고도 근시안에 대한 방사상 각막 절개술의 임상 결과

박규홍(Kyu Hong Pak),김재호(Jae Ho Kim) 대한안과학회 1991 대한안과학회지 Vol.32 No.8

동종 골수이식을 받은 환자의 안중상에 대한 임상적 고찰

박규홍(Kyu Hong Pak),명윤원(Yoon Won Myong),이상욱(Sang Wook Rhee) 대한안과학회 1991 대한안과학회지 Vol.32 No.4

비구면 다초점 인공수정체를 삽입한 백내장 수술안의 시각 및 광학적 단기 임상 결과

곽준영,최진석,박규홍,백남호,Jun-Young Gwak,MD,Jin-Seok Choi,MD,PhD,Kyu-Hong Pak,MD,Nam-Ho Baek,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.3

Purpose: To evaluate near, intermediate, and distant vision, optical quality, and patient satisfaction with Acri.LISA aspheric diffractive multifocal IOL. Methods: Forty eyes of 20 patients received phacoemulsification and implantation of Acri.LISA IOL. Visual acuity was measured postoperatively at 1 week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function via questionnaire were measured at postoperative 1 month. Results: Uncorrected near, intermediate, and distanct visual acuity at 1 month were 0.09 ± 0.14, 0.29 ± 0.17 and 0.11 ± 0.12, respectively. At 6 months, similar visual acuity results were measured. Total and higher-order wavefront aberration values were 0.66 ± 0.29 and 0.24 ± 0.08, respectively. Photopic contrast sensitivity at 1.5, 3, 6, 12, and 18 cycles/degree were 1.38 ± 0.32, 1.73 ± 0.24, 1.75 ± 0.21, 1.33 ± 0.18, and 0.77 ± 23, respectively, and mesopic contrast sensitivity values were 1.37 ± 0.27, 1.72 ± 0.16, 1.63 ± 0.14, 1.01 ± 0.19, and 0.50 ± 0.22. Total subjective visual function score was 3,127 ± 354, near work was 244 ± 36, distance work was 256 ± 21, and night driving was 221 ± 42. Conclusions: The Acri.LISA 366D multifocal IOL can be effective for improving patient satisfaction after cataract surgery as well as for presbyopia correction. J Korean Ophthalmol Soc 2012;53(3):396-402

안와 횡문근육종의 1 예

백남호(Nam Ho Baek),박규홍(Kyu Hong Pak),조문제(Moon Je Cho),정상문(Sang Moon Chung) 대한안과학회 1990 대한안과학회지 Vol.31 No.5

레스토; 다초점 인공수정체 삽입술 후 잔여굴절이상에 대한 레이저 굴절교정수술 효과

김성인,김숙진,오재윤,박규홍,강석재,Sung In Kim,MD,Suk Jin Kim,MD,Jae Yoon Oh,MD,Kyu Hong Pak,MD,Sug Jae Kang,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR<sup>? multifocal intraocular lenses. Methods: We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error. Results: After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 ± 0.89 D and the mean astigmatism was 2.08 ± 0.55 D. Six months after laser surgery, the mean SE was -0.33 ± 0.30 D (p = 0.354) and the mean astigmatism was 0.23 ± 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 ± 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100). Conclusions: On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR<sup>? multifocal intraocular lenses.

각막굴절수술에서 웨이브프론트가이드와 웨이브프론트최적화 방식의 고위수차 및 시력의 비교

김성인,오정재,오태훈,박규홍,백남호,최진석,Sung In Kim,MD,Jeong Jae Oh,MD,Tae Hoon Oh,MD,Kyu Hong Pak,MD,Nam Ho Baek,MD,PhD,Jin Seok Choi,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To compare higher-order aberrations (HOAs) and visual acuity after wavefront-guided and wavefront-optimized laser keratorefractive surgery. Methods: This retrospective study consisted of consecutive cases of eyes that underwent wavefront-guided (VISX S4 CustomVue<sup>®) or wavefront-optimized (WaveLight<sup>® EX500) laser assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and preoperative and 3 month postoperative HOAs were compared. Results: There were no statistical differences in UCVA, BCVA, MRSE, or total HOAs in either the LASIK and PRK groups (all <em>p</em> > 0.05). Induced amount of spherical aberration (SA) was significantly lower in the wavefront-optimized LASIK and PRK than wavefront-guided LASIK and PRK. Conclusions: In laser keratorefractive surgery, wavefront-guided and wavefront-optimized platforms produced equivalent visual outcomes and no differences in total HOAs. However, the wavefront-optimized platform caused less spherical aberration 3 months after operation. J Korean Ophthalmol Soc 2014;55(4):480-485

라식수술에서 발생한 유리절편을 절편회전술로 치료한 1예

나미리(Miri Na),정성근(Sung Kun Chung),박규홍(Kyu Hong Pak),최진석(Jin Seok Choi) 대한안과학회 2018 대한안과학회지 Vol.59 No.5

목적: 레이저각막절삭가공성형술(Laser-assisted in situ keratomileusis, LASIK) 중 발생한 유리절편으로 인해 생긴 불규칙난시를 절편회전술로 치료한 1예를 보고하고자 한다. 증례요약: 21세 여자 환자의 라식수술 중 의도치 않게 우안 유리절편이 발생하였다. 절편의 표시가 지워진 상태여서 임의의 위치에 놓은 후 수술을 종료하였다. 술 후 3개월째 우안 난시는 -3.00D, 좌안 난시는 -0.75D로, 우안 나안시력은 0.4, 좌안 나안시력은 1.0이 었다. 기존의 위치로 돌리기 위해 각막형태검사를 분석하여 절편회전술을 시행하여 불규칙난시를 치료해 우안 나안시력 1.0으로 호전 되었다. 결론: 라식수술 중 합병증으로 발생할 수 있는 유리절편 발생과 동시에 기존 수술 전 표식을 식별할 수 없는 경우에는 술 후 각막형태 검사 분석을 통해 2차적으로 유리절편회전술을 시행하여 기존의 위치로 돌려놓는 것이 난시 교정 및 나안시력 향상에 도움이 된다. <대한안과학회지 2018;59(5):484-490> Purpose: To report a case of irregular astigmatism caused by a free flap during laser-assisted in situ keratomileusis (LASIK) surgery that was treated with a flap rotation based on postoperative topography. Case summary: A 21-year-old female underwent LASIK, which was complicated by a free cap on her right eye. Because the gentian violet markings were no longer present, the exact orientation of the cap was unknown. At 3 months after surgery, the astigmatism of the right eye was -3.00 diopters (D) with an uncorrected visual acuity (UCVA) of 0.4, and the astigmatism of the left eye was -0.75 D with an UCVA of 1.0. The corneal topography was analyzed in order to return to the existing position. Free cap repositioning was performed and irregular astigmatism was corrected to improve the UCVA to 1.0. Conclusions: If the preoperative markings cannot be identified on a free flap during LASIK, secondary postoperative corneal topographic analysis can be performed to restore the corneal free flap to its original position to minimize astigmatism with good visual outcomes. J Korean Ophthalmol Soc 2018;59(5):484-490

라식수술 후 백내장수술 시에 Shammas-PL 공식을 이용한 인공수정체도수계산

박세영(Se Young Park),곽주영(Joo Young Kwag),최진석(Jin Seok Choi),박규홍(Kyu Hong Pak),정성근(Sung Kun Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.2

목적: 라식수술 과거력이 있는 환자의 백내장수술 시에 Shammas-PL 공식을 이용했을 때 인공수정체도수계산 방법을 알아보고자 한다. 대상과 방법: 2018년 9월부터 2019년 9월까지 본원에서 백내장수술을 시행한 환자 중 라식수술의 과거력이 있는 환자 29명 41안을 대상으로 하였다. 수술 전 안축장, 전방깊이, 각막곡률을 측정하였고, 인공수정체도수계산은 가장 많이 사용되고 있는 Shammas-PL (post laser in-situ keratomileusis, post LASIK) 공식을 이용하였다. 수술 전 굴절예측치와 수술 후 현성굴절검사값을 이용하여 평균 절대오차와 평균산술오차를 구하여 정확도를 파악하였다. 결과: 전체 41안 중 15안(36.6%)에서 수술 전의 굴절예측치와 비교해서 수술 후 상대적으로 원시로 이행되었고, 25안(61%)에서 상대적으로 근시 이행을 보였으며, 1안(2.4%)은 수술 전 굴절예측치와 동일하였다. 백내장수술 전 굴절이상치는 수술 후 근시, 정시, 원시의 이행과는 관련성이 없었다(p>0.05). 평균절대오차는 0.63 ± 0.57 diopter (D)였고, 원시로 이행한 경우의 평균절대오차는 0.41 ± 0.35 D, 근시로 이행한 경우의 평균절대오차는 0.78 ± 0.63 D였다. 결론: 라식수술 후 백내장수술 시에 Shammas-PL 공식을 이용하여 인공수정체도수계산을 했을 때 술 후 근시로 이행하는 경우가 더 많았고, 원시로 이행한 경우보다 근시로 이행한 경우의 평균절대오차가 더 컸으므로 목표 굴절예측치보다 더 원시쪽으로 인공수정 체도수를 결정하는 것이 좋을 것이다. Purpose: To calculate the intraocular lens (IOL) power using the Shammas-PL formula after laser in-situ keratomileusis (LASIK). Methods: Forty-one eyes of 29 patients that had undergone cataract surgery from September 2018 to September 2019 after LASIK were enrolled in this study. A preoperative AL-Scan?? (Nidek Co., Gamagori, Japan) was used to measure the axial length, anterior chamber depth, and corneal curvature. An IOL power calculation was performed using the Shammas-PL (post LASIK) formula. Mean absolute error (MAE) and mean arithmetic error (MARE) were calculated using preoperative manifest refraction and postoperative manifest refraction. Results: Of the 41 eyes, 15 eyes (36.6%) were relatively hyperopic-shifted after surgery compared to the predicted refractive error before surgery, 25 eyes (61%) showed a relative myopic shift, and one eye (2.4%) showed no change with respect to the previous refractive predicted error. Refractive errors before cataract surgery were not related to myopic, emmetropic, or hyperopic shifting after surgery (p > 0.05). Conclusions: When cataract surgery using the Shammas-PL formula was performed after LASIK, myopic shifting was more common than hyperopic shifting. The MAE was greater in myopic-shifted cases than that of hyperopic-shifted cases. Thus, it is better to determine IOL power toward the hyperopic side than the target refractive prediction.

경증 건성안증후군에서 눈물막 삼투압의 임상적 유용성

김미정(Mi Jeong Kim),박세영(Se Young Park),곽주영(Joo Young Kwag),최진석(Jin Seok Choi),박규홍(Kyu Hong Pak),정성근(Sung Kun Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.3

목적: 경증 건성안증후군에서 I-PEN?? (I-MED Pharma Inc.;Dollard-des-Ormeaux;Canada)으로 측정한 눈물막 삼투압과 건성안 지표인 쉬르머검사;눈물막파괴시간;안구표면질환지수와의 상관관계를 각각 분석하여 눈물막 삼투압에 대해 평가하고자 한다. 대상과 방법: 각막염색을 이용하여 구분한 각막미란이 없는 1군 50명(67안)과 각막미란만 보이는 2군 59명(91안);총 90명(158안)의 경증 건성안 환자들을 대상으로 I-PEN?瑛막? 측정한 눈물막 삼투압과 쉬르머검사;눈물막파괴시간;안구표면질환지수 사이에 상관관계를 Pearson 상관분석을 이용하여 분석하였다. 결과: 눈물막 삼투압 수치와 쉬르머검사(r<-0.01;p=0.97);눈물막파괴시간(r=0.05;p=0.54);안구표면질환지수(r=0.03;p=0.76)는 통계적으로 유의한 상관관계를 보이지는 않았다. 각막염색점수로 분류한 1군과 2군 사이에서 쉬르머검사(p=0.31);눈물막파괴시간(p=0.11);눈물막 삼투압(p=0.12) 측정치는 유의한 차이를 보이지 않았으나;안구표면질환지수에서 유의한 차이가 있었다(p<0.01). 결론: 경증 건성안증후군에서 눈물막 삼투압과 건성안 지표들 사이에 유의한 상관관계는 없었으나 중증 건성안증후군에서 눈물막 삼투압의 진단적 가치에 관한 추가적인 연구가 필요할 것으로 생각된다. Purpose: To seek Pearson correlations of tear film osmolarity measured by the I-PEN?? (I-MED Pharma Inc.;Dollard-des-Ormeaux;Canada) with Schirmer test result;tear break-up time;and Ocular Surface Disease Index score in patients with mild dry eye syndrome. Methods: Patients with mild dry eye syndrome were divided into two groups according to Ocular Staining Score: group 1 (50 patients; 67 eyes) and group 2 (59 patients; 91 eyes);90 patients and 158 eyes in total. The above mentioned correlations were derived. Results: No significant correlations were observed between tear film osmolarity and Schirmer test result (r < -0.01;p = 0.97);tear break-up time (r = 0.05;p = 0.54);or Ocular Surface Disease Index score (r = 0.03;p = 0.76). When the two groups were compared;the Ocular Surface Disease Index score significantly differed between groups (p < 0.01);whereas the Schirmer test result (p = 0.31);tear break-up time (p = 0.11);and tear film osmolarity (p = 0.12) did not. Conclusions: No significant correlations were found between tear film osmolarity and other dry eye indicators in patients with mild dry eye syndrome. The diagnostic utility of tear film osmolarity in patients with moderate dry eye syndrome is should be evaluated.

중등도 이하 소아 근시에서 안경과 각막굴절교정렌즈 착용이 안축장 성장에 미치는 영향 비교

김태희(Tae Hee Kim),김명훈(Myung Hun Kim),곽주영(Joo Young Kwag),최진석(Jin Seok Choi),박규홍(Kyu Hong Pak),이경욱(Kyeongwook Lee),박태성(Taeseong Park),정성근(Sung Kun Chung),현주(Joo Hyun) 대한안과학회 2018 대한안과학회지 Vol.59 No.11

목적: 중등도 이하 소아 근시에서 안경과 각막굴절교정렌즈(orthokeratology lens, OK) 착용이 안축장 성장에 미치는 영향 및 관련인자를 알아보고자 하였다. 대상과 방법: 2013년부터 2015년까지 내원한 6세에서 13세 사이 -4.50디옵터 이하의 구면렌즈대응치를 가진 소아 100명을 대상으로 후향적으로 OK군(75안)과 안경군(64안) 간에 안축장 변화와 안축장과 관계된 인자들을 분석하였다. 결과: 안축장 변화는 1년째에 OK군이 0.24 ± 0.29 mm의 증가를, 안경군이 0.42 ± 0.20 mm의 증가를 보였으며, OK군에서 안경군에 비해 유의하게 안축장 성장이 억제되는 양상을 보였다(Mann-Whitney U test, p<0.05). OK군에서 처음 착용한 나이만이 안축장 변화와 음의 상관관계가 있는 것으로 나타났다(Pearson’s correlation, r=-0.481, p<0.05). 안경군에서는 처음 착용한 나이가 안축장 변화와 음의 상관관계(Pearson’s correlation, r=-0.462, p<0.05)를, 그 외에 현성굴절검사의 초기 구면렌즈대응치 및 초기 구면렌즈값, 난시값은 안축장 변화와 양의 상관관계를 보였다. 안축장 변화를 비교해 보았을 때 OK를 착용한 경우 6세 이상 9세 미만군(28안)에비해 9세 이상 13세 이하군(47안)에서 유의하게 안축장 성장이 더 억제되는 양상을 보였다(Mann-Whitney U test, p<0.05). 결론: OK 착용은 안경 착용에 비해 효과적으로 안축장의 성장을 억제할 수 있으며, 9세 이상 13세 이하의 소아에서도 효과적인 안축장 성장 억제가 가능하다. Purpose: To assess the effect on axial elongation and associated factors between spectacles and of orthokeratology lens (OK) wearing in children with mild to moderate myopia. Methods: A total of one hundred subjects, ranging in age from 6 to 13 years, and with mild to moderate myopia no more than -4.50 diopters in spherical equivalent, visited our clinic from 2013 to 2015. The OK group (75 eyes) and the spectacles group (64 eyes) were compared and analyzed on the axial elongation and associated factors. Results: In the OK group, axial length was elongated in 1 year period with a mean increase of 0.24 ± 0.29 mm. In spectacles group, axial length was elongated in 1 year period with a mean increase of 0.42 ± 0.20 mm. The statistically significant suppression of axial elongation was observed in OK group compared to the spectacles group (Mann-Whitney U test, p < 0.05). For OK group, the age of starting OK (Pearson’s correlation, r = -0.481, p < 0.05) was the only influencing factor on axial elongation, which had negative correlation with axial elongation. In spectacles group, the age of starting spectacles had negative correlation with axial elongation (Pearson’s correlation, r = -0.462, p < 0.05) and baseline spherical equivalent, spherical diopter, cylindrical diopter from manifest refraction had positive correlation with axial elongation. Comparison of axial elongation in orthokeratology lens group and spectacles group by age groups (6 to 9 years [28 eyes], 9 to 13 years [47 eyes]), 9 to 13 years of orthokeratology lens group had the stronger suppression of axial elongation (Mann-Whitney U test, p < 0.05). Conclusions: The OK effectively suppresses axial elongation compared to the spectacles. Although the patients are in age from 9 to 13 years, the axial elongation was effectively suppressed.