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3회 이상 전층각막이식술을 시행 받은 환자의 장기간 임상결과와 이식실패의 위험인자
장재용,우제문,윤경철,Jae Yong Jang,Je Moon Woo,Kyung Chul Yoon 대한안과학회 2011 대한안과학회지 Vol.52 No.12
Purpose: To evaluate the primary indications, surgical outcomes, causes and risk factors for graft failure in patients with three or more penetrating keratoplasty (PKP) surgeries. Methods: We retrospectively analyzed indications for the initial corneal graft, survival periods, causes and risk factors for failure in 25 patients (26 eyes) who had undergone three or more PKP with minimum follow-up periods of nine months. Results: The most common primary indications were herpes simplex keratitis (26.9%), followed by fungal keratitis (19.2%) and bacterial keratitis (11.5%). The average survival period of graft in three or more PKP was 12.9 ± 9.1 months. As the frequency of PKP increased, the survival period became shorter; the survival period was the longest in pseudophakic bullous keratopathy and the shortest in herpes simplex keratitis. The most common cause of graft failure was allograft rejection (82.8%), and the risk factors for graft failure were short interval between penetrating keratoplasties and corneal neovascularization. Conclusions: In three or more PKP, as the frequency of PKP increases, the survival period becomes shorter. Short interval between keratoplasties and cornel neovascularization were risk factors for graft failure; this results must be considered before surgery. J Korean Ophthalmol Soc 2011;52(12):1399-1404
마이토마이신을 사용한 섬유주절제술 후 여과포 관리에 대한 석상 봉합의 유용성
이승주,우제문,김상우,안재환,임진호,Sung Ju Lee,Je Moon Woo,Sang Woo Kim,Jae Hwan An,Jin Ho Yim 대한안과학회 2013 대한안과학회지 Vol.54 No.2
Purpose: To evaluate the usefulness of external bandage suture for bleb-related management that follows trabeculectomy with mitomycin C. Methods: External bandage sutures were performed on 10 patients having hypotony maculopathy, persistent low intraocular pressure (IOP) caused by either hyperfiltration or focal leakage, or a persisting large bleb caused by hyperfiltration and who received trabeculectomy using mitomycin C as an adjuvant treatment. The changes in IOP measured before and 4 weeks after the procedure along with complication incidences were evaluated. Results: The mean IOP 4 weeks after the procedure compared with the mean IOP prior to the procedure increased from 5.8 ± 2.0 mm Hg (3.0-9.0 mm Hg) to 14.1 ± 8.5 mm Hg (4.0-32.0 mm Hg), with statistical significance (p = 0.008). After the procedure, improvement in visual acuity was observed but without statistical significance. One patient had persistent focal leakage from an avascular bleb and conjunctival advancement with removal of the avascular conjunctiva was performed. Conclusions: An external bandage suture can be a good alternative for correction of post-trabeculectomy hypotony and severe chemosis with minimal effect on blebs while correcting focal leakage and hyperfiltration.
생체 내 분해 콜라겐기질을 이용한 섬유주절제술의 임상적 소견 및 임상 효과에 대한 분석
이승주,우제문,민정기,기창원,임진호,Sung Ju Lee,Je Moon Woo,Jung Kee Min,Chang Won Kee,Jin Ho Yim 대한안과학회 2012 대한안과학회지 Vol.53 No.2
Purpose: To observe the effects of biodegradable collagen matrix (OculusGenTM) on filtering bleb formation and maintenance and to investigate its clinical effects and usefulness in trabeculectomy. Methods: Ophthalmologic examinations were preformed 1 day, 2 weeks, 1 month, 2 months, 3 months, 6 months, and 12 months postoperatively in the case and control groups. The clinical findings of the filtering bleb were observed, and the clinical effects measured by mean intraocular pressure and complications were evaluated in both groups. Results: The success rates were 76% in the case group and 88% in the control group, and there were no significant differences between the case and control groups. In the case group, postoperative conjunctival injection persisted for more than 1 month with increasing severity, while ultrasound biomicroscopy revealed increased echogenicity of the subconjuctival and tenon tissue with no definite space-occupying effect. Conclusions: Trabeculectomy utilizing collagen matrix showed similar clinical results compared to the current traditional trabeculectomy; slit-lamp and ultrasound biomicroscopy findings did not reveal any advantageous changes to filtering bleb function. J Korean Ophthalmol Soc 2012;53(2):297-305
건성안이 있는 이식편대숙주질환에서 사이클로스포린 A 점안치료 후 장기간의 경과관찰
이승현,임성규,우제문,윤경철,Seung Hyun Lee,Seoung Kyu Im,Je-Moon Woo,Kyung Chul Yoon 대한안과학회 2009 대한안과학회지 Vol.50 No.1
Purpose: This study was performed to evaluate the long-term effect of 0.05% cyclosporine A emulsion (Restasis, Allergan Inc. USA.) on dry eye associated with graft-versus-host disease (GVHD). Methods: Sixteen eyes of 8 patients with severe dry eye associated with GVHD were treated with 0.05% cyclosporine A emulsion twice a day. Tear film parameters were evaluated before treatment and after 1, 3, 6, and 12 months of treatment. Results: One month after treatment, tear break-up time improved from 3.88±1.78 s to 4.17±1.90 s (P=0.02). Three months after treatment, symptom score and basal secretion improved from 3.00±0.38 and 4.44±1.59 mm to 2.33±0.52 (P=0.04) and 5.42±2.50 mm (P=0.04), respectively. Twelve months after treatment, the keratoepitheliopathy score improved from 2.38±1.31 to 1.13±0.35 (P=0.02). Conclusions: Use of a 0.05% cyclosporine A emulsion is effective for dry eye associated with GVHD as it helps to increase tear secretion and to relieve symptoms. Treatment with 0.05% cyclosporine A emulsion for longer than 1 year may be necessary to improve keratoepitheliopathy.
공막 돌륭술 환자에서 피브리노겐-트롬빈 접착제를 사용한 결막 부착법의 유용성
박경수,김상우,우제문.Kyung Soo Park. MD. Sang Woo Kim. MD. PhD. Je Moon Woo. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.12
Purpose: We investigated the efficacy of fibrin glue for conjunctival closure in scleral buckling operations.<br /> Methods: Thirty-seven eyes of 35 patients who underwent conjunctival closure for a scleral buckling operation with a minimum follow-up period of 3 months were evaluated. Postoperative discomfort (average score), presence of remnant adhesives, scleral buckle material infection, and wound dehiscence were evaluated prospectively in 35 eyes of 33 patients undergoing surgery with fibrin glue.<br /> Results: The eyes showed decreasing conjunctival injection and hemorrhage over time and near to full recovered without any treatment after 1 month. With time, the average discomfort score decreased significantly (p < 0.05) and wound dehiscence was found in only 1 eye. There was no adhesive remnant in any of the eyes.<br /> Conclusions: The use of fibrin glue for conjunctival closure in scleral buckling operations is excellent as a cosmetic and functional method. The glue can reduce postoperative discomfort and is especially useful as a method to replace conventional conjunctival sutures. <br /> J Korean Ophthalmol Soc 2013;54(12):1832-1837