시 빈도가 높다는 증거는 찾을 수 없었다.


Purpose: The purpose of this study was to assess the incidence of postoperative complications and the change of refractive error in infantile eyes after cataract surgery and single intraocular lens(IOL) or temporary piggyback IOL implantation. Methods: Eight consecutive patients (13 eyes) who underwent IOL implantation under 12 months of age between 1999 and 2002 were enrolled. Eight eyes of 6 patients had a single IOL implanted and the other 5 eyes of 3 patients underwent temporary piggyback IOL implantations. A retrospective chart review was conducted. Results: The mean age at surgery was 6.1 months. The mean follow-up period was 10 months. The average postoperative refraction at one week was +7.82D after single IOL and +0.32D after piggyback IOL. The average postoperative refraction at last follow-up was +4.25D and -3.5D respectively. Over the follow-up period, the mean refractive change per months was -0.34D in the single IOL group and -0.45D in the piggyback IOL group. Postoperative complications were 12.5 % (1/8 eyes) in single IOL and 20.0% (1/5 eyes) in piggyback IOL. Reoperations were conducted for the complicated eyes in both groups. Conclusions: The rates of complications and reoperations were slightly higher in piggyback IOL than in single IOL. Nonetheless, additive correction for residual hyperopia was not needed in the piggyback IOL group. There was more deteriorative evidence of amblyopia in piggyback IOL than in single IOL.