방사상 각막절개술 후 백내장 수술을 시행한 1예

이은정,한종철,기창원.Eun Jung Lee. MD. Jong Chul Han. MD. Chang Won Kee. MD. PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.7

<b>Purpose:</b> To report a patient who underwent successful cataract surgery without wound dehiscence in the eye that had undergone previous radial keratotomy by performing a clear corneal incision between previous incisions. <b>Case summary:</b> A 59-year-old female visited our medical center for decreased vision. The patient underwent radial keratotomy for correction of myopia in both eyes 11 years prior. On slit-lamp examination, cataract and eight radial keratotomy incisions were found. Phacoemulsification and posterior capsule intraocular lens implantation were performed for both eyes at a one-week interval. For the right eye, a clear corneal incision was made over the previous incision scar and wound dehiscence was successfully managed by prompt corneal suturing. For the left eye, a clear corneal incision was made between the previous incision scars, and wound dehiscence did not occur. <b>Conclusions:</b> As radial keratotomy patients age, cataract surgery should be considered. A successful surgery was possible without wound dehiscence in an eye that had undergone previous radial keratotomy in which a clear corneal incision was made between previous incision scars. J Korean Ophthalmol Soc 2014;55(7):1089-1092

새로운 시신경 테 너비의 규칙을 이용한 정상안과 녹내장안의 구별

이명원,신종훈,기창원,Myung Won Lee,Jong Hoon Shin,Chang Won Kee 대한안과학회 2014 대한안과학회지 Vol.55 No.1

Purpose: To evaluate the diagnostic ability of the modified ISNT rule (disc rim thickness of the smaller of inferior and superior > the larger of nasal and temporal) for normal and glaucomatous eyes compared to the classic ISNT rule (disc rim thickness of inferior > superior > nasal > temporal). Methods: Color stereo optic disc photographs of 113 normal subjects and 108 open angle glaucoma patients with early and moderate stage were morphometrically evaluated. The classic ISNT rule and the modified ISNT rule were assessed by masked evaluation of disc photographs at the 3, 6, 9 and 12 o’clock positions. Results: Among normal subjects, 58 of 113 eyes (51.3%) were normal and in open angle glaucoma patients, 104 of 108 eyes (96.3%) were abnormal with the classic ISNT rule. Among normal subjects, 98 of 113 eyes (94.2%) were normal and in open angle glaucoma patients, 102 of 108 eyes (94.4%) were abnormal with the modified ISNT rule. The modified ISNT rule was more accurate than the classic ISNT rule in terms of Cohen’s Kappa analysis used for discriminating between normal and glaucomatous eyes. Conclusions: The modified ISNT rule is useful for differentiating between normal and glaucomatous optic nerves and easily applied in clinical practice. J Korean Ophthalmol Soc 2014;55(1):93-101

여러 방법으로 시도한 실리콘 관의 부분적 폐쇄가 개폐압과 유출률에 미치는 영향

이재현(Jae Hyeun Lee),김용명(Yong Myeoung Kim),기창원(Chang Won Kee) 대한안과학회 2000 대한안과학회지 Vol.41 No.12

한국인의 정상 Tear Film Break - up Time

이진학(Jin Hak Lee),기창원(Chang Won Ki) 대한안과학회 1985 대한안과학회지 Vol.26 No.6

안내 이물증의 임상분석

이재흥(Jae Heung Lee),장무환(Moo Hwan Chang),기창원(Chang Won Kee) 대한안과학회 1984 대한안과학회지 Vol.25 No.6

한국인에서 선천백내장수술을 받은 환자들의 녹내장 발생 위험인자에 대한 분석

이가인(Ga In Lee),한종철(Jong Chul Han),김시범(Si Bum Kim),이은정(Eun Jung Lee),기창원(Chang Won Kee) 대한안과학회 2018 대한안과학회지 Vol.59 No.6

목적: 선천백내장수술을 받은 환아에서 장기관찰 결과 녹내장 발생 위험인자를 알아보고자 하였다. 대상과 방법: 선천백내장으로 진단 받고 본원 또는 타원에서 백내장수술을 받은 환아 91명 148안을 대상으로 의무기록을 후향적으로 분석하였다. 이차녹내장의 진단은 안압이 21 mmHg를 초과하면서, 각막 직경, 안축장, 또는 유두함몰비가 증가하거나 안압 조절을 위해 수술을 시행한 경우로 하였고, 대상 환자들의 임상 양상 및 녹내장 위험 인자를 분석하기 위해 백내장수술 시 나이, 양안 여부, 핵백내장 유무, 백내장수술 방법 및 인공수정체 유무, 백내장수술 후 녹내장을 진단 받기까지의 기간, 경과관찰 기간, 가장 최근 최대 교정 시력, 굴절 오차, 경과관찰 하면서 측정된 최고 안압을 분석하였다. 결과: 술 후 녹내장이 발생한 눈은 35안(23.6%), 녹내장을 진단 받은 환자 중 녹내장수술을 시행한 눈은 11안(31.4%), 평균 3.4회의 녹내장수술을 받았다. 백내장수술 이후 녹내장 발생까지의 기간은 평균 112.2 ± 113.1개월이었다. 수정체관류흡인술만 시행한 경우는 일차인공수정체삽입술을 시행한 경우보다 녹내장 발생 위험이 유의하게 높았다(p=0.001). 선천백내장수술 이후 녹내장 발생 위험 요인으로는 3개월 미만에서 수술한 경우, 핵백내장, 일차 인공수정체 삽입보다는 무수정체안으로 나타났으며, 이차 인공수정체 삽입의 경우 녹내장 발생 위험이 증가하는 경향을 보였다(p=0.03, p=0.006, p<0.001, p=0.052). 결론: 선천백내장수술을 받은 환아에서 무수정체안의 경우 녹내장 발생 위험이 높고, 3개월 미만에서 수술한 경우, 핵백내장이 이차녹내장의 위험인자로 나타났다. 선천백내장수술을 한 환아들은 녹내장 발생 위험을 항상 갖고 있기 때문에 조기 발견을 위해서 장기적인 모니터링이 필요하다. Purpose: To assess the risk of development of secondary glaucoma after congenital cataract surgery using a long-term follow-up study. Methods: In total, 148 eyes of 91 patients who underwent congenital cataract surgery at our hospital or other hospitals were included in a retrospective chart review. A diagnosis of secondary glaucoma was made if the intraocular pressure (IOP) exceeded 21 mmHg and the corneal diameter, axial length, or the cup-to-disc ratio increased, or surgery was performed to control the IOP. To analyze the clinical features and risk factors of secondary glaucoma, we evaluated the mean age at cataract surgery, binocularity, presence of a nuclear cataract, methods of cataract surgery, presence of an intraocular lens (IOL), duration of diagnosis of secondary glaucoma after cataract surgery, duration of follow-up, recent best-corrected visual acuity, and refractive errors. Results: Thirty-five eyes (23.6%) were diagnosed with secondary glaucoma as a complication of congenital cataract surgery. Of these, 11 eyes (31.4%) were treated with glaucoma surgery a mean of 3.4 times. The mean duration from congenital cataract surgery to diagnosis of glaucoma was 112.2 ± 113.1 months. Patients with aphakia had a higher risk of developing secondary glaucoma compared with patients undergoing primary IOL implantation (p = 0.001). Younger age (<3 months at surgery), a nuclear cataract, and aphakia were risk factors for the development of secondary glaucoma (p = 0.03, p = 0.006, and p < 0.001, respectively), and the risk of developing secondary glaucoma increased with secondary IOL implantation (p = 0.052). Conclusions: Secondary glaucoma after congenital cataract surgery was more common in patients with secondary IOL implantation, aphakia, a younger age (<3 months), and a nuclear cataract. Patients who underwent congenital cataract surgery had an increased risk for developing secondary glaucoma. Long-term monitoring of the IOP and optic nerve is therefore required for these patients.

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

녹내장 환자에서 TIGR 유전자 돌연변이 분석

이선주(Sun Joo Lee),허원희(Won Hee Hur),기창원(Chang Won Lee) 대한안과학회 2000 대한안과학회지 Vol.41 No.5

건성안 진단시 Tear Film Break - up Time ( BUT ) 값이 가지는 의의

이진학(Jin Hak Lee),기창원(Chang Won Ki),노광국(Kwang Gook Roh) 대한안과학회 1985 대한안과학회지 Vol.26 No.6

굴절교정술 후 백내장 수술 환자에서 인공수정체 도수계산법 비교

이명옥,정태영,정의상,기창원,Myoung-Ok Lee,MD,Tae-Young Chung,MD,PhD,Eui-Sang Chung,MD,PhD,Chang Won Kee,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.2

Purpose: To investigate the predictability of and propose guidelines for intraocular lens (IOL) power calculation in post-cataract surgery patients with prior corneal refractive surgery and suggest the guideline. Methods: Medical records of 18 eyes of 16 patients were retrospectively evaluated for IOL power calculation predictability using three combinations of methods: 1) clinical history method, modified Maloney method, and the Feiz-Mannis method; 2) single-K formula versus double-K formula; and 3) Three IOL formulas (SRK/T, Holladay 1, and Hoffer Q). Results: The clinical history method using the single-K formula with the SRK/T and Holliday 1 formula showed the best predictability, with an absolute error of 0.60±0.63 D and 0.74±0.60 D, respectively. The Feiz-Mannis method showed a tendency of myopic prediction, whereas the modified Maloney method showed a tendency of hyperopic prediction, especially in the patients with myopia more than 7 D prior to the refractive surgery. The double-K formula, when compared to the single-K formula, prevented hyperopic prediction when used with the clinical history method or modified Maloney method. Conclusions: IOL power calculation using the clinical history method with SRK/T or Holliday 1 formula showed the best predictability in patients after corneal refractive surgery. IOL power calculation using the modified Maloney method, however, because of the hyperopic prediction tendency, should be used cautiously, especially for patients with myopia of 7 D or more prior to the refractive surgery. J Korean Ophthalmol Soc 2010;51(2):180-187