섬유주절제술 및 섬유주절제술과 백내장수술을 겸한 경우에서 Mitomycin - C 가 수술후 난시에 미치는 영향

최철명(Chul Myong Choe),정학성(Hak Sung Chung),홍영재(Young Jae Hong) 대한안과학회 1995 대한안과학회지 Vol.36 No.6

상피제거회전솔을 이용한 굴절교정레이저각막절제술과 상피통과굴절교정레이저각막절제술의 임상결과 비교

강현승,최철명,최태훈,김세경 대한안과학회 2014 대한안과학회지 Vol.55 No.9

Purpose: To compare the results of transepithelial photorefractive keratectomy (trans PRK) and brush-assisted photorefractive keratectomy (brush PRK) for the treatment of myopia. Methods: A total of 146 eyes from 78 patients who received brush PRK or trans PRK with the Schwind Amaris laser platform were included in the present study. Uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent (MRSE) at postoperative 1 week, 1, 3, 6, and 12 months were compared between the 2 groups as well as epithelial healing time. Results: The mean time to complete epithelial healing was 3.27 ± 0.75 days in the trans PRK group and 3.67 ± 0.93 days in the brush PRK group (p < 0.05). At 1 week after surgery, UDVA recovered more rapidly after trans PRK than brush PRK (brush PRK: 0.13 ± 0.12 log MAR units, trans PRK: 0.09 ± 0.08 log MAR units, p < 0.05), however, UDVA was not significantly different at 1, 3, 6, and, 12 months postoperatively between the 2 groups. Conclusions: Re-epithelialization and visual recovery were faster in the trans PRK group while visual outcome and postoperative complications were equivalent to the brush PRK group.J Korean Ophthalmol Soc 2014;55(9):1284-1290

접이식 홍채고정 안내렌즈 삽입술의 1년 경과 관찰 임상성적 및 각막내피세포 변화

성산,최철명,최태훈,김세경 대한안과학회 2015 대한안과학회지 Vol.56 No.7

목적: 고도 근시 및 난시 환자에서 접이식 홍채고정 안내렌즈(Artiflex??, Ophtec BV, Groningen, Netherlands) 삽입술의 임상성적을 평가하고 각막내피세포밀도 변화를 추적관찰하였다. 대상과 방법: 1년 이상 추적관찰이 가능했던, 근시 교정을 위해 Artiflex 삽입술을 시행 받은 20명 40안, 근시 및 난시 교정을 위해Toric Artiflex 삽입술을 시행 받은 10명 20안을 대상으로 시력, 굴절력, 난시변화, 각막 내피세포 밀도를 후향적으로 비교 분석하고 이에 영향을 주는 인자에 대해 상관계수 분석을 시행하였다. 결과: 술 전 평균 구면렌즈 대응치는 -9.18 ± 2.27 D였으며, 술 후 1년째 -0.45 ± 0.45 D였다. 술 후 1년째 나안시력이 1.0 이상인경우는 93.3%였으며, 0.8 이상인 경우는 99.9%였다. Toric Artiflex 삽입술을 시행 받은 경우, 수술 전 평균 난시는 -2.67 ± 0.87D였으며, 술 후 1년째 -0.76 ± 0.40 D로 유의하게 감소하였다(p<0.001). 각막내피세포의 밀도는 수술 전 2,850 ± 230 cells/mm2였으며, 술 후 최종 추적 관찰 시 2,812 ± 261 cells/mm2로 1.3% 감소하였으나 통계학적으로 유의한 감소를 보이지는 않았다(p=0.465).수술 전후의 전방 깊이에 따른 내피세포의 밀도 변화는 통계학적으로 유의한 상관관계를 보이지 않았다(상관계수=-0.146, p=0.267). 결론: 1년 경과 관찰 결과 홍채고정 안내렌즈인 알티플렉스 삽입술은 고도 근시 및 난시를 교정하는 데 있어 안전하고 효과적인 수술방법으로 생각된다. Purpose: To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex??,Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism. Methods: The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction,any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed. Results: The mean preoperative refractive spherical equivalent was -9.18 ± 2.27 D and reached -0.45 ± 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 ± 0.87 D, and at 1 year postoperatively -0.76 ± 0.40 D, showing a statistically significant decrease (p < 0.001). The preoperative mean endothelial cell density was 2,850 ± 230 cells/mm2 and decreased 1.3% on the final follow-up (2,812 ± 261 cells/mm2) but without statistical significance (p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r2 = -0.146, p = 0.267). Conclusions: Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.

눈부심측정기를 이용한 눈부심의 정량적 측정

송유경,최철명,김성수,이형근,Yoo Kyung Song,Chul Myung Choe,Sung Soo Kim,Hyung Keun Lee 대한안과학회 2012 대한안과학회지 Vol.53 No.7

Purpose: To report glare disability measured by a glaremeter. Methods: Glaremeter values were measured in 270 normal eyes and 100 pseudophakic eyes. The normal eyes were classified into 3 age groups (teenage to 60’s) with 90 eyes in each group. The pseudophakic eyes were classified into the monofocal IOL (intraocular lens) and multifocal IOL implanted groups with 50 eyes in each group. Glaremeter values of each group were measured using a glaremeter under photopic (82.2 ± 5.1 cd/m2) and mesopic (5.5 ± 0.3 cd/m2) conditions. Results: The highest mean glaremeter value in the normal eyes was 8657.34 ± 691.04 mm2 under the photopic condition and 8837.97 ± 805.83 mm2 under the mesopic condition in the oldest group. The glaremeter value of the multifocal IOL implanted group was 9390.87 ± 846.7 mm2 under the photopic condition and 9799.87 ± 823.72 mm2 under the mesopic condition, which was significantly higher than the normal eye and the monofocal IOL implanted groups (p < 0.05). Conclusions: In the normal population, the mean glaremeter values were increased according to age, and a significant increase was observed in the multifocal IOL implanted group. The present study results provide good basic data for cataract and presbyopia refractive surgery predicted to produce glare disability inevitably. J Korean Ophthalmol Soc 2012;53(7):953-959

고도근시 환자에서 부분결합간섭계와 초음파를 이용한 생체측정

정진권,최철명,유용성,이성진.JK Chung. M.D.. Chul Myong Choe. M.D.. Yong Sung You. M.D.. Sung Jin Lee. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.3

Purpose: To compare the refractive outcome of clear lens extraction employing partial coherence interferometry data with that of applanation ultrasonography. Methods: Thirty eyes of 17 patients with axial length greater than 26 mm who underwent clear lens extraction were enrolled in this study. IOL power was measured using IOLMaster and conventional ultrasonography. Differences between predicted refraction and actual refraction were compared and analyzed according to the biometry method and IOL power calculation formulas. Results: Axial length according to IOLMaster measurement (29.23±1.40 mm) was significantly longer than that measured by ultrasonography (28.68±1.32 mm) (p=0.000). The difference between actual and predicted refraction was 0.75±0.40 diopter by SRK/T with IOLMaster and 0.44±0.52 diopter by SRK/T with A-scan. The standard errors of the two measurement methods were 0.08 and 0.10, respectively. Eighty-five percent and one hundred percent of patients were within 1 diopter, as measured by SRK/T with IOLMaster and with A-scan, respectively. Conclusions: The use of the IOLMaster with the SRK/T formula may be an accurate method of IOL calculation in cases of high myopes, if surgeon factors are corrected for.

원전 주제어실의 지진응답 저감을 위한 면진 장치 적용에 관한 연구

김우범,최철명 대한건축학회지회연합회 2005 대한건축학회지회연합회 학술발표대회논문집 Vol.1 No.1

An experimental and analytical study was performed to apply the friction pendulum system(FPS) to main control room of nuclear power plant. A friction pendulum bearing was fabricated and dynamic response of the bearing was evaluated. A partial model of main control room attached FPS was tested on the shake table. The model consisted of a cabinet, access floor(2.3m x 2.3m) and 4 friction pendulum bearings. Artificial time history based on floor response spectrum of main control room was used as earthquake input signal in the test. Comparisons between analytical study and experimental study were conducted in order to verify the results as well as to extend the experimental study to the range of parameters which could not be experimentally studied.

건성안에서 사이클로스포린 0.05% 점안 후 눈물 삼투압의 변화

강현승,성산,최철명,김세경,최태훈 대한안과학회 2015 대한안과학회지 Vol.56 No.2

목적: 건성안 환자에서 사이클로스포린 0.05% (Restasis; Allergan, Irving, CA)의 점안효과를 눈물 삼투압과 다른 건성안 지표들을통하여 알아보고자 하였다. 대상과 방법: 기존의 인공눈물을 사용하고 있는 건성안 환자 86명(남자 16명, 여자 70명)을 대상으로 국소 사이클로스포린 0.05% 사용 전,사용 후 1개월, 3개월, 6개월째에 눈물삼투압검사(tear osmolarity), 눈물막파괴시간(TBUT), 안구표면염색점수(ocular surface staining),쉬르머 검사(Schirmer test), 그리고 ocular surface disease index (OSDI)를 이용하여 건성안 증상의 호전 여부를 평가하였다. 결과: 사이클로스포린 0.05% 점안 전 평균 TBUT는 4.41 ± 1.63초, 1개월째 5.34 ± 2.36초(p=0.305), 3개월째 6.26 ± 2.16초(p=0.022),6개월째 5.95 ± 1.90초(p=0.197)였으며, OSDI는 점안 전 45.02 ± 22.38점에서 1개월째 44.13 ± 22.23점(p=0.242), 3개월째 34.98 ±20.19점(p=0.032), 6개월째 49.11 ± 22.06점(p=0.660)으로 각 항목에서 3개월째에 유의한 호전을 보였다. 눈물 삼투압과 쉬르머 검사, 안구표면염색점수는 6개월의 기간 동안 점안 전에 비해 모두 호전되었으나 통계학적으로 유의한 변화를 보이지는 않았다. 결론: 6개월의 사이클로스포린 0.05% 사용기간 동안 일반적인 건성안 증상의 호전은 3개월간 유지되었으며, 눈물 삼투압의 유의한변화는 보이지 않았다. Purpose: To evaluate the effect of topical cyclosporine 0.05% (Restasis; Allergan, Irving, CA, USA) on tear osmolarity in patientswith dry eye disease. Methods: The present study was a single-center, randomized, prospective, and longitudinal trial. Patients who had been usingartificial tears to treat dry eye disease were prescribed cyclosporine 0.05% and evaluated using tear osmolarity, tear break-uptime, ocular surface staining score, Schirmer test, and the Ocular Surface Disease Index for symptomatic improvement. Clinicalmeasurements of commonly used objective tests were performed at baseline and after 1, 3, and 6 months. Results: At the end of the study, patients demonstrated statistically significant improvement in tear break-up time (6.26 ± 1.26sec at 3 months vs. 4.41 ± 1.63 sec at baseline, p = 0.022) and OSDI (34.98 ± 20.19 at 3 months vs. 45.02 ± 22.38 at baseline,p = 0.032) only at 3 months. Other measures such as Schirmer test, ocular surface grade, and tear osmolarity also showedimprovement. However, the differences were not significant. Conclusions: Over a 6-month period, topical cyclosporine 0.05% showed beneficial effects on symptoms and other commonlyused signs of dry eye disease for 3 months; however, the tear osmolarity values were not significantly improved.

정상인에서 단기간 사용한 Timoptic(R)과 Cosopt(R)의 효과 및 부작용 비교

심재철 ( Jae Chol Shim ),최철명 ( Chul Myong Choe ),성공제 ( Gong Je Seong ) 대한안과학회 2002 대한안과학회지 Vol.43 No.7

라식시 자동미세각막절삭기 사용에 따른 안구 변화와 각막절편에 미치는 영향 인자

이은석 ( Eun Suk Lee ),최철명 ( Chul Myong Choe ),이재범 ( Jae Bum Lee ) 대한안과학회 2002 대한안과학회지 Vol.43 No.6

원시에서 굴절교정레이저각막절제술과 라식수술의 비교

김돈경,최재호,김성원,최태훈,최철명 대한안과학회 2019 대한안과학회지 Vol.60 No.6

Purpose: We compared the results of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for the correction of hyperopia. Methods: Patients who underwent PRK or LASIK, under +6.00 diopters (D) hyperopia and under ‐2.00 D astigmatism were included. In total, 21 patients (38 eyes) underwent PRK surgery and 25 patients (41 eyes) underwent LASIK surgery. We compared the visual acuity, refractive error, safety, and efficacy between the two groups. Results: The manifest refractive spherical equivalent (MRSE) of the PRK and LASIK groups at 1 and 3 months after surgery was significantly different between the two groups (p < 0.05). However, the MRSE was not significantly different at postoperative 6 and 12 months between the two groups. The uncorrected visual acuity (UCVA) of the PRK and LASIK groups at 1 month after surgery was significantly different between the two groups (p < 0.05). However, the UCVA was not significantly different at postoperative 3, 6, and 12 months between the two groups. The best‐corrected visual acuity was not significantly different at postoperative 1, 3, 6, and 12 months between the two groups. The safety index was not significantly different between the two groups at postoperative 1, 3, 6, and 12 months. The efficacy index of the PRK group was lower than that of the LASIK group at 1 month after surgery. However, the efficacy index was not significantly different at postoperative 3, 6, and 12 months between the two groups. There was no statistically significant difference between the predictability of the two groups at postoperative 1 year. Conclusions: After PRK treatment, temporary myopic deviation was observed after 1 month, but there was no significant difference between the two treatments after 3 months of follow‐up. In the correction of hyperopia, there was no significant difference between PRK and LASIK in efficacy or safety. 목적: 원시에서 굴절교정레이저각막절제술(photorefractive keratectomy, PRK)과 라식수술을 비교 분석하였다. 대상과 방법: +6.00 D 이내 원시, 난시 ‐2.00 D 이내인 환자들 중, PRK수술을 시행받은 38안(21명)과 라식수술을 시행받은 41안(25명)을 대상으로 술 후 시력, 굴절력, 안정성, 효율성 및 예측성을 비교 분석하였다. 결과: 평균 구면렌즈 대응치는 술 후 1개월, 3개월에 PRK군과 라식군 사이에 통계적으로 유의한 차이가 있었으나(p<0.05), 술 후 6, 12개월에는 유의한 차이는 없었다(p>0.05). 나안시력은 술 후 1개월째 PRK군과 라식군 사이에 통계적으로 유의한 차이가 있었으나(p<0.05), 술 후 3, 6, 12개월에는 유의한 차이는 없었다(p>0.05). 최대교정시력은 술 후 1, 3, 6, 12개월에 두 군에서 통계적으로 유의한 차이는 없었다. 안정성은 술 후 1, 3, 6, 12개월에 두 군에서 통계적으로 유의한 차이는 없었다(p>0.05). 효율성은 술 후 1개월째 PRK군이 라식군보다 통계적으로 유의하게 낮았으나(p<0.05), 술 후 3, 6, 12개월에 통계적으로 유의한 차이는 없었다(p>0.05). 술 후 1년째 예측성은 두 군 사이에 통계적으로 유의한 차이는 없었다(p>0.05). 결론: PRK수술에서 술 후 1개월째 라식수술에 비해 근시 양상을 보였으나, 술 후 3개월 이후에는 두 수술 간의 차이가 없었다. 원시환자에서 PRK수술과 라식수술의 효율성과 안정성은 술 후 3개월 이후 차이가 없는 것으로 판단된다.