초음파와 두 가지 부분결합간섭계를 이용한 안구의 생체 계측 비교

곽주영,최시환,Joo Young Kwag,MD,Si Hwan Choi,MD,PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.2

Purpose: To evaluate the reproducibility and repeatibility of biometry in cataractous eyes, pseudophakic eyes and eyes having undergone refractive surgery. The OcuScan?RxP, LENSTAR? and IOL Master? instruments were compared, as were. The accuracies of the refractive results after cataract surgery. Methods: The biometries of 45 cataractous eyes, 31 pseudophakic eyes, and 32 eyes having undergone refractive surgery were measured by two practitioners using OcuScan?RxP, LENSTAR? and IOL Master? instruments. The paired t-test was used to compare the reproducibilities in the three groups. Results: There were no differences in axial length among the groups when using any of the instruments. There was no significant difference in the repeatibility regardless of the instrument used, although. In the cataractous eyes, pseudophakic eyes and eyes with refractive surgery, OcuScan?RxP showed the highest repeatability. However, we knew that all three instruments were excellent in the repeatability because the difference was less than 1.5%. The Prediction error of the instruments with regard to refractive results could not be determined after cataract surgery. In some patients with severe cataract, measurement was impossible for both the LENSTAR? and IOL Master? instruments. Conclusions: In all groups, OcuScan?RxP, LENSTAR? and IOL Master? showed no significant differences with regard to reproducibility or prediction of refractive power after surgery. Among three groups, the repeatability was rather high in the existing ultrasound method than in the partial coherence interferometers. In some patients with severe cataract, measurement was impossible for both the LENSTAR? and IOL Master? instruments. J Korean Ophthalmol Soc 2011;52(2):169-174

선체유동분석을 통한 작전 중 군함의 해양구조방안 연구

곽주영 ( Joo Young Kwag ) 국군의무사령부 2012 대한군진의학학술지 Vol.43 No.1

Objective : This study suggests the available method of sea-rescue-measure by the flow analysis for the warship even though it is in charge of operation. Method : The Kriso Ship has been analysed for the investigation in which the WAVIS commercial code including the level-set method is used. The Reynolds averaged Navier- Stokes equation is used for the governing formula, and the k-epsilon model is for turbulence. The GRIDEN code is applied for the grid generation. Results : The up-and-down fluctuations are repeatedly found three-times in the wave height along the hull. The bow region is dangerous in the sea-rescue-measure because of rapid flow speed, while the midship shows outward and low speed. Around the stern, it is extremely dangerous because of the circulating propeller. Conclusion : The flow analysis shows the result that the stern is extremely dangerous, and the lifeguard equipments & safety devices should be arranged near the stern, if possible. And when the rescue team approaches from the rear of propeller, it is advantageous to have an access to left-handed side. The fluctuation of wave height, with a peak and bottom three-times along the hull, provides further information on the sea-rescue -measure.

개방성 안구손상 환자의 시력 예후 인자와 안외상점수의 예측도

이연희,곽주영,이성복,Yeon Hee Lee,MD,Joo Young Kwag,MD,Sung Bok Lee,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.6

Purpose: To determine the prognostic factors of visual outcome in open globe injury and to assess the possibility of an ocular trauma score (OTS) model of predictive value in open globe injuries in Koreans. Methods: The medical records of 242 patients with open globe injury from 2000 to 2010 were retrospectively reviewed. Prognostic factors of visual outcome, positive predictive rate, and negative predictive rate were surveyed. Results: In the multivariate analysis, old age, relative afferent pupillary defect, impaired initial visual acuity and retinal detachment were the worst predictive factors of vision survival. In OTS categories 1 and 2, worse final visual acuity was acquired, and positive predictive rate and negative predictive rate for assessment of final visual acuity less than 0.02 were 70.1% and 89.8%, respectively. Conclusions: The prognostic factors of open globe injury associated with impaired final visual acuity were old age, relative afferent pupillary defect, worse initial visual acuity, retinal detachment and OTS categories 1 and 2. The OTS may have prognostic value in open globe injuries in Korean patients. However, identified prognostic factors of the present study did not entirely coincide with those of other Koreans or previous studies. Therefore, additional studies on the modified open globe injury as a prognostic model in Korean patients are needed. J Korean Ophthalmol Soc 2012;53(6):825-832

굴절교정수술 후 Haigis-L 공식을 이용한 인공수정체 도수계산

윤용준,곽주영,최시환,Yong Jun Yun,Joo Young Kwag,Si Hwan Choi 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To evaluate the Haigis-L method of IOL Master that does not require preoperative data for intraocular lens (IOL) power calculations and compare the results with other methods requiring preoperative data. Methods: Fifty eyes of 25 patients who had undergone laser-assisted subepithelial keratectomy (LASEK) and were followed for 1 month or longer were selected for this study. IOL power was calculated by four different methods: clinical history method, Feiz-Mannis method, modified Masket method, and Haigis-L method. Results: The mean calculated IOL powers showed the following results: clinical history method; 23.65 D, Feiz-Mannis method; 24.45D, modified Masket method; 22.89D, and Haigis-L method; 23.80D. Each IOL power differed statistically from others (p=0.000). The difference between each method was analyzed by the Bonferroni test, with the Feiz-Mannis method showing the highest result and the modified Masket method, the lowest. The clinical history method and Haigis-L method presented similar results. Conclusions: For patients without data prior to corneal refractive surgery, the Haigis-L method is as accurate as the clinical history method. Therefore, comparatively accurate results can be produced in IOL power calculations using the Haigis-L method after corneal refractive surgery. J Korean Ophthalmol Soc 2010;51(5):664-669

안와 외상 후 발생한 하사근 기능항진 환자 1예

이성복,곽주영,이연희,Sung Bok Lee,MD,PhD,Joo Young Kwag,MD,Yeon Hee Lee,MD 대한안과학회 2011 대한안과학회지 Vol.52 No.5

Purpose: To report a case of inferior oblique muscle overaction after orbital trauma. Case summary: A 19-year-old male presented with a blowout fracture of the right inferior orbital wall. The patient had no history of facial asymmetry, head tilt, strabismus or diplopia. The day after the reduction operation, the patient complained of diplopia on the down-gaze. The patient had orhthophoria in the primary position. However, the right eye showed a limitation on infraduction. Six weeks later, the limitation of infraduction resolved, however the diplopia worsened. The right eye showed excessive elevation in adduction and hypertropia in the primary position. The hypertropia increased on left gaze, and decreased on right gaze. Bielschowsky’s head test revealed a negative result. The fundus photographs showed a mild excyclotorsion of the right eye. Five months later, the symptoms and signs were stable and surgery was performed. Under general anesthesia, the exaggerated forced duction test and traction with strabismus hook on the right inferior oblique muscle revealed tightness. The inferior oblique muscle was found to be recessed. After the operation, the diplopia, hypertropia and the excessive elevation on adduction of the right eye resolved. Conclusions: A contracture and resultant overaction of inferior oblique muscle could develop after trauma on the inferior orbital wall. Trauma on the inferior orbital wall should be considered as one of the primary causes of acquired inferior oblique overaction. J Korean Ophthalmol Soc 2011;52(5):639-643

각막 기질창상에서 양막이 각막상피두께와 반결합체의 형성에 미치는 영향

윤용준,곽주영,최시환,Yong Jun Yun,MD,Joo Young Kwag,MD,Si Hwan Choi,MD,PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.5

Purpose: To investigate the effects of an amniotic membrane patch on corneal epithelial thickness and formation of hemidesmosomes during corneal stromal wound healing. Methods: A stromal wound 9 mm in diameter and 130 μm in depth was created on rabbit cornea using a microkeratome. The changes in corneal epithelial thickness and hemidesmosome formations were compared between the amniotic membrane, contact lens, and control groups. Changes in the corneal epithelium were examined using H&E staining and hemidesmosome formation was examined using an electron microscope at 2 and 4 weeks after flap removal. Results: Two weeks after treatment, the corneal epithelial thickness was 95.3 ± 6.3 μm in the amniotic membrane group being significantly thicker than 76.4 ± 5.1 μm in the contact lens group and 68.3 ± 6.1 μm in the control group. Furthermore, more hemidesmosome formations were observed in the amniotic membrane group compared to the other 2 groups. However, there were no significant differences in corneal epithelial thickness or hemidesmosome formation among the 3 groups at week 4. Conclusions: The amniotic membrane group showed a thicker corneal epithelium and more hemidesmosome formation than the other 2 groups 2 weeks after flap removal. Thus, the use of an amniotic membrane patch appears to be effective in the early stages of corneal stromal wound healing. J Korean Ophthalmol Soc 2011;52(5):589-596

라식수술 후 백내장수술 시에 Shammas-PL 공식을 이용한 인공수정체도수계산

박세영(Se Young Park),곽주영(Joo Young Kwag),최진석(Jin Seok Choi),박규홍(Kyu Hong Pak),정성근(Sung Kun Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.2

목적: 라식수술 과거력이 있는 환자의 백내장수술 시에 Shammas-PL 공식을 이용했을 때 인공수정체도수계산 방법을 알아보고자 한다. 대상과 방법: 2018년 9월부터 2019년 9월까지 본원에서 백내장수술을 시행한 환자 중 라식수술의 과거력이 있는 환자 29명 41안을 대상으로 하였다. 수술 전 안축장, 전방깊이, 각막곡률을 측정하였고, 인공수정체도수계산은 가장 많이 사용되고 있는 Shammas-PL (post laser in-situ keratomileusis, post LASIK) 공식을 이용하였다. 수술 전 굴절예측치와 수술 후 현성굴절검사값을 이용하여 평균 절대오차와 평균산술오차를 구하여 정확도를 파악하였다. 결과: 전체 41안 중 15안(36.6%)에서 수술 전의 굴절예측치와 비교해서 수술 후 상대적으로 원시로 이행되었고, 25안(61%)에서 상대적으로 근시 이행을 보였으며, 1안(2.4%)은 수술 전 굴절예측치와 동일하였다. 백내장수술 전 굴절이상치는 수술 후 근시, 정시, 원시의 이행과는 관련성이 없었다(p>0.05). 평균절대오차는 0.63 ± 0.57 diopter (D)였고, 원시로 이행한 경우의 평균절대오차는 0.41 ± 0.35 D, 근시로 이행한 경우의 평균절대오차는 0.78 ± 0.63 D였다. 결론: 라식수술 후 백내장수술 시에 Shammas-PL 공식을 이용하여 인공수정체도수계산을 했을 때 술 후 근시로 이행하는 경우가 더 많았고, 원시로 이행한 경우보다 근시로 이행한 경우의 평균절대오차가 더 컸으므로 목표 굴절예측치보다 더 원시쪽으로 인공수정 체도수를 결정하는 것이 좋을 것이다. Purpose: To calculate the intraocular lens (IOL) power using the Shammas-PL formula after laser in-situ keratomileusis (LASIK). Methods: Forty-one eyes of 29 patients that had undergone cataract surgery from September 2018 to September 2019 after LASIK were enrolled in this study. A preoperative AL-Scan?? (Nidek Co., Gamagori, Japan) was used to measure the axial length, anterior chamber depth, and corneal curvature. An IOL power calculation was performed using the Shammas-PL (post LASIK) formula. Mean absolute error (MAE) and mean arithmetic error (MARE) were calculated using preoperative manifest refraction and postoperative manifest refraction. Results: Of the 41 eyes, 15 eyes (36.6%) were relatively hyperopic-shifted after surgery compared to the predicted refractive error before surgery, 25 eyes (61%) showed a relative myopic shift, and one eye (2.4%) showed no change with respect to the previous refractive predicted error. Refractive errors before cataract surgery were not related to myopic, emmetropic, or hyperopic shifting after surgery (p > 0.05). Conclusions: When cataract surgery using the Shammas-PL formula was performed after LASIK, myopic shifting was more common than hyperopic shifting. The MAE was greater in myopic-shifted cases than that of hyperopic-shifted cases. Thus, it is better to determine IOL power toward the hyperopic side than the target refractive prediction.

발살바조작 후 유발된 일과성 흑암시

조영준,윤용준,곽주영,김정열,Young Joon Jo,MD,Yong Jun Yun,MD,Joo Young Kwag,MD,Jung Yeul Kim,MD 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To report the case of a patient with amaurosis fugax that occurred following a Valsalva maneuver. Case summary: A 40-year-old man presented with amaurosis fugax of the right eye, which had occurred several times during the previous month. After coughing, the visual acuity of the right eye decreased temporarily during the first episode. Subsequently, any time a Valsalva maneuver, such as coughing, occurred, this symptom reappeared. Initially, this symptom persisted for five to ten minutes and occurred once or twice a day, but it gradually increased in frequency. The physical examination was normal, and his best corrected visual acuity was 20/20 bilaterally. Neither specific findings in the slit lamp examination nor abnormal findings in the fundus examination were detected. On fluorescein fundus angiography, no abnormal finding was observed before the symptom was triggered by a Valsalva maneuver, but after the symptom was triggered by coughing, the choroidal and retinal arterial phases were delayed. Hematological and neurological examinations, including magnetic resonance imaging, magnetic resonance angiography, and cerebral angiography, were all normal. Therefore, he was diagnosed with amaurosis fugax generated by a Valsalva maneuver. Conclusions: In any patient who complains of amaurosis fugax repeatedly, as seen in this case, one must consider the possibility that it results from a Valsalva maneuver, after eliminating occlusive vascular diseases, such as carotid stenosis or atherosclerotic disease. J Korean Ophthalmol Soc 2010;51(5):779-783

시삭증후군 환자에서 빛간섭단층촬영의 소견

김정열,이행진,곽주영,이연희,Jung Yeul Kim,Haeng Jin Lee,Joo Young Kwag,Yeon Hee Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.7

Purpose: To report a case of optic tract syndrome in which optical coherence tomography (OCT) demonstrated the specific findings of the retinal nerve fiber layer (RNFL). Case summary: A 32-year-old male patient visited the hospital with right side visual field defect in both eyes that occurred immediately after a traffic accident 8 months prior. The visual acuity of both eyes was normal, and a relative afferent papillary defect was evident in the right eye. In addition, suspicious band atrophy of the right optic disc and thinning of the superior and inferior arcuate bundle were observed in the left eye. On visual field examination, homonymous hemianopia was present. Optic tract syndrome was suspected, although there was no abnormality of the visual tract on MRI. On fast RNFL thickness 3.4 scan, a thinning of RNFL in the nasal and temporal segments in the right eye and superior and inferior segments in the left eye were observed. Based on the findings, optic tract syndrome was diagnosed in the left eye. Conclusions: We report specific OCT findings which can be useful when making a diagnosis of optic tract syndrome.

경증 건성안증후군에서 눈물막 삼투압의 임상적 유용성

김미정(Mi Jeong Kim),박세영(Se Young Park),곽주영(Joo Young Kwag),최진석(Jin Seok Choi),박규홍(Kyu Hong Pak),정성근(Sung Kun Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.3

목적: 경증 건성안증후군에서 I-PEN?? (I-MED Pharma Inc.;Dollard-des-Ormeaux;Canada)으로 측정한 눈물막 삼투압과 건성안 지표인 쉬르머검사;눈물막파괴시간;안구표면질환지수와의 상관관계를 각각 분석하여 눈물막 삼투압에 대해 평가하고자 한다. 대상과 방법: 각막염색을 이용하여 구분한 각막미란이 없는 1군 50명(67안)과 각막미란만 보이는 2군 59명(91안);총 90명(158안)의 경증 건성안 환자들을 대상으로 I-PEN?瑛막? 측정한 눈물막 삼투압과 쉬르머검사;눈물막파괴시간;안구표면질환지수 사이에 상관관계를 Pearson 상관분석을 이용하여 분석하였다. 결과: 눈물막 삼투압 수치와 쉬르머검사(r<-0.01;p=0.97);눈물막파괴시간(r=0.05;p=0.54);안구표면질환지수(r=0.03;p=0.76)는 통계적으로 유의한 상관관계를 보이지는 않았다. 각막염색점수로 분류한 1군과 2군 사이에서 쉬르머검사(p=0.31);눈물막파괴시간(p=0.11);눈물막 삼투압(p=0.12) 측정치는 유의한 차이를 보이지 않았으나;안구표면질환지수에서 유의한 차이가 있었다(p<0.01). 결론: 경증 건성안증후군에서 눈물막 삼투압과 건성안 지표들 사이에 유의한 상관관계는 없었으나 중증 건성안증후군에서 눈물막 삼투압의 진단적 가치에 관한 추가적인 연구가 필요할 것으로 생각된다. Purpose: To seek Pearson correlations of tear film osmolarity measured by the I-PEN?? (I-MED Pharma Inc.;Dollard-des-Ormeaux;Canada) with Schirmer test result;tear break-up time;and Ocular Surface Disease Index score in patients with mild dry eye syndrome. Methods: Patients with mild dry eye syndrome were divided into two groups according to Ocular Staining Score: group 1 (50 patients; 67 eyes) and group 2 (59 patients; 91 eyes);90 patients and 158 eyes in total. The above mentioned correlations were derived. Results: No significant correlations were observed between tear film osmolarity and Schirmer test result (r < -0.01;p = 0.97);tear break-up time (r = 0.05;p = 0.54);or Ocular Surface Disease Index score (r = 0.03;p = 0.76). When the two groups were compared;the Ocular Surface Disease Index score significantly differed between groups (p < 0.01);whereas the Schirmer test result (p = 0.31);tear break-up time (p = 0.11);and tear film osmolarity (p = 0.12) did not. Conclusions: No significant correlations were found between tear film osmolarity and other dry eye indicators in patients with mild dry eye syndrome. The diagnostic utility of tear film osmolarity in patients with moderate dry eye syndrome is should be evaluated.