증식당뇨망막병증 유리체절제술 후 발생한 신생혈관녹내장과 아메드밸브 삽입술

이준훈,권순재,신재필,홍승표,김시열.Jun Hun Lee. M.D.. Soon Jae Kwon. M.D.. Jae Pil Shin. M.D.. Sung Pyo Hong. M.D.. Si Yeol Kim. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.9

Purpose: To evaluate the clinical features of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy and the effect of Ahmed valve implantation. Methods: The medical records of 217 eyes of 178 patients who had undergone pars plana vitrectomy for proliferative diabetic retinopathy were reviewed. The clinical data on preoperative, intraoperative, and postoperative factors of these patients were compared with that of those who developed neovascular glaucoma (20 eyes of 18 patients) after vitrectomy. The effect and complications of Ahmed valve implantation were also reviewed. Results: The type 1 diabetes, the presence of NVD, grade of NVE, grade of preoperative PRP, presence of postoperative vitreous hemorrhage, and postoperative tractional retinal detachment were significantly correlated with the development of neovascular glaucoma. Ahmed valve implantation in these patients was effective in controlling intraocular pressure and improving visual acuity. Complications of the Ahmed valve implantation were hyphema, tube exposure, recurrent vitreous hemorrhage, hypotony, and choroidal effusion. Conclusions: The risk factors for the development of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy were evaluated. Ahmed valve implantation in these patients is considered an effective treatment for controlling intraocular pressure.

골수이형성증후군환자에서 발생한 맥락막박리

박한상 ( Han Sang Park ) , 이준훈 ( Jun Hun Lee ) , 김인택 ( In Taek Kim ) 대한안과학회 2004 대한안과학회지 Vol.45 No.12

무방부제성 플루오로메토론 0.1% 점안액의 안구건조증에서의 효과 및 안정성 비교

박준호,이준훈,박영정,김홍균,Joon Ho Park,Jun Hun Lee,Young Jeung Park,Hong Kyun Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: To evaluate the efficacy and safety of topical unpreserved 0.1% fluorometholone (FML) ophthalmic solution in patients with dry eye syndrome. Methods: Patients with mild to moderate dry eye syndrome were divided into the control group (Group I), topical unpreserved 0.1% FML group (Group II), and topical preserved 0.1% FML group (Group III). Intraocular pressure (IOP), Ocular Surface Disease Index (OSDI), tear film break-up time (TF-BUT), Oxford stain score (OSS), and tear osmolarity (Tosm) were evaluated at 2 weeks, 4 weeks, 8 weeks, and 12 weeks (Trial 1). Patients with severe dry eye syndrome were divided into 1% methylprednisolone (MP) group (Group I) and 0.1% unpreserved FML group (Group II). Same parameters were evaluated in both groups (Trial 2). Results: In clinical trial I, OSS scores of Group II were lower than other groups (p < 0.05). For severe dry eye patients in clinical trial 2, there were no significant differences in all parameters between the 2 groups. Conclusions: Topical unpreserved 0.1% fluorometholone was shown to be an effective and relatively safe treatment in patients with dry eye syndrome.

초음파유화술 중 각막의 건조를 막기 위한 점탄물질 도포와 평형염용액 관류의 비교

이진영,이준훈,김홍균,Jin Young Lee,Jun Hun Lee,Hong Kyun Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.10

Purpose: To compare the corneal wetting properties of balanced salt solution (BSS) and ophthalmic viscosurgical device (OVD) during cataract surgery. Methods: The patients with senile cataract were randomly assigned to receive either BSS or viscous dispersive OVD for maintaining optical clarity during phacoemulsification. Intraoperative factors (VAS pain score, occurrence of corneal punctate epithelial erosions (PEE)) and postoperative factors (visual acuity, Oxford staining score, changes in endothelial cell counts, corneal thickness and volume) were compared. Results: Twenty-two eyes were assigned to the BSS group and; 33 eyes were assigned to the OVD group. There were no significant differences in demographic variable between the 2 groups. Intraoperative PEE was observed in 6 eyes in the BSS group and in 2 eyes in the OVD group. The incidence of PEE in the OVD group was significantly lower than in the BSS group (p = 0.045). There were no significant differences in other parameters (VAS pain score, postoperative factors). Conclusions: Corneal wetting with OVD (Discovisc<sup>®) provides better surgical view and reduces mechanical damage to the corneal surface without additional material or cost than BSS.

플루오로퀴롤론 점안약의 안구 내 수술에서의 예방적 사용의 효과와 안정성에 대한 연구 결과

김명준,이준훈,윤영란,김홍균,Myung Jun Kim,Jun Hun Lee,Young Ran Yoon,Hong Kyun Kim 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To report the results of a clinical comparison study of a prophylactic new generation fluoroquinolone (FQs; levofloxacin 0.5%, gatifloxacin 0.3% and moxifloxacin 0.5%) topical antibiotic regimen administered prior to intraocular microsurgery. Methods: From May 2007 to April 2010, Trial 1, 214 eyes of 211 patients scheduled for intravitreal injection were randomized into one of three FQ-treated groups or the control (non-treated) group. Patients who were randomized into FQ-treated groups were treated with eye drops containing one of three FQ antibiotics (levofloxacin 0.5%, gatifloxacin 0.3% and moxifloxacin 0.5%) preoperatively four times a day for three days before surgery. The rate of positive bacterial cultures from conjunctival scrapings were assessed and compared. Trial 2, 159 eyes of 159 patients scheduled for cataract surgery were randomized into one of three FQ-treated groups, and treated with eye drops as same method in trial 1. The concentration of antibiotics in the anterior chamber of the eye were measured and compared. Results: The positive bacterial culture rates of trial 1 were 48.9%, 38.3%, 23.4% in the levofloxacin-treated group, the gatifloxacin- group, and the moxifloxacin-treated group, respectively. These rates were all significantly lower than the 70.2% positivity rate observed in the control group. Average antibiotic residue concentrations in the aqueous humor measured in trial 2 were 0.37 ± 0.49 μg/ml in the levofloxacin-treated group, 0.31 ± 0.37 μg/ml in the gatifloxacin-treated group and 0.59 ± 0.72 μg/ml in the moxifloxacin-treated group. These concentrations were not significantly different. There were no reported side effects during the study period. Conclusions: Eye drops containing new generation FQ antibiotics instilled three days before microscopic ophthalmic surgery can be used safely and effectively for the prevention of postoperative endophthalmitis. J Korean Ophthalmol Soc 2011;52(12):1440-1447

심부표층각막이식술에서 전층각막이식술로 전환한 환자에서 발생한 이중데스메막 1예

임종찬,김홍균,이준훈,Jong Chan Im,Hong Kyun Kim,Jun Hun Lee 대한안과학회 2014 대한안과학회지 Vol.55 No.3

Purpose: To report a case of double Descemet's membrane in a patient who had penetrating keratoplasty after rupture of Descemet's membrane during deep anterior lamellar keratoplasty (DALK). Case summary: A 24-year-old female had keratoconus in her right eye and underwent DALK for treatment. Descemet's membrane was ruptured while separating the corneal stroma from Descemet's membrane with the big bubble technique. The operation method was changed from DALK to penetrating keratoplasty. Detached Descemet's membrane was observed in the anterior chamber after suturing. Sterile air was injected into the anterior chamber to attach the Descemet's membrane. Five days after the surgery, Descemet's membrane was detached and a second air injection was performed. Corneal edema was improved but Descemet's membrane was re-detached. Double Descemet's membrane was observed by anterior segment optical coherence tomography (OCT). The detached Descemet's membrane originated from the recipient's cornea and not from the donor's cornea. Detached Descemet's membrane was removed successfully. Patient's cornea was clear and best corrected visual acuity was 20/25. Conclusions: When penetrating keratoplasty is performed instead of DALK, the surgeon should completely remove the remnant corneal stroma and Descemet's membrane. Remnant Descemet's membrane can be disregarded as it comes from the donor cornea. Unnecessary anterior chamber air injection causes endothelial damage. Anterior segment OCT is a useful tool to identify anatomical structures of transplanted cornea. J Korean Ophthalmol Soc 2014;55(3):449-453

Nd:YAG 레이저 후낭절개술 후 유리체탈출에 의해 발생한 동공차단 및 안압상승

강경민,김종진,이준훈,신재필,Kyoung Min Kang,Jong Jin Kim,Jun Hun Lee,Jae Pil Shin 대한안과학회 2013 대한안과학회지 Vol.54 No.5

Purpose: To report a case of pupillary block and increased intraocular pressure caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy. Case summary: A 70-year-old male visited the hospital for decreasing visual acuity and ocular pain in the left eye. Two days earlier, he had undergone Nd:YAG laser posterior capsulotomy in the left eye. Best corrected visual acuity (BCVA) was 0.63 in the right eye and FC 60 cm in the left eye. Intraocular pressure (IOP) was 14 mm Hg in the right eye and 64 mm Hg in the left eye. Slit-lamp examination revealed diffuse corneal stromal edema and iris bombe with vitreous prolapse in the anterior chamber. Gonioscopy confirmed a closed angle. Pupillary block and increased intraocular pressure were diagnosed. A Nd:YAG laser iridotomy was performed. Three days after the iridotomy, BCVA was 0.2 and IOP was 11 mm Hg in the treated eye. Slit-lamp examination revealed reduced vitreous prolapse in the anterior chamber. Conclusions: This is the first report of pupillary block and increased IOP caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy in Korea. Physicians should be aware that pupillary block could be caused by prolapsed vitreous after Nd:YAG laser posterior capsulotomy and Nd:YAG laser iridotomy could be performed effectively in such cases.

골수이형성증후군환자에서 발생한 맥락막박리

박한상 ( Han Sang Park ),이준훈 ( Jun Hun Lee ),김인택 ( In Taek Kim ) 대한안과학회 2004 대한안과학회지 Vol.45 No.12

근시 환자에서 노안교정 비구면 미세단안시 라식 수술의 장기적인 임상 결과

강경민,정보영,조희태,이준훈,김홍균,Kyoung Min Kang,Bo Young Jung,Hee Tae Cho,Jun Hun Lee,Hong Kyun Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.12

Purpose: To evaluate the efficacy, safety, and satisfaction of patients who underwent LASIK for presbyopia correction in myopic patients using aspheric micro-monovision.<br /> Methods: LASIK for presbyopic correction using aspheric micro-monovision was performed in 18 patients between December 2010 and December 2011. Distance, intermediate, and near visual acuity, refractive change, and patient’s satisfaction were evaluated for at least 12 months after the surgery.<br /> Results: Among dominant eyes, 100% achieved uncorrected distance and intermediate visual acuity of 0.8 or better and 100% of the eyes achieved 0.8 or better binocularly. In the non-dominant eyes, 83% achieved uncorrected near visual acuity of J3 or better, and 94% of the eyes achieved J3 or better binocularly. Postoperatively, the mean manifest refraction spherical equivalent (MRSE) of the dominant eyes were -0.09 ± 0.35D, -0.17 ± 0.42D, and -0.17 ± 0.47D at 1, 6 and 12 months, respectively. The MRSE of the non-dominant eyes were -0.94 ± 0.53D, -1.03 ± 0.56D, and -1.02 ± 0.50D at postoperative 1, 6, and 12 months, respectively, without significant regression. After surgery, the patient’s overall satisfaction score was good (4.2 out of 5).<br /> Conclusions: The aspheric micro-monovision protocol showed good distance, intermediate, and near visual outcomes, and was a well-tolerated, stable, and effective procedure for treating patients with myopic presbyopia.<br /> J Korean Ophthalmol Soc 2013;54(12):1893-1901