방수유출장치삽입술을 이용하여 여과포로 인한 감각이상을 치료한 1예

강규동,김연덕,AmanShahB,AbdulMajid,곽지현,JohnSalmon,임혜빈,Kui Dong Kang,MSc,Yeon Deok Kim,Aman Shah B,Abdul Majid,BSc,MB ChB,Jee Hyun Kwag,D,Phil&#,John Salmon&#,Hye Bin Yim 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To report a case of bleb dysesthesia successfully treated after Baerveldt tube implantation. Case summary: A 37-year-old woman presented with a history of persistent foreign body sensation and pain in the left eye. The patient was referred to our hospital and was diagnosed as having had plateau iris syndrome. Having shown no improvement with conservative management, she eventually received trabeculectomy in the left eye six months prior to her current presentation. Under the impression of bleb dysesthesia, she received artificial tears and a bandage contact lens. These, however, failed to alleviate her symptoms. She then had a compression suture of the bleb and bleb revision. These were performed sequentially but neither was effective. Finally, a Baerveldt tube implantation was performed successfully, and, three months later, bleb revision was performed using a donor sclera, which resulted in no further complaint of ocular discomfort. Conclusions: Bleb dysesthesia, although not a common postoperative complication, can occur after trabeculectomy and can be successfully treated with Baerveldt tube implantation. Patients should receive appropriate counseling and advice on bleb dysesthesia prior to undergoing trabeculectomy. J Korean Ophthalmol Soc 2010;51(5):790-793

광간섭단층촬영에 내장된 시신경섬유층두께 지표와 새로 계산된 지표의 녹내장 진단 정확도 비교

강규동,박찬기.Kui Dong Kang M.D.. Chan Kee Park M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.2

Purpose: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis using optical coherence tomography (OCT) and to compare the diagnostic precision between the new discriminant formula and the preprogrammed indicator (95%, 99% cut off value of normal RNFL thickness) in the diagnosis of glaucoma. Methods: The study comprised 499 eyes of 284 patients. Routine ophthalmic examinations, fundus examination, visual field test, OCT optic nerve head analysis and OCT RNFL analysis were performed. Results were analyzed and classified into normal, suspected glaucoma, and glaucoma groups. Results: There were 237 glaucomatous eyes and all parameters of the OCT RNFL analysis showed statistically significant differences between the glaucoma and non-glaucoma groups. The average RNFL thickness was most significantly correlated with the visual field indexes and was the most useful parameter in the detection of glaucoma. Using age, horizontal integrated rim area (HIRA) and average thickness, the accuracy, sensitivity and specificity of the new discriminant formula were 76.2%, 73.1% and 73.1% respectively. Conclusions: Average thickness was the most useful parameter in the detection of glaucoma. The next most useful parameter was inferior average thickness, and both were more precise than the preprogrammed indicator. The new discriminant formula is useful in the diagnosis and follow-up of the glaucoma patients.

치료 경험이 없는 당뇨황반부종에서 유리체내 덱사메타손삽입물-베바시주맙 병합요법과 베바시주맙 단독 요법의 단기 치료 결과 비교

이여진(Yeo Jin Lee),강규동(Kui Dong Kang) 대한안과학회 2020 대한안과학회지 Vol.61 No.12

목적: 치료 경험이 없는 당뇨황반부종에서 유리체강내 베바시주맙과 덱사메타손삽입물(Ozurdex??) 병합주사요법과 베바시주맙 단독주사요법에 대한 치료 효과를 비교하였다. 대상과 방법: 당뇨황반부종이 있는 환자 41명 41안의 의무기록을 후향적으로 분석하였으며 이 중 20안은 베바시주맙 단독요법을 시행받았고 21안은 덱사메타손삽입물과 베바시주맙 병합요법을 시행 받았다. 시술 전과 시술 후 1, 3, 6개월의 최대교정시력, 중심황반두께, 안압, 재치료 빈도를 비교 분석하였다. 결과: 병합요법군에서는 주사 후 3개월, 6개월째 최대교정시력이 유의하게 상승되었다. 단독요법군에서는 3개월까지는 유의한 값을 보이지 않았으나 6개월째에는 치료 전과 비교하여 유의한 시력호전이 관찰되었다. 중심황반두께는 3개월까지는 병합요법군이 단독요법군보다 유의하게 감소하였다. 병합요법군에서 1개월째 중심황반두께는 264.39 ± 54.95 μm였고 단독요법군에서는 349.00 ± 112.18 μm로 유의한 차이가 있었다(p=0.011). 병합요법군에서 3개월째의 중심황반두께 역시 단독요법군과 비교하였을 때 유의한 차이가 있었으나(p<0.001), 6개월에는 두 군 간 차이가 없었다. 6개월간 평균 재주사 횟수는 병합요법군이 0.45회, 단독요법군이 1.15회였다. 병합요법군에서 6개월간 두 단계 이상 진행된 피질혼탁과 후낭혼탁성 백내장 발생은 7%, 15%였다. 결론: 당뇨황반부종에서 베바시주맙과 덱사메타손삽입물의 병합요법은 베바시주맙 단독요법과 비교하여 첫 3개월 동안 중심황반두께의 감소 효과가 있었고 재주사의 빈도를 감소시켰다. Purpose: To compare the visual and anatomical outcomes of intravitreal bevacizumab combined with the dexamethasone intravitreal implant (Ozurdex??) and bevacizumab monotherapy in eyes with treatment-naive diabetic macular edema. Methods: We retrospectively reviewed 41 eyes of 41 patients with diabetic macular edema who underwent either intravitreal bevacizumab (1.25 mg) (21 eyes, intravitreal bevacizumab [IVB] group) injection alone or simultaneous injection of bevacizumab (1.25 mg) and dexamethasone implant (0.7 mg) (20 eyes, intravitreal dexamethasone [IVD] group). Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure, and retreatment percentages were accessed 1, 3, and 6 months after injection. Results: At 3 and 6 months, the IVD group showed a significant improvement in BCVA compared to the baseline. Only a slight improvement in BCVA was observed in the IVB group during the initial 3 months; however, significant improvement was evident at 6 months compared with the baseline. During the first 3 months, the IVD group showed significant improvement in CMT compared with the IVB group; at 1 month after the initial injection, the CMT was 264.39 ± 54.95 μm for the IVD group versus 349.00 ± 112.18 μm for the IVB group (p = 0.011). At 3 months, the CMT in the IVD group had improved significantly compared with that of the IVB group (p < 0.001). The average number of additional intravitreal injections during the 6-month follow-up was 0.45 and 1.15 for the IVD and IVB groups, respectively. In the IVD group, cortical (7%) and posterior subcapsular (15%) cataracts developed by two grades or more during follow-up in phakic eyes. Conclusions: In patients with diabetic macular edema, simultaneous therapy combining a dexamethasone implant plus bevacizumab showed significant improvement in CMT during the initial 3 months and the combined treatment group had fewer additional intravitreal injections.

쇼그렌 및 비쇼그렌증후군 환자에서 안구표면염색점수와 혈중 비타민 D 농도의 상관관계 비교

공예슬(Yeseul Gong),강규동(Kui Dong Kang),김현승(Hyun Seung Kim),황형빈(Hyung Bin Hwang) 대한검안학회 2021 Annals of optometry and contact lens Vol.20 No.1

Purpose: To analyze the correlation between the ocular surface staining score (OSS) and serum vitamin D level for patients of Sjögren s syndrome (group A) and non-Sjögren s syndrome (group B) with dry eye symptoms. Methods: In this observational cross-sectional study, The Schirmer I test, OSS, tear film break-up time and serum vitamin D level were measured in 65 eyes of 65 adults complaining of dry eye. Among 65 people, 35 people in group A and 30 people in group B. The Student’s t-test was used for analyzing the ocular surface staining respectively, in group A and group B patients. Pearson’s correlation was used to analyze the correlations of OSS with serum vitamin D level. Results: The serum vitamin D level (rho = -0.245, p = 0.049) was negatively correlated with OSSs. Especially, the serum vitamin D level (rho = -0.440, p = 0.008) was significantly negatively correlated with OSSs in Sjögren s syndrome patients even more than total patient group. Conclusions: This suggests that the OSS is highly related to immunological factors such as vitamin D in dry eyes due to an underlying immunological disease. Finding the exact relationship between the inducer of dry eye and the degree of dry eye and clarifying the correlation seems to play an important role in the direction of treatment for dry eye.

국내 아이스텐트와 아이스텐트 인젝트의 백내장 병합술 성공률 비교와 예후 인자 분석

공예슬(Yeseul Gong),황형빈(Hyung Bin Hwang),강규동(Kui Dong Kang),김용찬(Yong Chan Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.9

목적: 한국인에서 아이스텐트(iStent??) 또는 아이스텐트 인젝트(iStent inject??) 삽입술 시행 후 치료 효과, 예후 인자, 수술 후 발생한 합병증에 대해 분석하고자 한다. 대상과 방법: 한국인에서 녹내장으로 아이스텐트 또는 아이스텐트 인젝트 삽입술을 단독 혹은 백내장수술과 병합하여 수술 후 6개월 이상 추적 관찰이 가능했던 42안을 대상으로 의무기록을 통하여 후향적으로 분석하였다. 수술 성공 여부는 수술 후 안압이 21 mmHg 미만이며, 수술 전 안압에 비하여 20% 이상 감소하였을 경우로 정의하였다. 결과: 수술 후 6개월 누적 성공률은 아이스텐트 인젝트 단독 삽입술(A군)이 45.3 ± 8.1%, 아이스텐트 단독 삽입술(B군)이 28.6 ± 13.1%, 아이스텐트 인젝트와 백내장수술 병합(A-1군) 81.2 ± 6.8%, 아이스텐트와 백내장수술 병합(B-1군) 27.3 ± 21.8%로 A-1군이 B-1군에 비해 유의하게 높은 성공률(p=0.007)을 보였으며, A군과 B군의 성공률 차이는 유의하지 않았다(p=0.579). 성공 예후 인자를 콕스 회귀분석으로 분석하였을 때, 수술 전 안압이 높을수록 수술 성공률이 높은 것으로 나타났다(hazard ratio 0.80, p=0.02). 결론: 한국인에서 아이스텐트와 백내장수술 병합 시 아이스텐트 인젝트가 아이스텐트보다 안압하강 효과가 좋으며, 수술 전 안압이 높을수록 유의하게 수술 성공률이 높았다. Purpose: To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent?? or iStent inject?? implantation in South Korean glaucoma patients. Methods: We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent?? or iStent inject?? implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. Results: The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject?? alone (group A), 28.6 ± 13.1% for iStent?? alone (group B), 81.2 ± 6.8% for iStent inject?? combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent?? combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). Conclusions: In our patient group, iStent inject?? was more effective than iStent?? in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.