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RISS 인기검색어
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- 저자 : 안병현(Byung Heon Ahn) (검색결과 3 건)
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안병현,서병로 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2
A new glaucoma drainage implant, silicone tube attached to an expanded polytetrafluoroethylene (e-PTFE) membrane, was used in patients with recalcitrant glaucomas. Aqueous was shunted via the silicone tube to reservoir which was formed under the posterior Tenon's capsule by an oval piece of e-PTFE memberane, (Japan Gore-tex Inc., Tokyo) was 0.1mm thick, malleable and foldable. Therefore, the e-PTFE membrane of the implant could be introduced through a small incision of a quadrant conjunctiva in folded form and then spreaded over the sclera. The implant had been placed in 18 eyes of 17 patients with one or more unsuccessful glaucoma filtration surgeries including three neovascular glaucoma (NVG) patients. After follow-up of peroids ranging between seven and 18 months (mean: 10 months), 15 of the 18 eyes (83%) had controlled intraocular pressure (IOP) using 20 mmHg as normal. Three patients were not on any glaucoma medication. Seven patients required one β-blocker. Five patients were on one β-blocker and pilocarpine or a small dose of acetazolamide on their final visits. Three eyes with an unsuccessful surgery had an IOP over 25 mmHg in spite of maximum tolerated medical therapy. A postequatorial filtration bleb was found in each operated eye following removal of 5-0 cat-gut threaded through the silicone tube for the prevention of aqueous overdrainage. Postoperative complications included hyphema and fibrinous aqueous in the eyes with NVG(17%), prolonged shallow chamber(22%), obstruction of the silicone tube in the anterior chamber(6%), and choroidal datachment(6%) silicone tube in the anterior chamber (6%), and choroidal detachment(6%). The required conjuctival incision for the installation of the e-PTFE drainage implant was less than 90° and the overall surgical procedures seemed to be simple.
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Trabecular Pigment Change Following Posterior Chamber Intraocular Lens Implantation
Ahn, Byung-Heon,Cha, Moo-Byung,Park, Keun-Sung,Kim, Chang-Sik 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1
백내장수술 후 색소분산의 정도와 안압 변화의 관계를 알아보기 위하여 82명의 환자 82안에서 전방각촬영술과 안압 측정을 시행하였다. 대상군의 평균 연령은 51.7세(24-78세)였으며 42안은 계획적 백내장낭외적출술을, 40안은 수정체유화술로 백내장을 제거하고 후방인공수정체를 삽입하였다. 수술후 평균 추적기간은 14.6개월(6-42개월)이었다. 수술 전 섬유주 색소는 하방이 1+이고 다른 부위는 색소침착이 없는 경우가 82안 중 36안(43.9%)으로 가장 흔하였으며 수술 후에는 33안(40.2%)에서 하방 3+, 비측 2+, 이측 1+ 또는 2+, 상방은 1+ 색소침착이 보였다. 항상 색소침착은 하방, 비측, 이측, 상방의 순으로 심하였다. 수술 후 4+ 색소침착이 최소한 한 개의 4분위에서 관찰된 예는 22안(26.8%)이었으며 이 중 2안(2.4)은 전체 4분위에, 1안(1.2%)은 3개, 8안(9.8%)은 2개의 4분위에서 보였다. 수술 후 3안(3.7%)에서 지속적 안압 상승이 있었으며 1안은 수술 직후에 2안은 각각 1.5년후에 발생하였고 모두 약물치료가 필요하였다. 다른 한 눈은 수술 후 1년 째에 불안정한 안압 상승이 있었다. 이상의 4안은 모두 전체 대상 중에서 가장 색소침착이 심하였던 예들로 270°이상에서 4+의 색소침착을 보였다. 본 연구로 백내장 수술 후 2개월 내에 전방각경검사를 시행하여 270°범위 이상에 4+ 섬유주색소침착이 관찰되면 향후에 녹내장 발생 가능성이 많으므로 밀접한 추적 관찰을 하여야 할 것으로 나타났다. To study the relationship between pigment dispersion and intraocular pressure(IOP) change after cataract extraction, goniophotographic assessment of pigment on the trabecular meshwork(TM) and IOP measurements were performed in 82 eyes of 82 subjects with a mean age of 51.7 years(range, 24 to 78 years), who underwent a planned extracapsular cataract extraction(42 eyes) or phacoemulsification(40 eyes) with posterior chamber intraocular lens(PC-IOL) implantation. The average followup period was 14.6 months(range, 6-42 months). The most frequent gonioscopic appearance of TM pigment was that of 1+ inferiorly and nil in the other quadrants in 36 of 82 eyes(43.9%) preoperatively, and pigment of 3+ inferiorly, 2+ nasally, 1+ or 2+ temporally and 1+ superiorly in 33 eyes(40.2%) after PC-IOL implantation. This also implies a conspicuous tendency of quadrantal differences in TM pigment density, that is always inferior >nasal >temporal >superior. After cataract extraction, TM pigment increased in all operated eyes with involving multiple quadrants of the angle. The eye with a heavy 4+ pigmentation at least in one quadrant of TM was observed in 22 eyes (26.8%) ; two eyes(2.4%) with 4+ pigment in 4 quadrants, one eye(1.2%) in 3 quadrants and eight eyes(9.8%) in 2 quadrants. Three eyes(3.7%) developed a persistent IOP rise, one in the immediate postoperative days and two 1.5 years postoperatively, and they continued to be on antiglaucoma medication. One more eye had a fluctuating increase in IOP at one year after surgery. All the four eyes ranked the first to the fourth in TM pigment density among all the subjects and had 4+ pigment in 270˚or greater angle. From the study, we may suggest a gonioscopy within two months after PC-IOL implantation would give us a decision clue whether the patient will be followed up with caution or not, based on the gonioscopic finding of 4 + pigment over 270°of the angle.
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