목적: 웨이브프론트 라식수술에서 파면수차의 수술 전 특성과 수술 후 변화를 알아보고자 하였다. 방법: 웨이브프론트 라식수술(NAVEX EC-5000 CXⅡExcimer Laser System: NIDEK Co.)을 시행한 50안(27.64±5.2세)을 대상으로 수술 전, 수술 후 1개월, 3개월, 6개월의 시력, 굴절도, 파면수차, 제니케계 수를 측정하여 비교분석하였다. 결과: 수술 전 파면저위수차는 6.084±2.313 ㎛, 파면고위수차 0.396±0.092 ㎛, 총파면수차 6.100± 2.307 ㎛이었고, 제니케계수는 파면저위수차에서 틸트수차 0.520±0.255 ㎛, 난시와 디포커스수차 6.052± 2. 325 ㎛, 파면고위수차에서 구면수차 0.115±0.077 ㎛, 코마수차 0.214±0.112 ㎛, 세 조각수차 0.235± 0.087 ㎛, 고위난시수차 0.076±0.039 ㎛, 네 조각수차 0.094±0.042 ㎛이었다. 수술 후 6개월째 총파면수 차는 수술 전보다 3.42배 감소하였고, 파면저위수차는 3.67배 감소하였으며, 파면고위수차에서는 1.45배 증 가하였다. 제니케계수는 난시와 디포커스수차가 4.18배 감소하였고, 틸트수차는 1.29배, 구면수차 1.93배, 코마수차 1.45배, 세 조각수차 1.11배, 고위난시수차 1.75배, 네 조각수차는 1.47배 증가하였으며 세 조각수 차와 네 조각수차는 통계적으로 유의하지 않았다. 수술 후 6개월째 파면저위수차는 자동굴절이상도의 구면 도수(r=-0.520, p=0.000) 및 구면렌즈대응치(r=-0.534, p=0.000)와 음의 상관성을 보였고, 총파면수차도 구면도수(r=-0.457, p=0.001) 및 구면렌즈대응치(r=-0.478, p=0.000)와 음의 상관성을 보였다. 결론: 웨이브프론트 라식수술 후 파면저위수차와 총파면수차는 유의하게 감소하였고 파면고위수차는 유 의하게 증가하였으며, 구면수차와 고위난시수차가 가장 크게 증가하였다.

Purpose: To investigate the preoperative characteristics and postoperative change of the wavefront aberrations in wavefront-guided LASIK surgical operation. Method: Wavefront-guided LASIK surgical operation was performed in 50 eyes(age 27.64±5.2) using the NAVEX EC-5000 CXⅡexcimer Laser System. analysis was performed preoperative and months(1, 3, 6) postoperative visual acuity, refractive, wavefront aberrations, Zernike coefficients in measurement. Results: 6.084±2.313 ㎛ in LOA, 0.396±0.092 ㎛ in HOA, 6.100±2.307 ㎛ in TOA was measured before LASIK. Analysing Zernike coefficients taken before LASIK. 0.520±0.255 ㎛ of tilt and 6.052±2.325 ㎛ of astigmatism and defocus in LOA, and 0.115±0.077 ㎛ of spherical aberration, 0.214±0.112 ㎛ of coma, 0.235±0.087 ㎛ of trefoil, 0.076±0.039 ㎛ of astig and 0.094±0.042 ㎛ of tetrafoil in HOA was measured respectively. six months postoperative, 1.657±0.934 ㎛ in LOA, 0.575±0.318㎛ in HOA, 1.784±0.929㎛ in TOA was measured. Analysing Zernike coefficient, 0.668±0.378 ㎛ of tilt and 1.448±0.963 ㎛ of astigmatism and defocus in LOA and 0.222±0.141 ㎛ of spherical aberration, 0.311±0.158 ㎛ of coma, 0.260±0.168 ㎛ of trefoil, 0.133±0.138 ㎛ of astig and 0.138±0.228 ㎛ of tetrafoil in HOA was measured respectively six months postoperative of LASIK. TOA and LOA decreased 342% and 367% respectively and HOA increased 145% at post operative. Negative correlations between LOA and spherical power(r=-0.520, p=0.000) and spher ical equivalent(r=-0.534, p=0.000) of auto refraction were shown six months postopera tive. Also, negative correlation between TOA and spherical power(r=-0.457, p=0.001) and spherical equivalent(r=-0.478, p=0.000) of shown. Conclusions: The wavefront aberrations, especially spherical aberration and astig aberration shown the most increased after wavefront-guided LASIK surgical operation. Also, decreased to significantly statistically low order wave front aberrations(LOA) and total wavefront aberration(TOA) but, increased to significantly statistically higher order wavefront aberrations(HOA).

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