동공크기에 따른 초음파유화흡인술의 결과

조양경,김은철,김만수,Yang Kyung Cho,Eun Chul Kim,Man Soo Kim 대한안과학회 2007 대한안과학회지 Vol.48 No.6

Purpose: To evaluate surgical results of phacoemulsification cataract surgery with respect to pupil size and iris retractors and to compare the effects of iris retractors according to the pupil size. Methods: This retrospective study included 90 eyes that underwent phacoemulsification cataract surgery. All of the eyes had a maximally dilated pupil size of 7 mm or smaller. Results: When the patients were evaluated according to pupil size, we found no difference in BCVA (best-corrected visual acuity) and phaco power × time between patients who had surgery involving iris retractors and those who did not. However, in patients with pupil sizes 3 mm or smaller, we did observe a statistically significant decrease in endothelial cell density (CD) when the iris retractor was used compared to when the retractor was not used (p<0.05). A comparison of preoperative and postoperative BCVA measurements revealed a significant BCVA increase in eyes with pupils larger than 3 mm. In contrast, in eyes with pupils smaller than 5 mm, significant decreases in CD were found when the preoperative and postoperative measurements were compared. Conclusions: In this study, we found that the iris retractor is useful for protecting corneal endothelial cells when the pupil size is smaller than 3 mm.

콘택트렌즈 착용 후 발생한 알칼리제네스 자일로속시던스에 의한 각막염 1예

조양경,지동현,김현경,나태윤,Yang Kyung Cho,Dong Hyun Gi,Hyun Kyung Kim,Tae Yoon La 대한안과학회 2010 대한안과학회지 Vol.51 No.11

Purpose: To report a case of corneal ulcer due to Alcaligenes xylosoxidans in a soft contact lens wearer. Case summary: A 20-year-old female patient presented with a corneal ulcer. The patient had been wearing soft contact lenses over 6 months. The ulcer had a typical appearance, similar to that of immune infiltration due to contact lenses. However, the corneal scraping and culture yielded Alcaligenes xylosoxidans, which is susceptible to ceftazidime and levofloxacine in the antibiotic susceptibility test. After treatment with topical antibiotics, her eye improved, with only a mild corneal scar remaining. Conclusions: Alcaligenes xylosoxidans should be considered as a potential causal pathogen of keratitis upon wearing soft contact lenses. Additionally, any lesion should be suspected as a bacterial corneal ulcer, even if appearing as an immune infiltration due to contact lenses. J Korean Ophthalmol Soc 2010;51(11):1525-1527

후층판각막이식술후 이식편의 부착 및 각막기능의 회복에 관한 연구

조양경,김만수,Yang Kyung Cho,M,D,Man Soo Kim,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.7

Purpose: Posterior lamella keratoplasty has been described as a new procedure to treat corneal conditions involving endothelial dysfunction by selective transplantation of only the posterior corneal tissue composed of the endothelium, Descemet membrane, and posterior stroma. This study has been conducted to evaluate the recovery of endothelial function and adhesion mechanism of transplanted posterior corneal tissue to the donor stroma after posterior lamella keratoplasty. Methods: Dog corneal endothelium and posterior stroma were transplanted to recipient dog cornea stripped of endothelium and posterior stroma. The recovery of endothelial function and corneal thickness were measured by specular microscopy; pachymetry and slit lamp examination were done immediately after posterior lamella keratoplasty and at 1, 2, 4, 8 weeks post-operative. Eight weeks after operation, enucleation was performed and the histopathologic changes in the transplanted area of enucleated eyes were examined by light microscopy, fluorescent microscopy, and electron microscopy. Results: Corneal thickness, endothelial function, and corneal transparency were recovered by the end of experiment. The newly produced collagen fibrils were absent at the corneal posterior flap and anterior stromal bed interface. The collagen fibrils adjacent to the flap interface were irregularly arranged and morphologically transformed in some cases (2 of 8 cases) and were linearly arranged in a parallel manner in others (6 of 8 cases). Conclusions: It can be suggested that the stability of transplanted posterior corneal flap is maintained by incomplete wound healing and recovery of corneal endothelial function.

안와 과립구육종 1 예

조양경(Yang Kyung Cho),문정식(Jung Sig Moon),박미라(Mi Ra Park),최웅철(Woong Chul Choi) 대한안과학회 1999 대한안과학회지 Vol.40 No.11

홍채에서 발생한 흑색 세포종 1예

이진아,안용선,조양경,Jin Ah Lee,MD,Yong Sun Ahn,MD,Yang Kyung Cho,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To report a case of melanocytoma originating from the iris observed for the first time in Korea. Case summary: A 53-year-old female with an unexpected iris mass was referred to our clinic. A round, 2.5 mm x 3.5 mm-sized iris mass was found on slit lamp examination in the 12 o'clock area of the patient's left eye. The mass was densely pigmented and had a smooth surface. Gonioscopy showed the mass had reached the peripheral cornea frontward and the lens backward. An excisional biopsy was performed for diagnosis. After the operation, a gonioscopic examination showed an intact ciliary body behind the surgical margin of the iris. A melancytoma of the iris was observed on subsequent histopathological examination. The patient has remained symptom-free with no iris mass recurrence since the operation. Conclusions: A few cases of iris melanocytomas have been reported worldwide but not in Korea. We confirmed a case of melanocytoma originating from the iris for the first time in Korea. J Korean Ophthalmol Soc 2014;55(5):789-793

플릭텐각막염 환자에서 발생한 각막 천공

안용선,이진아,조양경,Yong Sun Ahn,Jin A Lee,Yang Kyung Cho 대한안과학회 2014 대한안과학회지 Vol.55 No.2

Purpose: Corneal perforation from phlyctenular keratoconjunctivitis is rarely reported worldwide and no case has been reported in Korea. We report a case of corneal perforation in a patient with phlyctenular keratoconjunctivitis along with a literature review. Case summary: A 15-year-old female presented to our clinic with repetitive tears, conjunctival injection, and discomfort in her right eye for several months. Slit-lamp examination revealed oily plugs at the meibomian gland orifices with collarettes, conjunctival injection and a round, whitish elevated lesion accompanying neovascularization of the inferotemporal side of the cornea. As an initial treatment, topical antibiotic was given but no signs of improvement were observed. Hence, topical steroid was applied on suspicion of phlyctenular keratitis and the patient’s symptoms and corneal lesion improved. Two months later, the patient’s symptoms relapsed and the lesion was found progressing towards the central cornea. The treatment was restarted and the symptoms improved but the corneal lesion continuously progressed towards the center, thinning the central cornea. Seventeen months from the time of initial diagnosis, the patient revisited prior to the scheduled appointment complaining of abrupt tears in her right eye. Slit-lamp examination revealed a corneal perforation at the center of the thinned cornea. Hence, we performed an emergent tectonic corneal patch graft. After the operation, opacity remained covering the visual axis at the central cornea, thus penetrating keratoplasty was performed 10 months later. Henceforth, the patient has remained free of symptoms and visual acuity has been recovered. Conclusions: Usually phlyctenular keratoconjunctivitis responds well to treatment and does not have a significant influence on vision. However, occasionally phlyctenular keratoconjunctivitis may not respond to treatment and may spread to the central cornea causing loss of visual acuity and even corneal perforation in rare occasions. Therefore, in order to prevent such complications, prompt diagnosis and treatment are essential. J Korean Ophthalmol Soc 2014;55(2):298-303

안축장이 긴 눈의 백내장수술 후 굴절력의 안정성 관찰 : 일체형과 세 부분 인공수정체 비교

이지혜(Ji Hye Lee),조양경(Yang Kyung Cho) 대한안과학회 2022 대한안과학회지 Vol.63 No.2

목적: 안축장이 긴 눈에서 백내장수술 후 굴절력의 변화 및 삽입한 인공수정체 종류에 따른 수술 후 굴절력의 변화 및 안정성을 비교해 보고자 하였다. 대상과 방법: 수정체유화술 및 후방인공수정체삽입술을 시행한 환자 중 안축장 길이가 22.0 mm 초과, 24.5 mm 이하인 안축장이 정상인 눈 44안과 24.5 mm 초과인 안축장이 긴 눈 49안을 대상으로 후향적 연구를 시행하였다. 자동 굴절곡률검사계를 이용하여 각막곡률 및 굴절률을 측정하였고, A-scan 초음파를 이용하여 술 후 목표굴절력을 계산하였다. 일체형 인공수정체 Precizon?怜? TECNIS?? ZCB00 그리고 세 부분 인공수정체 Hoya?? YA60BBR을 사용하였으며, SRK-T 공식에 의해 계산된 목표굴절력과 수술 후 2개월, 12개월째 측정한 굴절력의 차이(예측 오차)를 분석하였다. 삽입된 인공수정체에 따른 수술 후 2개월과 12개월 사이의 굴절력의 변화를 비교하였다. 결과: 안축장이 정상인 눈에 비해 안축장이 긴 눈에서 목표굴절력보다 수술 후 2개월과 12개월째 모두 유의하게 근시 방향의 예측 오차를 보였다(p=0.003, p=0.013). 삽입한 인공수정체에 따른 술 후 굴절력의 안정성을 비교해 보았을 때 안축장이 정상인 눈에서는 차이가 없었으나, 안축장이 긴 눈에서는 세 부분 인공수정체를 삽입하였을 때 가장 유의한 안정성을 보였다(p<0.05). 결론: 안축장이 긴 눈의 경우 삽입한 인공수정체에 따른 백내장수술 후 굴절력의 안정성 차이를 보였으며, 세 부분 인공수정체가 일체형 인공수정체보다 유의한 굴절력 안정성을 보임을 알 수 있었다. Purpose: To assess the refractive changes and stability after cataract surgery with insertion of three different intraocular lenses in axial myopes. Methods: A retrospective analysis was performed with 44 eyes of normal axial length (22.0 mm < axial length ≤ 24.5 mm) and 49 eyes of long axial length (24.5 mm < axial length) in patients who underwent phacoemulsification and posterior chamber lens insertion. Automated keratometry examination and refraction were performed using an autorefractor keratometer; A-scan ultrasound was used to calculate target refraction. One-piece intraocular lenses (IOLs) and three-piece IOLs were inserted. At 2 and 12 months postoperatively, refraction differences relative to the target refraction (calculated using the SRK-T formula) were analyzed. The refractive changes between 2 and 12 months postoperatively were compared according to the IOL. Results: Myopic shift from the target refraction was observed with eyes of long axial length, compared with eyes of normal axial length, at 2 and 12 months postoperatively (p = 0.003, p = 0.013). For refractive stability according to IOL, there was no significant difference in eyes with normal axial length; in eyes with long axial length, three-piece IOLs showed significant refractive stability (p < 0.05). Conclusions: In eyes with long axial length, there was a significant difference in postoperative refractive stability according to the inserted IOL; three-piece IOLs showed significant refractive stability compared with one-piece IOLs.

콘택트렌즈 착용 후 발생한 수지상각막염: 임상 증례 및 문헌고찰

오주상(Joo Sang Oh),조양경(Yang Kyung Cho) 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 저자들은 이전에 각막염으로 치료받은 과거력 없이 콘택트렌즈 사용 후 처음 발생한 수지상각막염의 7안의 증례들을 경험하고 이를 단순포진바이러스각막염으로 진단하고 치료하였기에 문헌고찰과 함께 보고하고자 한다. 대상과 방법: 안과 외래에 2년간 방문한 환자들을 대상으로 콘택트렌즈 착용 후 수지상 각막병변을 보인 환자의 진단 및 치료와 경과 관찰을 시행하였다. 결과: 콘택트렌즈 착용 후 수지상 각막병변을 보인 7안의 환자에 관한 과거력 청취와 임상양상 및 분자생물학적 방법을 통한 진단 및 치료 기간 동안의 경과 관찰을 하였다. 결론: 콘택트렌즈 착용을 한 후 수지상각막염을 보이는 환자의 경우, 통상적인 비감염성 각막침윤이나 세균 및 진균에 의한 각막염이 아닌 단순포진바이러스각막염의 가능성도 있으므로 정확한 과거력 청취 및 임상적, 분자생물학적 진단이 필요하고, 경험적 항바이러스 치료에 대한 반응을 면밀히 살펴볼 필요가 있다. Purpose: We report seven cases of first occurrence of dendritic keratitis associated with contact lens wear without previous keratitis history, based on a literature review. Those cases were finally diagnosed and treated as herpes virus keratitis. Methods: Among patients who visited the ophthalmology outpatient clinic over two years, patients with dendritic corneal lesions associated with contact lens wear were included. Authors performed the diagnosis, treatment and the clinical follow up. Results: Seven Patients with dendritic corneal lesions after wearing contact lens were diagnosed by history taking, clinical findings and molecular biological methods and were observed over the course of treatment. Conclusions: For patients with dendritic keratitis after wearing contact lenses, there is a possibility of herpes keratitis rather than the common lesions associated with non-infectious corneal infiltration or keratitis caused by bacteria and fungus. It is necessary to observe those eyes thoroughly in respect to the exact past history taking, diagnosis by molecular-biological method as well as clinical features and the response to empirical antiviral agents.

사이클로스포린 A 0.05% 투여군 간 안전성 및 유효성을 비교평가하기 위한 제3상 임상시험

양순원(Soon won Yang),변용수(Yong Soo Byun),노창래(Chang Rae Rho),김수영(Su Young Kim),조양경(Yang Kyung Cho),김은철(Eun Chul Kim),정성근(Sung Kun Chung),주천기(Choun Ki Joo) 대한안과학회 2016 대한안과학회지 Vol.57 No.12

목적: 중등증 이상의 건조각막결막염과 관련된 안염증질환으로 인해 눈물생성이 억제된 환자를 대상으로 사이클로스포린 0.05% 시험약과 대조약을 12주간 투여한 후 각 군의 각막염색 점수 변화로 안구건조 완화효과를 평가하여 시험약이 대조약에 비해 임상적으로 열등하지 않음을 입증하고자 하였다. 대상과 방법: 본 임상시험은 다기관, 무작위배정, 이중눈가림, 활성군 대조, 병행설계 임상시험으로 디자인하였다. 시험대상자가 임상시험에 참여할 것을 동의하면, 2주간의 Run-in 기간을 가지며, 시험대상자들은 2주의 Run-in 기간 동안 인공눈물을 필요시 증상이 있는 눈에 1일 수회 점적하였다. Run-in 기간을 완료한 후, 시험군 또는 대조군으로 무작위 배정하였다. 무작위 배정된 시험대상자는 12주 동안 4주 간격으로 유효성 및 안전성 평가를 실시하였다. 결과: 본 임상시험결과 사이클로스포린 0.05% 시험약과 대조약 투여 후 12주에 각막염색 점수 변화량을 비교한 결과, Per Protocol Set 분석군에서 시험군이 대조군과 비교하여 비열등함을 만족하는 것으로 분석되었다. 이는 Full analysis set 분석군에서도 동일한 결과를 나타내었다. 본 임상시험 기간 동안 나타난 모든 이상반응을 분석한 결과, 군 간 차이는 통계적으로 유의하지 않았다(p=0.1107). 또한 이상반응 외에 내약성평가, 임상병리 검사, 활력징후에서도 임상적으로 유의한 변화를 나타내는 항목은 없었다. 결론: 결과적으로 사이클로스포린 A 0.05% 시험약은 대조약과 같이 유효하고 안전하게 사용할 수 있는 약제라고 사료된다. Purpose: To evaluate and compare the efficacy and safety of cyclosporine 0.05% (Cyporin N eye drops 0.05%) to an active comparator (Restasis??) in moderate to severe dry eye patients. Methods: This is a multicenter, randomized, double-blind, parallel, active control, non-inferiority, phase Ⅲ study. Patients had a 2-week run-in period (during the run-in period, patients used artificial tears, if applicable), and afterward 158 patients were randomly assigned treatment for 12 weeks with cyclosporine 0.05% (with artificial tears, if applicable), in which the efficacy and safety were evaluated every four weeks. Results: Corneal staining tests showed that in the per protocol set group, the study group was not inferior to the control group; the results for the full analysis set analytic group were the same. The number of adverse events reported from the 158 patients was not significantly different between groups (p = 0.1107). Additionally, other evaluations, including tolerability evaluations, clinical pathology examinations, and vital signs, show that there is no difference in terms of safety between the groups. Conclusions: Cyclosporine A 0.05% (Cyporin N eye drops 0.05%) is considered to have the same efficacy and safety compared to the active comparator.

상층각막성형술을 받은 환자에서 시행한 백내장 수술 1예

전수지(Soo Ji Jeon),조양경(Yang Kyung Cho) 대한안과학회 2016 대한안과학회지 Vol.57 No.2

Purpose: To report a case of cataract surgery in an epikeratophakia patient. Case summary: A 59-year-old female with a history of epikeratophakic surgery 20 years ago complained of decreased visual acuity of both eyes for several months. She had nucleosclerotic and posterior subcapsular types of cataracts. Phacoemulsification and posterior capsule intraocular lens implantation were performed in both eyes. During surgery, corneal edema was especially prominent at the cornea with epikeratophakic lenticules in both eyes. In the left eye, severe corneal edema after one day of surgery was observed; however, after one week, corneal edema had subsided and visual acuity of both eyes had improved. Conclusions: When it necessary that cataract surgery is performed in patients with epikeratophakic lenticules, it is important to anticipate the corneal edema intraoperatively and postoperatively. Moreover, the surgeon should consider the acute calculation of the target refraction of intraocular lens in an epikeratophakia patient. 목적: 상층각막성형술을 받은 환자에서 백내장수술을 시행한 1예를 경험하여 아직까지 국내에 보고된 바가 없어 이를 보고하고자 한다. 증례요약: 59세 여자 환자가 수개월 전부터 발생한 양안 시력저하를 주소로 내원하였다. 환자는 20년 전 양안에 상층각막성형술을 시행 받았으며, 양안에 중증도의 핵경화성 백내장 및 후낭하 백내장을 보였다. 초음파유화술 및 인공수정체 삽입술을 시행하였다. 백내장 수술 중 상층각막성형술을 시행 받은 각막 부분에서 현저한 각막부종이 발생하고, 조직렌즈 부착부위의 굴곡으로 수술시야에 장애를 주었다. 수술 후 1병일 때 좌안의 현저한 각막 부종이 관찰되었으나 수술 1주일 후 각막 부종은 수술 전 상태로 회복되었다. 술 후 6주째 우안 시력은 0.5, 굴절력은 0.00 Dsph=0.00 Dcyl×180o, 좌안 시력은 0.5로 측정되었고 굴절력은 +0.25 Dsph=-1.75 Dcyl×130o였으며, 술 후 4개월까지 유지되었다. 결론: 본 증례에서는 상층각막성형술을 시행 받은 환자에서 조직렌즈를 그대로 유지한 채 백내장 수술을 시행하여 만족스러운 수술결과를 얻었으나, 술 중 각막부종이나 각막의 굴곡에 의한 시야확보의 어려움을 경험하였고 수술 직후 심한 각막부종을 경험하였다. 상층각막성형술 후 시행하는 백내장 수술에서는 정밀한 인공수정체 도수의 계산과 더불어 시야확보의 어려움 및 수술 중과 수술 후 각막의 부종 가능성을 예상하고 수술에 임해야 할 것으로 생각된다.