Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
권호 표지

Impact of Laser in Situ Keratomileusis (LASIK) Treatment on Quality of Life in Myopia Patients

레이저각막절삭성형술이 근시환자의 삶의 질에 미치는 영향

Lee, Jong-Ho;Lee , Je-Myung;Park, Kil-Ho;Jwa, Woon-Bong;Hong, Soon-Jae;Cho, Woo-Hyun;Kang, Hye-Young;Kim, Ji-Yoon
이종호;이제명;박길호;좌운봉;홍순재;조우현;강혜영;김지윤

  • Published : 20031100
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the impact of LASIK on vision-related quality of life (QOL) in myopia patients Methods: This study included 288 patients who received laser in situ keratomileusis (LASIK) between July and December 2001 from two eye clinics located in Seoul and Pusan. Myopia-specific Quality of Life Questionnaire (MQLQ) was developed. MQLQ contained 34 questions in 4 domains that assess the effect of LASIK on visual function, visual symptoms, social and role function, and psychological well-being. Baseline QOL for the condition that refractive error was corrected by glasses or contact lenses before undergoing LASIK were evaluated by means of self-administered questionnaire. The evaluation was repeated at 4 days, 1 month, 3 months, and 6 months after LASIK. All question items were rated on a scale ranging from 1 (maximal dysfuntion) to 5 (no dysfunction). Results: Average score for the MQLQ changed from 3.20 preoperatively to 3.76, 3.99, 4.07, and 4.11 at 4 days, 1 month, 3 months, and 6 months after surgery, indicating a continuous improvement of overall QOL following LASIK. Among the 4 dimensions, social and role function showed the biggest improvement (changes in score: 1.48, p=0.001), followed by psychological well-being(0.98, p=0.001), visual function(0.67, p=0.001), and visual symptoms (0.49, p=0.001). Conclusions: LASIK has a significant contribution to improve QOL in myopia patients.

목적 : 레이저각막절삭성형술이 육체적, 사회적, 심리적 불편함을 해소하여 삶의 질 향상에 어느 정도 기여하는지 조사하였다. 대상과 방법 : 두 개의 안과에서 2001년 7월부터 12월 사이에 양안 모두 레이저각막절삭성형술을 받은 총 288명의 환자를 대상으로 술전, 술후 4일, 1, 3, 6개월에 근시관련 삶의 질 설문조사를 반복 수행하였다. 결과 : 술전 안경 및 콘택트렌즈로 굴절교정한 상태의 삶의 질은 총 34 문항의 평균척도값으로 측정한 결과 5점 만점에 3.20이었다. 술후 각 시점별로 반복 측정한 값은 3.76, 3.99, 4.07, 4.11로 시간경과에 따라 지속적으로 증가하였다. 사회적 역할기능(변화량: 1.48, p=0.001), 심리적 안녕(0.98, p=0.01), 시 기능(0.67, p=0.001), 안과적 증세(0.49, p=0.001) 순으로 향상을 보여 주었다. 결론 : 철저한 사전검사를 거쳐 적절히 시술된 레이저각막절삭성형술은 안경이나 콘택트렌즈를 이용한 굴절교정술에 비해시 기능 향상을 비롯하여 근시로 인한 사회적 역할기능장애의 해소와 심리적 위축의 감소를 가져와 근시환자의 삶의 질 향상에 효과적인 것을 알 수 있었다.

Keywords

References

  1. Pallikaris IG, Papatzanaki ME, Siganos DS, Tsilimbaris MK. A corneal flap teclmique for laser in situ keratomileusis: human studies. Arch Ophthahnol 1991;109:1699-702. https://doi.org/10.1001/archopht.1991.01080120083031
  2. Pillikaris IG, Papatzanaki M, Stathi E, et al. Laser in situ keratomileusis. laser Surg Med 1990;10:463-8. https://doi.org/10.1002/lsm.1900100511
  3. 동아일보. 라식수술, 중간근시에 큰 효과. 2000년 5월 19일. 55면(과학, 의학).
  4. 한국일보. 라식. 사전검사 철저히 하세요. 2002년 11월 10일.
  5. 조선일보, 라식수술 부작용과 대응법, 라식열풍 주의보. 2000년 9월 28일. 30면(사회).
  6. Gimbel HV, van Westenbrugge JA, Penno EE, et al. Simultaneous bilateral laser in situ keratomileusis: safety and efficacy. Ophthahnology 1999;106:1461-7.
  7. Holladay JT. Dudeja DR Chang J. Fnnctional vision and corneal changes after laser in situ keratomileusis determined by contrast sensitivity, glare testing, and corneal topography. J Cataract Refract Surg 1999;25:663-9.
  8. Dulaney DD, Barnet RW, Perkins SA, Kezirian GM. Laser in situ keratomileusis for myopia and astigmatism: 6 month results. J Cataract Refract Surg 1998;24:758-64. https://doi.org/10.1016/S0886-3350(98)80127-2
  9. 김상준, 차흥원. 고도근시에서 LASIK 수술: 1년 결과. 한안지 2000;41:88-95.
  10. 성민철, 주천기. 고도근시안에서 수정체적출술과 레이저 각막절삭가공성형술의 임상성적비교. 한안지 1999;40:102-9.
  11. Choi MS, Lee DR, Lee HB. Comparison of the clinical results in photorefractive keratectomy with that in laser in situ keratomileusis for correction of moderate myopia. 한안지 1998;39:60-6.
  12. McGhee CN, Craig JP, Sachdev N, Weed KH. Functional, psychological, and satisfaction outcomes of laser in laser keratomileusis for high myopia Journal of Cataract Refractive Surgery 2000;26:497-509.
  13. Hadden OB, Ring P, Morris AT, et al. Visual, refractive, and subjective outcomes after photorefracti e keratectomy for myopia of 6 to 10 diopters using the Nidek laser. Journal of Cataract Refractory Surgery 1999;25:936-42. https://doi.org/10.1016/S0886-3350(99)00073-5
  14. Rose K, Harper R, Tromans C, et al. Quality of life in myopia. British Journal of Ophthahnology 2000;84:1031-4. https://doi.org/10.1136/bjo.84.9.1031
  15. Vitale S, Schein OD, Meinert CL, Steinberg EP. The Refractive Status and Vision Profile: A questinnaire to measure vision-related quality of life in persons with refractive error. Ophthahnology 2000;107:1529-39.
  16. Desai P, ReidyA, Minassian DC. Gains from cataract surgery: visual function and quality of life. British Journal of Ophthahnology 1996;80:868-73. https://doi.org/10.1136/bjo.80.10.868
  17. Feritas C, Oliveiros BM, Marques E, et al. Effect of photorefractive keratectomy on visual functioning and quality of life. Journal of Refractive Surgery 1995;11:S327-34.
  18. Mangione CM, Berry S, Spritzer K, et al. Identifying the content area for the 51-item National Eye Institute Visual Fnnction Questionnaire. Arch Ophthahnology 1998;116:22733.
  19. Mangione CM, Lee PP, Pitts J, et al. Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEl-VFQ). Archives of Ophthahnology 1998b;116:1496504.
  20. Steinberg EP, Tielsch JM, Schein OD, et al. The VF-14. An index of functional impairment in patients with cataract. Arch Ophthal 1994;112:630-8.
  21. Ben Sira A, Loewenstein A, Lipshitz I, et al. Patient satisfaction after 5.0-mm photorefractive keratectomy for myopia J Refract Surg 1997;13:129-34.
  22. Halliday BL. Refractive and visual results and patient satisfaction after excimer laser photorefractive keratectomy for myopia. Br J Ophthahnol 1995;79:881-7. https://doi.org/10.1136/bjo.79.10.881
  23. 임성수, 허명회. SAS 실험설계 및 분산분석 입문. 자유아카데미 1998.
  24. Schein O, Vitale S, Cassard SD, et al. Patient outcomes of refractive surgery: The refractive status and vision profile. J Cataract Refract Surg 2001;27:665-73. https://doi.org/10.1016/S0886-3350(01)00844-6
  25. O'Brart DPS, Gartry DS, Lohmann CP, et al. Excimer laser photorefractive keratectomy for myopia: comparison of 4.00 and 5.00- millimeter ablation zones. J Refract Corneal Surg 1994;10:87-94.
  26. Vesaluoma M, Perez-Santonja J, Petroll WM, et al. Corneal stromal changes indaced by myopic LASlK. Invest Ophthahnol Vis Sci 2000;41:369-76.
  27. Chang SW, Benson A, Azar DT. Corneal light scattering with stromal reformation after laser in situ keratomileusis and photorefractive keratectomy. J Cataract Refract Surg 1998;24:1064-9. https://doi.org/10.1016/S0886-3350(98)80099-0
  28. Jain S, Khoury JM, Charnon W, et al. Corneal light scattering after laser in situ keratomileusis and photorefractive keratec torny. Am J Ophthalrnol 1995;120:532-4. https://doi.org/10.1016/S0002-9394(14)72672-8
  29. Lackner B, Pieh S, Schrnidinger G, et al. Glare and halo phenomena after laser in situ keratomileusis. J CataractRefract Surg 2003;29:444-50. https://doi.org/10.1016/S0886-3350(02)01816-3
  30. Aras C, Ozdamar A, Bahcecioglu H, et al. Decreased tear secretion after laser in situ keratomileusis for high myopia. J Refract Surg 2000;16:362-4.
  31. Siganos DS, Popescu CN, Siganos CS, et al. Tear secretion following excimer laser in situ keratomileusis. J Refract Surg 2002;18:124-6.
  32. Benitez-del-Castillo JM, Rio T, Iradier T, et al. Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea 2001;20:30-2. https://doi.org/10.1097/00003226-200101000-00005
  33. Ishikawa T, Park SB, Cox C, et al. Corneal sensation following excimer laser keratectomy in humans. Refract Corneal Surg 1994;10:417-20.
  34. Gilbard JP, Rossi SR. Tear film and ocular surface changes in a rabbit model of neurotrophic keraitis. Ophthalmology 1990;97:308-12. https://doi.org/10.1016/S0161-6420(90)32587-3
  35. Martin XY. Safran AB. Corneal hypoesthesia. Surv Ophthalmol 1988;33:28-40.
  36. Gobbels M, Spitznas M. Corneal epithelial permeability of dry eyes before and after treatment with artificial tears. Ophthalmology 1992;99:873-8. https://doi.org/10.1016/S0161-6420(92)31879-2
  37. Gobbels M, Spitznas M. Effects of artificial tears on corneal epithelial permeability in dry eyes. Graefes Arch Clin Exp Ophthalmol 1991;229:345-9. https://doi.org/10.1007/BF00170693
  38. Gobbels M, Spitznas M. Influence of artificial tears on corneal epithelium in dry-eye syndrome. Graefes Arch Clin Exp Ophthalmol 1989;227:139-41. https://doi.org/10.1007/BF02169786
  39. Grene RB, lankston P, Mordaunt J, et al. Non-preserved carboxymethylcellulose artificial tears evaluated in patients with keratoconjunctivitis sicca. Cornea 1992;11:294-301. https://doi.org/10.1097/00003226-199207000-00004
  40. Gilbard JP, Rossi SR. An electrolyte-based solution that increase corneal glycogen and conjunctival goblet-cell in a rabbit model for keratoconjunctivitis sicca. Ophthalmology 1992;99:600-4. https://doi.org/10.1016/S0161-6420(92)31929-3
  41. Lenton LM, Albietz JM. Effect of carrnellose-based artificial tears on the ocular surface in eyes after laser in situ keratornileusis. J Refract Surg 1999;15:S227-31.