Journal of Yeungnam Medical Science

Soon Cheol Cha

8 Articles

Limbal Lensectomy with or without Anterior Vitrectomy for the Management of Lens Subluxation.: Ju Hee Chang, Soon Cheol Cha; Yeungnam Univ J Med. 2007;24(2):243-251. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.243

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Abstract PDF: PURPOSE: This study was conducted to assess the surgical outcomes of limbal lensectomy with or without anterior vitrectomy for the management of lens subluxation. MATERIALS AND METHODS: The medical records of 20 consecutive patients (33 eyes) with lens subluxation who had undergone limbal lensectomy with or without anterior vitrectomy from February 1999 to January 2004 were retrospectively reviewed. RESULTS: All the patients, except one high axial myopic patient, were implanted with scleral sutured posterior chamber intraocular lens. We evaluated the preoperative, postoperative visual acuity and postoperative complications and compared the results in group I (limbal lensectomy with anterior vitrectomy, 27 eyes) to those in group II (limbal lensectomy without anterior vitrectomy, 6 eyes). The preoperative best-corrected visual acuity was 0.21 and postoperative best-corrected visual acuity was improved by 2 lines or more in all 27 eyes in group I, and in 5 eyes in group II (p>0.05). The most frequent postoperative complication was intraocular lens dislocation in four eyes (14.8%) in group I alone. No retinal detachment occurred in either group, even in patients with high myopia. CONCLUSION: Limbal lensectomy without anterior vitrectomy improved visual acuity similarly to limbal lensectomy with anterior vitrectomy without significant increase of postoperative complications. This results of this study suggest that anterior vitrectomy is not necessarily required for the management of lens subluxation.

Trabeculectomy Using Mitomycin C in Aphakic and Pseudophakic Eyes.: Jun hyuk Son, Soon Cheol Cha; Yeungnam Univ J Med. 2007;24(2):232-242. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.232

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Abstract PDF: BACKGROUND
The safety and efficacy of trabeculectomy with Mitomycin C (MMC) for surgical treatment in aphakic and pseudophaic eyes were retrospectively evaluated. MATERIALS AND METHODS: The authors reviewed 51 eyes of 45 patients who had been followed up for at least 6 months after trabeculectomy using MMC for aphakic and pseudophakic eyes. The success rate and complications were analyzed. The success criteria included intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as a postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. RESULTS: The average follow up period was 27.7 months and the intraocular pressure was controlled under 21 mmHg in 36 eyes of 51 (70.6%) after the procedure with or without medication for glaucoma. Using the Kaplan-Meier survival analysis, the cumulative success rate at the 3-, 6-, 12-, 24- and 36-month intervals were 98.0%, 94.1%, 91.9%, 83.4% and 75.5%, respectively. The complications observed were hyphema (4 eyes), serous choroidal detachment (4 eyes), hypotony (3 eyes), and endophthalmitis (1 eye). CONCLUSION: Trabeculectomy using Mitomycin C for the treatment of aphakic and pseudophaic eyes was safe and effective.

Surgical Management of Coexisting Glaucoma and Cataract.: Soon Cheol Cha; Yeungnam Univ J Med. 2004;21(1):12-22. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.12

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Abstract PDF: The management of coincident glaucoma and cataract is not only a common clinical challenge but also an important research topic in the ophthalmic surgical field. The purpose of this article is to compare the different surgical options on the basis of their achievable postoperative intraocular pressure (IOP) control, success rates, and complication rates reported in the related literature, and to give advice on how to manage typical situations of patients with both glaucoma and cataract. Main topics were focused on indications and rationale of 3 surgical options (only cataract surgery first and later trabeculectomy, only trabeculectomy first and later cataract surgery, or simultaneous combined surgery). Modern clear corneal cataract extraction techniques resulted in a modest intermediate-term reduction of IOP and has considerably improved the success rates of combined glaucoma and cataract surgery. It also enabled future trabeculectomy to be successfully performed at a later date if necessary. Trabeculectomy alone achieved better IOP regulation than phacotrabeculectomy (combined surgery), but subsequent cataract surgery may compromise preexisting filtering bleb. Combined surgery augmented with mitomycin C achieved a lower IOP than combined surgery alone but had a higher complication rate. In conclusion, the choice of the preferred surgical method should be determined according to the target pressure, the amount of glaucomatous damage, and the grade of visual disturbance caused by the cataract. Phacotrabeculectomy with adjunctive mitomycin C offers visual improvement and achieves the best IOP lowering of all types of combined glaucoma and cataract surgery currently used but is associated with potentially sight-threatening complications.

The Results and Prognostic Factors of Mitomycin C Trabeculectomy in Neovascular Glaucoma.: Yun Tae Kim, Soon Cheol Cha; Yeungnam Univ J Med. 2002;19(2):126-135. Published online December 31, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.2.126

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Abstract PDF: BACKGROUND
Neovascular glaucoma is common secondary glaucoma at high risk for failure of glaucoma filtering surgery. Recently, trabeculectomy with adjunctive mitomycin C trabeculectomy has been tried to improve the surgical success rate of conventional trabeculectomy. But, the long-term effects of mitomycin C trabeculectomy for neovascular glaucoma are unknown. Thus, we evaluated the long-term effects of mitomycin C trabeculectomy and its prognostic factors influencing the outcome. MATERIALS AND METHODS: Medical records of 62 eyes of 55 neovascular glaucoma who had undergone mitomycin C trabeculectomy were retrospectively reviewed. Surgical success was defined as intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. RESULTS: Postoperative success was obtained in 37 (60%) out of 62 eyes after mean follow- up period of 23.9+/-16.2 months. Using Kaplan-Meier survival analysis, cumulative success rate at the 6-, 12-, 24- and 36-month intervals were 85%, 71%, 57% and 52%, respectively. Success rate was greater in eyes with diabetic retinopathy than other causes(p=0.005) and in eyes with preoperative panretinal photocoagulation(PRP) than without PRP(p=0.015). However, Cox proportional hazard regression analysis revealed that preoperative PRP was not a significant risk factor for surgical failure. CONCLUSION: Prognosis of neovascular glaucoma caused by diabetic retinopathy was better than that caused by the other disorders following mitomycin C trabeculectomy. The author would suggest that mitomycin C trabeculectomy could be effective and relatively safe as the first procedure of choice before performing glaucoma drainage device implantation or cyclodestructive procedure.

Acute Phase Retinal Phototoxicity Induced by Blue Fluorescent Light.: Young Hoon Park, Soon Cheol Cha, Duk Kee Hahn; Yeungnam Univ J Med. 1995;12(1):75-83. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.75

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Abstract PDF: Even though phototherapy is an effective means of treating hyperbilirubinemia, adequate binocular shields are essential to prevent light hazard of retina during phototherapy. The phototherapy to young albino rabbits was performed under various conditions; exposured for 12, 24, and 48 hours, continuity or intermittence of irradiation, and use of shields. Although there was no definite pathologic change in indirect ophthalmoscopic examination, severe damage was seen at electron microscopic level. In all experimental groups, swelling and edema of photoreceptor were seen. at right after phototherapy. Futhermore, more severe damage was seen in case of intermittent irradiated group and prolong exposed group. In mydriatic eyes, severity of damage was similiar to non mydi iatic eyes, but area of retinal damage was more extensive than non-mydriatic eves.. In control group which was protected by binocular shields during phototherapy, no significant abnormality was found.

The Effect of Extracapsular Cataract Extraction and Posterior Chamber Lens Implantation on Intraocular Pressure.: Soon Cheol Cha, Kyoo Won Lee; Yeungnam Univ J Med. 1994;11(2):277-283. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.277

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Abstract PDF: We studied the change in intraocular pressure (IOP) in 15 consecutive cataract patients who underwent extracapsular cataract extraction and posterior chamber lens implantation between Feb. 1993 and Apr. 1993 to evaluate the effect of this surgery on postoperative IOP. To evaluate the clinical usefulness of non-contact tonometer, the intraocular pressures were measured with Kowa non-contact tonometer (TM-2000, Japan) as well as Goldmann applanation tonometer. There was a decrease in IOP of 3.4±2.9mmHg (p<0.001) 3 months after this surgery and the intraocular pressure differences between pseudophakic eyes and contralateral phakin eyes at 3 months postoperatively were 2.4±3.8mmHg (p<0.05). The correlation coefficient between non-contact tonometer and Goldmann tonometer was 0.8876 (p=0.001) in the postoperative 76 eyes. Therefore, out results suggest that extracapsular cataract extraction and posterior chamber lens implantation alone can be a useful surgical method in cataract patient with ocular hypertension, and non-contact tonometer was relatively accurate in measuring the postoperative intraocular pressure.

Cliniclal Experiences of Trabeculectomy with Mitomycin C.: Soon Cheol Cha; Yeungnam Univ J Med. 1994;11(1):55-62. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.55

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Abstract PDF: The use of intraoperative application of Mitomycin C at the filtration site has been known to improve the surgical outcome in glaucomatous eyes with high risk for failure of trabeculectomy. The author performed trabeculectomies with intraoperative Mitomycin C on 25 eyes of 20 patients with poor surgical prognosis to study the efficacy and safety of this technique in glaucomatous patients with high risk for failure of trabeculectomy. After the preparation of a scleral flap, 0.2mg/ml sulution of Mitomycin C was applied between Tenon's capsule and the sclera for 2 minutes. The exposed area was then irrigated with 200 ml of balanced salt solution. The follow-up period was from 1 to 7 months (mean 3.8 months). The mean preoperative intraocular pressure (IOP) was 38.6±6.6mmHg. The mean final postoperative IOP was 11.7±3.8mmHg. Twenty three (88%) of the 25 eyes were successfully controlled with the IOP of less than or equal to 20 mmHg wthout glaucoma medication. There were early postoperative complications of hyphema in 5 eyes (20%), shallow anterior chamber in 4 eyes(16%), punctate keratopathy in 3 eyes (12%), aqueous leaking from conjunctival wound in 2 eyes (8%), encapsulated bled in 1 eye (4%) and choroidal detachment in 1 eye (4%), and 4 eyes had long term hypotony lasting more than 2 months. Although Mitomycin C is simple to use and effective adjunct to trabeculectomy, further study will be needed to determine the mechanism of action, indication, dosage and optimal exposure time of Mitomycin C.

Clinical experience in marginal rotation.: Wha Sun Chung, Chae Ju Kim, Soon Cheol Cha; Yeungnam Univ J Med. 1992;9(1):23-28. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.23

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Abstract PDF: Fifty-four marginal rotation procedures for cicatrical entropion and marginal entropion were performed in twenty-eight patients (8 males, 20 females). The age ranged from 4 to 74 years old (meant 51.1 years old). After the follow up periods of 6 to 48 months, excellent correction of the eyelid margin and good cosmetic appearance were noticed in most cases, but nine cases combined with severe trichiasis showed recurred trichiasis requiring reoperation.

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