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백내장 수술 전후 이중샤임플러그 전안부 분석기로 측정한 수정체 내부 신호강도
노진우(Jin Woo Ro),이가영(Ka Young Yi),김하경(Ha Kyung Kim),현준영(Joon Young Hyon),위원량(Won Ryang Wee),신영주(Young Joo Shin) 대한안과학회 2015 대한안과학회지 Vol.56 No.5
목적: 백내장 수술 환자에서 이중샤임플러그카메라를 사용하여 측정한 수정체 내부 신호강도의 의의를 알아보고자 하였다. 대상과 방법: 2012년 2월부터 2013년 1월까지 백내장수술을 받은 148명 151안을 대상으로 하여 수술 전 샤임플러그카메라로 수정체 내부신호강도를 측정하였고 수술 전과 수술 후 1개월에 최대교정시력과 이중샤임플러그카메라로 상측, 하측, 이측, 비측 전방각의 크기와 전방의 깊이를 측정하였다. 수술 전후의 시력을 측정하였고 상측, 하측, 이측, 비측 전방각의 수술 전후의 변화와 수정체 내부신호강도와의 연관성을 조사하였다. 결과: 수정체내부 신호강도는 수술 전 시력, 수술 전 전방 깊이와는 유의한 상관관계를 보였다(r=0.287, p=0.001 and r=-0.271, p=0.004). 수술 전후 전방각은 수술 후 유의하게 증가하였고(p<0.001) 수술 전후의 전방각의 변화량은 수술 전 전방각의 크기와 상관관계를 보였다(p<0.001). 그러나 수정체 내부신호강도는 수술 전 전방각의 크기와 연관이 없었고 수술 전후 전방각의 변화량과 상관관계를 보였다(p<0.001). 결론: 이중샤임플러그전안부촬영기로 측정한 수정체 내부신호강도는 수정체의 혼탁 정도를 객관적으로 측정하고 수정체의 부피를 예측하여 전안부의 구조를 이해하고 백내장수술 후 예후를 예측하는 데 도움이 될 것으로 생각한다. <대한안과학회지 2015;56(5):702-708> Purpose: To investigate the clinical significance of the internal lens signal measured using dual Scheimpflug anterior segment analyzer (GalileiTM, Ziemer, Switzerland) in patients receiving cataract surgery. Methods: The present study included 151 eyes of 148 patients who received surgery for senile cataracts from February 2012 to January 2013. Preoperative internal lens signals were measured preoperatively. The depth of anterior chamber and anterior an-gles were measured using dual Scheimpflug anterior segment analyzer preoperatively and 1 month postoperatively. Preoperative and postoperative best-corrected visual acuities (BCVAs) were measured. The relationships between preoperative internal lens signal and the changes in BCVA or anterior angles were evaluated. Results: Internal lens signal and preoperative BCVA (log MAR) or preoperative anterior chamber depth were highly correlated (r = 0.287, p = 0.001 and r = -0.271, p = 0.004, respectively). Anterior angles increased 1 month after surgery compared with the preoperative values (p < 0.001). The amount of change between preoperative and postoperative anterior angles correlated with preoperative anterior angles (p < 0.001). However, no statistically significant correlation was observed between internal lens sig-nal and preoperative anterior angles or postoperative BCVA. Internal lens signal correlated with changes in postoperative ante-rior angles (p < 0.001). Conclusions: Internal lens signal correlated with preoperative visual acuity and may help evaluate the cataract severity quantita-tively and objectively. Internal lens signal may aid in understanding the structure of anterior segments by predicting the lens volume. Knowing the effect of visual impairment due to cataracts and predicting visual improvement after cataract surgery is necessary. J Korean Ophthalmol Soc 2015;56(5):702-708
김용우,최혁진,김미금,위원량,유영석,오주연.Yong Woo Kim. MD. Hyuk Jin Choi. MD.. Mee Kum Kim. MD. Won Ryang Wee. MD.Young Suk Yu. MD. Joo Youn Oh. MD 대한안과학회 2013 대한안과학회지 Vol.54 No.5
Purpose: To investigate the clinical outcomes of primary pediatric keratoplasty. Methods: Records of patients who underwent penetrating keratoplasty at the age of 5 years or younger were retrospectively reviewed. The survival rates of corneal grafts, postoperative complications, and causes of graft failure were evaluated. Results: A total of 31 penetrating keratoplasties were performed in 29 patients, two of which were bilateral. The mean follow- up period was 78.72 ± 8.94 months. The overall graft survival rate was 51.61%. The graft survival rate was 77.4% at 6 months, 61.3% at 12 months, 57.5% at 2 years, and 49.5% at 5 years after the surgery (the median survival time, 39.2 months). The main surgical indications included sclerocornea (35.5%), followed by Peter’s anomaly (25.8%) and congenital glaucoma (9.7%). There were significant differences in graft survival time among the surgical indications, of which sclerocornea was the worst (p = 0.003). The main cause of graft failure was rejection (46.7%), followed by infection (26.7%) and primary endothelial decompensation (20%). When patients were sub-grouped according to age (under 12 months, between 12 to 48 months, and over 48 months), there was significant difference in graft survival time (p = 0.037) but not in overall graft survival rate (p = 0.154). Graft rejection occurred more frequently in patients between 12 to 48 months of age compared to other age groups (p = 0.016). Three out of 13 graft infections occurred in patients under 12 months of age. Conclusions: The type of disease causing corneal opacity was a significant factor affecting the clinical outcomes of penetrating keratoplasty in children.