• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.2
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• pp.187-195
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• 2024

Perianeurysmal cysts are a rare and poorly understood finding in patients both with treated and untreated aneurysms. While the prior literature suggests that a minority of perianeurysmal cysts develop 1-4 years following endovascular aneurysm treatment, this updated review demonstrates that nearly half of perianeurysmal cysts were diagnosed following aneurysm coiling, with the other half diagnosed concurrently with an associated aneurysm prior to treatment. 64% of perianeurysmal cysts were surgically decompressed, with a 39% rate of recurrence requiring re-operation. We report a case of a 71-year-old woman who presented with vertigo and nausea and was found to have a 3.4 cm perianeurysmal cyst 20 years after initial endovascular coiling of a ruptured giant ophthalmic aneurysm. The cyst was treated with endoscopic fenestration followed by open fenestration upon recurrence. The case represents the longest latency from initial aneurysm treatment to cyst diagnosis reported in the literature and indicates that the diagnosis of perianeurysmal cyst should remain on the differential even decades after treatment. Based on a case discussion and updated literature review, this report highlights proposed etiologies of development and management strategies for a challenging lesion.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.253-260
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• 2014

Purpose: The present study was conducted to investigate whether near work with smartphone could induce the change of accommodative function. Methods: Total 63 subjects(26 male and 37 female) in their 20s were firstly examined their visual functions related to accommodation and uncorrected spherical equivalent power as the control. After that, the subjects were asked to read a book for 30 min and sequentially watch a movie on smartphone for the same time after 30 min-break under the indoor light or as it was in the reverse order to avoid time-ordered effect. Their accommodative functions, 1) accommodative amplitude, 2) accommodative facility, 3) relative positive/negative accommodation, and 4) accommodative lag and their uncorrected spherical equivalent power were examined again following each task and compared with the control values. Results: The monocular accommodative amplitude was significantly decreased after smartphone watching compared with it after reading. The monocular and binocular accommodative facilities were tended to reduce after smartphone watching and book reading but were not significantly different. Neither significant change in positive relative accommodation was determined after smartphone watching nor book reading. Negative relative accommodation after smartphone watching was almost unchanged unlike reading a book. The accommodative lag after smartphone work was significantly higher than after book reading. Conclusions: The near work with a smartphone for 30 min induced the change of some accommodative functions, which was significantly greater than when reading under the same working environment.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.153-162
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• 2014

Purpose: This study was assessed to investigate the change of subjective and/or objective symptoms and the light transmittance of lens caused by the use longer than recommended wearing time of daily disposable circle contact lenses (circle lens) in dry eyes. Methods: Three daily disposable circle lenses made of etafilcon A, hilafilcon B, and nelfilcon A were applied on 30 dry eyes with smaller tear volume than normal eyes in their twenties free from any eye diseases by when subjects complained any kind of discomfort. On the first and the last days of lens wearing, subjective discomfort, blinking rate, lens centration on corneal surface and visible light transmittance of lens were recorded at every case and compared. Results: The circle lens wearers complained subjective discomfort and quit the lens wearing when they wore the circle lens longer than 10 hours even though there were some difference according to the lens materials of daily disposable circle lens. However, around 20% of dry eyes could wear the circle lens made of non-ionic materials longer than 40 hours. Dry eyes showed most sensitive feeling of subjective discomfort against the circle lens made of etafilcon A among three different lens materials. On the last day of lens wearing, the representative subjective discomforts were irritation, stiffness, dryness and tiredness. When the subjects wore circle lens more than the recommended time, blinking rate was significantly increased about 20~30% regardless of lens materials when it compared with the values right after lens wearing. On the last day of lens wearing, the vertical direction of lens centration was shifted to pupil center however, its distribution in horizontal direction was wide compared with the distribution right after lens wearing. Especially, the centration of etafilcon A lens was unstable. Furthermore, the visible light transmittance of 3 different circle lenses in dry eyes has significantly been reduced around 15% averaged. Conclusions: From these results, it was known that the increase of dryness and stiffness caused by overusage of daily disposable circle lens induced excess irritation and decreased visible light transmittance and caused significant more blinking, which provoked lens decentration. It was also revealed that dry eyes showed sensitive reaction subjectively and objectively against the overusage of circle lens made of high water content/ionic lens material even there were some difference of the degree depending on the individual and the lens material. Thus, this research can be suggested as the basic reference for the education about some unexpected problems and the side effect caused by the wearing of circle lens in dry eyes.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.179-188
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• 2014

Purpose: The present study was aimed to investigate the cleaning efficacy of multi-purpose solutions containing different types and content of surfactants and their effect on the visible light transmittance of soft lens. Methods: Soft lenses made of different materials (etafilcon A and hilafilcon B) were deposited tear proteins by using the artificial tear and then compared the resulting cleaning efficacy and visible light transmittance after cleaning the lens with 6 types of multi-purpose solutions containing different content of surfactants. Results: The cleaning efficacy of multi-purpose solutions was variously shown as approximately 23~43% according to the active concentration of surfactants and surface tension in multi-purpose solution when etafilcon A lens cleaned with rubbing. The highest cleaning efficacy was detected when cleaned with the multi-purpose solution containing hydrogen peroxide besides surfactant however, the amount of remaining protein was still high on the lens. After washed with multi-purpose solution, the visible light transmittance of lens was in 89.8 to 90.8%. The amount of protein deposited on hilafilcon B lens was very small compared with it on etafilcon A lens even though it was incubated in artificial tears for 7 days, which showed 5~10% of protein amount in etafilcon A lens and the decrease of visible light transmittance was also not significant. In case of rubbing with multi-purpose solution, the cleaning efficacy on hilafilcon B lens was in 45.4 to 67.4% however, the order of cleaning efficacy of multi-purpose solution was different from it on etafilcon A lens. The visible light transmittance of hilafilcon B lens has been restored to the level of new lens. Conclusions: From the result, it is concluded that the appropriate multi-purpose solution should be selected according to the lens material and the amount of protein deposit on the basis of understanding surfactants and active principle for proper care of protein deposit on soft lens and the cleaning with rubbing is more efficient for lens care regardless of manufacturer's guideline.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.199-206
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• 2014

Purpose: The present study was aimed to investigate the correlation between higher-order aberration and myopic degree by the analysis of fluctuation of high-order aberration according to the change of myopic degree in certain ranges of myopia and astigmatism. Methods: The high-order aberration in a total of 992 eyes was analyzed by using a LADARWave device employing Hartmann-Shack system, and the relation between high-order aberration and myopia by the change of myopic degree through manifest refraction test. Results: In all subjects, spherical aberration and total coma aberration were significantly increased by the increase of myopic degree, however, trefoil aberration and astigmatic aberration and tetrafoil aberration were decreased. With the group of lower myopic degree, the change of coma aberration was greater by myopic degree and its change was significantly different. The change of spherical aberration by myopic degree was greatly large in the a group of -3.00 D or more and the group of -6.00 D or more where as its change was not large in the group of lower than -3.00 D. The significant decrease of coma aberration was observed only in the group of astigmatic degree of -1.00 D or less when analyzing the correlation between the higher-order aberrations and myopia in the certain groups of astigmatic degree. In the case of spherical aberration, the significant change was shown in all astigmatic groups, however, its increase was larger with the increase of myopic degree in lower degree of astigmatism. The consistent relationship in variations of horizontal and vertical coma aberration in certain myopic and astigmatic groups was neither established nor statistically significant. Conclusions: It is concluded that the correlation between the higher-order aberration and low-order aberration obtained from the results of the present study can help the understanding related to vision quality and the improvement of vision quality.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.217-224
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• 2014

Purpose: This study was conducted to compare and analyze the accommodative system (accommodative response and accommodative lag) according to the material and font size of near visual media that we often encounter in daily life. Methods: Forty adult men and women aged 20 to 30 who not had specific ocular diseases and refractive surgery experience were examined to measure and compare the accommodative response according to the material of near visual media (print paper, newspaper, magazine, the I-Phone, LCD monitor) and font size (6, 8, 10, 12) by using both eyes open-view auto-refractometer. Results: The accommodative stimulus was $2.28{\pm}0.11D$ and the accommodative response was $1.66{\pm}0.30D$. The accommodative lag namely the difference between accommodative stimulus and accommodative response was $0.62{\pm}0.28D$. The accommodative response according to material of visual media using LCD monitor was $1.35{\pm}0.26D$ (p=0.00) and using the I-Phone was $1.55{\pm}0.25D$ (p=0.04). Both of them were statistically significant lower. The accommodative lag using LCD monitor was $0.93{\pm}0.24D$ (p=0.00) and using the I-Phone was $0.73{\pm}0.25D$ (p=0.04) and they were statistically significant higher. The accommodative response and accommodative lag according to font size were not statistically significant (p>0.05). Conclusions: During near working, the accommodative system was more affected by material than font size of visual media. Especially, visual media of non-luminous material (print paper, newspaper, magazine) are considered fewer burdens on eyes than luminous material (I-Phone, LCD monitor) in terms of accommodative system.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.417-423
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• 2011

Purpose: This study was to investigate that near gradient AC/A ratio could be used to prescribe a patient with distance exophoria, we compared the difference between distance gradient AC/A ratio and near gradient AC/A ratio. Also, this thesis was to understand the relationship between calculated AC/A ratio and gradient AC/A ratio. Methods: Objective and subjective refractive error were corrected and we used Howell (3 m) chart for distance phoria tests and Howell-Kim (40 cm) chart for near phoria tests. The near gradient AC/A ratio and calculated AC/A ratio were used by Howell-Kim (40 cm) combined with +1.00 D, -1.00 D, +2.00 D and -2.00 D. Results: The average value of distance exophoria was 1.17${\pm}$1.17 $\Delta$, and the average value of near exophoria was 3.71${\pm}$2.80 $\Delta$ (t-test. p<0.001). The correlation of distance phoria with near phoria was little higher (r = 0.59, p < 0.001). Gradient AC/A ratios depending on measuring distance and stimulus were higher (r = 0.11~0.53. P < 0.001), when distance was shorter and stimulus to accommodation was more. Also, stimulus to accommodation by plus lens was higher than stimulus to accommodation by minus lens (paired t-test. p < 0.001). There was negative correlation between calculated AC/A ratio and gradient AC/A ratio. As the calculated AC/A ratio was higher, gradient AC/A ratio was lesser. Near gradient AC/A ratio was slightly higher than distance gradient AC/A ratio. Distance and near gradient AC/A ratio taken through the subjective -1.00 D were 1.30 $\Delta$/D and 1.68 $\Delta$/D(t-test. t=1.67, p < 0.001). Conclusions: There is negative correlation between calculated AC/A ratio and gradient AC/A ratio. Also, there is subtle difference between near gradient AC/A ratio and distance gradient AC/A ratio. Therefore, we need to measure distance gradient AC/A ratio when a practitioner prescribe glasses for a patient with distance exophoria.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.383-390
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• 2011

Purpose: The present study was conducted to investigate whether refractive powers of soft contact lenses were induced by the deposition of tear proteins when wearing soft contact lenses. Methods: The soft contact lenses (material: etafilcon A, hilafilcon A and comfilcon A) with refractive powers of -1.00 D, -3.00 D, -5.00 D and -7.00 D were incubated in artificial tear for 1 day, 3 days, 5 days, 7 days and 14 days, respectively. After incubation, their refractive powers were measured by wet cell method with an auto-lens meter and their protein deposited on the lenses was determined by the method of Lowry. Results: Among three types of soft contact lenses, the most protein deposition was detected in ionic etafilcon A lens material and significant change of its refractive power was manifested. In other words, refractive powers of etafilcon A lenses firstly decreased after 1 day incubation in artificial tear and then gradually increased with increasing incubation period again. The observed change in refractive powers of all diopters of etafilcon A material was beyond the scope of standard error and bigger in the lens with lower optical power. On the other hand, non-ionic hilafilcon A showed less protein deposition as much as about 20% in etafilacon A and statistically significant increase of refractive powers with increasing incubation period in artificial tear. The change in refractive power of hilafilcon A was also beyond the scope of the standard of error when incubating in artificial tear and greater in the lens with lower diopter. The least protein deposit was shown in silicone hydrogel lens material, comfilcon A as approximately 10% of it in etafilcon A, indicating less change in refractive power within the standard range of error. Conclusions: The large change of refractive powers that was beyond the scope of standard error by the deposition of tear proteins on soft contact lenses was differently detected depending on lens materials in the current study. Thus, the deposition of tear proteins induced by longer period of lens wearing may be one of the causes that induces blurred vision, suggesting that soft contact lens wearers with the amount of tear proteins may need to choose proper lens material.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.391-401
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• 2011

Purpose: In the present study, the actual management state of trial contact lenses and lens care products in local optical shops was surveyed and analyzed to reduce the risk of lens complication possibly induced by neglecting lens care. Methods: The feeling of contact lens wearers during the wear of trial contact lenses was surveyed. Futhermore, the actual management state of trial contact lenses such as cosmetic lens and RGP lens and lens care products was also investigated by surveying opticians who trade contact lenses in local optical shops. Results: It was found that consumers trusted the sanitary conditions of the lens since trial cosmetic contact lens and RGP lens were cleaned before and after trails by over 98% of opticians in local optical shops. For trial cosmetic lens, cleaning with normal saline, multipurpose solution for soft lens and combination of saline and multipurpose solution were 38.5%, 40.5% and 21%, respectively, before trials. After trials, cosmetic lenses were cleaned with normal saline, multipurpose solution for soft lens and a combination of saline and multipurpose solution were 13%, 75%, and 12%, respectively. On the other hand, cleaning with normal saline, multipurpose solution for RGP lens and combination of saline and multipurpose solution were 28.5%, 38.5% and 33%, respectively, before trying trial RGP lens. After trials, RGP lenses were cleaned with normal saline, multipurpose solution for RGP lens and a combination of saline and multipurpose solution were 2.5%, 70%, and 27.5%, respectively, indicating that relatively many opticians followed the lens cleaning regimen. In local optical shops, the cleaning trial cosmetic lens was mainly conducted at every 10 days or a month and the washing cycle of cosmetic lens case was in a month or 2~3 months. The cleaning interval of trial RGP lens was primarily in a month or 2~3 months. For those lens cases, more than 75% of opticians washed them with a surfactant and then rinsed with cold water. The storing periods of lens care products were primarily in a week for saline and in a month and 2~3 months indicating that storing period of lens care products was relatively well-kept in local optical shops. Conclusions: It is thought that the concern about any microbial infection is not that high since trial contact lenses and lens care products were generally well-managed by opticians in local optical shops from the results above. However, better public eye health and better public confidence in opticians may be possible if further strengthen in avoidance of lens cleaning with saline, keep of cleaning cycles within 2 weeks and rinsing of lens cases with hot water happens.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.2
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• pp.15-26
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• 2009

Purpose: To compare and analyze the ocular changes after wearing conventional and 2-weeks cosmetic tinted contact lens, which were made of different material and fabrication method. Methods: Thirty five university students, age of twenties, participated in this study. With daily wearing schedule, they had worn temporary cosmetic tinted lens for 2 weeks and conventional tinted lens for two month in their right and left eye, respectively. Subjective symptoms and objective signs were graded by using CCLRU scales and corneal thickness were measured after 1 day and 2 months wearing, and under or over 5 hours wearing in a day, respectively. Results: Major subjective symptoms found in the student wearing cosmetic tinted contact lens for a 1 day and 2 months were dryness, redness, foreign body sensation and itchiness. It was also found that those symptoms were more severe in left eye (conventional cosmetic tinted contact lens) than right eye (2-weeks cosmetic tinted contact lens). However, symptoms of redness in both eyes showed statistically significant difference in the case of 1 day and 2 months wearing and under or over 5 hours wearing in a day (p=0.000). After 2 months wearing, left eye with conventional cosmetic tinted contact lens showed limbal redness (p=0.000) and bulbar conjunctival redness (p=0.012) with statistically significance, whereas there was no significant difference in both eyes before lens wear. Left eye showed statistically significant changes in all objective signs, but right eye showed palpebral conjunctival redness, corneal staining and conjunctival staining. Therefore, it was concluded that conventional cosmetic tinted contact lens may be more effective on ocular changes after wearing of lens. A statistically significant changes in both eyes after wearing lens were found that corneal thickness increased about $5{\mu}m$ (p=0.001) in right eye whereas $7{\mu}m$ (p=0.004) in left eye. Conclusions: A statistically significant number of participants in this study preferred to wearing of high Dk/t temporary cosmetic tinted contact lens made by sandwich method which resulted in less ocular changes and may give more healthy and safe ocular conditions.