미세표면분석 기법을 이용한 미용 콘택트렌즈와 일반 콘택트렌즈의 표면거칠기와 세균부착성 비교

지용우,홍순호,정동룡,김응권,이형근,Yong Woo Ji,Soon Ho Hong,Dong Yong Chung,Eung Kweon Kim,Hyung Keun Lee 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To determine the surface roughness of cosmetic and conventional contact lenses (CLs) and their susceptibility to bacterial adhesion. Methods: Concave surface roughness of cosmetic and conventional hydrogel (Etafilcon A) CLs was measured by atomic force microscopy (AFM) and scanning electron microscopy (SEM). In particular, the surface of the color tinted area of cosmetic CLs was measured. CLs were immersed into a bacterial solution of Pseudomonas aeruginosa for 1, 12, or 24 hours and culture of P. aeruginosa that had adhered to the CLs was performed. Results: Concave surface roughness of cosmetic CLs significantly increased compared with conventional CLs by AFM (<em>p</em> < 0.05). Bacterial colony formation of <em>P. aeruginosa</em> adhering to cosmetic CLs within one hour significantly increased compared with conventional CLs (<em>p</em> = 0.047). Adhesions of <em>P. aeruginosa</em> to CLs within one hour was found to correlate significantly with the surface roughness of CL (r > 0.9, <em>p</em> < 0.05). By SEM, <em>P. aeruginosa</em> had adhered to the color-tinted area more than to the non-color-tinted area of cosmetic CLs. Conclusions: Surface of cosmetic CLs was significantly rougher and initial adhesion of bacteria was higher to cosmetic CLs than to conventional CLs. In particular, an increased number of bacteria was found to be adhered to the color-tinted area of cosmetic CLs. Initial bacterial adhesion is important because it is the first stage of bacterial attachment process to any surface. After then, the adherent bacteria can progress to form a biofilm. Increased surface roughness of CLs contributes to opportunities for the CL to come into contact with bacteria, and thus, initial bacterial adhesion increases. In this study, it is clear that cosmetic CLs are more vulnerable to bacterial adhesion. To avoid serious complications, such as bacterial keratitis, the manufacturing process for smoothing and treating the surface in order to inhibit bacterial adhesion should be developed in the future. J Korean Ophthalmol Soc 2014;55(5):646-655

건성안 진단에서 눈물띠 측정 스트립의 유효성

김문경(Moon Kyoung Kim),지용우(Yong Woo Ji),이형근(Hyung Keun Lee),서경률(Kyoung Yul Seo),김응권(Eung Kweon Kim),김태임(Tae im Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.10

목적: 건성안 환자에서 strip meniscometry를 이용한 눈물 측정치와 기존의 눈물 검사들과의 상관성을 분석하여 strip meniscometry 검사의 진단적 유효성을 평가하고자 한다. 대상과 방법: 연구에 포함된 대상자를 strip meniscometry를 이용한 눈물띠 측정, 쉬르머 검사, 눈물막 파괴시간, 빛간섭단층촬영을 이용한 눈물띠 측정 등을 시행한 후 건성안군(n=46안)과 정상안군(n=30안)을 비교분석하였으며, Spearman 상관분석을 이용하여 strip meniscometry 측정치와 그 외 검사와의 상관성을 평가하였다. 결과: Strip meniscometry를 이용한 눈물띠 수치는 쉬르머 검사(r=0.6080), 눈물막 파괴시간(r=0.5980), 빛간섭단층촬영을 이용한 눈물띠 깊이(r=0.6210), 너비(r=0.6080), 면적(r=0.6370) 수치와 모두 유의한 상관관계를 가졌다(p<0.01). 또한 정상안군(7.07 ± 2.61 mm) 에 비해 건성안군(4.58 ± 1.94 mm)에서 strip meniscometry 측정치가 유의하게 낮았다(p<0.05). 결론: Strip meniscometry는 건성안 환자 및 정상안 환자에서 유의한 차이를 보이며 기존의 눈물 검사와도 유의한 상관관계를 가진다. Strip meniscometry는 쉬르머 검사에 비해 적은 검사시간이 필요하고 비침습적인 방법이므로 건성안 환자의 평가에 유용한 수단이 될 수 있을 것으로 기대된다. <대한안과학회지 2016;57(10):1521-1526> Purpose: To evaluate the efficacy of strip meniscometry test for dye eye syndrome (DES) by measuring the correlation between strip meniscometry and conventional test measurements. Methods: All subjects were examined using the Schirmer test, tear breakup time (TBUT) and strip meniscometry using SMTube (Echo Electricity Co., Ltd., Fukushima, Japan). Tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus area (TMA) were measured using Fourier-domain optical coherence tomography. The DES group (n = 46 eyes) was compared with the normal group (n = 30 eyes) and correlation was assessed using Spearman’s correlation coefficient. Results: Strip meniscometry measurement was significantly correlated with Schirmer score (r = 0.6080, p < 0.01), TBUT (r = 0.5980, p < 0.01), TMH (r = 0.6210, p < 0.01), TMD (r = 0.6080, p < 0.01) and TMA (r = 0.6370, p < 0.01). Strip meniscometry was significantly lower in the DES group (4.58 ± 1.94 mm) than the normal group (7.07 ± 2.61 mm, p < 0.05). Conclusions: Strip meniscometry was significantly correlated with other conventional test measurements for dry eye syndrome. Strip meniscometry is less time consuming and a less invasive method than the Schirmer test. Strip meniscometry could be an efficient tool to evaluate patients with dry eye syndrome in a clinical setting. J Korean Ophthalmol Soc 2016;57(10):1521-1526

한국에서 시행된 각막인레이 삽입술의 초기 임상결과 보고

김문경(Moon Kyoung Kim),이제훈(Jei Hoon Lee),박시윤(Si Yoon Park),지용우(Yong Woo Ji),이형근(Hyung Keun Lee),서경률(Kyoung Yul Seo),김응권(Eung Kweon Kim),김태임(Tae-im Kim) 대한검안학회 2016 Annals of optometry and contact lens Vol.15 No.2

Purpose: To evaluate clinical outcomes after implantation of a corneal hydrogel inlay (Raindrop Near Vision Inlay) with concurrently performing laser in situ keratomileusis (LASIK) to correct presbyopia Methods: Raindrop inlay (ReVision Optics, Inc., Lake Forest, CA, USA) was implanted at non-dominant eyes of 10 patients with presbyopia. Concurrent LASIK was performed for patients who have refractive error. Ophthalmologic evaluation included visual acuities at near, intermediate and far distance, higher-order aberration and complication cases. Subjective satisfaction was assessed by patient questionnaire. Results: Compared to preoperative visual acuity, uncorrected near vision acuity (p=0.045) and far vision acuity (p=0.126) of inlay implanted eye was improved at one year after operation. There was no significant difference in the RMS total, coma and trefoil aberration between pre-operative and six month post-operative values. Almost patients were satisfied with task assessment at near, intermediate and far distance. However, two patients removed inlay at six months after operation due to subjective discomfort and another two patients removed inlay at one year after operation due to myopic shift. Conclusions: Raindrop inlay implantation with concurrent LASIK effectively correct presbyopia. However, further long-term investigation about subjective discomfort and refraction change should be needed for confirmation of efficacy and safety.

인공눈물 점안 후 안구 표면 두께 간섭계를 이용한 눈물 지질층 두께의 변화 분석

김서희(Seo Hee Kim),박시윤(Si Yoon Park),지용우(Yong Woo Ji),서경률(Kyoung Yul Seo),김응권(Eung Kweon Kim),김태임(Tae im Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.12

목적: 농도 및 보존제 유무에 따른 히알루론산 나트륨제제의 인공누액 점안 후 LipiView?? II 간섭계(TearScience Inc., Morrisville, NC, USA)를 이용하여 눈물 지질층 두께의 시간에 따른 변화를 측정, 비교 분석함으로써, 인공눈물의 사용이 LipiView?? II 검사 결과에 미치는 영향을 분석하고자 한다. 대상과 방법: 건성안 환자를 대상으로 전향적 연구를 시행하였다. 모든 대상자에게 눈물막 파괴 시간 측정, 쉬르머 검사, 각막 및 결막형광염색 검사, 마이봄샘 기능부전 평가, ocular surface disease index 설문조사를 실시하였으며, 대상자를 난수표를 이용한 무작위 추출로 인공누액 종류에 따라 세 그룹(1군: 무보존제 0.1% 히알루론산 나트륨제제 인공눈물, 2군: 무보존제 0.3% 히알루론산 나트륨 인공눈물, 3군: 0.003% 염소 벤잘코니움을 포함하는 0.1% 히알루론산 나트륨제제 인공눈물)으로 나눠 각각의 인공눈물을 점안 전, 직후, 1, 3, 6시간 후의 눈물지칠층의 두께를 LipiView?? II 간섭계로 측정 후 비교 분석하였다. 안검염의 유무에 따라 두 군으로 나누어 눈물지칠층의 두께를 추가로 분석하였다. 결과: 눈물 지질층의 두께를 측정한 결과, 인공눈물제제를 점안하고 3시간 뒤 눈물 지질층의 두께 변화가 유의하게 나타났다(p=0.03). 제1군 및 2군에서 시간에 따른 눈물 지질층 두께의 변화가 유의하게 측정되었고(p<0.01, p<0.01), 제3군에서는 눈물 지질층 두께 변화가 관찰되지 않았다(p=0.71). 환자를 안검염 그룹과 비안검염그룹으로 세분화하여 분석해 보았을 때, 비안검염 그룹에서는 인공눈물점안과 상관 없이 눈물지질층의 두께가 일정하였고(p=0.19), 안검염 그룹에서는 제1군과 2군에서 인공눈물 점안 후 시간 경과에 따라 눈물지질층 두께가 변화하였다(p<0.01, p=0.01). 안검염 그룹에서 제1군과 2군의 눈물 지질층의 두께를 비교하면, 인공눈물 점안 직후 및 1시간, 3시간 뒤까지 유의한 차이를 보였으며(p=0.04, p<0.01, p=0.02), 6시간째에는 유의한 차이가 없었다. 제1군과 3군의 경우에는 시간별 차이가 없었다(p=0.08). 결론: LipiView?? II 간섭계를 이용해 측정한 눈물 지질층 두께는 인공눈물의 농도와 보존제의 유무에 따라서도 수치의 차이를 보였으며, 안검염의 유무에 따라서도 인공눈물 점안 후 눈물 지질층의 두께 변화 양상에 차이가 있었다. 이는 LipiView?? II 간섭계로 눈물 지질층을 측정하는 경우 인공눈물 종류와 관계없이 적어도 6시간의 점안을 금해야 하며, 또한 안검염이 있는 환자군과 보존제를 포함하는 인공눈물을 사용하는 환자에서 더욱 유의해야 함을 시사한다. Purpose: The changes in tear film lipid layer thickness (LLT) after artificial tears application using LipiView??II interferometer were assessed. Methods: We performed a prospective study of patients with dry eye disease. All subjects underwent measurement of tear film break-up time, Schirmer test, ocular surface staining, meibomian gland evaluation, and subjective score assessment using the Ocular Surface Disease Index. All subjects were randomly assigned to 1 of 3 groups using table of random numbers (group 1, sodium hyaluronate [HA] 0.1% eye drops without preservatives; group 2, HA 0.3% eye drops without preservatives and group 3, HA 0.1% with benzalkonium chloride 0.003%). LLT was measured before, immediately after and 1 hr, 3 hrs, and 6 hrs after artificial tears application. Additionally, the patients were divided into 2 subgroups depending on the presence of meibomian gland dysfunction (MGD) and further evaluated. Results: Significant change in LLT was observed at 3 hrs after artificial tears instillation. LLT in groups 1 and 2 showed significant changes over time (p < 0.01 and p < 0.01, respectively). However, LLT in group 3 showed no change. LLT was unchanged in patients without MGD. Conversely, in MGD patients, a significant difference in LLT between groups 1 and 2 was observed immediately after and 1 hr and 3 hrs after instillation of artificial tears (p = 0.04, p < 0.01 and p = 0.02, respectively) but not at 6 hrs. However, no significant difference in LLT between groups 1 and 3 was observed in MGD patients. Conclusions: LLT after instillation of artificial tears measured using LipiView??II interferometer was affected by artificial tear concentration and presence of preservatives. Additionally, the presence of MGD can impact the pattern of LLT changes induced by artificial tear instillation. Therefore, LLT measurements using LipiView??II interferometer require at least a 6-hrs interval after use of eye drops, especially for patients with MGD or using artificial tears with preservatives.