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1.
Article in Korean | WPRIM | ID: wpr-916458

ABSTRACT

Purpose@#To compare the degree of meibomian gland drop-out associated with Demodex infestation using non-contact meibography. @*Methods@#We performed noncontact meibography using an infrared digital camera on 24 adult subjects infested by Demodex and 40 without infestation. The right upper and lower lids were scored based on the loss of meibomian glands, and the scores of the upper and lower eyelids were summed to obtain the total meiboscore for each subject. Meiboscores were evaluated according to Demodex infestation and gender in each group. @*Results@#Sixty-four eyes of 64 people were enrolled in this study. The study subjects had an average age of 67.9 years (range, 40-79 years; men, 65.2 years; women, 69.1 years). There was a significant association between Demodex infestation and total meiboscore and upper and lower eyelid meiboscores (p = 0.000, p = 0.002, p = 0.004, respectively). There was no significant difference in the meiboscores between men and women. Age and meiboscore suggested a weak positive correlation; however, the R2 value was low, due to the concentrated age distribution of the study population. @*Conclusions@#Based on noncontact meibography, the authors concluded that the prevalence of changes in the meibomian glands was significantly related to Demodex infestation; however, there was no significant difference between men and women.

2.
Article in Korean | WPRIM | ID: wpr-893408

ABSTRACT

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

3.
Article in Korean | WPRIM | ID: wpr-893397

ABSTRACT

Purpose@#To report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) for graft failure after primary DMEK.Case summary: A 47-year-old female underwent primary DMEK in her left eye with a diagnosis of Fuchs’ endothelial dystrophy. At 6 weeks later, corneal stromal edema with epithelial and subepithelial bullae was first observed. From that point on, the condition of the cornea and the visual acuity continued to degrade. After 7 months, a second DMEK procedure (i.e., a repeat DMEK) for graft failure was performed successfully without any complications. Since the second procedure, the cornea has been clear, and the best-corrected visual acuity has remained at 0.6 for 8 months. @*Conclusions@#To manage graft failure after primary DMEK, we performed a second DMEK procedure. The removal of the previous graft was easy, and there were no complications. Thus, repeat DMEK may be a feasible procedure.

4.
Article in Korean | WPRIM | ID: wpr-893356

ABSTRACT

Purpose@#To report a case of a successful secondary Descemet membrane endothelial keratoplasty in failed penetrating keratoplasty. Case summary: A 46-year-old male with keratoconus in both of his eyes underwent penetrating keratoplasty in his right eye 30 years ago and in his left eye 14 years ago. From one and a half year ago, the patient’s visual acuity decreased in his left eye due to graft failure. For treatment, secondary Descemet membrane endothelial keratoplasty was performed. Partial detachment of Descemet membrane was observed at 13 days after the operation, and an additional air injection was performed. At 8 months after the operation, the patient’s uncorrected visual acuity improved to 0.5 and the cornea maintained its clearance without rejection. @*Conclusions@#Secondary Descemet membrane endothelial keratoplasty was successfully performed in a patient with failed penetrating keratoplasty.

5.
Article in Korean | WPRIM | ID: wpr-901112

ABSTRACT

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

6.
Article in Korean | WPRIM | ID: wpr-901101

ABSTRACT

Purpose@#To report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) for graft failure after primary DMEK.Case summary: A 47-year-old female underwent primary DMEK in her left eye with a diagnosis of Fuchs’ endothelial dystrophy. At 6 weeks later, corneal stromal edema with epithelial and subepithelial bullae was first observed. From that point on, the condition of the cornea and the visual acuity continued to degrade. After 7 months, a second DMEK procedure (i.e., a repeat DMEK) for graft failure was performed successfully without any complications. Since the second procedure, the cornea has been clear, and the best-corrected visual acuity has remained at 0.6 for 8 months. @*Conclusions@#To manage graft failure after primary DMEK, we performed a second DMEK procedure. The removal of the previous graft was easy, and there were no complications. Thus, repeat DMEK may be a feasible procedure.

7.
Article in Korean | WPRIM | ID: wpr-901060

ABSTRACT

Purpose@#To report a case of a successful secondary Descemet membrane endothelial keratoplasty in failed penetrating keratoplasty. Case summary: A 46-year-old male with keratoconus in both of his eyes underwent penetrating keratoplasty in his right eye 30 years ago and in his left eye 14 years ago. From one and a half year ago, the patient’s visual acuity decreased in his left eye due to graft failure. For treatment, secondary Descemet membrane endothelial keratoplasty was performed. Partial detachment of Descemet membrane was observed at 13 days after the operation, and an additional air injection was performed. At 8 months after the operation, the patient’s uncorrected visual acuity improved to 0.5 and the cornea maintained its clearance without rejection. @*Conclusions@#Secondary Descemet membrane endothelial keratoplasty was successfully performed in a patient with failed penetrating keratoplasty.

8.
Article in Korean | WPRIM | ID: wpr-893237

ABSTRACT

Purpose@#We report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) to treat graft failure after Descemet stripping endothelial keratoplasty (DSEK).Case summary: A 66-year-old female underwent DSEK of her right eye to treat pseudophakic bullous keratopathy that developed after cataract surgery and intraocular lens exchange. After 5 years, she complained of decreased vision; graft failure was observed. Secondary DMEK was performed; no additional air injection was needed. The corrected visual acuity was 0.2, 3 months after surgery, and the cornea became clear. @*Conclusions@#Visual recovery can be achieved by performing secondary DMEK after primary DSEK graft failure.

9.
Article in Korean | WPRIM | ID: wpr-811345

ABSTRACT

PURPOSE: To quantify the size of commotio retinae and investigate its spontaneous resolution over time using ultra-wide field (UWF) color fundus photography.METHODS: We analyzed serial UWF color fundus photographs of 33 eyes of 33 ocular trauma patients with commotio retinae. Total visible retinal areas and the areas of commotio retinae were measured at baseline, 3 days, 1 week, and 4 weeks from the initial traumatic event.RESULTS: The median time of observation was 10.8 ± 12.1 (4-44) weeks. Spontaneous resolution of commotio retinae was observed in all patients, and no patients experienced any complications during the follow-up period. The mean percentage of commotio retinae at 3 days significantly decreased compared to the baseline (8.51 ± 9.66% versus 12.23 ± 10.39%; p < 0.001), and more decreased at 1 week (1.04 ± 2.75%; p < 0.001), but no significant differences were observed between 1 week and 4 weeks (0.00 ± 0.00%; p = 0.219). The spontaneous resolution percentages during the first 3 days, between 3 days and 1 week, and during the next 4 weeks were 12.97 ± 13.44%/day, 19.62 ± 9.22%/day, and 0.87 ± 1.87%/day, respectively (p = 0.192 and p < 0.001, respectively). The resolution rate was higher during the first 1 week.CONCLUSIONS: We quantified the size of commotio retinae using UWF color fundus photography. Most patients with commotio retinae resolved spontaneously during the first 1 week following trauma, and all cases completely resolved at 1 month without any complications.

10.
Article in Korean | WPRIM | ID: wpr-811328

ABSTRACT

PURPOSE: To determine the through-focus optical bench test performance of monofocal, bifocal, and extended depth-of-focus intraocular lenses (IOLs), and to measure their defocus curves.METHODS: A model eye was placed on an optical bench to test three different IOLs (TECNIS ZXR00, ZMB00, and ZCB00; Abbott Medical Optics, Santa Ana, CA, USA). The focus was changed by inserting trial lenses from +1.00 diopters to −4.00 diopters, in increments of +0.25 diopters. The 1951 United States Air Force Resolution chart was used to determine the quality of the images. The degree of similarity with reference images was given by the cross-correlation coefficient, and defocus curves were drawn and compared.RESULTS: Bifocal IOLs showed lower image quality with the addition of minus diopter trial lenses, but showed good image quality at near distance. Bifocal IOLs also showed a ‘double peak’ in their defocus curve. Monofocal IOLs showed a lower image quality and cross-correlation coefficient with addition of lower-diopter trial lenses. The extended depth of focus IOLs showed a single peak in their defocus curve, but had a wider range of diopters and better image quality than monofocal IOLs.CONCLUSIONS: Bifocal IOLs showed a double peak defocus curve, and extended depth of focus IOLs showed a wider diopter range and better image quality than monofocal IOLs.


Subject(s)
Lenses, Intraocular , United States
11.
Article | WPRIM | ID: wpr-833236

ABSTRACT

Purpose@#To compare optical coherence tomography (OCT) and histological findings of Meibomian glands in rats. Based onthese results, the histological findings of the structures seen using OCT were clarified. @*Methods@#En bloc excision was performed on the upper and lower eyelids in two rats. The axis of the Meibomian gland was verticallyscanned with three-dimensional (3D) OCT and reconstructed into 3D images. The samples were fixed in 10% formalinagain and stained with hematoxylin and eosin. The findings of the OCT and histological examinations were then compared to determinethe histological characteristics of the structures observed in the OCT. @*Results@#The surface of the acinus was well-delineated in the Meibomian glands of rats using OCT. However, no deep acini wereobserved in the central ducts. @*Conclusions@#The structure of Meibomian glands imaged by OCT in rats was limited to the surface of the acinus. The structureof the reconstructed Meibomian gland ex vivo was similar to that of the human Meibomian gland. The possibility of developing anin vivo meibography system was therefore confirmed in animals.

12.
Article in Korean | WPRIM | ID: wpr-900941

ABSTRACT

Purpose@#We report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) to treat graft failure after Descemet stripping endothelial keratoplasty (DSEK).Case summary: A 66-year-old female underwent DSEK of her right eye to treat pseudophakic bullous keratopathy that developed after cataract surgery and intraocular lens exchange. After 5 years, she complained of decreased vision; graft failure was observed. Secondary DMEK was performed; no additional air injection was needed. The corrected visual acuity was 0.2, 3 months after surgery, and the cornea became clear. @*Conclusions@#Visual recovery can be achieved by performing secondary DMEK after primary DSEK graft failure.

13.
Article in Korean | WPRIM | ID: wpr-738595

ABSTRACT

PURPOSE: To report a case of macular edema and retinal vasculitis treated with intravitreal dexamethasone implantation in a Behcet's disease patient after cataract surgery. CASE SUMMARY: A 26-year-old male with Behcet's disease, without recurrence of uveitis for 3 months, underwent phacoemulsification and posterior chamber intraocular lens implantation for a cataract in the left eye. The preoperative best corrected visual acuity (BCVA) of the left eye was 0.15. At day 1 after surgery, his BCVA was 0.4, and slit lamp examination of his left eye revealed a mild anterior chamber reaction. At 1 week after surgery, he presented with left vision impairment, his BCVA was 0.04, and mild inflammation was observed in both the anterior chamber and the vitreous in his left eye. Unilateral macular edema was confirmed with optical coherence tomography, and fluorescein angiography revealed retinal vasculitis on the fovea and peripheral retina. Intravitreal dexamethasone implantation was performed in his left eye, 1 month after treatment, the macular edema and retinal vasculitis had improved, and the BCVA of his left eye was 0.8. CONCLUSIONS: In patients with Behcet's disease, intravitreal dexamethasone implantation can be an effective treatment option for macular edema and retinal vasculitis after cataract surgery.


Subject(s)
Adult , Anterior Chamber , Behcet Syndrome , Cataract , Dexamethasone , Fluorescein Angiography , Humans , Inflammation , Lens Implantation, Intraocular , Macular Edema , Male , Phacoemulsification , Recurrence , Retina , Retinal Vasculitis , Slit Lamp , Tomography, Optical Coherence , Uveitis , Vasculitis , Visual Acuity
14.
Article in Korean | WPRIM | ID: wpr-916188

ABSTRACT

This review gives an overview of the current multifocal intraocular lenses (IOLs) landscape, in terms of the technology, benefits, and limitations of different premium IOLs, as well as significant clinical outcomes. Cataract is the most common cause of visual impairment in older adults. From 1980, the number of blind and visually impaired people have decreased due to cataract surgery. As the number of surgical procedures increases every year, patient demands have also changed with many patients expecting excellent visual acuity without glasses. Multifocal IOLs can provide spectacle-independence for near, intermediate, and distant vision tasks. Multifocal IOLs can be classified into bifocal, trifocal, and extended depth of focus multifocal IOLs. The ultimate goal of multifocal lenses includes reduced incidence of photic phenomena, and improved uncorrected near, intermediate, and far visual acuities for those working with computers and smartphones, as well as no contrast sensitivity loss. Although some patients have issues with halos and glare, overall patient satisfaction and quality of life are generally high after multifocal IOL implantation. Careful patient selection should be made to satisfy different individual needs.

15.
Article in English | WPRIM | ID: wpr-760055

ABSTRACT

PURPOSE: To describe current cataract surgery practice patterns and changing trends among Korean ophthalmologists. METHODS: A survey of members of the Korean Society of Cataract and Refractive Surgery was performed in July 2018. One hundred and two (12.7%) of 801 questionnaires were returned for analysis. The data were analyzed using descriptive statistics and compared with previous surveys. RESULTS: Most of the respondents (75%) had been in practice for 6 or more years and performed an average of 31 cataract surgeries per month. The preferred method for cataract surgery was phacoemulsification (95%); 5% used a femtosecond laser. The use of topical anesthesia markedly increased from 69% (2012) to 80% (2018). The use of optical biometry exceeded that of ultrasound A-scan biometry. A multifocal intraocular lens was used by 76% of the respondents compared with 44% of the respondents in 2012. Topical nonsteroidal anti-inflammatory drugs were used by 70% of the respondents postoperatively. Most (59%) of these anti-inflammatory drugs were prescribed for 4 weeks. CONCLUSIONS: This survey provided a comprehensive update of the present cataract surgery practices in the Republic of Korea. The results emphasized the increasing use of premium intraocular lenses, optical biometry, and topical anesthesia.


Subject(s)
Anesthesia , Biometry , Cataract , Lenses, Intraocular , Methods , Phacoemulsification , Refractive Surgical Procedures , Republic of Korea , Surveys and Questionnaires , Ultrasonography
16.
Article in English | WPRIM | ID: wpr-760043

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of cyclosporine nanoemulsion 0.05% compared to cyclosporine emulsion 0.05% and diquafosol sodium 3%. METHODS: This was a multicenter, randomized, evaluator-masked, active control, parallel, phase IV study. A total of 227 patients were randomly allocated to instill cyclosporine nanoemulsion 0.05% (CN) twice daily, cyclosporine emulsion 0.05% (CE) twice daily, or diquafosol sodium 3% (DQ) six times daily. Non-inferiority of CN was analyzed by primary endpoint (cornea and conjunctival staining scores at week 12). The secondary endpoints were scores of corneal staining, conjunctival staining, tear break-up time, Schirmer test, and Ocular Surface Disease Index at weeks 4 and 12. RESULTS: Primary endpoints showed statistically significant improvements in all groups. Primary endpoints were −6.60 for the CN group, −5.28 for the CE group, and −6.63 for the DQ group (National Eye Institute scale from 0 to 33), verifying the non-inferiority of CN compared to CE (95% confidence interval, −0.15 to 2.80, Δ>−2.88). In intergroup comparison between CN and CE groups, the CN group had significantly more decreased conjunctival staining score at week 12. Intergroup comparison between CN and DQ groups showed consistent statistically significant improvements in TBUT and Schirmer test in the CN group. In the DQ group, TBUT showed late statistically significant improvement at week 12 and Schirmer test showed relatively short-term statistically significant improvement at week 4. CONCLUSIONS: Cyclosporine nanoemulsion 0.05% was equivalently efficient compared to cyclosporine emulsion 0.05% and diquafosol sodium 3%. In addition, CN showed significant improvements in several parameters for treatment of dry eyes.


Subject(s)
Cyclosporine , Dry Eye Syndromes , Humans , Nanotechnology , Sodium , Tears
17.
Article in English | WPRIM | ID: wpr-786342

ABSTRACT

PURPOSE: We sought to elucidate the influence of acetazolamide on choroidal structure changes during the treatment of central serous chorioretinopathy (CSC).METHODS: This was a retrospective study of 45 eyes from 45 patients with acute CSC who were divided into an acetazolamide group (group 1, n = 20) and an observation group (group 2, n = 25). The main outcome measures were the changes in best-corrected visual acuity, subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) at one week, one month, two months, and three months, respectively.RESULTS: Although statistical significance was not reached, best-corrected visual acuity improved in both groups at month 3 (from 0.06 ± 0.07 to 0.01 ± 0.03 in group 1 and 0.17 ± 0.24 to 0.09 ± 0.18 in group 2; p = 0.083 and 0.183, respectively). Separately, SRF height and CVI showed a significant decrease at three months in both groups (all p < 0.05), while a significant SRF height decrease was also noted in group 1 at one month (p = 0.038). In group 1, a significant decrease in the SFCT and CVI started at one week and one month (p = 0.021 and 0.008), respectively. However, in group 2, a significant decrease in the SFCT and CVI started at one month and two months (p = 0.005 and 0.015), respectively.CONCLUSIONS: Acetazolamide has no effect on final functional or anatomical status at three months in eyes with CSC but does shorten the time for SRF absorption and accompanying choroidal structural changes.


Subject(s)
Absorption , Acetazolamide , Central Serous Chorioretinopathy , Choroid , Humans , Outcome Assessment, Health Care , Retrospective Studies , Subretinal Fluid , Visual Acuity
18.
Article in Korean | WPRIM | ID: wpr-786171

ABSTRACT

This review gives an overview of the current multifocal intraocular lenses (IOLs) landscape, in terms of the technology, benefits, and limitations of different premium IOLs, as well as significant clinical outcomes. Cataract is the most common cause of visual impairment in older adults. From 1980, the number of blind and visually impaired people have decreased due to cataract surgery. As the number of surgical procedures increases every year, patient demands have also changed with many patients expecting excellent visual acuity without glasses. Multifocal IOLs can provide spectacle-independence for near, intermediate, and distant vision tasks. Multifocal IOLs can be classified into bifocal, trifocal, and extended depth of focus multifocal IOLs. The ultimate goal of multifocal lenses includes reduced incidence of photic phenomena, and improved uncorrected near, intermediate, and far visual acuities for those working with computers and smartphones, as well as no contrast sensitivity loss. Although some patients have issues with halos and glare, overall patient satisfaction and quality of life are generally high after multifocal IOL implantation. Careful patient selection should be made to satisfy different individual needs.


Subject(s)
Adult , Cataract , Contrast Sensitivity , Eyeglasses , Glare , Glass , Humans , Incidence , Lenses, Intraocular , Patient Satisfaction , Patient Selection , Presbyopia , Quality of Life , Smartphone , Vision Disorders , Visual Acuity
19.
Article in Korean | WPRIM | ID: wpr-766511

ABSTRACT

Dry eye syndrome is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms. Tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Symptom screening with the Five-item Dry Eye Questionnaire or Ocular Surface Disease Index can be used to identify the possibility that a patient might have DED dry eye syndrome and triggers. The results of these screening tools can lead to performing diagnostic tests of (ideally non-invasive) breakup time, osmolarity and ocular surface staining with fluorescein and lissamine green (observing the cornea, conjunctiva and eyelid margin). Meibomian gland dysfunction, lipid thickness/dynamics and assessments of the volume and severity of tear allow the subclassification of dry eye syndrome as predominantly evaporative or aqueous deficient, which informs the management of dry eye syndrome. A staged management algorithm was derived that presents a stepwise approach to implementing the various management and therapeutic options according to disease severity.


Subject(s)
Conjunctiva , Cornea , Diagnosis , Diagnostic Tests, Routine , Dry Eye Syndromes , Eyelids , Fluorescein , Homeostasis , Humans , Inflammation , Mass Screening , Meibomian Glands , Osmolar Concentration , Tears
20.
Article in Korean | WPRIM | ID: wpr-916125

ABSTRACT

Dry eye syndrome is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms. Tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Symptom screening with the Five-item Dry Eye Questionnaire or Ocular Surface Disease Index can be used to identify the possibility that a patient might have DED dry eye syndrome and triggers. The results of these screening tools can lead to performing diagnostic tests of (ideally non-invasive) breakup time, osmolarity and ocular surface staining with fluorescein and lissamine green (observing the cornea, conjunctiva and eyelid margin). Meibomian gland dysfunction, lipid thickness/dynamics and assessments of the volume and severity of tear allow the subclassification of dry eye syndrome as predominantly evaporative or aqueous deficient, which informs the management of dry eye syndrome. A staged management algorithm was derived that presents a stepwise approach to implementing the various management and therapeutic options according to disease severity.

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