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김소열,최석규,양석우,DonOKikkawa,So Youl Kim,Suk Kyue Choi,Suk Woo Yang,Don O Kikkawa 대한안과학회 2006 대한안과학회지 Vol.47 No.10
Purpose: To evaluate the effect of strabismus surgery on proptosis in thyroid-related orbitopathy Methods: The medical records of 22 consecutive patients (38 eyes) undergoing strabismus surgery were reviewed. Data pertaining to number of muscles operated, the length of muscle recession, prior orbital decompression, and exophthalmometry (by either Hertel or Naugle devices) were evaluated. Results: Thirty-eight eyes in 22 patients with thyroid-related orbitopathy were studied before and after the muscle surgery. The mean change in exophthalmometry for all eyes was an increase of 0.6 mm (p<0.01). Eyes with prior decompression averaged a 0.9 mm increase following strabismus surgery (p<0.01); those without decompression averaged a 0.2 mm decrease, although not statistically significant. For eyes with multiple muscles operated on a given eye averaged 1.2 mm increase; in those with one muscle operated the average increase was 0.2 mm. In cases where the inferior rectus muscle was operated on, the average increase was 0.9 mm. When the total length of muscle recession was less than or equal to 5 mm, the mean exophthalmometric change was a increase of 0.3 mm. If more than 5 mm, the mean was an increase of 0.8 mm. Conclusions: Strabismus surgery on patients with thyroid-related orbitopathy can worsen proptosis, especially those with prior decompression. When planning for orbital decompression, the surgeon should consider this effect. Patients should be made aware of possible changes to their appearance.
김소열,신소정,양석우,한승호.So Youl Kim. M.D.. So Jung Shin. M.D.. Suk Woo Yang. M.D.. Seung Ho Han. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.2
Purpose: To study the microscopic anatomic relation of capsulopalpebral fascia, orbital septum, and tarsus of the lower eyelid in Korean. Methods: Foureteen normal Korean lower eyelids from 14 formalin-fixed cadavers (mean age of 66.5 years) were harvested and studied with light microscopy after staining with hematoxylin and eosin. Dimensions of the structures and distances between them was measured by analyzing the digital photographs. Results: There was no fusion of the orbital septum and the capsulopalpebral fascia at the lower border of the tarsal plate in 10 specimens and limited fusion of these tissue in 4 specimens. The average distance from the inferior tarsal border to the first identifiable smooth muscle nuclei of the inferior tarsal muscle was 1.38 mm. The average tarsal plate thickness was 0.98 mm and the average tarsal plate height was 3.96 mm. Conclusions: The Korean lower lid anatomy differs from that of their non-Asian counter parts. Furthermore, there was a difference in tarsal plate thickness in comparison to Chinese lower lids. There was no consistent fusion between the capsulopalpebral fascia and the orbital septum. No extension of the capsulopalpebral fascia to the skin was observed.
김소열,이승범,양석우,So-Youl Kim,Seung-Bum Lee,Suk-Woo Yang 대한안과학회 2005 대한안과학회지 Vol.46 No.7
Purpose: To report a patient with malignant conjunctival melanoma with extensive corneal invasive growth. Methods: A 63-year-old woman with 9×7 mm sized dark brown colored conjunctival mass with extensive corneal invasive growth over a 3-month history was seen. The mass was removed and biopsy was done. Fontana-Masson, S-100 protein, and HMB stainings were used to confirm the diagnosis of malignant melanoma. Results: The tumor was easily separated from the corneal surface and adjacent conjunctiva was excised. Fontana-Masson, S-100 protein, and HMB stainings revealed corneally-displaced malignant conjunctival melanoma. There was no evidence of metastasis. Conclusions: Corneally displaced malignant conjunctival melanoma was very rare. A good surgical result was obtained with its removal.