• Title/Summary/Keyword: lens surgery

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Double-Pass System (Optical Quality Analysis System) for Analysis of the Multifocal Function of a Diffractive Multifocal Intraocular Lens (Acrysof ReSTOR®) Compared to a Monofocal Intraocular Lens (Acrysof IQ®)

  • Hwang, Ho Sik;Shin, Hye Young;Joo, Choun-Ki
    • Journal of the Optical Society of Korea
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    • v.18 no.2
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    • pp.110-117
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    • 2014
  • In this study, we objectively determined whether the ReSTOR as a multifocal IOL (intraocular lens) has a multifocal function compared to the IQ as a monofocal IOL in vivo by OQAS (Optical Quality Analysis System). Eighteen patients who had cataract surgery with implantation of ReSTOR (27 eyes) and 15 patients with IQ (21 eyes), were included inthis study. Uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UCNVA)and distance corrected near visual acuity (DCNVA) were measured. After setting the artificial pupil size to 3 mm, we performed 'Optical quality'. We inputted defocus diopters of (objective spherical refraction)(far), (objective spherical refraction-1.25 D)(intermediate),(objective spherical refraction-2.5 D)(near), and (objective spherical refraction-3.5 D)(very near) into 'selected spherical refraction' simulating the optical quality at far, intermediate, and near distance. We changed the pupil size to 5 mm and repeated the same measurements. The UCDVA and CDVA did not show significant differences between the 2 groups. But, the UCNVA and DCNVA of the ReSTOR group were better than those of the IQ group (p=0.000, p=0.000). For 3 mm pupil, at far distance, modulation transfer function (MTF) cut off and point spread function (PSF) width at 50% of ReSTOR were worse than those of IQ (p=0.039, p=0.020). At intermediate distance, MTF cut off, Strehl ratio and PSF width at 50% of ReSTOR were worse than those of IQ (p=0.001, p=0.001, p=0.000). At near distance, MTF cut off of ReSTOR was worse than that of IQ (p=0.033). At very near distance, MTF cut off and Strehl ratio of ReSTOR were worse than those of IQ (p=0.002, p=0.002), but PSF width at 50% of ReSTOR was better than that of IQ. For 5 mm pupil, most parameters at each distance, there was no significant difference between the 2 groups. Only PSF width at 50% of ReSTOR were worse than those of IQ at intermediate distance (p=0.013). It was impossible to show the multifocal function of ReSTOR compared to the IQ byOQAS.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

The Change of Medical Care Pattern and Cost of Cataract Surgery by the DRG Payment System in a General Hospital (한 종합병원의 포괄수가제 실시 전후 수정체수술환자의 의료서비스 및 진료비 비교분석)

  • Lee, Mi-Rim;Lee, Yong-Hwan;Koh, Kwang-Wook
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.48-70
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    • 2005
  • The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

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Registration of 3D CT Data to 2D Endoscopic Image using a Gradient Mutual Information based Viewpoint Matching for Image-Guided Medialization Laryngoplasty

  • Yim, Yeny;Wakid, Mike;Kirmizibayrak, Can;Bielamowicz, Steven;Hahn, James
    • Journal of Computing Science and Engineering
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    • v.4 no.4
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    • pp.368-387
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    • 2010
  • We propose a novel method for the registration of 3D CT scans to 2D endoscopic images during the image-guided medialization laryngoplasty. This study aims to allow the surgeon to find the precise configuration of the implant and place it into the desired location by employing accurate registration methods of the 3D CT data to intra-operative patient and interactive visualization tools for the registered images. In this study, the proposed registration methods enable the surgeon to compare the outcome of the procedure to the pre-planned shape by matching the vocal folds in the CT rendered images to the endoscopic images. The 3D image fusion provides an interactive and intuitive guidance for surgeon by visualizing a combined and correlated relationship of the multiple imaging modalities. The 3D Magic Lens helps to effectively visualize laryngeal anatomical structures by applying different transparencies and transfer functions to the region of interest. The preliminary results of the study demonstrated that the proposed method can be readily extended for image-guided surgery of real patients.

A Study of the Retina Image Controllability using a Sledge (망막 영상 조절 장치에 관한 연구)

  • 이숙희;이영춘;양연식
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 1997.10a
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    • pp.273-276
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    • 1997
  • Seeing is an intelligent act. Retina is the most important part among the components of eye which is comprised of iris, pupil, lens, optic disk, and so forth. Because retina acts like a photo receiver to detect light from every object, if damaged, animals have a severe problem to live along with themselves and sometimes they lose their sight. In the ophthalmology, doctors use special instrument to see exact retina image of object and operate the surgery by rotating focus control knob. In this study, a basic test is done to achieve the auto focus control instrument. Specially made sledge and attenuator are installed on the optic bed to change the distance and laser power between the first reflective mirror and the second one. Control panel which is compiled by Visual C t t to control stepping motors ,laser power and photodiode are implemented with ADA-board.

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Simulation of the Through-Focus Modulation Transfer Functions According to the Change of Spherical Aberration in Pseudophakic Eyes

  • Kim, Jae-hyung;Kim, Myoung Joon;Yoon, Geunyoung;Kim, Jae Yong;Tchah, Hungwon
    • Journal of the Optical Society of Korea
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    • v.19 no.4
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    • pp.403-408
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    • 2015
  • To evaluate the effects of spherical aberration (SA) correction on optical quality in pseudophakic eyes, we simulated the optical quality of the human eye by computation of the modulation transfer function (MTF). We reviewed the medical records of patients who underwent cataract surgery in Asan Medical Center, retrospectively. A Zywave aberrometer was used to measure optical aberrations at 1-12 postoperative months in patients with AR40e intraocular lens implants. The MTF was calculated for a 5 mm pupil from measured wavefront aberrations. The area under the MTF curve (aMTF) was analyzed and the maximal aMTF was calculated while changing the SA ($-0.2{\sim}+0.2{\mu}m$) and the defocus (-2.0 ~ +2.0 D). Sixty-four eyes in 51 patients were examined. The maximal aMTF was $6.61{\pm}2.16$ at a defocus of $-0.25{\pm}0.66D$ with innate SA, and $7.64{\pm}2.63$ at a defocus of $0.08{\pm}0.53D$ when the SA was 0 (full correction of SA). With full SA correction, the aMTF increased in 47 eyes (73.4%; Group 1) and decreased in 17 eyes (26.6%; Group 2). There were statistically significant differences in Z(3, -1) (vertical coma; P = 0.01) and Z(4, 4) (tetrafoil; P = 0.04) between the groups. The maximal aMTF was obtained at an SA of $+0.01{\mu}m$ in Group 1 and an SA of $+0.13{\mu}m$ in Group 2. Optical quality can be improved by full correction of SA in most pseudophakic eyes. However, residual SA might provide benefits in eyes with significant radially asymmetric aberrations.

Effects of Various Laser Wavelengths and Power Densities on the Ocular Damage in Pigmented Rats

  • Chung, Phil-Sang;Shin, Jang-In;Chang, Moo-Hwan;Chang, So-Young;Kang, Jung-Wook;Hwang, Hee-Jun;Ahn, Jin-Chul
    • Biomedical Science Letters
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    • v.14 no.3
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    • pp.173-178
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    • 2008
  • With the widespread use of laser in medical and industrial settings, the incidence of laser injury to the ocular continues to grow among workers involved in handling lasers. The aim of this study is to compare ocular damages after irradiation with various laser wavelengths and power density. Ocular of pigmented rats was irradiated with $CO_2$ laser, 1064 nm Nd:YAG laser, and 532 nm diode laser. We observed damage of cornea, lens, and retina using slit lamp microscope and funduscopy. H&E staining of histopathology were applied to study the specimens. The higher exposure ($200mW/cm^2$, 10 sec) with $CO_2$ laser resulted in severe damage at the cornea. For the 1064 nm Nd:YAG laser, the higher exposure than $10mW/cm^2$ (10 sec) resulted in damage at the cornea and lens. Further, with the 532 nm diode laser, retinal lesions were induced when $10mW/cm^2$ (0.25 sec) was delivered to the eye. Theses results suggest that the ocular damages are different from various laser wavelength and power density.

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The Effects of Various Extracellular Matrices on Motility of Cultured MC3T3-E1 Cell (다양한 세포외기질이 배양 골아세포의 이동에 미치는 영향)

  • Park, Beyoung Yun;Seo, Sang Woo;Lee, Won Jai;Ryu, Chang Woo;Rah, Dong Kyun;Son, Hyun Joo;Park, Jong Chul
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.143-148
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    • 2005
  • Chemotactic migration of bone forming cell, osteoblast, is an important event during bone formation, bone remodeling, and fracture healing. Migration of cells is mediated by adhesion receptors, such as integrins, that link the cell to extracellular matrix ligands, type I collagen, fibronectin, laminin and depend on interaction between integrin and extracellular ligand. Our study was designed to investigate the effect of extracellular matrix like fibronectin, laminin, type I collagen on migration of osteoblast. Migration distance and speed of MC3T3-E1 cell on extracellular matrix-coated glass were measured for 24 hours using 0.01% type I collagen, 0.01% fibronectin, 100 microliter/ml laminin. The migration distance and speed of MC3T3-E1 cell was compared using a video-microscopy system. To determine migration speed, cells were viewed with a 4 phase- contrast lens and video recorded. Images were captured using a color CCD camera and saved in 8-bit full-color mode. The migration distance on 0.01% type I collagen or 0.01% fibronectin was longer than that on $100{\mu}l/ml$ laminin-coated glass. The migration speed on fibronectin-coated glass was 68 micrometer/hour which was fastest. The migration speed on type I collagen-coated glass was similar with that on fibronectin-coated glass. The latter two migration speeds were faster than that on no-coated glass. On the other hand, the average migration speed on laminin-coated glass was 37micrometer/hour and not different from that of control group. In conclusion, the extracelluar matrix ligands such as type I collagen and fibronectin seem to play an important role in cell migration. The type I collagen or fibronectin coated scaffold is more effective for migration of osteoblast in tissue engineering process.

Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision (각막절개 위치와 크기에 따른 난시교정인공수정체의 난시교정의 정확성)

  • Park, Wookyung;Kim, Man Soo;Kim, Eun Chul
    • 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.

Comparison of Tear Distributions by the Corneal Eccentricity when Fitted with Spherical and Aspherical RGP Lenses (구면 및 비구면 RGP렌즈 피팅 시 각막 이심률별 눈물분포 비교)

  • Kim, Jihye;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.2
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    • pp.99-108
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    • 2016
  • Purpose: The present study was aimed to compare the tear volume and distribution by corneal eccentricity when fitted with spherical and aspherical RGP lenses. Methods: Spherical and aspherical RGP lenses were fitted in best alignment on a total of 77 subjects (136 eyes) in their twenties and thirties without any ocular disease or ocular surgery experience. The tear volume was analyzed by estimating the concentration of tear stained with fluorescein in the center of RGP lens as well as at the mid-peripheral and peripheral areas, and the difference of tear distributions was analyzed according to corneal eccentricity. Results: Tear distribution from the center to the peripheral area was not significantly different when spherical RGP lenses were fitted on the corneal eccentricities of e < 0.38 and $0.68{\leq}e$, indicating the relatively even tear distribution compared with other corneal eccentricity. In the case of aspherical RGP lenses, the difference of tear distribution between the central and peripheral areas was smaller than spherical RGP lenses. The significant difference of tear distribution according to RGP lens design was observed in the corneal eccentricity of 0.48 < e < 0.68. In other words, more even tear distribution was shown when aspherical RGP lenses were fitted on the cornea with eccentricity of $0.48{\leq}e<0.68$ and spherical RGP lenses were fitted on the cornea with eccentricity $0.68{\leq}e$. Furthermore, tear volume in the mid-peripheral area increased with higher corneal eccentricity. Conclusions: The results suggest that the appropriate selection of RGP lens design according to corneal eccentricity is necessary since tear volume and distribution by the regions of spherical and aspherical lenses are affected by corneal eccentricity.