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임원일,김형수,이은구,Won Il Rhim,Hyung Soo Kim,Eun Koo Lee 대한안과학회 2008 대한안과학회지 Vol.49 No.9
Purpose: To investigate the clinical manifestation and the result of vitrectomy in patients with vitreomacular traction syndrome. Methods: Optical coherent tomography (OCT) was used to evaluate the clinical manifestation and the results of vitrectomy for 26 eyes with vitreomacular traction syndrome. Results: Spontaneous relief of vitreomacular traction was achieved in 3 of 8 eyes after a mean follow-up duration of 9 months. One eye recovered visual acuity, but the other 2 eyes could not attain better visual acuity because of persistent sponge-like macular edemas. Six of 13 eyes (46%) improved by two or more lines of visual acuity after vitrectomy. The presence of simple macular cysts without sponge-like macular edemas or tractional retinal detachment seemed to be related to good results after vitrectomy. Conclusions: Vitrectomy is a preferable way to treat vitreomacular traction syndrome. Preoperative OCT could predict the surgical prognosis. J Korean Ophthalmol Soc 2008;49(9):1468-1474
추가적 내경계막 제거술과 액체가스교환술을 통한 지속성 황반원공의 재수술 3예
임원일(Won Il Rhim),구희찬(Hee Chan Ku),이은구(Eun Koo Lee) 대한검안학회 2009 Annals of optometry and contact lens Vol.8 No.1
목적: 유리체절제술 후 폐쇄되지 않고 지속된 황반원공 환자에게 추가적 내경계막 제거술과 액체가 스교환술을 통한 재수술 결과를 보고하고자 한다. 대상과 방법: 2기 황반원공 1안, 3기 황반원공 1안, 4기 황반원공 1안에서 유리체절제술과 내경계막제거술 및 액체가스교환술을 시행하였다. 1차 수술 후 황반원공이 폐쇄되지 않아 재수술을 시행하였다. 망막 혈관궁까지 내경계막을 추가로 넓게 제거하였으며 수술 종료 시 액체가스교환술을 시행하였다. 결과: 재수술 후 3안 모두 황반원공의 폐쇄가 이루어졌으며 시력의 호전을 보였다. 결론: 일차 수술 후 폐쇄되지 않은 황반원공 환자에서 추가적 내경계막 제거술과 액체가스교환술을 이용한 재수술을 통하여 해부학적 성공을 이루었기에 보고하는 바이다. Purpose: To report the result of retreatment using additional internal limiting membrane removal and intraocular gas tamponade for persistent macular holes after primary surgery. Methods: Three cases of macular hole (stage 1, stage 2, stage 3) were not closed despite primary macular hole surgery using internal limiting membrane removal and intraocular gas tamponade. Retreatment for the persistent macular hole consisted of additional broad internal limiting membrane removal reaching to the major retinal vascular arcade and intraocular gas tamponade. Results: All three cases showed macular hole closure and visual improvement after retreatment. Conclusions: We report the successful results of retreatment using additional broad internal limiting membrane removal and intraocular gas tamponade for persistent macular holes after primary surgery.
임원일(Won Il Rhim),구희찬(Hee Chan Ku),이은구(Eun Koo Lee) 대한검안학회 2010 Annals of optometry and contact lens Vol.9 No.1
목적: 백내장 수술 후 발생하는 급성 녹농균 안내염의 치료 방법에 대하여 고찰하고자 한다. 대상과 방법: 백내장 수술 후 급성 녹농균 안내염이 발생한 4안의 의무기록을 후향적으로 분석하였다. 결과: 같은 날 백내장 수술을 받은 3안에서 수술 후 1일째 녹농균 안내염이 발생하였으며, 수술 받은 순서대로 심한 양상을 보였다. 안저 검사가 불가능하였던 첫번째 환자는 유리체절제술과 유리체내 항생제 주입술을 시행하였으며 시력이 0.02로 호전되었다. 두번째, 세번째 환자는 유리체내 항생제 주입술만을 시행하였고 각각 시력이 0.9로 회복되었다. 다른 1안은 백내장 수술 후 2일째 녹농균 안내염이 발생하여 유리체절제술과 유리체내 항생제 주입술을 시행하고, 4주 후 증식유리체망막병증에 의한 망막박리와 저안압증이 발생하여 2차 유리체절제술을 시행하였다. 그 결과 안구를 유지할 수 있었으며 시력이 안전수동으로 호전되었다. 결론: 백내장 수술 후 급속한 진행을 보이는 급성 감염성 안내염은 발견 즉시 적절한 치료가 이루어져야 한다. Purpose: To discuss the treatment of acute postoperative endophthalmitis caused by Pseudomonas after cataract surgery. Methods: Retrospective review of four cases of acute postoperative Pseudomonas endophthalmitis after cataract surgery. Results: Acute postoperative endophthalmitis caused by Pseudomonas aeruginosa occurred in 3 cases who underwent cataract surgery on the same day at the same clinic. The first patient who had severe intraocular inflammation blocking fundus examination recovered visual acuity to 0.02 after vitrectomy and intravitreal antibiotics injection. The second and third patients recovered visual acuity to 0.9 after intravitreal antibiotics injection. In another patient who also had acute postoperative endophthalmitis caused by Pseudomonas aeruginosa. We performed vitrectomy and intravitreal antibiotics injection. In this case, secondary vitrectomy was performed for progressive retinal detachment and hypotony caused by proliferative vitreoretinopathy 4 weeks later. The eyeball was saved and the patient recovered visual acuity to hand movement. Conclusions: Immediate treatment is essential to preserve the eyeball and vision in cases of acute, rapid progressive postoperative endophthalmitis.
김형수,강경복,임원일,이은구,Hyung-Su Kim,Kyeong-Bok Kang,Won-IL Rhim,Eun-Koo Lee 대한안과학회 2007 대한안과학회지 Vol.48 No.8
Purpose: To report two cases of ocular ischemia following scleral encircling. Methods: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. Results: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. Conclusions: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.