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Delayed Epithelial Ingrowth Caused by Viral Conjunctivitis after LASIK
전루민,서울,김응권 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.4
To report a patient who presented with epithelial ingrowth caused by viral keratoconjunctivitis 3 months after LASIK surgery. A 41-year-old man presented with decreased visual acuity in the right eye, which had developed about 3 weeks before. He had undergone LASIK surgery 3 months prior without complications. Two months after the surgery, he was treated for viral conjunctivitis. During the treatment period, filamentary keratitis developed, and a therapeutic bandage contact lens was applied for 2 weeks. Upon presentation, examination revealed a corrected visual acuity of 20/100 and irregular epithelial sheets under the edematous flap. The flap was lifted, and the in-grown epithelium was removed. The flap was repositioned with double continuous 10-0 nylon sutures. Post-operatively, the patient developed a mild diffuse lamellar keratitis that resolved rapidly with topical corticosteroid treatment. At 2 months, the corrected visual acuity was 20/20 without interface opacities. As the patient showed no complications prior to viral conjunctivitis, we suspect that the viral infection caused edema of the corneal flap, which caused epithelial ingrowth under the flap. Patients who have viral conjunctivitis after LASIK surgery should be examined carefully and managed with consideration of flap complications.
고도 근시에서 부분 결합 간섭계를 이용한 인공수정체 도수 계측의 정확성
전루민,강수연,김병엽,Roo Min Jun,Soo Yeon Kang,Byoung Yeop Kim 대한안과학회 2008 대한안과학회지 Vol.49 No.11
Purpose: To investigate the accuracy of biometry and intraocular lens (IOL) power calculation using partial coherence interferometry (IOL Master®) in highly myopic patients with axial lengths of 26 mm or greater. Methods: Patients with axial lengths equal to or greater than 26 mm who had undergone cataract surgery were enrolled. IOL power was calculated using IOL Master and/or applanation ultrasonography with the SRK/T formula. Twenty-seven eyes using both IOL Master and applanation ultrasonography were included in a paired group, and forty-eight eyes using the IOL Master only and twenty-five eyes using applanation ultrasonography only were included in unpaired groups. The differences between the predicted refraction and the actual refraction were compared and analyzed. Results: In the paired study, the axial lengths in patients using IOL Master (29.14±2.32 mm) were significantly longer than those of patients using applanation ultrasonography (28.57±2.23 mm) (p<0.05). The mean absolute error (MAE) of the IOL Master and applanation ultrasonography groups were 0.62±0.58D and 0.87±0.49D, respectively (p>0.05). In the unpaired study, the MAEs of the IOL Master and applanation ultrasonography groups were 0.61±0.61D and 0.65±0.63D, respectively. Conclusions: In eyes with axial lengths of 26.0 mm or greater, the accuracy of IOL power calculation with IOL Master using the SRK/T formula was comparable to that with applanation ultrasonography. J Korean Ophthalmol Soc 2008;49(11):1746-1751
유행각결막염 후 재발되는 상피하 침윤에서 점안 사이클로스포린과 타크로리무스 사용
김나현,전루민,한경은 대한안과학회 2022 대한안과학회지 Vol.63 No.4
목적: 유행각결막염 이후 반복되는 상피하 침윤을 사이클로스포린 안약과 타크로리무스 연고를 사용하여 조절한 1예를 보고하고자한다. 증례요약: 33세 여자가 양안 유행각결막염으로 점안 항생제와 스테로이드를 사용하던 중 3주 후 좌안에서 더 심한 양상의 다발성의상피하 침윤이 양안에서 발생하였다. 이에 0.5% loteprednol etabonate를 하루 8회로 시작하여 하루 1회까지 줄이면서 0.1% 사이클로스포린을 하루 1회 병용하였으나, 상피하 침윤이 재발하여 이후 2회에 걸쳐 스테로이드 점안제를 증량했다가 줄였으며, 0.1% 사이클로스포린은 하루 2회씩 점안하였다. 우안은 0.1% 사이클로스포린만으로 조절되었고, 좌안은 스테로이드를 줄일 때마다 상피하 침윤이재발하여 0.02% 타크로리무스 연고를 추가하였다. 좌안의 상피하 침윤은 타크로리무스 점안 2주 만에 호전되어, 이후 환자는 우안은0.1% 사이클로스포린 하루 1‐2회, 좌안은 0.02% 타크로리무스 연고를 3일마다 6개월간 상피하 침윤을 조절하였다. 결론: 유행각결막염 후 발생한 만성적인 상피하 침윤이 지속적으로 재발하는 경우, 점안 사이클로스포린과 타크로리무스 사용해 볼수 있겠다.
녹내장 진행에 따른 망막신경섬유층의 두께 변화 : GDx-VCC를 이용한 분석
서울,전루민,최규룡,Wool Suh,Roo-Min Jun,Kyu-Ryong Choi 대한안과학회 2009 대한안과학회지 Vol.50 No.2
Purpose: The changes of retinal nerve fiber layer thickness with GDx-VCC were analyzed to assess the use of this instrument for longitudinal follow-up of retinal nerve fiber layers. Methods: From July 2004 to July 2007, patients suspected of glaucoma were measured with GDx-VCC at baseline and measurements were repeated at a minimum interval of 12 months. The medical records of 150 patients were reviewed and 42 patients that showed glaucomatous visual field progression in 36 months were classified into a `progression group` and 108 patients with no visual field loss were classified into a `nonprogression group`. Results: In the nonprogression group, the temporal superior-nasal-inferior-temporal (TSNIT) average and theinferior average showed statistically significant changes for the follow up periods. However, in theprogression group, there were no parameters with significant changes even though glaucomatous visual field loss was found. The visual field progressed at a rate of 0.1dB/year in the progression group but the relationship between MD, PSD and GDx-VCC parameters could not be established. Conclusions: GDx-VCC may not be sufficient for longitudinal assessment of the RNFL, especially during the early glaucomatous visual field changes. The progression of glaucoma only with GDx-VCC should be cautiously evaluated, and confirmation with the visual field which elucidates early glaucomatous changes is necessary. Further study is needed before GDx-VCC can be recommended as the instrument for longitudinal assessment.
세로토닌-노르에피네프린 재흡수 억제제 복합 투여로 유발된 양안 급성폐쇄각녹내장 발작
윤지현,전루민,최규룡,한경은 대한안과학회 2019 대한안과학회지 Vol.60 No.12
목적: 세로토닌-노르에피네프린 재흡수 억제제(serotonin-norepinephrine reuptake inhibitors, SNRI)인 둘록세틴 및 트라마돌 복합복용 후 유발된 양안 급성폐쇄각녹내장 발작 1예를 보고하고자 한다. 증례요약: 55세 여자 환자가 허리 통증 완화를 위해 처방받은 둘록세틴과 트라마돌을 포함한 여러 약제 복용 2일만에 발생한 양안시력저하, 안구 통증 및 두통으로 내원하였다. 나안시력은 우안 0.04, 좌안 0.02였으며, 안압은 우안 45 mmHg, 좌안 51 mmHg였다. 양안 중심 전방깊이는 중심각막두께와 같았고, 주변부 전방깊이는 1/4 이하였으며, 전방각은 닫혀 있었다. 양안에 경도의 수정체 핵경화가 있었다. 약물에 의한 양안 급성폐쇄각녹내장 발작 진단하에 약물을 중단하고 안압하강제를 투여하여 시력, 안압, 안구 통증은 호전되었으나, 전방깊이 및 전방각은 완전히 호전되지 않았다. 우안에 시행한 레이저홍채절개술은 불완전한 축동과 홍채출혈로 중단하고, 양안 수정체초음파유화술 및 후방 인공수정체삽입술을 시행하였다. 첫 방문 9개월 후까지 양안의 시력, 안압, 전방깊이 및 전방각이 안정적으로 유지되었다. 결론: SNRI 복합 복용에 의해 급성폐쇄각녹내장 발작이 발생할 수 있음을 고려해야 할 것이다. Purpose: This study reports a case of bilateral acute angle-closure crisis induced by two kinds of serotonin-norepinephrine reuptake inhibitors (SNRIs), duloxetine and tramadol. Case summary: A 55-year-old female visited our clinic, complaining of bilateral visual impairment, ocular pain, and headache, which began 2 days after taking several drugs including duloxetine and tramadol for the purpose of back pain relief. On the day of the first visit, her uncorrected visual acuity was 0.04 in the right eye and 0.02 in the left eye, and the intraocular pressure (IOP) was 45 mmHg in the right eye and 51 mmHg in the left eye. The anterior chamber was shallow and the anterior chamber-angle was closed in both eyes on gonioscopy. There was mild nuclear sclerosis of both lenses. Assuming drug-induced bilateral acute angle-closure crisis, all medications were discontinued, and IOP-lowering agents were prescribed. The symptoms, visual acuity, and IOP improved; however, both anterior chambers were still shallow and the iridocorneal angle was still closed in both eyes. Laser iridotomy was tried in the right eye but failed because the pupils were not completely constricted, and iris bleeding occurred. Phacoemulsification and posterior chamber lens insertion were conducted in both eyes, and her visual acuity, IOP, anterior chamber depth, and iridocorneal angle have been stable at 9 months since her first visit. Conclusions: The combined administration of SNRI may cause bilateral acute angle-closure attacks.