수입공여각막의 내피세포감소에 영향을 미치는 인자에 대한 분석

공석준,조경진,김만수,Seok Joon Kong,MD,Kyongjin Cho,MD,Man Soo Kim,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.1

Purpose: To evaluate the difference between corneal endothelial cell density at the moment of preservation and at keratoplasty in imported donor corneas and to analyze the correlated factors of the difference. Methods: Eighty-seven imported corneas were evaluated. Corneal endothelial cell density at the moment of preservation was obtained from the medical record and was measured just before the keratoplasty. Correlation of the difference in endothelial cell density with the following factors were analyzed; donor sex, donor age, death-to-preservation time, preservation- to-surgery time, death-to-surgery time, endothelial cell density at the moment of preservation, and preservation period of the corneas. Results: All of the corneas showed a decrease in endothelial cell density. Mean endothelial cell density of imported donor corneas at the moment of preservation and at keratoplasty was 2789 ± 235 cells/mm2 and 2592 ± 254 cells/mm2 (p <0.001), respectively. Mean endothelial cell loss was 197 ± 148 cells/mm2, which was significantly correlated with preservation-tosurgery time, death-to-surgery time and a preservation period longer than 7 days (p = 0.042, p = 0.045, p = 0.036, respectively). Conclusions: Reduced death-to-surgery time and keratoplasty before 7 days of preservation are needed for better surgical outcome. J Korean Ophthalmol Soc 2012;53(1):20-26

당뇨황반부종에서의 유리체강내 라니비주맙 주입술의 단기효과

공석준,양지욱,지동현,Seok Joon Kong,Ji Wook Yang,Dong Hyun Jee 대한안과학회 2010 대한안과학회지 Vol.51 No.11

Purpose: To evaluate the short-term effect of an intravitreal injection of ranibizumab in the treatment of diabetic macular edema. Methods: Eighteen eyes of 18 patients who underwent intravitreal ranibizumab injection for the treatment of diabetic macular edema between March 1 and November 30, 2009 were retrospectively evaluated. Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits at one and three months. Results: The mean visual acuity improved from logMAR 0.74 ± 0.45 at baseline to logMAR 0.44 ± 0.26 at one month and to logMAR 0.42 ± 0.23 at three months (p < 0.05). The mean central macular thickness decreased from 429.5 ± 71.9 μm at baseline to 299.9 ± 81.2 μm at one month and to 284.6 ± 82.6 μm at three months (p < 0.05). No adverse side effects were observed following the injections. Conclusions: The observed macular edema and visual acuity improvements demonstrated that intravitreal ranibizumab injection may be useful for the treatment of patients with diabetic macular edema. J Korean Ophthalmol Soc 2010;51(11):1453-1458

양안 백내장 동시수술에 대한 효용성과 안전성

김정희(Jeong Hee Kim),공석준(Seok Joon Kong),김재우(Jae Woo Kim),임태형(Tae Hyung Lim),최기용(Ki Yong Choi),조범진(Beom Jin Cho) 대한안과학회 2015 대한안과학회지 Vol.56 No.12

목적: 양안 백내장 동시수술(immediate sequential bilateral cataract surgery, ISBCS)의 효용성(efficacy) 및 안전성(safety)을 알아보았다. 대상과 방법: 2010년 1월부터 2014년 12월까지 본원에서 ISBCS 및 delayed sequential bilateral cataract surgery (DSBCS)를 시행받은 각 군 70명 140안의 수술 1개월 후 최대교정시력, 구면렌즈 대응치 및 굴절이상을 분석하고 같은 기간 내 본원에서 백내장 수술을 시행 받은 모든 환자를 대상으로 안내염 발생 건수를 조사하였다. 결과: 수술 후 1개월째 최대교정시력(logMAR)은 ISBCS군에서 0.06 ± 0.72, DSBCS군에서 0.09 ± 0.66이었으며 두 군에서 두 번째 수술한 눈의 최대 교정시력(logMAR)은 각각 0.07 ± 0.64, 0.07 ± 0.18이었다. 수술 후 최대 교정시력, 구면렌즈 대응치, 굴절이상 모두에서 두 군 간의 유의한 차이는 없었다. 총 21,140안에서 안내염은 10안(0.05%)에서 발생하였으며 462명, 924안의 ISBCS군에서는 발생하지 않았다. 결론: ISBCS는 적절한 적응증의 환자를 선택하여 경험 많은 술자가 수술을 시행하고, 예방적 항생제를 수술 후 철저히 사용한다면 환자의 만족도를 높이는 안전한 수술 방법으로 생각된다. Purpose: To evaluate the efficacy and safety of immediate sequential bilateral cataract surgery with respect to patient outcomes and complication rates. Methods: From January 2010 to December 2014, we conducted a retrospective study of patients who had immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS) with an interval of one to two months between the first and the fellow eye operations. The changes in visual acuity, manifest spherical equivalent, and refractive error of 140 eyes of 70 patients of both groups were compared postoperatively at one month. The incidence of endophthalmitis was investigated during the same period. Results: At one month postoperatively, log MAR best corrected visual acuity were measured to be 0.06 ± 0.72 in the ISBCS group and 0.09 ± 0.66 in the DSBCS group, and that of the fellow eyes were 0.07 ± 0.64 and 0.07 ± 0.18, respectively (p = 0.331, p = 0.781, respectively). The postoperative spherical equivalents were -0.18 ± 0.23 D in the ISBCS group and -0.19 ± 0.25 D in the DSCBS group, and that of the fellow eyes were -0.15 ± 0.18 D and -0.16 ± 0.21 D, respectively. There were no significant statistical differences between the two groups (p = 0.835, p = 0.676, respectively). The postoperative refractive error was -0.20 ± 0.21 D in the ISCBS group and -0.18 ± 0.13 D in the DSBCS group, and that of the fellow eyes were -0.14 ± 0.22 D and -0.19 ± 0.22 D, respectively (p = 0.482, p = 0.237, respectively). A total of 21,140 eyes had cataract surgery performed, and only 10 eyes (0.05%) developed endophthalmitis. Endophthalmitis did not occur in the ISBCS group. Conclusions: In experienced hands, with stringent patient selection criteria and with a strict aseptic protocol, ISBCS can safely provide comparable visual outcome and better satisfaction of the patient with good efficacy

노안환자에서 비구면 미세단안시 라식수술 및 단안시 굴절수술의 임상결과 비교

이수찬(Su chan Lee),장철원(Cheol won Jang),공석준(Seok Joon Kong),김재우(Jae Woo Kim),조영주(Young Joo Cho),임태형(Tae Hyung Lim),최기용(Kee Yong Choi),조범진(Beom Jin Cho) 대한안과학회 2016 대한안과학회지 Vol.57 No.12

목적: 노안이 동반된 근시환자에서 비구면 미세단안시 라식 수술(laser blended vision, LBV) 및 고식적 단안시 레이저 굴절 수술(monovision laser refractive surgery)의 효능과 안정성을 비교 분석하고자 하였다. 대상과 방법: LBV를 시행 받은 환자 21명 42안, monovision을 시행 받은 환자 25명 50안을 대상으로 후향적으로 비교하였다. 술 전과 술 후 3개월 원거리, 중간거리, 근거리 시력과 굴절력 변화를 단안과 양안 모두에서 조사하였으며 LBV군에서는 추가로 술 후 3개월에 구면수차를, 술 후 3-6개월에 환자 만족도를 조사하였다. 결과: 평균연령은 LBV군에서 47.9세, monovision군에서 41.7세였다. 술 후 3개월에 구면 대응치는 LBV군에서 우세안 +0.11 ± 0.17D, 비우세안 -1.52 ± 0.36D인 반면, monovision군에서는 우세안 +0.23 ± 0.26D, 비우세안 -0.82 ± 0.28D였다. 술 후 양안 원거리 나안시력의 경우 두 군 모두 minimal angle of resolution (logMAR) 시력으로 0.10보다 좋은 경우가 100%였으며, 중간거리 나안시력의 경우 0.10 이상은 LBV군에서 86%, monivision군에서 100%였다. 근거리 나안시력은 LBV군에서 0.18 이상이 95%, monovision군에서 100%였다. LBV군에서 수술 전보다 수술 후 평균 구면 수차는 증가하였으나 통계적으로 유의하지 않았다. 술 후 최대 교정시력저하나 각막 혼탁 등 시력저하가 발생할 수 있는 합병증은 두 군에서 모두 없었으며 전반적인 환자의 만족도는 LBV군에서 80%였다. 결론: 노안이 동반된 근시 환자에서 LBV는 상대적으로 높은 연령에도 불구하고 monovision과 비슷한 결과를 보였으며 효과적이고 안전한 수술방법으로 생각된다. Purpose: To compare the efficacy and safety of Laser Blended Vision (LBV) and monovision laser refractive surgery (monovision) for presbyopia correction in patients with myopia. Methods: This retrospective comparative study included 42 eyes of 21 patients with LBV and 50 eyes of 25 patients with monovision. Monocular and binocular distance, intermediate and near visual acuity, and refractive changes were evaluated preoperatively and 3 months after the surgery and compared. The patients in the LBV group underwent further evaluation of spherical aberration 3 months after the surgery and treatment satisfaction 3-6 months after the surgery. Results: The mean age of the patients was 47.9 years in the LBV group and 41.7 years in the monovision group. Three months after surgery, the spherical equivalents were +0.11 ± 0.17 D in the dominant eye and -1.52 ± 0.36 D in the non-dominant eye in the LBV group. In contrast, the spherical equivalents were +0.23 ± 0.26 D in the dominant eye and -0.82 ± 0.28 D in the non-dominant eye in the monovision group. All patients achieved a binocular uncorrected distance visual acuity of 0.10 (log MAR) or better, and 86% of the LBV group and 100% of the monovision group achieved a binocular uncorrected intermediate visual acuity of better than 0.10. Moreover, 95% of the LBV group and 100% of the monovision group achieved a binocular uncorrected near visual acuity of better than 0.18. In the LBV group, mean spherical aberration increased after surgery than before, but it was not statistically significant. Complications such as corneal opacity that could decrease visual acuity were absent in both groups. Overall patient satisfaction after surgery was 80% in the LBV group. Conclusions: Despite the relatively higher mean age of the LBV group, both groups showed similar results regarding presbyopia correction in patients with myopia.