Comparison of Higher-Order Aberration and Contrast Sensitivity in Monofocal and Multifocal Intraocular Lenses

김창염,정소향,김태임,조영재,윤근영,서경률 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.4

Purpose: The visual performance of pseudophakic eyes depends on the type of intraocular lenses (IOLs) that are implanted. Aspherical and multifocal IOLs have recently been developed to improve visual quality after cataract surgery, but multifocal IOLs can be associated with decreased contrast sensitivity (CS), halos, and glare. This study compares the visual performance of monofocal and multifocal IOLs by measurement of higher-order aberrations (HOAs) and CS values. Materials and Methods: HOAs and CS values of 42 eyes with implanted monofocal IOLs and 40 eyes with implanted multifocal IOLs were measured preoperatively and more than 6 months after surgery. In the multifocal IOL group, HOAs and CS values were also measured with addition of a trial lens of -0.5 diopter (D) to evaluate the compensatory effect on spherical aberration. Results: CS values of the multifocal IOL group were significantly lower than those of the monofocal IOL group for all spatial frequencies tested (p<0.01), and the spherical aberration was significantly higher in the multifocal IOL group than in the monofocal IOL group (p<0.001). Addition of a -0.5 D lens to the multifocal IOL group decreased the difference in CS between the two groups (p=0.003). Conclusion: Increased spherical aberration may contribute to lower CS in the multifocal IOL group. In such cases, CS can be improved by addition of a -0.5 D lens to compensate for the spherical aberration.

Orbital Lymphangioma: Characteristics and Treatment Outcomes of 12 Cases

우영준,김창염,Bradford Sgrignoli,윤진숙 대한안과학회 2017 Korean Journal of Ophthalmology Vol.31 No.3

Purpose: To report the patient characteristics and treatment outcomes in 12 cases of orbital lymphangioma. Methods: In this study, orbital lymphangioma was diagnosed based on clinical, radiologic (computed tomography,magnetic resonance imaging), and histologic findings when possible. Patients whose vision was notcompromised by orbital lymphangioma, or that did not have increased intraocular pressure (IOP), receivedoral corticosteroids. Orbital lymphangioma that affected vision or increased IOP was treated by surgery, whichincluded aspiration of blood or partial resection with or without injection of a sclerosant. Results: Four patients without compromised vision responded well to oral corticosteroids. Eight patients withcompromised vision underwent some form of surgery. Bleeding recurred in three patients after aspiration ofblood and in two after partial resection and intralesional injection of a sclerosant. Overall, five patients weretreated successfully by aspiration of blood, intralesional injection of a sclerosant, and application of continuousnegative pressure by appropriate drainage. Partial resection was successful in two patients with organized hematoma. Conclusions: Orbital lymphangioma that does not compromise vision can be treated medically using oral corticosteroids. Patients with threatened vision or elevated IOP due to acute hemorrhage should be treated by aspirationof blood, intralesional injection of a sclerosant, and application of continuous negative pressure. Partialresection may be effective only in patients with organized hematoma.

아벨리노각막이상증으로 진단된 한국인 환자의 각막병변의 분류 및 임상양상

정소향,김창염,김응권,So-Hyang Chung,Chang-Yeom Kim,Eung-Kweon Kim 대한안과학회 2005 대한안과학회지 Vol.46 No.6

Purpose: To classify Avellino corneal dystrophy (ACD) into 3 groups by slit lamp photography and to evaluate the inter-group differences. Methods: DNA analysis was performed in one member from each of 45 families who were clinically diagnosed as ACD. Corneal opacities were classified into mild (group I), moderate (group II), and severe (group III) based on slit lamp photograph. Results: Six patients were confirmed as homozygous ACD and ninety-two as heterozygous ACD. One homozygous patient was revealed to have a novel phenotype. The age increased with increasing severity, and the proportion of females in group III was significantly higher than that of the other two groups (p=0.001). The prevalence of laser in situ keratomileusis (LASIK) increased in group III (p=0.001), and the incidence of pterygium increased in group I compared with the other two groups (p=0.025). Conclusions: ACD was aggravated with age, while pterygium and LASIK altered the natural course of ACD.

Surgical Outcomes of Porcine Acellular Dermis Graft in Anophthalmic Socket: Comparison with Oral Mucosa Graft

Livia Teo,우영준,김동규,김창염,윤진숙 대한안과학회 2017 Korean Journal of Ophthalmology Vol.31 No.1

Purpose: We describe our experience with the Permacol graft in anophthalmic socket reconstruction, and compareit to the autologous buccal mucosal graft, emphasizing the postoperative vascularization and contractionof each graft. Methods: This was a retrospective comparative study. We measured the time necessary for the graft surface tobe completely vascularized, as well as the fornix depth of the conjunctival sac in anophthalmic patients. Results: Ten patients underwent Permacol graft reconstruction, with 44 undergoing buccal mucosal graft reconstruction. Seven eyelids (70%) in the Permacol group had a good outcome, with improvement in lower eyelidposition and prosthesis retention. Nine out of 10 eyelids (90%) in this group showed complete vascularizationof the graft at 2.6 ± 1.9 months postoperatively, while the grafted buccal mucosa was fully vascularized at 1.1± 0.3 months postoperatively (p < 0.01). Postoperative fornix depth in the Permacol group was 9.1 ± 2.2 mm,compared to 14.9 ± 4.5 mm in the buccal mucosal graft group (p < 0.01). Mean increases in fornix depth were33.1% and 67.9% of the mean vertical length of the implanted graft. Conclusions: The Permacol graft can be useful as spacer graft material in anophthalmic socket patients. Ittakes longer to vascularize, and undergoes greater graft shrinkage with time, compared to the buccal mucosalgraft.

시신경 수막종의 치료 및 임상 경과

이지민(Ji Min Lee),박시윤(Si Yoon Park),이상열(Sang Yeul Lee),윤진숙(Jin Sook Yoon),김창염(Chang Yeom Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.9

목적: 한국인에서 시신경 수막종 환자들의 임상양상 및 치료 경과를 알아보고자 하였다. 대상과 방법: 2002년 1월부터 2015년 12월까지 세브란스병원에서 시신경 수막종으로 진단 받은 환자 11명 11안을 대상으로 의무기록을 통한 후향적 방법으로 조사하였다. 결과: 환자의 평균 연령은 47.6세, 여성이 10명이었으며 모두 단안 침범 소견을 보였다. 환자의 초기 증상으로는 시력저하, 안구돌출이 가장 흔했고, 3명은 안구운동장애, 7명은 시야결손이 있었다. 이 중 3명은 종양 크기 증가 및 두개내로의 진행, 2명은 시력 저하가 발생하여 이들 5명에서 치료를 시행하였다. 치료 없이 경과관찰한 5명은 의미 있는 시력저하나 시야결손의 악화를 보이지 않았으나, 수술을 받은 1명은 시력저하 및 시야결손의 악화가 나타났으며 3차원 입체조형 방사선치료를 시행 받은 2명 중 1명은 치료 후 시야결손이 호전되었고, 다른 1명은 치료 후 시야결손의 변화는 없었으나 종양의 크기가 감소하고 더 이상 증가하지 않는 소견을 보였다. 감마나이프 치료를 받은 2명 중 1명은 시야결손이 악화되었고, 다른 1명은 치료 후 시력 저하가 발생하였다. 결론: 시신경 수막종은 진행이 느린 경우가 많고, 적극적인 치료 후에 시력 저하 또는 시야 결손이 악화될 수 있으므로 병의 초기에 치료 여부는 신중하게 결정해야 하며, 병의 진행이 빠르거나 경과가 진행된 경우에 국한하여 시행하는 것이 좋을 것으로 판단된다. 치료가 필요한 경우 3차원 입체조영 방사선치료가 우선적으로 고려될 수 있으나 이에 대해서는 향후 더 많은 연구가 필요하다. Purpose: To evaluate the clinical course of optic nerve sheath meningioma (ONSM) in Korean patients. Methods: A retrospective study of 11 eyes of 11 patients with a diagnosis of ONSM between 2002 and 2015 at Severance Hospital. Results: The mean age at symptom onset was 47.6 years. Ten females and 1 male participated in the study and all tumors were unilateral. Patients typically presented with visual loss and proptosis. Three patients complained of limited extraocular movements and seven patients exhibited visual field defects. Three patients who had a greater growth rate with intracranial involvement and two patients who had decreased vision received treatments. Five patients maintained good vision and visual field during the follow-up period. However, one patient who underwent surgical treatment presented significant visual loss and deterioration of visual field defect. One out of two patients who received three-dimensional conformal radiotherapy (3D-CRT) experienced improvement in visual field, and the other showed no change in visual field defect but remained stable with decreased tumor size. One out of two patients who underwent gamma-knife surgery showed aggravated visual field defect and the other presented with visual loss. Conclusions: ONSM is typically a slow-growing tumor. Deterioration of visual loss and visual field defect can occur after treatment of ONSM. Therefore, management should be considered carefully and should be limited to cases in which progression of the disease is advanced or tumor growth is fast. 3D-CRT can be considered in patients in need of treatment.