Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
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Changes of Refractive Errors Caused by Corneal Shape and Pupil Size

각막지형과 동공크기에 의한 굴절교정값의 변화

  • 노연수 (강원대학교 안경광학과) ;
  • 김상엽 (강원대학교 안경광학과) ;
  • 문병연 (강원대학교 안경광학과) ;
  • 조현국 (강원대학교 안경광학과)
  • Received : 2014.08.01
  • Accepted : 2014.09.18
  • Published : 2014.09.30
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Abstract

Purpose: To investigate the effect of corneal unique shape to changes of refractive full corrections when pupil size changes. Methods: Subjective refraction for monocular full correction was performed to 30 subjects ($23.33{\pm}1.78$ of age, 60 eyes) in two room conditions, 760 lx and 2 lx, respectively. Pupillary diameter was measured in two conditions and the change pattern was analyzed using a peak data of corneal topography. Results: Pupillary diameter was 3.74~4.00 mm in 760 lx and 5.52~5.90 mm in 2 lx. By comparison with refractive data in 760 lx, those data in 2 lx was changed as follows: more (-) spherical power of 17 eyes (28.3%), more (+) spherical power of 10 eyes (17.7%), more (-) cylinderical power of 17 eyes (28.8%), less (-) cylinderical power of 9 eyes (15.3%), and astigmatic axis rotation of 36 eyes (62.1%). From peak data of corneal topography, the changing pattern of two principal meridians was classified into 4 types. Conclusions: Expansion of the corneal refractive surface accompanied with pupillary dilation may be a main factor that effects the changing a values of subjective refraction because of unique corneal shape. Therefore, subjective refraction should be performed under the nearest lighting condition to a main living environment.

목적: 동공크기가 달라질 때 각막의 고유한 형태가 굴절검사 완전교정값에 미치는 영향을 조사하였다. 방법: 평균연령 $23.33{\pm}1.78$세의 30명(60안)을 대상으로 검사실 조도 760 lx와 2 lx에서 각각 자각적굴절검사를 실시하여 단안 완전교정하고, 동공의 크기를 측정하였다. 그리고 각막지형을 측정한 후 peak data를 이용하여 각막지형의 변화를 분석하였다. 결과: 검사실 조도 760 lx에서 측정된 동공크기는 3.74~4.00 mm, 2 lx에서는 5.52~5.90 mm로 측정되었다. 760 lx에서 2 lx로 조도가 변화될 때 (-)구면굴절력이 증가한 경우는 17안(28.3%), (+)구면굴절력이 증가한 경우는 10안(16.7%), (-)원주굴절력이 증가한 경우는 17안(28.8%), (-)원주굴절력이 감소한 경우는 9안(15.3%), 그리고 난시축이 변화한 경우는 36안(62.1%)이었다. 각막지형측정에서 나타난 peak data 분석 결과 각막 주경선의 변화는 4가지 형태로 분류되었다. 결론: 동공확대에 따른 각막굴절면 확장은 각막의 고유한 형태로 인해 자각적굴절 검사값을 변화시키는 요인으로 작용하므로, 자각적굴절검사는 주된 생활환경에 맞는 조도조건에서 실시하여야 한다.

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