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한눈 선천 눈꺼풀처짐 소아 환자의 한눈 눈꺼풀올림근 절제술과 이마근걸기술의 결과 비교
윤준명(Jun Myeong Yun),김성은(Sung Eun Kim),양석우(Suk Woo Yang) 대한검안학회 2018 Annals of optometry and contact lens Vol.17 No.1
Purpose: To compare the surgical results of unilateral levator resection and frontalis sling in unilateral congenital ptosis patients. Methods: Forty-eight patients with age < 15 years, who diagnosed with unilateral congenital ptosis and underwent surgical repair between January 2002 and December 2015 were included, and the authors retrospectively reviewed medical records of patients to compare the surgical results of 22 patients undergoing unilateral levator resection and 26 patients undergoing unilateral frontalis sling. Results: The mean postoperative marginal reflex distance (MRD)1 were 2.09 ± 0.91 mm in the levator resection group and, 1.41 ± 1.18 mm in the frontalis sling group. Postoperatively, the mean MRD1 was significantly increased in both groups (p < 0.001). Successful results defined as MRD1 symmetry (the difference in MRD1 between the two eyelids ≤1 mm) were obtained in 19 patients (86.4%) of levator resection group (22 patients) and 12 patients (46.2%) of frontalis sling group (26 patients), success rate was significantly higher in levator resection group than frontalis sling group (p=0.004). In poor levator function group (Levator function test < 4 mm), MRD1 symmetry was obtained in 10 patients (83.3%) of levator resection group (12 patients) and 4 patients (36.4%) of frontalis sling group (11 patients), success rate was also significantly higher in levator resection group (p=0.021). Reoperation due to undercorrection was required in 3 patients (13.6%) of levator resection group and 12 patients (46.2%) of frontalis sling group, reoperation rate was significantly higher in levator resection group (p=0.015). Conclusions: In children with unilateral congenital ptosis, It is considered that unilateral levator resection can provide better result and lower recurrence compared with unilateral frontalis sling.
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비쇼그렌 건성안 환자의 진단에서 눈물막 삼투압 측정의 임상적 유의성
윤준명(Jun Myeong Yun),임혜빈(Hye Bin Yim),김현승(Hyun Seung Kim),나경선(Kyung Sun Na) 대한안과학회 2017 대한안과학회지 Vol.58 No.6
목적: 비쇼그렌 건성안 환자들에게서 눈물막 삼투압(tear film osmolarity)과 건성안 지표와의 상관관계를 비교함으로써 눈물막 삼투압의 진단 도구로서의 가치를 평가하고자 한다. 대상과 방법: 본 단면연구(Cross-sectional study)에는 274명(274안)의 비쇼그렌 건성안 환자들을 대상으로, 눈물막 삼투압(tear film osmolarity)과 흔히 통용되는 건성안 지표: 쉬르머 검사(Schirmer’s test), 눈물막파괴시간(tear film break-up time), 안구표면지수 (ocular surface disease index), 각막염색점수(Corneal staining score)를 측정한 후, Spearman 상관분석을 이용하여 눈물막 삼투압 수치와 그 외 지표들 사이의 상관관계를 각각 비교하였다. 결과: 본 연구에서 대상 환자군의 평균 눈물막 삼투압 값은 296.34 ± 21.08 mOsm/L였고, 눈물막 삼투압 수치와 쉬르머검사 (r=-0.431, p<0.001), 눈물막파괴시간(r=-0.131, p=0.031)은 눈물 삼투압 수치와 통계적으로 유의한 음의 상관관계를 보였으며, 안구 표면질환지수(r=0.191, p=0.001) 및 각막염색점수(r=0.150, 0.013)와는 통계적으로 유의한 양의 상관 관계를 보였다. 결론: 눈물막의 삼투압이 다수의 비쇼그렌 건성안 환자군을 대상으로 하여도 기존에 사용되는 건성안 지표들과 유의한 상관관계가 있었으나, 단일 진단도구로서의 가능성에 대해서는 추후 연구가 필요할 것이다. Purpose: To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters. Methods: In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer’s test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman’s correlation coefficients. Results: The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer’s test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013). Conclusions: Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool. J Korean Ophthalmol Soc 2017;58(6):640-645
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두 단계 수술적 치료로 교정된 큰 각의 외편위를 동반한 양측성 핵간안근마비
박선경(Sun Kyoung Park),신희종(Hee Jong Shin),윤준명(Jun Myeong Yun),임혜빈(Hye Bin Yim) 대한검안학회 2019 Annals of optometry and contact lens Vol.18 No.2
Purpose: We report a case of two-staged adjustment surgery in wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) with severe bilateral lateral deviation after attack of cerebrovascular infarction. Case summary: A 67-year-old male patient diagnosed with acute intracranial hemorrhage was referred to department of ophthalmology due to severe diplopia that worsened during horizontal gaze of both eyes. On the alternate prism cover test, he had a severe exotropia of about 90 prism diopters (PD) at primary position, and -4 degrees of eye movement disorder were identified on both eyes. Brain magnetic resonance imaging showed a high-signal ischemic infarction on midbrain and pons. Nine months after the initial examination, we performed two-staged adjustment surgery of recession of lateral rectus muscle with resection of medial rectus muscle in both eyes. After 3 months of the two-staged adjustment surgery, he had an exotropia of about 2 PD at primary position on far alternate prism cover test and straight at primary position on near alternate prism cover test. Conclusions: We report a case of two-staged adjustment surgery in WEBINO with severe bilateral lateral deviation showed good results.
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