• Title/Summary/Keyword: 백내장 수술

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Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy (유리체절제술과 수정체유화술 동시 수술 시 백내장수술 후 앞방내 에피네프린 주입과 동공 확대)

  • Kim, Sangbum;Park, Jongyeop;Shin, Jaeryung;Lee, Seungwoo
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1137-1141
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    • 2018
  • Purpose: We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR). Methods: We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes). Results: The PCA ratios of the study group were $0.52{\pm}0.11$ before PE, $0.43{\pm}0.12$ after PE, and $0.51{\pm}0.11$ after PPV, respectively. Changes in pupil size were significant (p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were $0.52{\pm}0.10$ before PE, $0.39{\pm}0.15$ after PE, and $0.43{\pm}0.15$ after PPV, respectively. Changes in pupil size after PE were significant (p = 0.011) but the change after PPV was not (p = 0.056). Conclusions: Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.

노인성 안질환

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.30 no.6 s.331
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    • pp.28-29
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    • 2006
  • 백내장은 수정체가 흐려져 빛을 투과시키지 못하면서 시력장애를 일으키는 질환이며, 더욱이 뚜렷한 예방책도 없다. 따라서 백내장은 가능한 한 발병 초기에 발견하는 것이 중요하다. 적절한 시기에 수술을 받아야 떨어진 시력을 거의 회복할 수 있게 되기 때문이다. 하지만, 약물요법은 이미 진행된 백내장을 원래 상태로 회복시키지 못하고, 단지 진행을 더디게 하는 일종의 보조요법이라는 한계가 있다. 따라서 백내장을 확실히 극복하기 위해선 수술을 받아야 한다.

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A Comparison of Diclofenac versus Dexamethasone for the Treatment of Postcataract Inflammation

  • Lee, Suk Hyang;Suh, Ok Kyung;Jung, Hyun Ah;An, Gi Jung
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.1
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    • pp.1-6
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    • 2000
  • 백내장 수술 추 염증치료를 위해 일반적으로 부작용이 많은 국소 점안 스테로이드를 사용해왔다. 최근 NSAID계열의 점안액이 항염증 치료약물로 개발되면서 선택적인 약물치료가 가능하게 되었으나 단일치료약물로 사용하는 경우는 드물다. 본 연구는 NSAID계 diclofenac 점안액의 백내장 수술 후 염증치료 효과를 스테로이드체 dexamethasone 점안액과 비교하여 단일 치료약물로서 사용할 수 있는 지 연구하고자하였다. 백내장 수술을 받은 환자로서 안압이 22 mmHg 이상 당뇨환자, 수술대상 눈에 이미 질환 및 수술 경력이 있는 자를 제외하였다. 백내장 수술 후 항염종 약물로서 diclofenac 또는 dexamethasone을 28일 동안 투여하고 항염증효과의 평가를 위하여 세극등 검사로저 전방내 염증세포와 결막, 각막등의 전안부 관찰을 수술 전, 수술 후 1, 3, 7, 14, 28일에 시행하였고, 시력검사는 수술 추 7, 28일에 시행하였다. 안전성의 평가는 안압검사와 세극등 검사상 관찰된 이상소견으로 평가하였다. 총 73명의 연구대상 중 dexameasone군은 41명, diclofenac군은 32명이며 두 군간에 나이, 백내장의 심한 정도, 안구질환 등에 있어 유의한 차이가 없었다 전방내 항염증세포수의 감소에서 두 군간에 유의할 만한 차이가 없었고, 수술 후 최대 교정 시력에서도 동일한 효과를 보였다. 안전성에서 안압의 상승이 두군간에 통계적인 유의한 차이를 보이지 않았으나 dexamethasone군에서 1명의 환자가 45 mmHg 이상 증가하여 약물치료가 필요하였으나 diclofenac군에서는 안압이 상승한 환자가 없었다. 결론적으로 효능 및 안전성에서 두 약물간에 통제적, 임상적으로 유의한 차이가 없었으며 diclofenac 점안액은 백내장 수술 후 항염증치료제로서 충분한 효과가 있으며 안압상승, 감염 등 부작용이 우려되는 dexamethasone점안액의 대체약물로 사용될 수 있을 것으로 평가된다.

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Trends and Refractive Status of Cataract Surgery - An Optometry Clinic-Based Survey in Chungbuk (백내장 수술 경향과 굴절상태 - 충북 지역의 안경원 중심으로 조사)

  • Kim, Hyeong-Su;Son, Jeong-Sik;Yu, Dong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.2
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    • pp.143-148
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    • 2013
  • Purpose: The aim of this study was to investigate the distribution of age and gender, types of intraocular lens (IOL), and refractive errors in subjects who had cataract surgery. Methods: 2,217 subjects who had cataract surgery were surveyed at an optometry clinic in Chungbuk from 2010 to 2012. Information about IOL was obtained from case history, reflective and retroillumination images IOL by auto refracto-keratometer. Refractive errors were determined by objective and subjective refraction. Results: The mean age of the subjects was $71.74{\pm}10.62$ years. The number of cataract surgeries increased from 524 persons in 2010 to 888 persons in 2012. Of the subjects surveyed, 52 persons (2.3%) were under the 40 years of age, 144 persons (6.5%) were in 50s, 404 persons (18.2%) were in 60s, 1,132 persons (51.1%) were in 70s, 485 persons (21.9%) were in above 80s. Cataract surgery was significantly prevalent in more female (1,338 persons, 60.4%) than in male (879 persons, 39.6%). Types of IOL were 2,141 persons (96.6%) for monofocal lens, special IOLs such as multifocal, accommodative and toric lens were 76 persons (3.4%). The distribution of refractive errors after cataract operation were 1,588 eyes (38.5%) for simple myopic astigmatism, 327 eyes (7.9%) for simple hyperopic astigmatism, 601 eyes (14.6%) for mixed astigmatism, 1,240 eyes (30.0%) for myopia, 136 eyes (3.3%) for hyperopia, and 234 eyes (5.7%) for emmetropia. The uncorrected and best corrected visual acuity of the subjects were $0.55{\pm}0.25$ and $0.80{\pm}0.23$, respectively. Conclusions: The prevalence of cataract surgery increased with age until 70s years of age, it was more prevalent in men than women over 60s, and frequency of special types of IOL were low. Most cataract surgeries left residual refractive errors. Therefore even after cataract surgery it may need spectacles for better vision at either distance or near.

Effect of Music Therapy on Vital Signs, Anxiety, Cortisol and Pain of Cataract Surgery Patients in Elderly (음악요법이 노인백내장 수술환자의 활력징후, 불안, 코티졸 및 통증에 미치는 효과)

  • Park, Jung-Hae;Park, Kwang-Hi
    • Journal of Digital Convergence
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    • v.13 no.8
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    • pp.549-558
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    • 2015
  • Purpose of this study was to investigate the effect of music therapy on vital signs, anxiety, cortisol, and pain of Cataract Surgery Patients in elderly. Non equivalent control group pre-post test design was adopted. The number of subjects consists of 41 elderly having cataract surgery, 21 in the experimental group and 20 in the control group. Data were analyzed by $x^2$ test, Fisher's exact test, independent sample t-test, and Mann-Whitney U test. Results were: 1) there was no difference between two groups in their vital signs changes 2) anxiety, cortisol in the saliva, and pain of the experimental group decreased more significantly than those of the control group. This study confirmed the ability of music therapy to relieve pain and anxiety in cataract surgery, and suggested that music therapy could be used effectively in various interventions for the elderly.

Refractive Error Shift in Nuclear, Cortical, and Subcapsular Cataract (핵, 피질 그리고 낭 백내장의 굴절이상 전환)

  • Park, Sang-Chul;Lee, Soek-Ju;Sung, A-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.8 no.1
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    • pp.41-45
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    • 2003
  • The researchers have studied on the effect of three main morphological types(nuclear, cortical, and subcapsular cataract) of age related cataract on refractive error. We also identified that spherical and cylinderical shift in each type of morphological cataract accoding to their locations and effect of intraocular pressure before and after cataract surgery. Nuclear cataract showed myopic shift while cortical cataract showed hyperopic shift, and subcapsular cataract showed not significant changes on both direction. Age related cataract subjects(120 eyes) only were recruited from sun-cheon area. We use optic section of slit lamp biomicroscope to identify the anatomical location of cataract, and optimal refractive correction determined by objective(retinoscope) and subjective refraction then spherical changes were calculated from the spherical eqivalent value. Intra-ocular pressure were measured by auto-tonometer before and 7 days after cataract has been replaced by IOL. The change in cylindrical power, usually A-P diameter decreased according to increases of age, A-P diameter increased because intra-ocular pressure rises by progression of cataract and this convertion with the rule astigmatism to against the rule astigmatism and this increases more by intra-ocular pressure.

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A Clinical Study of Ocular Dimention and Visual Acuity Before and After Cataract Surgery Over Ninety Years Old (90세 이상 초고령 환자들의 백내장 수술전.후 안수치와 시력에 관한 임상연구)

  • Lee, Jung-Mi;Kim, In-Suk;Shin, Jin-Ah
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.3
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    • pp.275-280
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    • 2010
  • Propose: Due to the rapid growth of medical technologies and the increasing population of older people, we investigated clinical status of ocular dimensions and visual acuity for pre and post cataract surgeries of people over age 90. Methods: From March 2007 to February 2009, we investigated eighty-two eyes of forty-eight patients who had undergone cataract surgeries at an ophthalmic clinic (Ansung, Kyungi-do), investigated maximum corrected vision, axial length, anterior chamber depth and accompanied ocular diseases before and after the surgeries based on the collected data. Results: As patients aged, axial length unchanged but anterior chamber depth decreased over all due to the increase of intraocular lens thickness, and men tended to have a higher degree than women. Seventy-one (86.6%) of eighty-two eyes showed improved corrected vision than before surgeries and forty-three (52.4%) eyes could see more than visual acuity of 0.5. Conclusions: Patients with the systemic disease and accompanied ocular disease showed low vision less than 0.5 after cataract surgery compared to same healthy age peoples. But the others improved correction visual acuity more than 0.5, so the cataract surgery was surely necessary for people over 90 years old and also the presence of ocular disease could have a great influence on correction visual acuity.

A Study on the Difference of Cataract Surgery Prognosis between Adult Diseases and Non-adult Diseases (성인병 여부에 따른 백내장 수술 효과의 차이 연구)

  • Cho, Seon-Ahr
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.275-280
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    • 2016
  • Purpose: This study is intended to look into the difference in surgery effects through the analysis of risk factors on how the common adult diseases among Korean adults diseases (glaucoma, hypertension and diabetes) are affecting cataract. Methods: Cataract surgery patients' daily records at hospitals in Jeonnam were used as analysis data. Factors - which can affect the results of medical treatment before and after an operation - were classified into the input, process and outcome of medical treatment. The medical treatment and patient characteristics were reflected as the input of medical treatment, and clinical results, functional status and general status as the process of medical treatment. Results: There was a close relationship between adult diseases of glaucoma, diabetes and hypertension, and cataract. Visual acuity of adult diseases patients was 10% lower than of non-adult diseases patients. And for post-surgery it was around 16% difference in refractive error and visual acuity between two groups. Conclusions: According to a study result, the cataract has been confirmed that there is a close relationship of Adult disease patients's glaucoma, diabetes and hypertension. Depending on the type about these adult diseases, before and after cataract surgery, vision and refractive power was found to indicate a significant difference when compared with conventional low normal adult control.

Analysis of Refractive Errors of the before and after Cataract Surgery by Auto-refractor (안굴절계를 이용한 백내장 수술전후의 굴절이상 분석)

  • Oh, Hyun-Jin;Jung, Mi-A
    • Journal of Convergence Society for SMB
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    • v.6 no.3
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    • pp.65-69
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    • 2016
  • We investigated refractive errors and corneal power with 3 factors such as M, $J_0$, and $J_{45}$ as power vector to find out the changes of refractive errors of the before and after cataract surgery in 119 adults aged 45~85 years with cataract. After the surgery, the 3 factors were changed as $-0.29{\pm}2.38D$ to $-0.18{\pm}0.69D$ in spherical equivalent power which is the M factor, $-0.34{\pm}0.68D$ to $-0.05{\pm}0.42D$ in the $J_0$ factor, and $0.11{\pm}0.45$ to $0.02{\pm}0.17$ in the $J_{45}$ factor. Before and after the surgery, corneal mean refractive power, $J_0$, and $J_{45}$ were changed from $44.11{\pm}1.61D$ to $44.20{\pm}1.58D$, $0.01{\pm}0.50D$ to $0.08{\pm}0.49D$, and $0.02{\pm}0.29$ to $0.08{\pm}0.49$, respectively. The results showed that $J_0$ was the highest relativeness in correlation of the pre- and post-surgery for refractive errors, mean corneal power was the highest correlation for corneal power factor, and corneal power factor was the higher correlation much more than refractive error factor.

Refractive Error Induced by Combined Phacotrabeculectomy (섬유주절제술과 백내장 병합수술 후 굴절력 오차의 분석)

  • Lee, Jun Seok;Lee, Chong Eun;Park, Ji Hae;Seo, Sam;Lee, Kyoo Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1173-1180
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    • 2018
  • Purpose: We evaluated the postoperative accuracy of intraocular lens power prediction for patients undergoing phacotrabeculectomy and identified preoperative factors associated with refractive outcome in those with primary open-angle glaucoma (POAG). Methods: We retrospectively reviewed the medical records of 27 patients who underwent phacotrabeculectomy to treat POAG. We recorded all discrepancies between predicted and actual postoperative refractions. We compared the data to those of an age- and sex-matched control group that underwent uncomplicated cataract surgery during the same time period. Preoperative factors associated with the mean absolute error (MAE) were identified via multivariate regression analyses. Results: The mean refractive error of the 27 eyes that underwent phacotrabeculectomy was comparable to that of the 27 eyes treated via phacoemulsification (+0.02 vs. -0.01 D, p = 0.802). The phacotrabeculectomy group exhibited a significantly higher MAE (0.65 vs. 0.35 D, p = 0.035) and more postoperative astigmatism (-1.07 vs. -0.66 D, p = 0.020) than the phacoemulsification group. The preoperative anterior chamber depth (ACD) and the changes in the postoperative intraocular pressure (IOP) were significantly associated with a greater MAE after phacotrabeculectomy. Conclusions: POAG treatment via combined phacoemulsification/trabeculectomy was associated with greater error in terms of final refraction prediction, and more postoperative astigmatism. As both a shallow preoperative ACD and a greater postoperative change in IOP appear to increase the predictive error, these two factors should be considered when planning phacotrabeculectomy.