• Journal of Korean Ophthalmic Optics Society
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• v.18 no.2
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• pp.197-202
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• 2013

Purpose: This research was performed to measure and analyze scotopic pupil size in myopes and to figure out the factors that influence it. Methods: The pupil size of 191 healthy myopic subjects were measured with the pupillometer (Colvard pupillometer, OASIS medical, USA) in scotopic and analyzed with the age, corneal size, spherical equivalent refractive error, corneal curvature. In addition, it was compared with the measurements of intra-examiner and inter-examiner to verify reproducibility of pupillometer. Results: The mean (${\pm}$SD) scotopic pupil size was $6.64{\pm}0.68$ mm (range, 5.00~8.00 mm), the lower age and the larger corneal size, The bigger the pupil size. The lower spherical equivalent refractive error and steepper corneal curvature tends to be smaller. The reproducibility of intra-examiner and inter-examiner in pupillometer showed the reliability highly (Guttman splithalf point > 0.91). Conclusions: The pupil size associated with age, corneal size, spherical equivalent refractive error and corneal curvature in scotopic condition. It can refer to prevent inconvenience that may occur RGP contact lenses, cataract surgery and refractive surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3643-3646
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• 2016

Management of eyelid cancers is based on surgery and/or radiotherapy (RT). The treatment objective is to control tumors with acceptable functional and esthetic outcomes. The aim of this study was to evaluate the results of radiation therapy in management of epithelial eyelid cancers, reviewing retrospectively the clinical records of patients treated in our institution from January 1989 to December 2013. We focused on clinical and histological features, treatment characteristics, tolerance and disease control. One hundred and eight patients (62 men and 46 women) were enrolled, with a mean age of 61 years [ranges 15-87]. The most frequent tumor location was the inner canthus (42.6%). Median tumor size was 21 mm [ranges 4-70]. Histological type was basal cell carcinoma in 88 cases (81.5%), squamous cell carcinoma in 16 (14.8%) and sebaceous carcinoma in 4 (3.7%). Radiation therapy was exclusive in 67 cases (62%) and post-operative for positive or close margins in the remaining cases. Kilovoltage external beam radiotherapy (KVRT) was used in 63 patients (58.3%) and low-dose-rate interstitial brachytherapy in 37 (34.3%). Eight (7.4%) were treated with cobalt or with a combination of KVRT-cobalt, KVRT-electron beams, KVRT-brachytherapy or cobalt-electron beams. The total delivered radiation doses were 70 Gy (2 Gy/fraction) in 62 patients (57.4%), 66 Gy (2 Gy/fraction) in 37 (34.3%) and 61.2 Gy (3.4Gy/fraction) in 9 (8.3%). After a median follow-up of 64 months, we noted 10 cases of local recurrences(9.2%): 7 after exclusive and 3 after post-operative RT. No local recurrence occurred in patients treated with brachytherapy. Actuarial 5-year local recurrence-free rate, disease-free survival and overall survival were respectively 90%, 90% and 97%. T-stage was found to be a significant factor for recurrence (p=0.047). All acute radiation-related reactions were scored grade I or II. Delayed effects were eye watering in 24 cases (22.2%), eye dryness in 19 (17.6%), unilateral cataract in 7 (6.4%) and ectropion in 4 (3.7%). Radiation therapy and especially brachytherapy is an efficient treatment of eyelid cancers, allowing eye conservation and functional preservation with good local control rates and acceptable toxicity.

• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.400-411
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• 1993

The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.3
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• pp.65-73
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• 2009

Purpose: This study was conducted to investigate the changes in distance refractive power and reading addition that occur after wearing corrective glasses for prebyopia. Methods: The subjects aged 42 to 75 years who had no ophthalmologic diseases and did not undergo cataract or retina surgery, had a corrected visual acuity of 20/20 and did not have a previous history of wearing corrective glasses for presbyopia. These subjects were divided into 3 groups: the control, reading spectacles and multifocals wearing group and they were measured for distance refractive power and reading addition at their visit. The maximum follow-up period was 73 months. Results: As for distance refractive power, the power tends to shift to hyperopia depending on age (r=0.486, p<.001) and 50.0% of the subjects increased plus power during this study period. Plus power Increments per year in distance refractive power in the reading spectacle wearing group were significantly different with control and multifocals wearing group (p<.05). On the other hand, the multifocals wearing group's increments were not different with control. Increments in reading addition were also increased in the reading spectacles group than in the control and multifocals wearing groups (p<.05). Conclusions: The age related hyperopic shift could be occurred in the elderly people, routine refraction is mandatory. And reading spectacles could induce an age related hyperopic shift and the additional need for reading addition that the prescription of multifocals may reduce changes in distance refractive power and reading addition.

• 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.

• Journal of The Korean Ophthalmological Society
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• v.60 no.2
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• pp.126-134
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• 2019

Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1024-1029
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• 2018

Purpose: We examined aqueous humor levels of 25-hydroxyvitamin D (vitamin D) in patients with age-related macular degeneration to investigate possible relationships between aqueous humor vitamin D levels and clinical manifestations. Methods: Patients > 50 years of age, 52 eyes of 34 patients with age-related macular degeneration, and 23 eyes of 17 patients treated with cataract surgery without retinal disease, were examined for aqueous humor vitamin D levels and compared. The experimental group was divided into two groups according to the median value of aqueous humor vitamin D levels. We compared the clinical manifestations of macular degeneration in both groups and identified relationships between aqueous humor vitamin D levels and clinical features. Results: Vitamin D levels in the aqueous humor were significantly lower in the experimental group than in the control group (experimental, $10.03{\pm}10.1ng/mL$ vs. control group, $40.8{\pm}16.4ng/mL$; p < 0.001). Patients with high vitamin D levels in the macular degeneration group had a higher percentage of fibrovascular pigment epithelial detachments than those in the low grade group (high grade group, 65% vs. low grade group, 27%; p = 0.003). Multiple linear regression analysis showed a significant correlation between vitamin D levels and the total number of anti-vascular endothelial growth factor intravitreal injections within 6 months (standardize coefficient, ${\beta}=-0.336$). Conclusions: Patients with wet age-related macular degeneration had significantly lower vitamin D levels in the aqueous humor compared to control group subjects of similar ages. However, in patients with macular degeneration, low vitamin D levels were associated with a greater number of intravitreal injections, while higher levels of vitamin D may lead to more advanced forms of fibrovascular retinal pigment epithelium and related low vision. These relationships were not always constant, so further studies on the relationships between local vitamin D levels and ocular disorders are needed.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1017-1023
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• 2018

Purpose: A recently introduced phacoemulsification system, the WhiteStar $Signature^{(R)}$ PRO, has demonstrated improved nucleus followability and cutting efficiency via an improved pump regulator with a higher reaction response and an automatic occlusion sensing system. In this study, we compared various phacoemulsification parameters between the new system and an older version of the device. Methods: A total of 80 eyes of 68 patients with cataracts who had undergone phacoemulsification by a single surgeon were included in this study. Forty eyes of patients underwent phacoemulsification using the older $Signature^{(R)}$ system (WhiteStar); these patients were classified as the control group. Another 40 eyes of patients underwent phacoemulsification with the newer enhanced system, the WhiteStar $Signature^{(R)}$ PRO; these patients were assigned to the experimental group. During the operation, operative parameters, including the effective phaco time (parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds, EFX), ultrasound time (seconds [s]), effective phacoemulsification time (EPT, s), average phacoemulsification power (AVG, %), and balanced salt solution usage, were measured to determine the performance enhancement offered by the updated system. Central corneal thickness was measured before and after surgery to compare corneal edema. The relationships between the two groups were analyzed using an independent t-test. Results: The Signature $PRO^{(R)}$ system showed a lower EFX (p < 0.001), a shorter EPT (p < 0.001), and a smaller AVG (p < 0.001). Postoperative corneal thickness did not differ significantly between the two groups. Conclusions: Comparing the efficacy of the improved reaction speed of the device and automatic occlusion sensing system in performing phacoemulsification, the updated Signature $PRO^{(R)}$ system demonstrated superior followability and cutting efficiency regardless of nuclear cataract hardness.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.23 no.1
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• pp.25-30
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• 2023

Leigh syndrome is a rare progressive neurodegenerative mitochondrial disorder with clinical and genetic heterogeneity. Recently, balletic IARS2 variants have been identified in a number of patients presenting broad clinical phenotypes from Leigh and West syndrome to a rare syndrome CAGSSS characterized by cataracts, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, and skeletal dysplasia syndrome (OMIM#616007). We describe a child with Korean Leigh syndrome with urologic manifestations resulting from a compound heterozygote mutation in IARS2. A 5-year-old girl visited the emergency room with a complaint of abdominal pain accompanied by abdominal distension. Abdominal-pelvic CT showed a markedly distended urinary bladder without definite obstructive lesions. She was diagnosed with neurogenic bladder dysfunction based on a urodynamic study. She had global delayed development due to neurologic regression after 6 months of age and a history of bilateral cataract surgery at the age of 2 years. Her brain magnetic resonance imaging showed symmetrically increased signal intensities in the bilateral putamen and caudate nuclei with diffuse cerebral atrophy. No gene variants were identified through whole-mitochondrial genome analysis. Whole exome sequencing was performed for diagnosis, and compound heterozygous pathogenic variants were identified in IARS2: c.2446C>T (p. Arg816Ter) and c.2450G>A (p. Arg817His). To the best of our knowledge, this is the first case report of bladder dysfunction manifestation in a patient with IARS2-related Leigh syndrome. Thus, it broadens the clinical and genetic spectrum of IARS2-associated diseases.