2.2 mm 동축 소절개 백내장수술의 단기 임상 결과 비교

최진아,정성근,김현승,Jin A Choi,Sung Kun Chung Ph,D,Hyun Seung Kim 대한안과학회 2008 대한안과학회지 Vol.49 No.6

Purpose: To compare the postoperative results of 2.2 mm microcoaxial cataract surgery (MCCS) and conventional 3.0 mm cataract surgery (CCS). Methods: This study included 30 patients (40 eyes): 17 patients (21 eyes) had microcoaxial cataract surgery using a 2.2 mm microcorneal incision, and 13 patients (19 eyes) had conventional cataract surgery using a 3.0 mm corneal incision. In these two groups, we measured phacoemulsification time, total phacoemulsification percentage, and effective phacoemulsification time (EPT) during cataract surgery. We compared corneal thickness, endothelial cell count, uncorrected visual acuity, best‐corrected visual acuity, and surgically, induced astigmatism (SIA) by corneal topography between the two groups preoperatively and at 1 day, 1 week, 1 month, and 2 months postoperatively. Results: There were significantly lower SIA (p=0.025) at postoperative day 1 in MCCS, and there was no significant difference after that. No difference in phacoemulsification time, total phacoemulsification percentage, EPT, corneal thickness, postoperative uncorrected visual acuity or corrected visual acuity was noted between MCCS and CCS. Conclusions: MCCS using a 2.2 mm small corneal incision appears to be a safe and advanced procedure with a smaller amount of surgically-induced astigmatism during the early postoperative period. J Korean Ophthalmol Soc 49(6):904-910, 2008

경면현미경과 동일초점현미경을 이용한 각막내피 평가의 비교

이자영,이승희,정성근,이해영,Ja Young Lee,Seung Hee Lee,Sung Kun Chung,Ph,D,Hae Young Lee 대한안과학회 2008 대한안과학회지 Vol.49 No.10

Purpose: To compare the results of specular microscopy with those of confocal microscopy for evaluation of corneal endothelium. Methods: We evaluated corneal endothelium of 103 eyes using specular microscopy and confocal microscopy. Endothelial cell density, pleomorphism, and polymegathism were measured using a ConfoScan 4 confocal microscope (Nidek Technologies, Inc, Greensborom, NC) in automatic mode before and after manual correction. Also, endothelial cell density, the coefficient of variation, and hexagonality were evaluated using a Konan Noncon Robo-8400 noncontact specular microscope (Konan medical, Inc., Hyogo, Japan). The differences in results obtained from these various methods were compared: polymegathism was compared with the coefficient of variation, and pleomorphism was compared with the inversion of hexagonality. Results: Endothelial cell density as measured by specular microscopy, the automatic count of confocal microscopy, and the manual correction for confocal microscopy were 2797.6±354.14 cell/mm2, 2973.1±284.24 cell/mm2, and 2861.9±335.58 cell/mm2, respectively. Results of each test was not significantly different (p=0.241). The inversion of hexagonality, pleomorphism of automatically counted confocal microscopy, and the pleomorphism of manually corrected confocal microscopy were 56.14%, 54.77%, and 55.24%, respectively. Results of each test were not significantly different (p=0.147).The coefficient of variation of specular microscopy, the polymegathism of automatic counted confocal microscopy, and the polymegathism of manually corrected confocal microscopy were 33.71%, 39.68%, and 38.75%, respectively. Results of each test were significantly different (p=0.005). Conclusions: Endothelial cell density and polymegathism as measured by confocal microscopy were not different from specular microscopy results in normal corneas, but these results were different for polymegathism in normal corneas. Therefore, manual correction for endothelial cell evaluation of a disordered cornea should be performed during clinical evaluation. J Korean Ophthalmol Soc 2008;49(10):1572-1577

조혈모세포이식 환자에서 전신 스테로이드 요법이 건성안의 경과에 미치는 영향

황형빈,전은정,정성근,Hyung Bin Hwang,M,D,Eun Jeong Jeon,M,D,Ph,D,Sung Kun Chung,M,D,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.6

Purpose: To evaluate the effects of systemic steroid therapy on the development of dry eye syndrome (DES) in graft-versus-host disease (GVHD) resulting from hematopoietic stem cell transplantation (HSCT) in hematologic malignancy (HM) patients. Methods: We analyzed 108 HSCT patients. We measured tear film break‐up time (BUT) and basal tear secretion, and checked for corneal lesions. BUT under 10 seconds and basal tear secretion under 10 mm gave a diagnosis of DES. Significant corneal lesions were also described in this gorup. We compared the clinical aspect and frequency of dry eye according to GVHD and also compared clinical aspects of dry eye in GVHD patients before and after systemic steroid therapy. Results: Fifty-six patients (51.9%) developed GVHD, including 51 patients (91.1%) in the GVHD group and 31 patients (59.6%) in the non-GVHD group. The frequency of DES was statistically significant in the GVHD group (p<0.05). BUT and basal tear secretions were 4.08±1.76 sec and 6.05±2.57 mm in the GVHD group and 5.37±1.83 sec and 7.08±1.54 mm. There were 32 peoples (57.1%) with corneal lesions in the GVHD group and 13 peoples (25.0%) in the non-GVHD group. Based on these results, DES was statistically significant in the GVHD group. In the GVHD group, BUT and basal tear secretion levels were 4.08±1.76 sec and 6.05±2.57 mm before systemic steroid therapy and 5.20±2.91 sec and 6.73±1.80 mm after the therapy. The difference was statistically significant (p<0.05), so we concluded that systemic steroid therapy relieved DES. Before steroid therapy, 32 peoples (57.1%) had corneal lesions, and this number decreased to 25 peoples (44.6%) after steroid therapy. The difference was not statistically significant, but we presumed that steroid therapy improved the corneal lesions (p>0.05). Conclusions: The severity and frequency of DES were high in the GVHD group. At the same time, systemic steroid therapy could relieve DES in GVHD patients. Therefore, proper medical treatment and ocular examinations should be performed for HSCT patients. J Korean Ophthalmol Soc 49(6):891-896, 2008

안구건조증 환자에서 사이클로스포린 0.05% 점안액의 임상효과

변용수,전은정,정성근.Yong Soo Byun. M.D.. Eun Jeong Jeon. M.D.. Ph.D.. Sung Kun Chung. M.D.. Ph.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.10

Purpose: We conducted a study to evaluate the change of tear secretion and symptoms in the patients with dry eye syndrome after using Restasis<sup>® (Cyclosporine 0.05% ophthalmic emulsion, Allergan Inc., U.S.A.). Methods: We randomly selected 39 patients from newly or previously diagnosed dry eye syndrome patients and administered Restasis<sup>® to them. We checked their clinical parameters and symptoms over a period of 3 months. The clinical parameters evaluated were type I and type II Schirmer tests and tear break-up time, and the symptoms of dry eye syndrome were classified into pain, itching, foreign body sensation, blurred vision, and photophobia using a scoring scale for symptoms of 0 to 5. The results were analyzed with a Mann-Whitney test (P-values <0.05 was considered statistically significant). Results: For 26 of 39 patients (52 eyes) on whom all tests were carried out for 3 months, there was a significant improvement after 3 months in the type I Schirmer test, type II Schirmer test, and tear break-up time (P=0.012, 0.009, 0.001, respectively). Only 14 patients completed the questionnaire for scoring of symptoms. After using Restasis®, foreign body sensation only improved (P=0.010). Conclusions: In our study, tear secretion was increased by Restasis<sup>®, and a greater increase in tear secretion was seen in patients with systemic disease than in patients without systemic disease. Additional patients need to be evaluated and longer-term studies need to be performed to confirm our results. J Korean Ophthalmol Soc 2008;49(10):1583-1588