각막윤부 유피종의 미용적 치료 2예

조범주,한영근,현준영,위원량,이진학,권지원,Bum Joo Cho,Young Keun Han,Joon Young Hyon,Won Ryang Wee,Jin Hak Lee,Ji Won Kwon 대한안과학회 2007 대한안과학회지 Vol.48 No.10

Purpose: To report two cases of cosmetic treatment of limbal dermoid, which consist of local excision of the limbal dermoid, corneal tattooing, and amniotic membrane transplantation. Methods: Dermoid excision, corneal tattooing, and amniotic membrane transplantation were carried out in both a girl and a woman who each had a limbal dermoid in their left eyes. Postoperatively, they were followed up for more than six months. Results: No specific complications occurred. The patients were satisfied with the surgical results. After a few months the conjunctiva was found to grow into the tattooed cornea. Conclusions: In the treatment of limbal dermoid, local excision combined with corneal tattooing and amniotic membrane transplantation can be a cosmetically successful alternative choice.

오타모반의 미용적 치료 1예

조범주,한영근,김주학,위원량,이진학,권지원,Bum Joo Cho,M,D,Young Keun Han,M,D,Joo Hak Kim,M,D,Won Ryang Wee,M,D,Jin Hak Lee,M,D,Ji Won Kwon,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.6

Purpose: To report a case of cosmetically successful treatment of nevus of Ota performed by scleral painting and scleral allograft transplantation. Methods: Scleral painting and allograft transplantation were done in a 28-year-old woman who had cosmetic problem due to nevus of Ota, and she was followed up for 5 months postoperatively. Results: The patient had no specific postoperative complication and was satisfied with the surgical results. Conclusions: For patients of nevus of Ota who have not been treated successfully, scleral painting and allograft transplation can be an effective cosmetic treatment.

당뇨망막병증에서 짧은 노출시간을 이용한 패턴 범망막광응고술의 단기 임상결과

조범주,김태완,우세준,정흠,허장원,Bum Joo Cho,Tae Wan Kim,Se Joon Woo,Hum Chung,Jang Won Heo 대한안과학회 2009 대한안과학회지 Vol.50 No.3

Purpose: To investigate the clinical effect and complications of patterned scanning laser photocoagulation with short exposure time in diabetic retinopathy. Methods: A prospective study was performed on patients with diabetic retinopathy who required panretinal photocoagulation (PRP). Twenty-nine eyes of twenty five consecutive patients underwent patterned scanning laser photocoagulation with exposure time of 0.02 sec over the entire retina. Pain score at treatment, best-corrected visual acuity, the development of macular edema, regression of neovascularization in fluorescein angiography, and related complications were monitored during a three-month follow-up. Results: Treatment time for PRP was much reduced to 6.1 min on the entire retina. Pain during the photocoagulation was moderate, and enabled patients to finish PRP with ease. During a three-month follow-up, visual acuity was well preserved. Foveal minimum thickness increased at 1 month after treatment and maintained in a study period of three months. Macular volume showed significant increase (3.6%) at 1 month after treatment, maximum increase (9.8%) at 2 months, and persistent increase (4.9%) at 3 months. In every patient with very severe nonproliferative diabetic retinopathy, retina was maintained, and in 10 of 18 eyes with proliferative diabetic retinopathy, neovascularization regressed during follow-up period. No significant complication occurred except a transient vitreous hemorrhage in one eye. Conclusions: Patterned scanning laser photocoagulation with short exposure time may induce transient macular edema, but the visual acuity was preserved without any other significant complication. It is considered to be a safe and efficient treatment method in diabetic retinopathy.

비감염성 포도막염 환자의 백내장 수술과 병행한 유리체강내 덱사메타손 임플란트 삽입술의 효과

김동현(Dong Hyun Kim),조범주(Bum Joo Cho),정흠(Hum Chung),허장원(Jang Won Heo) 대한안과학회 2015 대한안과학회지 Vol.56 No.5

목적: 비감염성 포도막염 환자의 백내장 수술 시 술후 포도막염 조절을 위해 함께 시행한 유리체강내 덱사메타손 임플란트 삽입술의 효과 및 안전성에 대해 알아본다. 대상과 방법: 백내장 수술을 시행 받은 비감염성 포도막염 환자 중, 유리체강내 0.7 mg 덱사메타손 임플란트 삽입술을 시행 받은 환자들과(삽입군), 전통적인 경구 스테로이드 및 면역억제제 치료를 받은 환자들(비삽입군)의 술후 6개월까지의 경과를 후향적으로 분석하였다. 결과: 삽입군 10안, 비삽입군 20안이 포함됐고, 연령, 성별, 술전 염증정도, 술전 교정시력은 두 군 간에 각각 유의한 차이가 관찰되지 않았다(p=0.55, 1.00, 0.13, 0.76). 술후 포도막염의 재발은 삽입군 4안(40%), 비삽입군 10안(50%)에서 관찰됐다(p=0.70). 술후 사용된 경구 스테로이드 용량은 삽입군에서(3.5 ± 1.3 mg/day) 비삽입군에(8.8 ± 1.5 mg/day) 비해 유의하게 낮았다(p=0.02). 술후 시력은 두 군 모두에서 술전에 비해 현저히 증가하였고, 두 군 간에 술후 시력 차이는 없었다(p=0.78). 술후 안압 상승 빈도는 두 군에서 유의한 차이가 없었고(p=0.65), 두 군에서 각 1안씩 여과수술을 받은 것 외에 특별한 합병증은 관찰되지 않았다. 결론: 백내장 수술과 유리체강내 덱사메타손 임플란트 주입술 병행 시, 술후 포도막염의 재발은 기존 치료에 비해 별 차이가 없었고, 술후 경구 스테로이드 용량은 유의하게 줄일 수 있었다. 덱사메타손 임플란트는 비감염성 포도막염 환자의 백내장 수술 후 염증 조절에 효과적이고 안전한 대안이 될 수 있다. <대한안과학회지 2015;56(5):721-726> Purpose: To investigate the efficacy and safety of intravitreal dexamethasone implant for controlling postoperative inflammation among uveitis patients undergoing cataract extraction. Methods: Ten eyes with noninfectious uveitis underwent phacoemulsification with intraocular lens implantation followed by intra-vitreal injection of 0.7-mg dexamethasone implant (implant group) between February 2011 and January 2014. Twenty age- and gender-matched controls who received cataract surgery without implantation during the same period were recruited (non-im-plant group). Medical records of the subjects were retrospectively reviewed and 6-month postoperative clinical outcomes were compared between the 2 groups. Results: The mean age was 42.30  15.81 years in the implant group and 45.65  13.63 years in the non-implant group. The 2 groups were similar in terms of age, gender, preoperative inflammatory status, and preoperative visual acuity (p = 0.552, 1.000, 0.133 and 0.767, respectively). After surgery, oral steroid was used in the non-implant group (8.8  1.5 mg/day on average) and the implant group (3.5  1.3 mg/day; p = 0.029). Visual acuity (log MAR) improved significantly in both groups (p = 0.789) with no significant difference between the 2 groups. Postoperative recurrence rates of uveitis were reduced more (40%) in the implant group than in the non-implant group (50%) but without significance (p = 0.709). Elevated intraocular pressure ≥25 mm Hg oc-curred in 3 eyes (30%) in the implant group and 4 eyes (20%) in the non-implant group (p = 0.657), of which 1 in each group re-quired a filtering surgery. Otherwise, no significant complications developed in either group. Conclusions: Intravitreal dexamethasone implants help reduce conventional oral steroid dosage for controlling postoperative inflammation. Dexamethasone implants could be an effective and safe alternative to control the inflammation after cataract sur-gery in uveitis patients. J Korean Ophthalmol Soc 2015;56(5):721-726

마이봄샘촬영술을 이용한 콩다래끼절개술 전후의 마이봄샘 변화 관찰

정세윤(Se Yoon Chung),황호식(Ho Sik Hwang),신민철(Min Chul Shin),조범주(Bum-Joo Cho),한소영(So Young Han) 대한안과학회 2018 대한안과학회지 Vol.59 No.2

Purpose: To examine changes in meibomian glands by indirect meibography after incision and curettage of the chalazion, and to examine the relationship between meibomian gland drop out and meibomian gland dysfunction. Methods: We performed a prospective study of 16 patients, <5 years of age, who underwent incision and curettage of the chalazion between March 2017 and June 2017. We performed indirect meibography before incision and curettage of the chalazion, and 1 week and 1 month after the procedure. Photographs of meibomian glands were rated according to their meiboscore, the break-up time (BUT) was measured, and Schirmer’s test was performed. Results: Sixteen eyes of 16 patients were included in this study. Fifteen patients visited 1 week after incision and curettage of the chalazion, and eleven patients visited at 1 month after the procedure. The mean patient age was 32.9 ± 21.9 years. There were no significant changes in the meiboscore (p = 0.092), BUT (p = 0.068), and Schirmer’s test results (p = 0.972) after incision and curettage of the chalazion. In meibography, there were inflammatory changes and partial meibomian gland drop outs at the chalazion lesion before its incision and curettage. At 1 month after the procedure, only scarring remained in the chalazion lesion, and normal surrounding meibomian glands were found near the old lesions. When comparing meibography of the baseline with meibography at 1 month after incision and curettage of the chalazion, the normal area of the meibomian gland significantly increased(p = 0.041). Conclusions: In patients with chalazions, scarring was found after incision and curettage of the lesions, and surrounding meibomian glands were well preserved when determined by indirect meibography. There was no significant correlation between meibomian gland changes after incision and curettage of the chalazion and meibomian gland dysfunction.

연령에 따른 원발성 열공망막박리의 임상양상 및 수술결과

김계중(Gye Jung Kim),신민철(Min Chul Shin),황호식(Ho Sik Hwang),한소영(So Young Han),조범주(Bum-Joo Cho) 대한안과학회 2017 대한안과학회지 Vol.58 No.1

목적: 수술이 필요한 원발성 열공망막박리에서 환자 연령에 따른 망막박리의 임상양상과 수술 결과의 차이를 분석해 보고자 하였다. 대상과 방법: 본원에서 2008년 1월 1일부터 2016년 3월 31일까지 열공망막박리로 수술적 치료를 받은 환자들의 의무기록을 후향적으로 조사하였다. 환자군을 40세 이하 군과 40세 초과 군으로 나누어, 수술 전 임상 소견, 수술 방법, 수술 후 망막 유착 성공률 및 시력변화 등을 두 군 간에 비교 분석하였다. 결과: 전체 144명 144안이 포함되었고, 환자들의 진단 시 나이는 평균 48.6 ± 16.9세였고, 추적관찰 기간은 평균 18.0 ± 16.7개월이었다. 40세 이하 군에 42명 42안이, 40세 초과 군에 102명 102안이 포함되었다. 증상발현 후 망막박리 수술까지의 경과기간은 40세 이하 군에서 유의하게 짧았으며(7.6 ± 10.7일 vs. 14.5 ± 24.4일, p=0.029), 40세 이하 군에서 수술 전 증식유리체망막병증의 빈도가 유의하게 높았다(40.0% vs. 17.4%, p=0.007). 일차 수술 성공률은 40세 이하 군에서 78.6%, 40세 초과 군에서 91.2%로 두 군 사이에 유의한 차이가 있었다(p=0.038). 수술 전 증식유리체망막병증이 있는 경우 수술 실패율이 유의하게 증가하였다(40.0% vs. 6.2%,p<0.001). 수술 전 및 수술 1년 후 시력은 두 군 간에 차이가 없었다. 결론: 40세 이하 환자들에서 발생한 열공망막박리의 경우 수술 전 증식유리체망막병증의 빈도가 유의하게 높으며, 이는 망막유착수술실패의 위험인자이다. Purpose: To investigate the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) requiring surgery according to age. Methods: Medical records of patients who underwent surgery for primary RRD between January 2008 and March 2016 were reviewed retrospectively. Patients were classified into two groups according to age at diagnosis: the under-40 group and the over-40 group. The two groups were compared in terms of demographic features, ocular manifestation, operating methods, primary anatomical success rate, and visual outcome. Results: One hundred and forty-four eyes from 144 patients were included. Mean subject age was 48.6 ± 16.9 years old. The under- 40 group involved 42 eyes from 42 patients, and the over-40 group included 102 eyes from 102 patients. Symptom duration was shorter in the under-40 group compared to the over-40 group (7.6 ± 10.7 days vs. 14.5 ± 24.4 days; p = 0.029). Proliferative vitreoretinopathy (PVR) occurred more frequently in the under-40 group (40.0% vs. 17.4%, p = 0.007) than in the over-40 group. The anatomical success rate of primary surgery was significantly different between the two groups; 78.6% in the under-40 group and 91.2% in the over-40 group (p = 0.038). Preoperative PVR increased the rate of anatomical failure (40.0% vs. 6.2%, p <0.001). The visual outcomes were not significantly different between the two groups. Conclusions: RRD is combined with PVR more frequently in young patients than in old patients, which increases the failure rate of primary re-attachment surgery.