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        유리체절제술 시행 후 각막내피세포밀도의 변화

        이자영,이미리,최경식,이성진,Ja Young Lee,MD,Mi Ri Rhee,MD,Kyung Seek Choi,MD,PhD,Sung Jin Lee,MD,PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.5

        Purpose: To assess the effect of pars plana vitrectomy and gas tamponade on corneal endothelial cell density. Methods: The corneal endothelial cell density in 145 eyes that underwent pars plana vitrectomy was examined with a noncontact specular microscope 3 months pre- and post-operation. The subjects were divided as follows: Group 1 (32 eyes) underwent pars plana vitrectomy, group 2 (26 eyes) underwent pars plana vitrectomy combined with gas tamponade, group 3 (34 eyes) underwent pars plana vitrectomy combined with phacoemulsification and group 4 (48 eyes) underwent pars plana vitrectomy combined with phacoemulsification and gas tamponade. The changes in corneal endothelial cell density between groups was compared. Results: The mean endothelial cell loss was more significant in group 2 than in group 1 (p = 0.012), and there was no difference between groups 3 and 4 (p = 0.063). However, after excluding 6 eyes that had blood in the center of the corneal endothelium as a result of being in the prone position following gas tamponade, the mean endothelial cell loss in group 2 was not less than in group 1. In eyes with blood in the corneal endothelium, endothelial cell loss significantly increased (p < 0.001). Conclusions: The results of this study suggest that ophthalmic surgeons should attempt to carefully control bleeding and sufficiently irrigate the vitreous during pars plana vitrectomy combined with gas tamponade. J Korean Ophthalmol Soc 2011;52(5):544-549

      • KCI등재

        망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입술이 삶의 질에 미치는 영향

        김지욱,최경식,이미리,이성진,Jee Wook Kim,MD,Kyung Seek Choi,MD,PhD,Mi Ri Rhee,MD,Sung Jin Lee,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.10

        Purpose: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). Methods: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25 was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV) (using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). Results: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab- related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. Conclusions: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function. J Korean Ophthalmol Soc 2012;53(10):1465-1471

      • KCI등재

        유리체절제술과 가스주입술 후 체위에 따른 안압의 변화

        문찬희,최경식,이미리,이성진,Chan Hee Moon,Kyung Seek Choi,Mi Ri Rhee,Sung Jin Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.1

        Purpose: To assess the influence of body position on intraocular pressure (IOP) in patients who underwent vitrectomy and intraocular gas tamponade. Methods: Patients who did not undergo any surgery were defined as Group 1. The remaining patients were divided into 3 groups according to the surgery performed (Group 2; cataract surgery, Group 3; vitrectomy and cataract surgery, Group 4; vitrectomy with intraocular gas tamponade and cataract surgery). IOP was measured by a non-contact tonometer, Goldmann applanation tonometer, and Tono-Pen in the sitting, supine, and prone positions. Results: The difference of IOP measured in the sitting position among the 4 groups was not significant. IOP was significantly elevated by 2.04 mm Hg on average when the posture was changed from sitting to supine or prone in all 4 groups. The IOP discrepancy between supine and sitting positions was significantly greater in group 4 by 3.61 mm Hg than the other groups (p = 0.003, ANOVA test). The IOP difference between the prone and sitting position was also significantly higher in group 4 by 3.82 mm Hg than the other groups (p = 0.001, ANOVA test). Conclusions: The patients with vitrectomized gas tamponade eyes had a mean IOP increase of 3.82 mm Hg when the position was changed from sitting to prone. When performing vitrectomy and intraocular gas tamponade on patients in the prone position, an IOP elevation should be monitored thoroughly.

      • KCI등재

        백내장수술 중 낙하된 유리체내 수정체로 의뢰된 잔류수정체 제거술의 결과

        최연주,최경식,이성진,이미리,Youn Joo Choi,MD,Kyung Seek Choi,MD,PhD,Sung Jin Lee,MD,PhD,Mi Ri Rhee,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.1

        Purpose: To assess the clinical features and outcomes of patients referred for management of dropped lens fragments during cataract surgery. Methods: The medical records of 22 eyes from 22 patients who were referred to our hospital to undergo pars plana vitrectomy (PPV) for management of dropped lens fragments after phacoemulsification surgery at private clinics were reviewed. Data including patient demographics, preoperative and postoperative visual acuity, factors associated with dropped lens fragment, and postoperative complications were recorded. The factors were compared between 2 patient groups: postoperative Snellen acuity of 0.5 or better and acuity less than 0.5. The statistical significances of differences in factors between the 2 groups were calculated. Results: The mean interval between cataract surgery and PPV was 2.6 ± 3.7 days. At the final examination, the mean postoperative acuity was 0.57 ± 0.20, and 16 eyes (72.7%) had a visual outcome of 0.5 or better. After excluding 7 eyes with other pre-existing ocular co-morbidities, 14 eyes (93.0%) achieved a final visual acuity of 0.5 or better. Multivariate analysis showed that the predictor for visual outcomes of 0.5 or better was absence of preoperative eye disease (p = 0.007). Complications after PPV included 2 (9.0%) cases of cystoid macular edema and 1 (4.5%) case of retinal detachment. Conclusions: Prompt referral and surgical management within 1 week for dropped lens fragments during cataract surgery may achieve a better visual outcome in cases with no pre-existing eye disease. J Korean Ophthalmol Soc 2012;53(1):68-75

      • KCI등재후보

        낮은 각막내피세포 밀도를 보인 환자에서 시행한 공막고정술

        이용준(Yong Jun Lee),최경식(Kyung Seek Choi),이성진(Sung Jin Lee),이미리(Mi Ri Rhee) 대한검안학회 2012 Annals of optometry and contact lens Vol.11 No.1

        목적: 1,000 cells/mm² 미만의 낮은 각막내피세포 밀도를 보인 환자에서 공막고정술을 시행한 후 각막내피세포의 손상 정도를 평가해 보았다. 대상과 방법: 공막고정술을 시행한 환자들 중 술 전 1,000 cells/mm² 미만의 낮은 각막내피세포 밀도를 보였던 7안을 대상으로 의무 기록을 후향적으로 조사하였다. 후방 인공수정체 탈구는 외부 공막고정술을, 무수정체안은 작은 공막 절개창과 접형 인공 수정체를 이용한 공막고정술을 시행하였다. 술 전후 경면 현미경을 통한 각막내피세포의 손상 정도와 임상 결과 및 합병증에 대해 알아보았다. 결과: 술 전 평균 교정시력(LogMAR)은 0.44±0.24였고, 술 후 최종 평균 교정시력(LogMAR)은 0.25±0.19였다. 수술 전후 각막내피세포 밀도는 평균 56.0±86.1 cells/mm² 감소하였다. 술 후 각막내피세포 감소율은 7.5±9.7%였으며, 연령에 따른 자연적인 감소분을 고려하면 수술로 인한 각막 내피세포감소율은 6.6±10.0%였다. 술 중 1안에서 전방출혈이 있었으며 술 후 2안에서 부분적인 수포 각막병증이 관찰되었다. 결론: 각막내피세포의 손상을 줄일 수 있는 방법들을 잘 적용하면 낮은 각막내피세포 밀도를 가진 눈에서 비교적 큰 손상 없이 공막고정술을 시행할 수 있을 것이다. Purpose: To investigate the endothelial cell loss after scleral fixation of posterior chamber intraocular lens (PCIOL) in low endothelial cell density (ECD) under 1,000 cells/mm². Methods: Retrospective review of 7 eyes were subjected to scleral fixation of PCIOL in low ECD. PCIOL subluxated eyes were operated with ab externo scleral fixation and aphakic eyes were operated with scleral fixation using foldable PCIOL. Endothelial cell loss, complications and postoperative outcomes were analyzed. Results: Mean LogMAR best corrected visual acuity improved from 0.44±0.24 to 0.25±0.19. Mean observed endothelial cell loss was 7.5±9.7% (56.0±86.1 cells/mm², 6.6±10.0% corrected for a natural endothelial cell loss of 0.6% a year). One eye had a intraoperative hyphema during the operation and 2 eyes had a postoperative localized bullous keratopathy. Conclusions: The scleral fixation with careful endothelial cell protection appeared to reduced endothelial cell loss and resulted visual improvement in low ECD.

      • KCI등재
      • 망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입술이 삶의 질에 미치는 영향

        김지욱 ( Jee Wook Kim ),최경식 ( Kyung Seek Choi ),이미리 ( Mi Ri Rhee ),이성진 ( Sung Jin Lee ) 한국안전학회(구 한국산업안전학회) 2003 International Journal of Safety Vol.2 No.1

        목적: 망막분지정맥폐쇄로 인한 황반부종 환자에서 bevacizumab을 이용한 치료가 시력과 관련된 삶의 질에 미치는 효과를 알아보고자 하였다. 대상과 방법: 망막분지정맥폐쇄로 인한 황반부종으로 bevacizumab 안내주입술을 받은 32명을 대상으로 시술 전과 시술 3개월 후, 최대교정시력, 빛간섭단층촬영, 한국어판 미국 국립안연구센터 시각기능 설문지 25를 이용한 설문조사를 시행하여 그 변화를 관찰하였다. 결과: Bevacizumab 주입 후 3개월째 최대교정시력과 중심황반두께, 황반부용적은 치료 전과 비교하여 유의하게 호전되었다. 설문조사에서는 총점이 유의하게 증가하였으며, 세부항목별로는 전반적 시력, 근거리 시력, 원거리 시력, 사회적 기능, 정신 건강, 역할의 제한, 의존성, 주변부 시력은 유의하게 호전되었고, 전반적인 건강, 눈 통증, 운전과 색각 면에서는 유의한 차이를 보이지 않았다. 결론: 망막분지정맥폐쇄에 합병된 황반부종에서 bevacizumab 주입술은 황반부종을 감소시켜 시력뿐만 아니라 시력과 관련된 삶의질도 효과적으로 향상시켰다. 그러나 다른 세부항목에 비해 운전과 색각에 관련된 삶의 질은 상대적으로 회복 속도가 느린 것을 알수 있다. Purpose: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). Methods: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25 was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV) (using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). Results: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. Conclusions: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function. J Korean Ophthalmol Soc 2012;53(10):1465-1471

      • 선천성 색각이상자의 색분별에 관한 연구

        이미리,김재호,신환호 순천향대학교 1988 논문집 Vol.11 No.1

        A total of 75 subjects were examined using Hahn's color vision test & Double 15-Hue test. Among the 75 subjects, 62 subjects detected by screening test among 2700 high school students had defective color vision but good visual acuity and no retinal diseases. The other 13 subjects were detected in out-patient ophthalmic clinic. Results of examination in classifying the types and estimating the extent of color defects were obtained. 1. In the total 75 persons examined, extent of the color defects were as follows; mild--------6cases moderate----31 cases strong------38 cases 2. The classification of types of congenital color defects were as follows; Protan--------2 cases Deutan-------25 cases Unclassified---48 cases Lack of advanced study on color discrimination for congenital color deficiency resulted in existing job discrimination against a color defective person by restricting his/her job opportunity. Therefore this kind of research has very important meanings and should be continued.

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