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재발성 군날개 환자에서 미세 다공성 신전된 폴리테트라플루오로에틸렌 삽입의 임상효과
김경우,김재찬.Kyoung Woo Kim. MD. Jae Chan Kim. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.3
Purpose: To investigate the clinical effect of micro-multiporous e-PTFE insertion for severe recurrent pterygium with symblepharon. Methods: The present study included a total of 13 cases of recurrent pterygium associated with symblepharon, motility restriction and diplopia which had undergone micro-multiporous e-PTFE insertion after pterygium excision, 0.02% mitomycin C application, human amniotic membrane transplantation (AMT) and/or conjunctivo-limbal autograft (CLAU) between September 2010 and February 2011. One month after surgery, the inserted e-PTFE was removed. Recurrence of pterygium and symblepharon, motility restriction, diplopia and injection of ocular surface were evaluated for 11.92 ± 1.32 months of mean follow-up period. Results: Pterygial recurrence was not observed in 12 out of 13 eyes, and the 1 eye which recurred showed conjunctival recurrence. No postoperative symblepharon recurrence was observed in any of the 13 eyes. Diplopia and motility restriction disappeared in 11 out of 13 eyes, and were improved in the other 2 eyes. VAS (Visual Analogue Scale) injection scores in the wound site decreased after surgery in all patients. Conclusions: Micro-multiporous e-PTFE insertion combined with mitomycin C application, AMT and CLAU can be a useful surgical method to lower the postoperative recurrence rate and to improve the pterygium-related symptoms in severe recurrent pterygium.
무렌각막궤양 환자에서 시행한 자가 귀구슬 연골막 이식술 1예
이동익,김경우,김재찬,Dong Ik Lee,MD,Kyoung Woo Kim,MD,Jae Chan Kim,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.3
Purpose: To report the effectiveness of an autologous tragal perichondrium graft for an active Mooren's ulcer. Case summary: A 49-year-old male was referred to our clinic with Mooren's ulcer in his left eye. On the first visit, the ulcer involved the entire 360 degrees of the peripheral cornea and the visual acuity was 0.04. As the ulcer did not respond to medical treatment and progressed rapidly, the authors decided on surgical treatment. First, the involved cornea and nearby conjunctiva were removed and the defect was successfully reconstructed with autologous tragal perichondrium and allogenic limbal graft. The progression of corneal ulceration ceased after surgery and the patient's symptoms remarkably improved. Additionally, the graft showed rapid vascularization and engraftment within a week. However, as the opacity evolved and progressed to the central cornea, penetrating keratoplasty (PKP) was performed 5 months after the perichondrial graft. There was no rejection and corneal translucency was kept clear with low-dose steroid eye drops until 6 months after PKP without any sign of limbal deficiency. The patient's final best corrected visual acuity was 0.125. Conclusions: The present study shows that autologous tragal perichondrium graft is an effective method of treatment for active Mooren's ulcer by defect reconstruction and results in survival of the co-transplanted graft as well as maintaining corneal functions. J Korean Ophthalmol Soc 2014;55(3):437-442