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엑시머레이저 근시교정수술 후 각막지형도상의 광학대와 중심이탈 정도에 대한 연구
최중혁,양홍석,유호민,안재홍,Joong-Hyuk Choi,Hong-Seok Yang,Ho-Min Lew,Jae-Hong Ahn 대한안과학회 2005 대한안과학회지 Vol.46 No.6
Purpose: To identify factors influencing the ablation center and to evaluate the size of the ablation zone after PRK and LASIK using Technolas 217 C. Methods: This study examined the results of refractive surgery using Technolas 217 C Excimer laser with eye tracking system in 69 eyes, of which 31 underwent PRK and 38 LASIK. The ablation zone and degree of decentration were determined through corneal topography. We divided the eyes into two groups according to the degree of decentration: less than 0.5 mm as the first group, and from 0.5 to 1.0 mm as the second. The ablation zone diameter in topography was compared with the programmed preoperative optical zone. Results: The only factor influencing the ablation center in the PRK group was preoperative spherical equivalent(p=0.016), and no factor influenced the ablation zone in the LASIK group. In both groups, the long axis of the ablation zone was longer than that of the programmed optical zone(p=0.003), while the short axis was shorter (p=0.001). Conclusions: After refractive surgery using Technolas 217 C Excimer laser with eye tracking system, there was no clinically significant decentration. With greater preoperative spherical equivalent, more decentered ablation was noted in the PRK group. The topographical long axis of the ablation zone was longer than that of the programmed ablation zone, while the short axis of the ablation zone was shorter. During refractive surgery, we should be aware of the possibility that the short axis of the postoperative ablation zone may be shorter than that of the programmed preoperative optical zone.
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군날개에서 생체 접착제와 최소 결막 봉합을 사용한 양막이식술과 자가결막이식술의 임상결과
이수정(Su Jeong Lee),양홍석(Hong Seok Yang),최중혁(Joong Hyuk Choi),유재은(Jaeeun Yu),정유리(Yoo-Ri Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.5
목적: 군날개 절제 후 노출된 공막을 덮어주기 위하여 결막 봉합 혹은 생체 접착제를 이용한 결막피판술, 자가결막이식술, 양막이식술 등이 사용되고 있으며, 본 연구에서는 생체 접착제와 최소 결막 봉합을 사용한 양막이식술과 자가결막이식술을 이용한 군날개수술의 임상결과를 알아보고자 하였다. 대상과 방법: 2016년 5월부터 2019년 12월까지 군날개절제술 및 양막이식술 또는 자가결막이식술을 시행받은 군날개 환자 198명, 217안의 의무기록을 후향적으로 분석하여 임상결과를 비교하였다. 양 군에서 재발률과 합병증 발생 빈도를 조사하였고, 군날개 재발과 관련된 위험인자를 분석하였다. 결과: 군날개 재발은 자가결막이식술 군에서 185안 중 1안(0.5%), 양막이식술 군에서 32안 중 6명(18.8%)에서 재발하여, 자가결막이식술 군의 재발률이 통계적으로 유의하게 낮았다(p<0.001). 로지스틱 회귀분석 결과, 자가결막이식술에서 양막이식술에 비하여 유의하게 군날개 재발 위험이 낮았다(odd ratio, 0.023; 95% 신뢰구간, 0.003-0.206; p=0.001). 경과 관찰 중 화농육아종, 양막 탈락, 결막편 탈락, 공막 괴사 등의 다른 안과적 합병증은 발생하지 않았다. 결론: 군날개수술에서 생체 접착제를 사용한 자가결막이식술이 생체 접착제를 사용한 양막이식술과 비교하여 재발률이 낮아 임상적으로 보다 유용한 수술 방법으로 사료된다. Purpose: We compared clinical outcomes including recurrence rate between amniotic membrane transplantation (AMT) and conjunctival autograft using fibrin glue and minimal conjunctival sutures for pterygium surgery. Methods: We retrospectively analyzed 217 eyes of 198 patients with pterygia who underwent surgery from May 2016 to December 2019. Pterygium excision was performed with conjunctival autograft or AMT, using fibrin glue with both. Recurrence rates and complications were evaluated between the two groups. Results: Postoperative recurrences were noted in one of 185 eyes (0.5%) in the conjunctival autograft group, and in six of 32 eyes (18.8%) in the AMT group. The recurrence rate was significantly lower in the conjunctival autograft group (p < 0.001). Logistic regression analysis revealed that conjunctival autograft was associated with a significantly lower risk of pterygium recurrence compared to AMT (odds ratio, 0.023; 95% confidence interval, 0.003-0.206; p = 0.001). No ocular complication was noted in both groups during follow-up. Conclusions: Pterygium excision with conjunctival autograft using fibrin glue was more effective in preventing recurrence compared to AMT.
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