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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
이자영,이미리,최경식,이성진,Ja Young Lee,MD,Mi Ri Rhee,MD,Kyung Seek Choi,MD,PhD,Sung Jin Lee,MD,PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.5
Purpose: To assess the effect of pars plana vitrectomy and gas tamponade on corneal endothelial cell density. Methods: The corneal endothelial cell density in 145 eyes that underwent pars plana vitrectomy was examined with a noncontact specular microscope 3 months pre- and post-operation. The subjects were divided as follows: Group 1 (32 eyes) underwent pars plana vitrectomy, group 2 (26 eyes) underwent pars plana vitrectomy combined with gas tamponade, group 3 (34 eyes) underwent pars plana vitrectomy combined with phacoemulsification and group 4 (48 eyes) underwent pars plana vitrectomy combined with phacoemulsification and gas tamponade. The changes in corneal endothelial cell density between groups was compared. Results: The mean endothelial cell loss was more significant in group 2 than in group 1 (p = 0.012), and there was no difference between groups 3 and 4 (p = 0.063). However, after excluding 6 eyes that had blood in the center of the corneal endothelium as a result of being in the prone position following gas tamponade, the mean endothelial cell loss in group 2 was not less than in group 1. In eyes with blood in the corneal endothelium, endothelial cell loss significantly increased (p < 0.001). Conclusions: The results of this study suggest that ophthalmic surgeons should attempt to carefully control bleeding and sufficiently irrigate the vitreous during pars plana vitrectomy combined with gas tamponade. J Korean Ophthalmol Soc 2011;52(5):544-549
이자영,김미금,위원량,Ja Young Lee,Mee Kum Kim,Won Ryang Wee 대한안과학회 2011 대한안과학회지 Vol.52 No.10
Purpose: To report the clinical outcomes of total corneolimbal transplantation in two cases. Case summary: One patient, who previously underwent three rounds of penetrating keratoplasty and limbal transplantation for uncontrollable peripheral and central corneal melting, received total corneolimbal transplantation. The other patient who underwent penetrating keratoplasty with limbal transplanation for a chemical burn and who did not experience corneal perforation also received total corneolimbal transplantation. During the average 19 months of follow-up, cyclophotocoagulation was performed to control high intraocular pressure in both patients. Both eyes were tectonically maintained without further corneal destruction despite poor visual acuity and rejection. Conclusions: Total corneolimbal transplantation may be an effective tectonic procedure for corneal melting. This procedure can be considered as another option for patients with corneal melting after failed limbal and corneal transplantation. J Korean Ophthalmol Soc 2011;52(10):1238-1243