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한국인 녹내장 및 고안압증 환자에서 타플루프로스트의 안압 하강 효과
경학수(Haksu Kyung),이승재(Seung Jae Lee) 대한검안학회 2013 Annals of optometry and contact lens Vol.13 No.1
목적: 한국인 개방각 녹내장 및 고안압증에서 타플루프로스트(Tafluprost) 단독 치료 시 안압하강 효과를 알아보고자 하였다. 대상과 방법: 개방각 녹내장 및 고안압증으로 진단 받은 한국인 78명 135안을 대상으로 타플루프로스트 점안약을 단독 1일 1회 점안 치료하여 치료 전 안압과 치료 후 1주일, 1개월, 3개월, 6개월, 9개월에 안압 차이를 후향적으로 비교 분석하였다. 결과: 총 135안 중 정상안압녹내장 117안, 일차개방각녹내장 11안, 고안압증 7안으로 타플루프로스트 치료 전 평균 안압은 16.0 ± 3.7 mmHg에서 치료 1주일째 12.5 ± 2.5 mmHg (least squares [LS] mean difference: -4.6 mmHg; p<0.0001), 1개월째 12.6 ± 2.7 mmHg (-3.2 mmHg; p<0.0001), 3개월째 12.4 ± 3.0 mmHg (-2.8 mmHg; p<0.0001), 6개월째 12.8 ± 3.0 mmHg (-3.9 mmHg; p<0.0001), 9개월째 12.0 ± 2.5 mmHg (-2.7 mmHg; p<0.0001)로 통계적으로 유의하게 안압 하강 효과를 보였다. 결론: 개방각 녹내장 및 고안압증 치료제로 타플루프로스트는 한국인에서 치료 시작 후 9개월까지 안압 하강에 효과적이었다. Purpose: To investigate intraocular pressure (IOP) lowering effect of Tafluprost in Korean glaucoma and ocular hypertension patients. Methods: Seventy eight patients, one hundred thirty five eyes, diagnosed with glaucoma and ocular hypertension received Tafluprost once daily. We analyzed IOP and its change from baseline at week 1, month 1, moth 3, month 6 and month 9. Results: Among all 135 eyes, 117 eyes had normal tension glaucoma (NTG), 11 eyes had primary open angle glaucoma (POAG), and 7 eyes had ocular hypertension (OHT). The average IOP was 16.0 ± 3.7 mm Hg at baseline, 12.5 ± 2.5 mm Hg (least squares [LS] mean difference: -4.6 mm Hg; p < 0.0001) after 1 week, 12.6 ± 2.7 mm Hg (-3.2 mm Hg; p < 0.0001) after 1 month, 12.4 ± 3.0 mm Hg (-2.8 mm Hg; p < 0.0001) after 3 months, 12.8 ± 3.0 mm Hg (-3.9 mm Hg; p <0.0001) after 6 months and 12.0 ± 2.5 mm Hg (-2.7 mm Hg; p < 0.0001) after 9 months. All measurements showed a statistically significant IOP reduction. Conclusions: Tafluprost was effective in IOP lowering effects up to 9 months in Korean glaucoma and ocular hypertension patients.
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경학수(Haksu Kyung) 대한검안학회 2013 Annals of optometry and contact lens Vol.13 No.2
Humphrey Field Analyzer (HFA)는 전세계의 녹내장 환자에서 시야손상을 파악하는 대표적인 시야검사 기계로서 시야검사의 신뢰성을 측정하기 위한 몇 가지의 요소가 포함되어 있다. 위양성, 위음성, 주시실패가 대표적인데, 20% 이하의 주시실패와 15% 이하의 위양성, 위음성을 보여주어야 신뢰할 만한 시야검사이다. 시신경병증과 시신경절세포 손상을 반영하는 대표적인 시야검사인 HFA는 시간이 감에 따라 녹내장을 평가함에 있어 발전을 거듭하고 있다. The Humphrey Field Analyzer (HFA; Carl Zeiss Meditec, Dublin, CA, USA) is commonly used to monitor visual field (VF) damage in glaucoma patients inthe world. The instrument includes several methods to estimate the reliability of VF tests false positive, false negative and fixation loss. Reliable VFs were defined as results with less than 20% fixation losses and less than 15% false-positive and false-negative errors. HFA is the representative visual field method reflecting optic neuropathy and ganglion cell damage. Also HFA is more and more developing for the evaluation of glaucoma as time goes on.
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MEL-80으로 라섹수술 시 라식 모드 절삭과 PRK 모드 절삭의 임상적 유용성 비교
김영돈,이담호,경학수,Youngdon Kim,Damho Lee,Haksu Kyung 대한안과학회 2014 대한안과학회지 Vol.55 No.11
Purpose: We compared laser assisted in situ keratomileusis (LASIK) mode and photorefractive keratectomy (PRK) mode ablation methods in laser subepithelial keratomileusis (LASEK) surgery using the MEL-80 excimer laser.Methods: All patients were followed up for a minimum of 1 year. The PRK mode group consisted of 46 eyes of 23 patients and the LASIK mode group consisted of 97 eyes of 56 patients. The central corneal thickness (CCT), ablation thickness, manifest refractive error and uncorrected visual acuity were compared preoperatively, 1 month and 1 year postoperatively. Spherical equivalent (SE) of cycloplegic refraction at postoperative 1 month and the uncorrected visual acuity (UCVA) ratios of 1.0 or better at postoperative 1 year were compared between the two groups to evaluate clinical efficacy. Results: The SE of refractive error, CCT and target corneal ablation thickness of the two groups were not significantly different preoperatively. The PRK mode group obtained an actual ablation mean thickness of 82.8% of the target and the LASIK mode group obtained an actual ablation mean thickness of 94.1% of the target at postoperative 1 month. In each group, a statistically significant difference was observed between the actual corneal ablation thickness and target corneal ablation thickness. In the PRK mode group, the mean SE of postoperative 1 month cycloplegic refraction was +0.24 ± 0.47 D and in the LASIK mode group, +0.87 ± 0.54 D, indicating a statistically significant difference between the two groups. One year postoperatively, the UCVA ratios of 1.0 or better were 83% in the PRK mode group and 96% in the LASIK mode group, showing a statistically significant difference between the two groups. However, SE of manifest refractive error and CCT in the two groups were not statistically different at postoperative 1 year. Conclusions: The LASIK mode ablation method showed better results than the PRK mode ablation method in postoperative UCVA prognosis after LASEK surgery using the MEL-80 excimer laser. J Korean Ophthalmol Soc 2014;55(11):1625-1630
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석주용,이담호,경학수,김준모,Ju Yong Seok,Damho Lee,Haksu Kyung,Joon Mo Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.11
Purpose: The axial length measurement is an important variable in calculating the intraocular lens (IOL) power in cataract surgery. In this study, the effects of the implantable collamer lens (ICL) on the axial length measurement were investigated. Methods: The axial lengths of 141 eyes of 76 highly myopic patients were measured before ICL implantation and 1 month postoperatively using applanation A-scan ultrasound. Results: The measured axial lengths before ICL implantation and 1 month after the surgery were 28.03 ± 1.91 mm and 28.08 ± 1.86 mm respectively, with a statistically significant difference of 0.05 mm (p = 0.036). These 2 values showed a high correlation (R2 = 0.9829, p < 0.0001). Conclusions: Even though the axial length after ICL implantation significantly increased, the 0.05 mm change was too small to influence the determination of the IOL diopters in cataract surgery. Therefore, ICL implantation history may be reflected when measuring the axial length for the IOL power calculation in cataract surgery, but the axial length measured immediately before the cataract surgery may be used to calculate the IOL power regardless of the ICL implantation history. J Korean Ophthalmol Soc 2013;54(11):1675-1679
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