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석주용,이담호,경학수,김준모,Ju Yong Seok,Damho Lee,Haksu Kyung,Joon Mo Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.11
Purpose: The axial length measurement is an important variable in calculating the intraocular lens (IOL) power in cataract surgery. In this study, the effects of the implantable collamer lens (ICL) on the axial length measurement were investigated. Methods: The axial lengths of 141 eyes of 76 highly myopic patients were measured before ICL implantation and 1 month postoperatively using applanation A-scan ultrasound. Results: The measured axial lengths before ICL implantation and 1 month after the surgery were 28.03 ± 1.91 mm and 28.08 ± 1.86 mm respectively, with a statistically significant difference of 0.05 mm (p = 0.036). These 2 values showed a high correlation (R2 = 0.9829, p < 0.0001). Conclusions: Even though the axial length after ICL implantation significantly increased, the 0.05 mm change was too small to influence the determination of the IOL diopters in cataract surgery. Therefore, ICL implantation history may be reflected when measuring the axial length for the IOL power calculation in cataract surgery, but the axial length measured immediately before the cataract surgery may be used to calculate the IOL power regardless of the ICL implantation history. J Korean Ophthalmol Soc 2013;54(11):1675-1679
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석주용,이승재,오민진,이수영,Ju Yong Seok,Seung Jae Lee,Min Jin Oh,Soo Young Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.3
Purpose: To report a case of bilateral occlusive retinal vasculitis presumed to be associated with intravenous ceftriaxone injection. Case summary: A 26-year-old woman presented with a sudden visual impairment which developed 2 days earlier in her left eye combined with an anaphylactoid reaction. The patient was administered intravenous ceftriaxone (2 g / day) 9 times for 14 days due to aggravation of chronic osteomyelitis on her left ankle. There were no adverse events until the 7th intravenous ceftriaxone administration. However, anaphylactoid reactions occurred shortly after the 8th and 9th administration. On the 1st visit, her best corrected visual acuity in the right eye was 1.0, and in the left eye 0.1. On fundus examination, retinal hemorrhages and perivascular sheathing were observed in the superonasal area in the right eye and in the entire retina in the left eye. Anterior chamber cell reactions were not noted on slit lamp examination, and vitritis was absent in both eyes. Laboratory data showed no conclusive evidence of autoimmune or origin of infection. On the last visit, 25 months after the initial visit, the patient’s best corrected visual acuity was 0.02 in the left eye and visual acuity and fundus appearance were normal in the right eye. Conclusions: Bilateral occlusive retinal vasculitis may be associated with intravenous ceftriaxone injection, and immunological and serological tests should be performed thoroughly along with history taking to clarify the cause of retinal vasculitis.
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ICL 삽입술 후 백내장 발생의 위험인자: 평균 7.5년 추적관찰 연구
이담호,석주용,경학수,김준모 대한안과학회 2015 대한안과학회지 Vol.56 No.6
목적: V4형 implantable collamer lens (ICL) 삽입 후 평균 7.5년의 장기 경과관찰 시 백내장의 발생빈도와 그 위험인자를 알아보고자하였다. 대상과 방법: ICL 삽입술 전 평균 구면렌즈대응치가 -12.7D이고 수술 후 경과관찰 기간이 최소 3년 이상인 고도근시 환자 118명 228안을 대상으로 환자의 수술 전, 수술 후 3개월, 3년, 마지막 경과관찰 시의 데이터를 분석하여 백내장 발생의 위험인자들과 생존분석상10.3년째 백내장 누적발생률과 누적 백내장 수술률을 알아보았다. 결과: V4형 ICL 삽입술을 시행하고 최소 3년 이상 경과관찰하였을 때 생존분석상 10.3년째의 백내장 누적발생률은 20%였으며 실제백내장 발생 환자는 34안(14.9%)이었다. 생존분석상 10.3년째의 누적 백내장 수술률은 12%였으며, 실제 백내장 수술을 시행 받은 눈은 12안(5.3%)이었다. 백내장 발생의 위험인자로는 나이(odds ratio [OR]=1.10, p=0.00), 수술 전 구면렌즈대응치(OR=0.90, p=0.00),수술 전 수정체 두께(OR=9.54, p=0.00), 수술 전 안축장 길이(OR=1.33, p=0.00), 수술 후 3개월째 vault (OR=0.50, p=0.03), 마지막경과관찰 시 ICL과 수정체의 주변부 접촉(OR=7.84, p=0.00)이 있었다. 결론: ICL 삽입술 후 중심부 vault의 감소 및 ICL 광학부 테두리와 수정체 주변부 사이의 접촉이 ICL 삽입술 후 백내장 발생의 주된위험인자 중 한 가지로 생각된다. Purpose: To determine the risk factors and incidence of cataract formation over a long-term mean follow-up of 7.5 years after type V4 implantable collamer lens (ICL) implantation. Methods: We analyzed the preoperative, 3-month postoperative, 3-year postoperative, and last follow-up data of 228 eyes (118patients) with mean preoperative spherical equivalent of -12.7 D and minimum postoperative follow-up of 3 years. Additionally,we determined the risk factors for cataract formation and calculated the 10.3 year cumulative cataract formation rate and 10.3year cumulative cataract surgery rate using a survival curve. Results: After type V4 ICL implantation with minimum follow-up of 3 years, the calculated 10.3 year cumulative cataract formation rate was 20% and actual cataracts developed in 34 eyes (14.9%). The 10.3 year cumulative cataract surgery rate was12% based on a survival curve and actual cataract surgery was performed in 12 eyes (5.3%). The risk factors for cataract formation were age (odds ratio [OR] = 1.10, p = 0.00), preoperative spherical equivalent (OR = 0.90, p = 0.00), crystalline lens thickness(OR = 9.54, p = 0.00), axial length (OR = 1.33, p = 0.00), 3 months postoperative vault (OR = 0.50, p = 0.03), and existence of peripheral touch between ICL optic margin and crystalline lens at last follow-up (OR = 7.84, p = 0.00). Conclusions: We suggest one of the main risk factors for cataract formation after ICL implantation is decreased central vault and peripheral touch between ICL optic margin and crystalline lens.
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