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라섹 후 하이드로겔 및 실리콘하이드로겔 치료용 렌즈 착용 시의 임상 경과 차이
장승원,정의상,정태영,Seung Won Jang,Eui Sang Chung,Tae Young Chung 대한안과학회 2007 대한안과학회지 Vol.48 No.10
Purpose: To compare the effectiveness between wearing a conventional hydrogel vifilcon A bandage contact lens (BCL) and a silicone hydrogel lotrafilcon A BCL after laser-assisted subepithelial keratomileusis (LASEK). Methods: LASEK was performed on 38 eyes of 19 patients. Each patient was fitted with a silicone hydrogel lotrafilcon A lens in one eye and a conventional hydrogel vifilcon A lens in the other eye. The patient was masked on the type of lens in each eye. General preference between the two types of lenses, subjective symptoms (pain, photophobia, tearing, dryness, and foreign body sensation; graded as 0 to 4), and the area of non-viable corneal epithelium were assessed in each eye at one and four days after surgery. Results: Patients reported preferring the lotrafilcon A lens to vifilcon A at 1 (79%) and 4 (74%) days after LASEK. The mean symptom scores of tearing and foreign body sensation at 1 day after surgery (P=0.012 and P=0.034, respectively) and foreign body sensation at 4 days after surgery (P=0.027) were significantly lower in the lotrafilcon A group. The mean area of the non-viable corneal epithelium was smaller in the lotrafilcon A lens group at 1 day and 4 days after surgery, although not statistically significant. Conclusions: Patients better tolerated the silicone hydrogel lotrafilcon A BCL compared with the conventional hydrogel vifilcon A BCL. The mean symptom scores were significantly lower in the lotrafilcon A group at both 1 and 4 days after LASEK.
김미랑,정의상,Mi-Rang Kim,Eui-Sang Chung 대한안과학회 2005 대한안과학회지 Vol.46 No.9
Purpose: To evaluate the surgical outcome of deep anterior lamellar keratoplasty (DALKP) in patients with corneal opacity with an intact corneal endothelium. Methods: We transplanted partial thickness donor cornea, devoid of endothelium and Descemet’s membrane, on to a recipient bed of which the deep stromal area had been dissected to expose the smooth surface of Descemet’s membrane. We evaluated the visual acuity, refractive error, endothelial cell density, intraocular pressure, complication and graft rejection after a follow-up period of at least 6 months. Results: Twelve eyes of 11 patients (M:F=7:4) were enrolled in this study, with a mean age of 39 years (17~60). The mean follow-up period was 9.8 months. The underlying diseases were keratoconus in 6 eyes, corneal dystrophy in 4 and herpetic corneal lesion in 2. The mean postoperative visual improvement was 5 lines of Snellen chart. Microperforations occurred during operation in 4 eyes, and were treated with intracameral gas injection. One of them underwent penetrating keratoplasty due to persistent double anterior chamber. Transient elevation of intraocular pressure was noted in 7 eyes, but no case of graft rejection was observed during the follow-up period. Conclusions: Even though intraoperative microperforation may require an additional procedure such as gas injection which increases the possibility of intraocular pressure elevation, deep anterior lamellar keratoplasty is thought to be a good option for the primary surgery in patients with corneal opacity with an intact corneal endothelium due to its relatively fast recovery, reduced risk of rejection and preservation of endothelium without ongoing loss.
굴절교정술 후 백내장 수술 환자에서 인공수정체 도수계산법 비교
이명옥,정태영,정의상,기창원,Myoung-Ok Lee,MD,Tae-Young Chung,MD,PhD,Eui-Sang Chung,MD,PhD,Chang Won Kee,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.2
Purpose: To investigate the predictability of and propose guidelines for intraocular lens (IOL) power calculation in post-cataract surgery patients with prior corneal refractive surgery and suggest the guideline. Methods: Medical records of 18 eyes of 16 patients were retrospectively evaluated for IOL power calculation predictability using three combinations of methods: 1) clinical history method, modified Maloney method, and the Feiz-Mannis method; 2) single-K formula versus double-K formula; and 3) Three IOL formulas (SRK/T, Holladay 1, and Hoffer Q). Results: The clinical history method using the single-K formula with the SRK/T and Holliday 1 formula showed the best predictability, with an absolute error of 0.60±0.63 D and 0.74±0.60 D, respectively. The Feiz-Mannis method showed a tendency of myopic prediction, whereas the modified Maloney method showed a tendency of hyperopic prediction, especially in the patients with myopia more than 7 D prior to the refractive surgery. The double-K formula, when compared to the single-K formula, prevented hyperopic prediction when used with the clinical history method or modified Maloney method. Conclusions: IOL power calculation using the clinical history method with SRK/T or Holliday 1 formula showed the best predictability in patients after corneal refractive surgery. IOL power calculation using the modified Maloney method, however, because of the hyperopic prediction tendency, should be used cautiously, especially for patients with myopia of 7 D or more prior to the refractive surgery. J Korean Ophthalmol Soc 2010;51(2):180-187
영아기에 시행한 단일 또는 임시 이중인공수정체삽입술 후 굴절력 변화 및 합병증 비교 연구
최성호,정태영,정의상,Sung-Ho Choi,Tae-Young Chung,Eui-Sang Chung 대한안과학회 2005 대한안과학회지 Vol.46 No.4
Purpose: The purpose of this study was to assess the incidence of postoperative complications and the change of refractive error in infantile eyes after cataract surgery and single intraocular lens(IOL) or temporary piggyback IOL implantation. Methods: Eight consecutive patients (13 eyes) who underwent IOL implantation under 12 months of age between 1999 and 2002 were enrolled. Eight eyes of 6 patients had a single IOL implanted and the other 5 eyes of 3 patients underwent temporary piggyback IOL implantations. A retrospective chart review was conducted. Results: The mean age at surgery was 6.1 months. The mean follow-up period was 10 months. The average postoperative refraction at one week was +7.82D after single IOL and +0.32D after piggyback IOL. The average postoperative refraction at last follow-up was +4.25D and -3.5D respectively. Over the follow-up period, the mean refractive change per months was -0.34D in the single IOL group and -0.45D in the piggyback IOL group. Postoperative complications were 12.5 % (1/8 eyes) in single IOL and 20.0% (1/5 eyes) in piggyback IOL. Reoperations were conducted for the complicated eyes in both groups. Conclusions: The rates of complications and reoperations were slightly higher in piggyback IOL than in single IOL. Nonetheless, additive correction for residual hyperopia was not needed in the piggyback IOL group. There was more deteriorative evidence of amblyopia in piggyback IOL than in single IOL.
조절인공수정체를 이용한 백내장 수술 후 측정한 전방깊이 및 굴절값의 변화
김재휘,박준성,정의상,정태영,Jae Hui Kim,M,D,Chun-Sung Park,M,D,Eui-Sang Chung,M,D,Tae-Young Chung,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.11
Purpose: To evaluate the change in anterior chamber depth and refraction after AT-45 implantation Methods: Twenty-two eyes from 22 patients were enrolled in this prospective study. After phacoemulsification, AT-45 (11 eyes) and SA60AT (11 eyes) were implanted. Clinical data included anterior chamber depth and refractive error at 1 week, 1 month, 2 months and 6 months postoperatively. The correlation between anterior chamber depth change and spherical equivalent change was also evaluated. Results: In the AT-45 implanted group, the mean anterior chamber depth was 4.56±0.59 mm at 1 week postoperative, 4.70±0.69 mm at 1 month postoperative, 4.78±0.71 mm at 2 months postoperative and 4.76±0.69 mm at 6 months postoperative. The mean spherical equivalent was -0.53±0.48D, -0.37±0.42D, -0.27±0.47D, and -0.33±0.44D respectively. When analyzed using the Mann-Whitney U test, p-values of anterior chamber depth differences between the 2 groups were P=0.52 at 1 week to 1 month, P=0.32 at 1 month to 2 months, P=0.89 at 2 months to 6 months, and P=0.02 at 1 week to 6 months, showing a deeper anterior chamber in the AT-45 implanted group. P-values (Mann-Whitney U test) of spherical equivalent differences between the 2 groups were P=0.33, P=0.56, P=0.94, and P=0.19, respectively, showing more hyperopic change in the AT-45 implanted group. The correlation between anterior chamber depth change and spherical equivalent change in the AT-45 implanted group at 1 week to 6 months was not statistically significant (Spearman correlation analysis, P=0.223). Conclusions: Anterior chamber depth deepening and associated hyperopic refractive change were observed after AT-45 implantation, especially at 1 month after the surgery.