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데스메막박리 자동각막내피층판이식술 후 발생한 단순포진바이러스 각막염 1예
정세형,조재갑,윤경철,Se Hyeong Jeong,MD,Jae Kap Cho,MD,Kyung Chul Yoon,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.3
Purpose: To report a case of herpes simplex keratitis after descemet stripping automated endothelial keratoplasty (DSAEK). Case summary: A 66-year-old male underwent DSAEK in his right eye due to bullous keratopathy after cataract surgery. The corneal epithelium which was removed during surgery was healed, but the patient was experiencing pain and decreased visual acuity in his right eye 1 month after surgery. Increasing corneal epithelial defects and corneal edema were observed on slit-lamp examination. Therapeutic soft contact lenses and artificial tears were used for treatment but were not effective, thus amniotic membrane transplantation was performed. Three months after transplantation, the epithelial defect appeared as a geographic ulcer suspecting to be herpes simplex keratitis; therefore, ganciclovir ophthalmic ointment and oral acyclovir were administered. Six months after antiviral therapy, the epithelial lesion of herpes simplex keratitis completely disappeared, leaving only mild corneal opacity. Conclusions: If corneal epithelial defects are persistent after DSAEK in patients even with no past history of herpes simplex keratitis, herpes simplex keratitis should be considered in the differential diagnosis. J Korean Ophthalmol Soc 2012;53(3):473-477
건성안을 동반한 갑상샘안병증에서 0.05% 사이클로스포린 A 점안액 사용 후 눈물막과 안구표면의 변화
최원,박영걸,조재갑,윤경철,Won Choi,Yeoung-Geol Park,Jae-Kap Cho,Kyung-Chul Yoon 대한안과학회 2010 대한안과학회지 Vol.51 No.10
Purpose: The present study was performed to evaluate the changes in tear film and ocular surface parameters after using sodium hyaluronate (SH) 0.1% alone or in combination with cyclosporine A (CsA) 0.05% in patients with thyroid- associated ophthalmopathy accompanied by dry eye. Methods: A total of 72 eyes from 36 patients were divided into two groups; 36 eyes of 18 patients were treated with 0.1% SH alone (group 1), and 36 eyes of 18 patients were treated with SH 0.1% and CsA 0.05% (group 2). Tear break-up time (BUT), basal tear secretion test (BST), tear clearance rate (TCR), fluorescein staining (FS) and corneal sensitivity test (CST) were evaluated at pre-treatment and one, three and six months post-treatment. Conjunctival impression cytology was performed and tear CXCL11 (Chemokine (C-X-C motif) ligand) levels were measured pre-treatment and three months post-treatment. Results: BUT, BST, TCR, KEP and CST were significantly improved at six months in group 1 (p < 0.05) and at three months in group 2 (p < 0.05). The degree of conjunctival squamous cell metaplasia, goblet cell density and tear CXCL11 levels were significantly changed at three months in group 2 (p < 0.05). However, there were no significant changes in group 1 after 3 months. Conclusions: Combined use of topical 0.1% SH and 0.05% CsA can result in early improvement in tear films and ocular surface parameters in patients with thyroid-associated ophthalmopathy accompanied by dry eye. J Korean Ophthalmol Soc 2010;51(10):1319-1326
기존 치료에 반응하지 않는 진균 각막염에서 전방내 보리코나졸 주입술의 임상 효과
정세형,이효석,조재갑,윤경철,Se Hyeong Jeong,MD,Hyo Seok Lee,MD,Jae Kap Cho,MD,Kyung Chul Yoon,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.5
Purpose: To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy. Methods: Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 μg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 μg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated. Results: Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 ± 10.4 days (p = 0.04), 34.2 ± 7.8 days (p = 0.03), and 49.5 ± 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course. Conclusions: Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.
눈주위 트리암시롤론 주사를 이용한 갑상선 안병증의 치료효과
김종을,박정원,조재갑,윤경철 대한안과학회 2011 대한안과학회지 Vol.52 No.7
Purpose: The present study investigated the therapeutic effects of periocular triamcinolone acetonide injections to treat inflammatory signs in patients with severe acute thyroid-associated ophthalmopathy. Methods: Twenty-two patients with symptoms of severe acute thyroid ophthalmopathy were enrolled in the present study. The patients received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The changes in visual acuity, intraocular pressure, eye ball motility, exophthalmos, thickness of extraocular muscles, clinical activity score and NOSPECS score were measured. Results: Eighteen of 22 patients (81.8%) showed improvement in soft tissue swelling, ten patients (45.5%) showed improvement in conjunctival hyperemia and one patient showed improvement of ocular motility. Clinical activity score and NOSPECS score had significant improvements. No patient had changes in visual acuity, intraocular pressure, diplopia, proptosis or thickness of extraocular muscles. An ocular adverse effect was found in one patient, who had subcutaneous fat atrophy at the injection site. Conclusions: In patients with severe acute thyroid ophthalmopathy, periocular triamcinolone acetonide injection can be effective to improve acute inflammatory symptoms, without significant adverse effects. J Korean Ophthalmol Soc 2011;52(7):788-793