장기간의 연성 콘택트렌즈 착용이 각막두께, 각막곡률 및 각막내피세포에 미치는 영향

박영정,이광자,박준정,정병진,이규원,Young-Jeung Park,Gwang-Ja Lee,Joon-Jeong Park,Byung-Jin Jeong,Kyoo-Won Lee 대한안과학회 2005 대한안과학회지 Vol.46 No.6

Purpose: To investigate the effects of long-term contact lens (CL) wearing on corneal thickness, curvature, and endothelium. Methods: Using ultrasonic pachymetry, Orbscan topography and specular microscopy, we evaluated the cornea of 53 subjects who had used soft CL for more than 5 years compared with 47 controls who had never used CL. Results: There was a significant decrease of central corneal thickness in CL wearers. The difference of central corneal thickness between the two groups was 16.39 ?m. The percentage of central corneal thickness less than 500 ?m was 24.5% in the CL wearers and 12.2% in the controls. The mean corneal thickness of the CL wearers in the center and eight peripheral areas, as measured with Orbscan topography, was significantly reduced by about 7.28 to 17.87 ?m compared with that of the controls. The corneal curvature and elevation were significantly steeper in the CL wearers than in the controls but no difference in the mean corneal astigmatism was found between the two groups. Endothelial density and percentage of hexagonal cells were decreased and the coefficient of cell area variation was increased in the CL wearers compared to the controls. The percentage of endothelial cell densities less than 2500 cells/mm2 was 24.5% in the CL wearers and 4.25% in the controls. Conclusions: Long-term soft contact lens use may have a significant effect on corneal thickness, curvatures and endothelial morphology.

재발성군날개 치료에 있어 항혈관내피성장인자 항체 베바시주맙을 적용한 임상효과

이종욱,박영정,김인택,이규원,Jong Wook Lee,Young Jeung Park,In Taek Kim,Kyoo Won Lee 대한안과학회 2008 대한안과학회지 Vol.49 No.12

Purpose: To clinically establish the effectiveness and safety of bevacizumab on recurrent pterygium. Methods: Twenty patients with recurrent pterygium were given a subconjunctival injection of 0.3 cc bevacizumab, and were evaluated for periodic clinical results at 1 week, 2 weeks, 4 weeks, and every month thereafter. The patients were also evaluated for clinical results and complications. Results: Of recurrent pterygium patients with bevacizumab injection, the conjunctival injection decreased maximally after 1 to 2 weeks, but significantly increased at 4 weeks (above the lowest level measured at 1 to 2 weeks), and no patient presented conjunctival injection above the pre-injection level at 3 months, except in 2 cases. Two weeks after the injection, ICG anterior segment angiography revealed a significant decrease (30.14+17.69%) in vessel thickness of the pterygium 2 weeks after the bevacizumab injection compared to before the injection. There had been no cases of progression of pterygium, and no ocular or systemic complications due to bevacizumab. Conclusions: As shown above in the results, subconjunctival injection of 0.3 cc bevacizumab decreased the conjunctival injection and effectively suppressed any further progression of pterygium. Thus, bevacizumab subconjunctival injection appears to be effective in recurrent pterygium treatment instead of surgical methods.

청색광차단 인공수정체와 자외선차단 인공수정체의 시기능 비교

이근영(Geun Young Lee),김임규(Im Gyu Kim),유성(Sung Yu),이광자(Gwang Ja Lee),이규원(Kyoo Won Lee),박영정(Young Jeung Park) 대한안과학회 2017 대한안과학회지 Vol.58 No.1

목적: 백내장 수술을 받은 동일 환자에서 청색광 차단 황색 착색 인공수정체(Acrysof IQⓇ SN60WF)와 자외선 차단 투명 인공수정체(enVistaTM MX60)를 삽입 후 단기간 시력 및 시기능 결과를 비교하고자 한다. 대상과 방법: 양안 백내장 수술을 진행한 44명 환자를 대상으로 한 눈에는 SN60WF를 다른 눈에는 MX60을 삽입하였다. 대상환자는술 전, 술 후 1, 3개월에 굴절력, 나안시력을 측정하였다. 수술 후 3개월째 교정시력, OQAS ⅡⓇ를 이용한 시력의 질 측정, CGT 2000Ⓡ을 통한 대비감도 검사, 자동시야검사를 하여 두 눈에서 시력과 시기능을 비교하였고 두 눈에서 주관적 밝기를 평가하였다. 또한 인공수정체의 반짝임 변성 정도, 인공수정체의 낭내 안정성과 후낭혼탁을 검사하였다. 결과: 술 후 두 군에서 모두 1개월, 3개월째 평균 굴절력과 나안시력, 교정시력은 차이가 없었다(p>0.05). 술 후 3개월째 OQAS ⅡⓇ를 이용한 시력의 질, CGT 2000Ⓡ을 이용한 glare on 또는 off 상태의 대비감도, 시야검사결과 비교는 두 군에서 차이가 없었으며(p>0.05), 두 군 모두 반짝임 변성이 없었고, 후낭혼탁이 발생하지 않았다. 밝기를 묻는 설문에서는 48.3%에서 MX60군이 더 밝게보인다고 답하였다. 결론: 청색광 차단 황색 착색 인공수정체와 자외선 차단 투명 인공수정체는 단기간의 시력과 시기능에 차이가 없었으나 주관적 밝기는 자외선 차단 투명 인공수정체에서 높았다. Purpose: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ?? SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVistaTM MX60) in the same patient. Methods: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQASⅡ??), contrast sensitivity (CGT 2000??) and visual field(Humphrey Field Analyzer??), and subjective patients response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. Results: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQASⅡ??, the contrast sensitivity according to CGT 2000?? with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. Conclusions: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.

무방부제성 플루오로메토론 0.1% 점안액의 안구건조증에서의 효과 및 안정성 비교

박준호,이준훈,박영정,김홍균,Joon Ho Park,Jun Hun Lee,Young Jeung Park,Hong Kyun Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: To evaluate the efficacy and safety of topical unpreserved 0.1% fluorometholone (FML) ophthalmic solution in patients with dry eye syndrome. Methods: Patients with mild to moderate dry eye syndrome were divided into the control group (Group I), topical unpreserved 0.1% FML group (Group II), and topical preserved 0.1% FML group (Group III). Intraocular pressure (IOP), Ocular Surface Disease Index (OSDI), tear film break-up time (TF-BUT), Oxford stain score (OSS), and tear osmolarity (Tosm) were evaluated at 2 weeks, 4 weeks, 8 weeks, and 12 weeks (Trial 1). Patients with severe dry eye syndrome were divided into 1% methylprednisolone (MP) group (Group I) and 0.1% unpreserved FML group (Group II). Same parameters were evaluated in both groups (Trial 2). Results: In clinical trial I, OSS scores of Group II were lower than other groups (p < 0.05). For severe dry eye patients in clinical trial 2, there were no significant differences in all parameters between the 2 groups. Conclusions: Topical unpreserved 0.1% fluorometholone was shown to be an effective and relatively safe treatment in patients with dry eye syndrome.

소안구증 환자에서 piggyback 방법을 이용한 백내장 수술

이종욱,최원석,박영정,이규원.Jong Wook Lee. MD. Won Suk Choi. MD. Young Jeung Park. MD. PhD. Kyoo Won Lee. MD. PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.7

Purpose: To report a case of cataract surgery using a piggyback method in a patient with pure nanophthalmos with an axial length under 16.00 mm in both eyes. Case summary: The authors performed cataract surgery using a piggyback method inserting two intraocular lenses (IOLs) in a 44-year-old male with nanophthalmos with axial lengths of OD 15.36 mm, and OS 15.59 mm. Primary implantation of two IOLs of +53.0D as calculated by the SRK/T and Holladay formula was performed in the right eye using a piggyback method. In the left eye, two IOLs of +60.0D calculated by the Hoffer Q formula were implanted. Postoperative hyperopic refractive errors occurred in both eyes. The differences between the preoperative target spherical equivalent (SE) and the postoperative one year four month SE were 9.68D in the right eye and 1.63D in the left eye. Conclusions: Due to high diopter IOL requirements in nanophthalmic patients (less than 16.00 mm) during cataract surgery, the refractive errors were well corrected, without complications, by using a piggyback method. In the present case study, the Hoffer Q formula produced better results than did the SRK/T or Holladay formula in reducing the difference in preoperative and postoperative SEs, but more surgical cases and research are required to establish the most appropriate formula for cataract surgery in nanophthalmos.

고도근시에서 굴절교정레이저각막절제술 후 각막혼탁을 줄이기 위해 사용한 마이토마이신의 효과

정병진,김현호,박영정,이광자,이규원.Byung Jin Jeong. M.D.. Hyun Ho Kim. M.D.. Young Jeung Park. M.D.. Gwang Ja Lee. M.D.. Kyoo Won Lee. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.5

Purpose: To evaluate the safety and results of the prophylactic use of 0.02% mitomycin C (MMC) to inhibit haze formation after excimer laser photorefractive keratectomy (PRK) for high myopia in eyes that were not good candidates for laser in situ keratomileusis (LASIK) because of inadequate corneal thickness. Methods: On thirty eyes with high myopia (-6.0 to -10.13 diopters), PRK with intraoperative topical 0.02% MMC application was performed. Visual acuity, refraction, keratometry, corneal haze, central corneal thickness, corneal endothelium, repair of corneal epithelium, and other complications were evaluated for 1 year. Results: No eyes showed any BCVA loss, and some even presented a BCVA increase, except in one case: one eye had lost a line 1 year after PRK. At 1 year after surgery, the spherical equivalent was within ±0.5 D of the desired refraction in 73.33% of the cases, and 86.67% were within ±1.0 D of the intended refraction. At 3 months after surgery, the mean corneal haze scale stabilized at about 0.22, and decreased further thereafter. Central corneal thickness increased steadily postoperatively, whereas endothelial density decreased significantly, however, the percentage of hexagonal cells and coefficient of variation in cell area showed no change. Epithelial regeneration was complete within 4 days, and there were no other complications. Conclusions: The prophylactic use of a 0.02% MMC applied intraoperatively after PRK produced lower haze rates and a better visual outcome. But, due to the decrease in endothelial cell density, the safety of MMC can be determined only after long-term observation.

공막연화증에서 조직접합제를 이용한 공막이식술, 자유자가결막이식술 및 일시적 양막이식술

최원석,이광자,박영정,이규원,Won Suk Choi,Gwang Ja Lee,Young Jeung Park,Kyoo Won Lee 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To evaluate the surgical results and complications arising from scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation as the surgical treatment for scleromalacia. Methods: Scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation was performed in 20 eyes of 20 patients with scleromalacia caused by pterygium excision. The surgical results and complications arising from the procedure were monitored and analyzed through follow-up. Results: During the follow-up period of 17.6 ± 5.9 months, the wound injection and edema at the free conjunctival autograft and operation site healed in all the cases except 1 at postoperative 1 month. The stability of the ocular surface for graft transplantation was maintained at postoperative 3 months. Although a partial absorption of the conjunctival autograft induced by careless treatment occurred 2 weeks postoperative in 1 case, the ocular surface stabilized due to suitable treatment after 6 months. Although the edges of the scleral graft in 3 patients were partially absorbed 6 months postoperatively, the ocular surface stability was maintained by covering the conjunctival autografts. Conclusions: For scleromalacia patients, scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation rapidly stabilized the ocular surface and presented excellent aesthetic results. J Korean Ophthalmol Soc 2011;52(12):1405-1413

양쪽머리 군날개의 수술적 치료에 대한 임상연구

이병희,이광자,박영정,이규원.Byeong Hee Lee. MD. Gwang Ja Lee. MD. Young Jeung Park. MD. Kyoo Won Lee. MD 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To evaluate two surgical methods-amniotic membrane transplantation (AMT) and split-conjunctival grafts (SCG)-for double-head pterygium, with regard to the postoperative outcome and recurrence rate. Methods: In a total of 16 eyes (14 patients), 7 eyes (6 patients) receiving amniotic membrane transplantation and 9 eyes (8 patients) receiving split-conjunctival grafts were compared to evaluate recurrence and complications. Results: Within the amniotic membrane transplantation group, two eyes (29%) had corneal recurrence, and 3 eyes (43%) had conjunctival recurrence. The mean follow-up period was 21.9±3.5 months, and all recurrences were on the nasal side. The average period preceding the corneal recurrences was 7.2±1.8 months. Within the split-conjunctival grafts group, the mean follow- up was 13.6±2.1 months, and neither the corneal nor conjunctival recurrences were observed. In addition, the eyes of this group were more aesthetically stable, with only one eye exhibiting pseudo-pterygium at the donor site. Conclusions: In cases of double-head pterygium without contraindication of conjunctival autograft, the split-conjunctival grafts produced fewer recurrences and showed enhanced cosmetic results, as compared to the amniotic membrane transplantation, indicating that the split-conjunctival grafts is the superior choice over amniotic membrane transplantation. J Korean Ophthalmol Soc 2010;51(5):642-650

공막연화증에 대하여 조직접합제를 이용한 동종공막이식술과 양막이식술의 임상성적

이병희,문홍재,박영정,이규원,Byeong Hee Lee,MD,Hong Jae Mun,MD,Young Jeung Park,MD,Kyoo Won Lee,MD 대한안과학회 2010 대한안과학회지 Vol.51 No.4

Purpose: To examine the effects, complications, and safeties of sclera allograft and amniotic membrane transplantation with fibrin glue as surgical treatment methods for scleromalacia. Methods: The study included 14 eyes of 14 scleromalacia patients who needed surgical treatment. Among them, seven eyes of seven patients whose scleral defect was small (<6 mm) were operated on using only fibrin glue and no suturing, while seven eyes of seven patients whose defect was large (>6 mm) were operated on using fibrin glue and minimum suturing. Amniotic membrane transplantation was performed at the site of the conjunctival defect. Results: In all of the cases, the results of grafting were successful throughout the follow-up period, which was 14.6±4.4 months, on average (ranging from 12 to 27 months). No particular complication was observed during the follow-up period after using fibrin glue. Conclusions: For scleromalacia patients, sclera allograft and amniotic membrane transplantation were performed using fibrin glue. The grafted sclera survived successfully, allowing this treatment modality to be considered an effective and safe option without complications. J Korean Ophthalmol Soc 2010;51(4):485-491

원추각막에서 수기 각막링 터널 생성을 이용한 인택스(Intacs;)링 삽입술의 임상 결과

김은주,구성현,이광자,이규원,박영정,Eun Joo Kim,MD,Sung Hyun Koo,MD,Gwang Ja Lee,MD,Kyoo Won Lee,MD,Young Jeung Park,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To report the clinical results after the implantation of intrastromal corneal ring segments (Intacs<sup>?) by manual tunnel creation for the correction of keratoconus. Methods: This retrospective case series was comprised of 10 eyes of 8 consecutive keratoconic patients. Visual acuity, refractive outcome, keratometric values, anterior chamber depth, central corneal thickness, and endothelial cell density were evaluated before and at 1 month, 3 months, and 6 months postoperatively. In addition, the implanted ring segment depth was measured by anterior segment optical coherence tomography at postoperative 6 months. Any postoperative complications were also recorded. Results: Visual acuity was improved in 9 out of 10 eyes. Spherical equivalent and keratometric values were decreased in all eyes. There was no significant difference in central corneal thickness, but endothelial cell density and anterior chamber depth were slightly decreased. The depth of ring segments was almost constant at superior, middle, and inferior. There was a single case of descented implanted ring segments and 6 cases of stromal infiltration around ring segments, but visual acuity was unaffected. In addition, 1 case showed implanted ring exposure, thus the superior ring segment was removed at postoperative 4 months. Conclusions: Intrastromal corneal ring segment implantation (Intacs<sup>?) by manual tunnel creation appears to be effective in improving the visual acuity and stabilizing corneal refractive power in keratoconic patients. J Korean Ophthalmol Soc 2012;53(12):1756-1765