Purpose: To investigate the refractive accuracy of intraocular lens (IOL) power calculation for biometric formulas in phacovitrectomy.
Methods: This retrospective study included 357 eyes of 357 patients who underwent phacovitrectomy using four commonly available IOL power formulas: Hoffer Q (87 eyes), Holladay 1 (78 eyes), Holladay 2 (91 eyes), and SRK/T (101 eyes). The mean refractive error (ME) and the mean absolute refractive error (MAE) were calculated based on the predicted postoperative refraction error, and they were compared using analysis of variance test. Subjects were divided into high myopic eyes (axial length, ≥26 mm) and nonhigh myopic eyes (axial length, <26 mm).
Results: The ME and the MAE after phacovitrectomy did not show a significant difference among the four IOL power formulas (p = 0.546 and p = 0.495, respectively). There was no significant statistical difference in formulas when the eyes were grouped into high myopia and nonhigh myopia (ME: p = 0.526 and p = 0.482, respectively; MAE: p = 0.715 and p = 0.627, respectively). The ME showed myopic shift in all formulas regardless of IOL formula used. The ME showed greater myopic shift in high myopia group than nonhigh myopia group in all formulas.
Conclusions: Our study did not find evidence for superiority of any formula in phacovitrectomy. However, in phacovitrectomy, possible myopic shift should be considered for IOL power calculation. Especially, in phacovitrecotmy in patients with high myopia, more myopic shift should be considered when selecting IOL.
目的:探讨人工晶状体切除术中人工晶状体度数计算方法的屈光准确性。方法:采用四种常用的人工晶状体度数公式:Hoffer Q(87眼)、Holladay 1(78眼)、Holladay 2(91眼)和SRK/T(101眼)，对357例接受晶状体切除术的357眼进行回顾性研究。根据预测的术后屈光误差计算平均屈光不差(ME)和平均绝对屈光不差(MAE)，并采用方差分析检验进行比较。受试者分为高度近视眼(眼轴长度≥26 mm)和非高度近视眼(眼轴长度≤26 mm)。结果:晶状体切除术后的ME和MAE在4种IOL度数公式中差异无统计学意义(p = 0.546, p = 0.495)。高度近视组与非高度近视组的计算公式差异无统计学意义(ME: p = 0.526、p = 0.482;MAE: p = 0.715和p = 0.627)。无论采用何种人工晶状体配方，ME均显示近视偏移。在所有配方中，高度近视组的ME均比非高度近视组有更大的近视偏移。结论:我们的研究没有发现任何配方在晶状体切除术中的优越性。然而，在晶状体切除术中，在计算人工晶状体度数时应考虑可能的近视移位。尤其在高度近视患者的晶状体手术中，在选择人工晶状体时应考虑更多的近视偏移。
{"title":"Postoperative Refractive Outcomes of Biometric Formulas in Phacovitrectomy with Gas Tamponade.","authors":"Yu-Jin Choi, Donghyun Jee","doi":"10.3341/kjo.2023.0012","DOIUrl":"https://doi.org/10.3341/kjo.2023.0012","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the refractive accuracy of intraocular lens (IOL) power calculation for biometric formulas in phacovitrectomy.</p><p><strong>Methods: </strong>This retrospective study included 357 eyes of 357 patients who underwent phacovitrectomy using four commonly available IOL power formulas: Hoffer Q (87 eyes), Holladay 1 (78 eyes), Holladay 2 (91 eyes), and SRK/T (101 eyes). The mean refractive error (ME) and the mean absolute refractive error (MAE) were calculated based on the predicted postoperative refraction error, and they were compared using analysis of variance test. Subjects were divided into high myopic eyes (axial length, ≥26 mm) and nonhigh myopic eyes (axial length, <26 mm).</p><p><strong>Results: </strong>The ME and the MAE after phacovitrectomy did not show a significant difference among the four IOL power formulas (p = 0.546 and p = 0.495, respectively). There was no significant statistical difference in formulas when the eyes were grouped into high myopia and nonhigh myopia (ME: p = 0.526 and p = 0.482, respectively; MAE: p = 0.715 and p = 0.627, respectively). The ME showed myopic shift in all formulas regardless of IOL formula used. The ME showed greater myopic shift in high myopia group than nonhigh myopia group in all formulas.</p><p><strong>Conclusions: </strong>Our study did not find evidence for superiority of any formula in phacovitrectomy. However, in phacovitrectomy, possible myopic shift should be considered for IOL power calculation. Especially, in phacovitrecotmy in patients with high myopia, more myopic shift should be considered when selecting IOL.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 4","pages":"322-327"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/74/kjo-2023-0012.PMC10427902.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10372815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor, Ectopic lacrimal gland tissue is reported to be located at epibulbar conjunctiva, other locations including orbital, eyelid, intraocular, lacrimal sac, and nasal mucosa sites [1]. Although ectopic lacrimal glands in the ciliary body are quite rare, there have been more than 10 cases reported worldwide [2,3]. Although accompanying proptosis at the time of diagnosis has been frequently reported, studies on long-term follow-up outcomes and complications are limited. Herein, we report a single case of ectopic lacrimal gland on ciliary body, resulting in secondary glaucoma during 20 years of follow-up. Informed consent for publication of the research details and clinical images was obtained informed consent from the patient. A previously healthy 10-month-old female patient presented with right upper eyelid swelling and redness. And she was admitted to an emergency room in 2003. B-scan ultrasonography and orbit computed tomography demonstrated right orbital cellulitis and a round-shaped, 0.8-cm ciliary body mass. Fine needle aspiration and incisional biopsy were done, which revealed ectopic lacrimal gland tumor in histology. The size of residual mass gradually increased and there was no sign of malignant transformation during 17 years of follow-up period. The patient was transferred to the glaucoma clinic due to intermittent high intraocular pressure and corresponding ocular pain of the right eye once or twice a month in 2020. Thus, she started dorzolamide 2%/timolol maleate 0.5% fixed combination (Cosopt, Merck & Co Inc). No other abnormal findings were observed on slit-lamp examination. On January 10, 2021, she was admitted to an emergency room due to ocular pain and decreased vision in the right eye that started a day ago. Best-corrected visual acuity was 2 / 20 and intraocular pressure (IOP) measured by Goldman applanation tonometer was 44 mmHg. Slit-lamp examination showed corneal edema and moderate anterior chamber inflammation (cell grade from +2 to +3). Anterior chamber was deep enough and there was no peripheral angle closure. Pupil was fixed and fundus was normal in the right eye. The left eye was normal. Under the impression of secondary glaucoma associated with uveitis, she was treated with additional oral acetazolamide, topical prednisolone acetate 1% (Prednilone, Daewoo Pharm), brimonidine 0.15% (Alphagan–P, Allergan Inc) and intravenous mannitol injection. IOP was in the normal range after 3 days. Although she used Cosopt and Alphagan prophylactically, there were two more additional acute glaucoma attacks in 2021. Slit-lamp examination revealed new cystic lesion in superotemporal iris in March 2, 2022 (Fig. 1A). On July 6, 2022, the cystic lesion became larger than 4 months before (Fig. 1B), but there was no other abnormal sign such as increased IOP or anterior chamber inflammation. On July 29, 2022, she was admitted to emergency room with a third attack, presented with decreased visual acuity and 33 mmHg of IOP in the right
{"title":"Complication of Ectopic Lacrimal Gland Tumor on Long-term Follow-up: A Case Report.","authors":"Ji Youn Choi, Yoon Kyung Jang, Jong Chul Han","doi":"10.3341/kjo.2023.0035","DOIUrl":"https://doi.org/10.3341/kjo.2023.0035","url":null,"abstract":"Dear Editor, Ectopic lacrimal gland tissue is reported to be located at epibulbar conjunctiva, other locations including orbital, eyelid, intraocular, lacrimal sac, and nasal mucosa sites [1]. Although ectopic lacrimal glands in the ciliary body are quite rare, there have been more than 10 cases reported worldwide [2,3]. Although accompanying proptosis at the time of diagnosis has been frequently reported, studies on long-term follow-up outcomes and complications are limited. Herein, we report a single case of ectopic lacrimal gland on ciliary body, resulting in secondary glaucoma during 20 years of follow-up. Informed consent for publication of the research details and clinical images was obtained informed consent from the patient. A previously healthy 10-month-old female patient presented with right upper eyelid swelling and redness. And she was admitted to an emergency room in 2003. B-scan ultrasonography and orbit computed tomography demonstrated right orbital cellulitis and a round-shaped, 0.8-cm ciliary body mass. Fine needle aspiration and incisional biopsy were done, which revealed ectopic lacrimal gland tumor in histology. The size of residual mass gradually increased and there was no sign of malignant transformation during 17 years of follow-up period. The patient was transferred to the glaucoma clinic due to intermittent high intraocular pressure and corresponding ocular pain of the right eye once or twice a month in 2020. Thus, she started dorzolamide 2%/timolol maleate 0.5% fixed combination (Cosopt, Merck & Co Inc). No other abnormal findings were observed on slit-lamp examination. On January 10, 2021, she was admitted to an emergency room due to ocular pain and decreased vision in the right eye that started a day ago. Best-corrected visual acuity was 2 / 20 and intraocular pressure (IOP) measured by Goldman applanation tonometer was 44 mmHg. Slit-lamp examination showed corneal edema and moderate anterior chamber inflammation (cell grade from +2 to +3). Anterior chamber was deep enough and there was no peripheral angle closure. Pupil was fixed and fundus was normal in the right eye. The left eye was normal. Under the impression of secondary glaucoma associated with uveitis, she was treated with additional oral acetazolamide, topical prednisolone acetate 1% (Prednilone, Daewoo Pharm), brimonidine 0.15% (Alphagan–P, Allergan Inc) and intravenous mannitol injection. IOP was in the normal range after 3 days. Although she used Cosopt and Alphagan prophylactically, there were two more additional acute glaucoma attacks in 2021. Slit-lamp examination revealed new cystic lesion in superotemporal iris in March 2, 2022 (Fig. 1A). On July 6, 2022, the cystic lesion became larger than 4 months before (Fig. 1B), but there was no other abnormal sign such as increased IOP or anterior chamber inflammation. On July 29, 2022, she was admitted to emergency room with a third attack, presented with decreased visual acuity and 33 mmHg of IOP in the right","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 4","pages":"348-349"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/9e/kjo-2023-0035.PMC10427904.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10101547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sokheang Sin, Hyun Goo Kang, Christopher Seungkyu Lee
Dear Editor, The recent COVID-19 pandemic, caused by infection from the SARS-COV-2, has affected more than 328 million people and is responsible for more than 5 million deaths worldwide f rom 2019 to January 2022 [1]. COVID-19 patients may have a number of complex and varied coagulation abnormalities that induce a hypercoagulable state and provoke venous thromboembolism, a condition called COVID-19–associated coagulopathy [2]. In fact, COVD-19 appears to also affect the retina, with the most common retinal manifestations involving microvascular changes such as cotton wool spots and retinal microhemorrhages [3]. Thus, retinal vein occlusions (RVO) in COVID-19 patients can be associated with this hypercoagulable state. Herein, we report a case of central RVO (CRVO) in a young teenage girl with COVID-19. Written informed consent for publication of the research details and clinical images was obtained from the patient. A 13-year-old girl presented with decreased vision in her left eye for 13 days. Her past medical history was unremarkable, except for COVID-19 infection, with which she was diagnosed 16 days before the onset of ocular symptoms. Her best-corrected visual acuity was 20 / 25 in the right eye and 20 / 63 in the left eye. Her intraocular pressures were 20 and 17 mmHg in the right and left eyes, respectively. Anterior segment findings were within normal limits in both eyes. Fundus findings in her right eye was unremarkable. The left eye fundus showed multiple retinal hemorrhages with optic disc edema and dilated tortuous vessels in all quadrants (Fig. 1A). Optical coherence tomography (OCT) showed macula edema with subretinal f luid and a central foveal thickness of 397 μm (Fig. 1B). Fluorescein angiography showed marked delay in arteriovenous transit time and staining of the dilated tortuous veins (Fig. 1C, 1D). Based on these clinical findings, the patient was diagnosed with nonischemic CRVO, with possible association with COVID-19. A full diagnostic workup, including blood pressure measurement, complete blood count and hypercoagulability tests with peripheral blood smears, tests for homocysteine, anti-DNA, ELISA, anti–β 2 glycoprotein 1 (anti-β2GP1) immunoglobulin G (IgG), anti-β2GP1 IgM, anti–cyclic citrullinated peptide antibody, cholesterol, and anticardiolipin antibodies IgM and IgG, were unremarkable, except for positive antinuclear antibody. After 2 monthly intravitreal anti–vascular endothelial growth factor injections in the left eye, her visual acuity improved to 20 / 40 and OCT showed resolution of macula edema (Fig. 1E, 1F), with resolution of flame-shaped hemorrhage and decreased vascular tortuosity on fundus examination. CRVO typically occurs in elderlies and far less commonly in healthy teenagers. Our 13-year-old patient did not have major risk factors of CRVO, including diabetes mellitus, hypertension, hypercoagulability, atherosclerosis, and Received: November 15, 2022 Final revision: February 20, 2023 Accepted: February 2
{"title":"Central Retinal Vein Occlusion in a 13-Year-Old COVID-19 Patient: A Case Report.","authors":"Sokheang Sin, Hyun Goo Kang, Christopher Seungkyu Lee","doi":"10.3341/kjo.2022.0149","DOIUrl":"https://doi.org/10.3341/kjo.2022.0149","url":null,"abstract":"Dear Editor, The recent COVID-19 pandemic, caused by infection from the SARS-COV-2, has affected more than 328 million people and is responsible for more than 5 million deaths worldwide f rom 2019 to January 2022 [1]. COVID-19 patients may have a number of complex and varied coagulation abnormalities that induce a hypercoagulable state and provoke venous thromboembolism, a condition called COVID-19–associated coagulopathy [2]. In fact, COVD-19 appears to also affect the retina, with the most common retinal manifestations involving microvascular changes such as cotton wool spots and retinal microhemorrhages [3]. Thus, retinal vein occlusions (RVO) in COVID-19 patients can be associated with this hypercoagulable state. Herein, we report a case of central RVO (CRVO) in a young teenage girl with COVID-19. Written informed consent for publication of the research details and clinical images was obtained from the patient. A 13-year-old girl presented with decreased vision in her left eye for 13 days. Her past medical history was unremarkable, except for COVID-19 infection, with which she was diagnosed 16 days before the onset of ocular symptoms. Her best-corrected visual acuity was 20 / 25 in the right eye and 20 / 63 in the left eye. Her intraocular pressures were 20 and 17 mmHg in the right and left eyes, respectively. Anterior segment findings were within normal limits in both eyes. Fundus findings in her right eye was unremarkable. The left eye fundus showed multiple retinal hemorrhages with optic disc edema and dilated tortuous vessels in all quadrants (Fig. 1A). Optical coherence tomography (OCT) showed macula edema with subretinal f luid and a central foveal thickness of 397 μm (Fig. 1B). Fluorescein angiography showed marked delay in arteriovenous transit time and staining of the dilated tortuous veins (Fig. 1C, 1D). Based on these clinical findings, the patient was diagnosed with nonischemic CRVO, with possible association with COVID-19. A full diagnostic workup, including blood pressure measurement, complete blood count and hypercoagulability tests with peripheral blood smears, tests for homocysteine, anti-DNA, ELISA, anti–β 2 glycoprotein 1 (anti-β2GP1) immunoglobulin G (IgG), anti-β2GP1 IgM, anti–cyclic citrullinated peptide antibody, cholesterol, and anticardiolipin antibodies IgM and IgG, were unremarkable, except for positive antinuclear antibody. After 2 monthly intravitreal anti–vascular endothelial growth factor injections in the left eye, her visual acuity improved to 20 / 40 and OCT showed resolution of macula edema (Fig. 1E, 1F), with resolution of flame-shaped hemorrhage and decreased vascular tortuosity on fundus examination. CRVO typically occurs in elderlies and far less commonly in healthy teenagers. Our 13-year-old patient did not have major risk factors of CRVO, including diabetes mellitus, hypertension, hypercoagulability, atherosclerosis, and Received: November 15, 2022 Final revision: February 20, 2023 Accepted: February 2","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"270-272"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/8a/kjo-2022-0149.PMC10270778.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor, Double primary malignancies are relatively rare, occurring in only 0.18% of cancer patients, according to a study that analyzed 23,260 cancer patients who were registered to a regional cancer institute in India [1]. Double primary malignancies can be totally incidental, but it can also be relevant to note whether they share inherited, environmental, and iatrogenic risk factors. It has been reported that multiple myeloma (MM) patients show an increased incidence of squamous cell carcinoma (SCC) [2]. To the best of our knowledge, however, this is the first case report of conjunctival SCC in a MM patient. Written informed consent for publication of the research details and clinical images was obtained from the patient. A 69-year-old man with a past history of coronary artery occlusive disease, chronic kidney disease, and MM, was referred to the Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine (Seoul, Korea) for conjunctival mass in his left eye. About 1 year prior to his visit, he was diagnosed with MM at Severance Hospital, and went through nine cycles of a bortezomib-melphalan-prednisolone (VMP) regimen systemic chemotherapy. Upon the slit-lamp examination of his lef t eye, gray-whitish, gelatinous, well circumscribed, immobile, elevated 2 × 2-mm sized conjunctival mass was detected at the nasal perilimbal area (Fig. 1A). The morphologic findings and location suggested the impression of conjunctival intraepithelial neoplasia or SCC. Conjunctival mass excision with biopsy and local cryotherapy was done on July 1, 2020. The biopsy results confirmed the diagnosis of well differentiated type of SCC. Hematoxylin-eosin–stained sections presented with nests of atypical squamous cells (Fig. 1C, 1D). Postoperative orbital magnetic resonance imaging with contrast enhancement showed no residual tumor, and interferon alfa-2a 1 mIU/mL eye drops, made from Roferon-A prefilled injection (3 mIU/0.5 mL, Roche), were applied to his left eye four times a day for 1 month as an adjuvant chemotherapy. After this course, 0.04% mitomycin C (MMC) eye drops, diluted from MMC injection 10 mg (Korea United Pharm Inc) were used four times per day since, interferon alfa-2a became unavailable. After three cycles (one cycle meaning 2 weeks of use and 2 weeks of rest) of topical MMC chemotherapy, regular follow-ups were done for 2.5 years and no recurrence was noticed until the last follow-up on January 5, 2023 (Fig. 1B). The association between MM and nonmelanomatous skin cancer (NMSC) has been noticed relatively recently, since MM patients have begun to live longer with improved treatment techniques. Robinson et al. [2] designated MM diagnosis as one of the significant predictors of skin Received: December 28, 2022 Final revision: February 24, 2023 Accepted: March 15, 2023
{"title":"Second Primary Conjunctival Squamous Cell Carcinoma on Multiple Myeloma: A Case Report.","authors":"Woo Gyeong Jo, Ikhyun Jun","doi":"10.3341/kjo.2022.0165","DOIUrl":"https://doi.org/10.3341/kjo.2022.0165","url":null,"abstract":"Dear Editor, Double primary malignancies are relatively rare, occurring in only 0.18% of cancer patients, according to a study that analyzed 23,260 cancer patients who were registered to a regional cancer institute in India [1]. Double primary malignancies can be totally incidental, but it can also be relevant to note whether they share inherited, environmental, and iatrogenic risk factors. It has been reported that multiple myeloma (MM) patients show an increased incidence of squamous cell carcinoma (SCC) [2]. To the best of our knowledge, however, this is the first case report of conjunctival SCC in a MM patient. Written informed consent for publication of the research details and clinical images was obtained from the patient. A 69-year-old man with a past history of coronary artery occlusive disease, chronic kidney disease, and MM, was referred to the Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine (Seoul, Korea) for conjunctival mass in his left eye. About 1 year prior to his visit, he was diagnosed with MM at Severance Hospital, and went through nine cycles of a bortezomib-melphalan-prednisolone (VMP) regimen systemic chemotherapy. Upon the slit-lamp examination of his lef t eye, gray-whitish, gelatinous, well circumscribed, immobile, elevated 2 × 2-mm sized conjunctival mass was detected at the nasal perilimbal area (Fig. 1A). The morphologic findings and location suggested the impression of conjunctival intraepithelial neoplasia or SCC. Conjunctival mass excision with biopsy and local cryotherapy was done on July 1, 2020. The biopsy results confirmed the diagnosis of well differentiated type of SCC. Hematoxylin-eosin–stained sections presented with nests of atypical squamous cells (Fig. 1C, 1D). Postoperative orbital magnetic resonance imaging with contrast enhancement showed no residual tumor, and interferon alfa-2a 1 mIU/mL eye drops, made from Roferon-A prefilled injection (3 mIU/0.5 mL, Roche), were applied to his left eye four times a day for 1 month as an adjuvant chemotherapy. After this course, 0.04% mitomycin C (MMC) eye drops, diluted from MMC injection 10 mg (Korea United Pharm Inc) were used four times per day since, interferon alfa-2a became unavailable. After three cycles (one cycle meaning 2 weeks of use and 2 weeks of rest) of topical MMC chemotherapy, regular follow-ups were done for 2.5 years and no recurrence was noticed until the last follow-up on January 5, 2023 (Fig. 1B). The association between MM and nonmelanomatous skin cancer (NMSC) has been noticed relatively recently, since MM patients have begun to live longer with improved treatment techniques. Robinson et al. [2] designated MM diagnosis as one of the significant predictors of skin Received: December 28, 2022 Final revision: February 24, 2023 Accepted: March 15, 2023","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"275-277"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/f1/kjo-2022-0165.PMC10270781.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acupuncture is recognized as a component of alternative medicine and is increasingly used worldwide. Many studies have shown the various effects of acupuncture around the eyes for ophthalmologic or nonophthalmologic conditions. For ophthalmologic conditions, the effect of acupuncture on dry eye syndrome, glaucoma, myopia, amblyopia, ophthalmoplegia, allergic rhinoconjunctivitis, blepharospasm, and blepharoptosis has been reported. Recently, several studies on dry eye syndrome have been reported and are in the spotlight. However, given the variety of study designs and reported outcomes of periocular acupuncture, research is still inconclusive, and further studies are required. In addition, although a systematic and reliable safety assessment is required, to the best of our knowledge, there have been no reports of a literature review of ocular complications resulting from periocular acupuncture. This review collected cases of ocular injury as severe adverse events from previously published case reports of periocular acupuncture. A total of 14 case reports (15 eyes of 14 patients) of adverse events published between 1982 and 2020 were identified. This review article provides a summary of the reported cases and suggestions for the prevention and management of better visual function prognosis.
{"title":"Severe Adverse Events of Periocular Acupuncture: A Review of Cases.","authors":"Sang-Mok Lee, Jun Wu, Daniel Duck-Jin Hwang","doi":"10.3341/kjo.2022.0111","DOIUrl":"https://doi.org/10.3341/kjo.2022.0111","url":null,"abstract":"<p><p>Acupuncture is recognized as a component of alternative medicine and is increasingly used worldwide. Many studies have shown the various effects of acupuncture around the eyes for ophthalmologic or nonophthalmologic conditions. For ophthalmologic conditions, the effect of acupuncture on dry eye syndrome, glaucoma, myopia, amblyopia, ophthalmoplegia, allergic rhinoconjunctivitis, blepharospasm, and blepharoptosis has been reported. Recently, several studies on dry eye syndrome have been reported and are in the spotlight. However, given the variety of study designs and reported outcomes of periocular acupuncture, research is still inconclusive, and further studies are required. In addition, although a systematic and reliable safety assessment is required, to the best of our knowledge, there have been no reports of a literature review of ocular complications resulting from periocular acupuncture. This review collected cases of ocular injury as severe adverse events from previously published case reports of periocular acupuncture. A total of 14 case reports (15 eyes of 14 patients) of adverse events published between 1982 and 2020 were identified. This review article provides a summary of the reported cases and suggestions for the prevention and management of better visual function prognosis.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"255-265"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/5b/kjo-2022-0111.PMC10270772.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To evaluate and compare intraoperative pain during upper eyelid blepharoplasty (UEB) between on first and second operated eyelids.
Methods: In this cross-sectional observational study, the patients were divided into two groups, with group 1 representing 40 patients whose surgery was first started on the right and group 2 representing the other 40 patients who started surgery on the left first. UEB was performed to all patients by the same surgeon under the same and equal amount of local anesthesia. Degree of pain felt during surgery on first and second operated eyelid was evaluated with the visual analoge scale (VAS) and Wong-Baker Facial Pain Expression Scale (WBFPES) of all patients immediately after surgery and was compared using paired t-test.
Results: There were 20 female and 20 male patients in both groups. In group 1, the VAS value was 2.8 ± 1.5 and WBFPES value was 2.7 ± 1.6 UEB in the first operated eyelid; the VAS value was 4.1 ± 1.8 and WBFPES value was 3.9 ± 1.8 UEB in the second operated eyelid. A significant difference was found between pains felt during first and second operated eyelid UEB regarding VAS and WBFPES values in group 1 (p = 0.003 and p = 0.002, respectively). In group 2, the VAS value was 1.9 ± 1.0 and WBFPES value was 2.0 ± 1.0 UEB in the first operated eyelid; the VAS value was 3.0 ± 1.5 and WBFPES value was 2.8 ± 1.6 UEB in the second operated eyelid. A significant difference was found between pains felt during first operated and second operated eyelid UEB regarding VAS and WBFPES values in group 2 (p = 0.009 and p = 0.005, respectively).
Conclusions: To the best of our knowledge, this study is the first to evaluate which eyelid is more painful during surgery in UEB. Patients tend to feel more pain during surgery on the second operated eyelid. Therefore, surgeons should consider using local anesthetics with more volume or longer duration in the second operating eyelid in light of this information and patients should be given detailed information about pain.
{"title":"Comparison of Pain between First and Second Operated Eyelids after Upper Eyelid Blepharoplasty.","authors":"Mehmet Icoz, Bilge Tarım, Sule Gokcek Gurturk Icoz, Emine Kalkan Akcay","doi":"10.3341/kjo.2023.0011","DOIUrl":"https://doi.org/10.3341/kjo.2023.0011","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare intraoperative pain during upper eyelid blepharoplasty (UEB) between on first and second operated eyelids.</p><p><strong>Methods: </strong>In this cross-sectional observational study, the patients were divided into two groups, with group 1 representing 40 patients whose surgery was first started on the right and group 2 representing the other 40 patients who started surgery on the left first. UEB was performed to all patients by the same surgeon under the same and equal amount of local anesthesia. Degree of pain felt during surgery on first and second operated eyelid was evaluated with the visual analoge scale (VAS) and Wong-Baker Facial Pain Expression Scale (WBFPES) of all patients immediately after surgery and was compared using paired t-test.</p><p><strong>Results: </strong>There were 20 female and 20 male patients in both groups. In group 1, the VAS value was 2.8 ± 1.5 and WBFPES value was 2.7 ± 1.6 UEB in the first operated eyelid; the VAS value was 4.1 ± 1.8 and WBFPES value was 3.9 ± 1.8 UEB in the second operated eyelid. A significant difference was found between pains felt during first and second operated eyelid UEB regarding VAS and WBFPES values in group 1 (p = 0.003 and p = 0.002, respectively). In group 2, the VAS value was 1.9 ± 1.0 and WBFPES value was 2.0 ± 1.0 UEB in the first operated eyelid; the VAS value was 3.0 ± 1.5 and WBFPES value was 2.8 ± 1.6 UEB in the second operated eyelid. A significant difference was found between pains felt during first operated and second operated eyelid UEB regarding VAS and WBFPES values in group 2 (p = 0.009 and p = 0.005, respectively).</p><p><strong>Conclusions: </strong>To the best of our knowledge, this study is the first to evaluate which eyelid is more painful during surgery in UEB. Patients tend to feel more pain during surgery on the second operated eyelid. Therefore, surgeons should consider using local anesthetics with more volume or longer duration in the second operating eyelid in light of this information and patients should be given detailed information about pain.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"201-206"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/17/kjo-2023-0011.PMC10270782.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: A systematic review of the literature on diagnostic and therapeutic indications, techniques, and complications of dacryoendoscopy (DE) was performed.
Methods: The authors performed a PubMed search of articles published in English on DE. Data were collected and classified according to the categories of the disease. The clinical outcomes and limitations were particularly analyzed.
Results: The lacrimal drainage system from the canaliculus to the inferior meatus could be examined based on the specific anatomical features by DE. The canalicular mucosa is smooth and brightly colored, the lacrimal sac shows covering mucosa with good vascularization and the nasolacrimal duct is lined with bright tubular mucosal folds. DE allows direct visualization of the detailed internal condition of the lacrimal disorders, to directly diagnose the site of obstruction with accuracy and address the causes and recanalize the lacrimal drainage system using assisted micro lacrimal surgical instruments in the tearing patients.
Conclusions: Better visualization of the lacrimal canal with DE improves the understanding of physiology and precise identification of the obstructing lesions, both of which are the key to a comprehensive management for the tearing patients.
{"title":"Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review.","authors":"Yuri Kim, Jeong Yoon Park, Helen Lew","doi":"10.3341/kjo.2023.0014","DOIUrl":"https://doi.org/10.3341/kjo.2023.0014","url":null,"abstract":"<p><strong>Purpose: </strong>A systematic review of the literature on diagnostic and therapeutic indications, techniques, and complications of dacryoendoscopy (DE) was performed.</p><p><strong>Methods: </strong>The authors performed a PubMed search of articles published in English on DE. Data were collected and classified according to the categories of the disease. The clinical outcomes and limitations were particularly analyzed.</p><p><strong>Results: </strong>The lacrimal drainage system from the canaliculus to the inferior meatus could be examined based on the specific anatomical features by DE. The canalicular mucosa is smooth and brightly colored, the lacrimal sac shows covering mucosa with good vascularization and the nasolacrimal duct is lined with bright tubular mucosal folds. DE allows direct visualization of the detailed internal condition of the lacrimal disorders, to directly diagnose the site of obstruction with accuracy and address the causes and recanalize the lacrimal drainage system using assisted micro lacrimal surgical instruments in the tearing patients.</p><p><strong>Conclusions: </strong>Better visualization of the lacrimal canal with DE improves the understanding of physiology and precise identification of the obstructing lesions, both of which are the key to a comprehensive management for the tearing patients.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"245-254"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/45/kjo-2023-0014.PMC10270774.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm resulting from BCR-ABL translocation [1]. Typical retinopathy caused by CML includes retinal hemorrhages, Roth spots, cotton wool spots, venous dilatation, and tortuosity due to the penetration of leukemic tumor cells or secondary influence through anemia and thrombo - cytopenia [2]. Leukostasis, also known as symptomatic hyperleukocytosis, forms plugs consisting of white blood cells with increased volume and adhesion, which cause microvascular occlusion. Leukostasis retinopathy is a rare complication of CML compared to typical leukemic retinopathy. Herein, we report retinal and choroidal changes in patients with leukostasis retinopathy as the first sign of CML using multimodal imaging. Informed consents for publication of the research details and clinical images were obtained from the patients.
{"title":"Leukostasis Retinopathy as the First Sign of Chronic Myeloid Leukemia with Severe Hyperleukocytosis: Two Case Reports.","authors":"Jinam Lim, Inhye Kim, Min Sagong","doi":"10.3341/kjo.2023.0033","DOIUrl":"https://doi.org/10.3341/kjo.2023.0033","url":null,"abstract":"Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm resulting from BCR-ABL translocation [1]. Typical retinopathy caused by CML includes retinal hemorrhages, Roth spots, cotton wool spots, venous dilatation, and tortuosity due to the penetration of leukemic tumor cells or secondary influence through anemia and thrombo - cytopenia [2]. Leukostasis, also known as symptomatic hyperleukocytosis, forms plugs consisting of white blood cells with increased volume and adhesion, which cause microvascular occlusion. Leukostasis retinopathy is a rare complication of CML compared to typical leukemic retinopathy. Herein, we report retinal and choroidal changes in patients with leukostasis retinopathy as the first sign of CML using multimodal imaging. Informed consents for publication of the research details and clinical images were obtained from the patients.","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/b0/kjo-2023-0033.PMC10270769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10017444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Eun Kim, Sung Sik Kim, Jihei Sara Lee, Kwanghyun Lee, Hyoung Won Bae, Sang Yeop Lee, Wungrak Choi, Chan Yun Kim
Purpose: To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmed glaucoma valve (AGV) tube placement.
Methods: A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tube placed in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 were compared with consecutive cases operated with MMC from 2019 to 2021. Surgical failure was defined as intraocular pressure (IOP) exceeding 21 mmHg in two consecutive visits after postoperative 3 months or ≤30% IOP reduction, IOP ≤5 mmHg in two consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to compare the surgical failure rates.
Results: A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8 years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4 mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperative antiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) but no difference was found at 6 months. No statistical difference was noted in the rates of postoperative complications. Kaplan-Meier survival analysis showed comparable survival rates between MMC group and no MMC group (p = 0.356).
Conclusions: The intraoperative use of MMC significantly lowered IOP in the 1st postoperative month but did not increase 6 months success rates in patients receiving AGV tube placement in CS.
{"title":"Effect of Intraoperative Mitomycin C on the Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Ciliary Sulcus Tube Placement.","authors":"Na Eun Kim, Sung Sik Kim, Jihei Sara Lee, Kwanghyun Lee, Hyoung Won Bae, Sang Yeop Lee, Wungrak Choi, Chan Yun Kim","doi":"10.3341/kjo.2022.0146","DOIUrl":"https://doi.org/10.3341/kjo.2022.0146","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmed glaucoma valve (AGV) tube placement.</p><p><strong>Methods: </strong>A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tube placed in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 were compared with consecutive cases operated with MMC from 2019 to 2021. Surgical failure was defined as intraocular pressure (IOP) exceeding 21 mmHg in two consecutive visits after postoperative 3 months or ≤30% IOP reduction, IOP ≤5 mmHg in two consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to compare the surgical failure rates.</p><p><strong>Results: </strong>A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8 years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4 mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperative antiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) but no difference was found at 6 months. No statistical difference was noted in the rates of postoperative complications. Kaplan-Meier survival analysis showed comparable survival rates between MMC group and no MMC group (p = 0.356).</p><p><strong>Conclusions: </strong>The intraoperative use of MMC significantly lowered IOP in the 1st postoperative month but did not increase 6 months success rates in patients receiving AGV tube placement in CS.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"216-223"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/8f/kjo-2022-0146.PMC10270779.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9643484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor, Peters anomaly is the most common cause of congenital corneal opacity. It commonly presents bilaterally and sporadically, but it is sometimes inherited in the autosomal dominant or recessive patterns [1]. Its cardinal feature is central corneal opacity and iris strands adhered to the posterior cornea, with defects that can occur throughout the whole layers in the cornea from the endothelium to stroma [2]. Previous reports suggest that Peters anomaly is related to prematurity, fetal alcohol syndrome, intrauterine infections, and antenatal teratogenic exposure [3]. Herein, we report a case of Peters’ anomaly in one premature twin with antenatal hydroxychloroquine exposure. Written informed consent for publication of the research details and clinical images was obtained from the patient’s mother. To the best of our knowledge, this is the first report of a Peters anomaly case following hydroxychloroquine exposure during pregnancy in Korea. A 2-day-old female infant was referred by the pediatric department for presenting a visible corneal opacity in her left eye. She is one of the twins born first at 34 gestational weeks, weighing 2.06 kg, via Cesarean section due to preterm labor. The second twin showed no anomaly in eye globes and no systemic findings. Her former brother who was born at 33 gestational weeks weighing 1.5 kg died at 2 years of age due to pulmonary hypertension. Her mother tested positive for antinuclear antibody, thyroglobulin antibody, and antithyroid microsomal antibody. Therefore, she had been treated with aspirin 100 mg/day and hydroxychloroquine 300 mg/day to manage the rheumatoid disease. The hydroxychloroquine treatment was continued throughout the pregnancy. During the eye examination, central corneal opacities which were more prominent in the left eye were noted with iris-cornea strands and lens-cornea strands in both eyes (Fig. 1A–1D). The intraocular pressures were 15 mmHg in both eyes. No definite signs of lens opacity or retinopathy of prematurity were seen in both eyes. Systemically, patent foramen ovale and intraventricular hemorrhage were noted. This Peters anomaly case is intriguing because the previous report of its occurrence and the antenatal exposure history to hydroxychloroquine is rare. Costedoat-chalumeau et al. [4] reported that no ocular abnormalities were seen in the children of 133 mothers with rheumatoid disease treated with hydroxychloroquine during pregnancy. Another teratogen associated with anterior segmental dysplasia, 2-Chloro-2’-deoxyadenosine, is known to induce microphthalmia and keratolenticular dysgenesis in mice. Additionally, there have been reports of Peters anomaly due to fetal alcohol exposure. By far, there is only one case report which describes the possible relationship between Peters anomaly and hydroxychloroquine treatment, although the case was superimposed with the concomitant exposure to methotrexate as well. Hydroxychloroquine is an antimalarial agent and there is no e
{"title":"Peters Anomaly in One Premature Twin Following Hydroxychloroquine Exposure During Pregnancy: A Case Report.","authors":"Do-Ah Kim, Seungsoo Rho","doi":"10.3341/kjo.2023.0007","DOIUrl":"https://doi.org/10.3341/kjo.2023.0007","url":null,"abstract":"Dear Editor, Peters anomaly is the most common cause of congenital corneal opacity. It commonly presents bilaterally and sporadically, but it is sometimes inherited in the autosomal dominant or recessive patterns [1]. Its cardinal feature is central corneal opacity and iris strands adhered to the posterior cornea, with defects that can occur throughout the whole layers in the cornea from the endothelium to stroma [2]. Previous reports suggest that Peters anomaly is related to prematurity, fetal alcohol syndrome, intrauterine infections, and antenatal teratogenic exposure [3]. Herein, we report a case of Peters’ anomaly in one premature twin with antenatal hydroxychloroquine exposure. Written informed consent for publication of the research details and clinical images was obtained from the patient’s mother. To the best of our knowledge, this is the first report of a Peters anomaly case following hydroxychloroquine exposure during pregnancy in Korea. A 2-day-old female infant was referred by the pediatric department for presenting a visible corneal opacity in her left eye. She is one of the twins born first at 34 gestational weeks, weighing 2.06 kg, via Cesarean section due to preterm labor. The second twin showed no anomaly in eye globes and no systemic findings. Her former brother who was born at 33 gestational weeks weighing 1.5 kg died at 2 years of age due to pulmonary hypertension. Her mother tested positive for antinuclear antibody, thyroglobulin antibody, and antithyroid microsomal antibody. Therefore, she had been treated with aspirin 100 mg/day and hydroxychloroquine 300 mg/day to manage the rheumatoid disease. The hydroxychloroquine treatment was continued throughout the pregnancy. During the eye examination, central corneal opacities which were more prominent in the left eye were noted with iris-cornea strands and lens-cornea strands in both eyes (Fig. 1A–1D). The intraocular pressures were 15 mmHg in both eyes. No definite signs of lens opacity or retinopathy of prematurity were seen in both eyes. Systemically, patent foramen ovale and intraventricular hemorrhage were noted. This Peters anomaly case is intriguing because the previous report of its occurrence and the antenatal exposure history to hydroxychloroquine is rare. Costedoat-chalumeau et al. [4] reported that no ocular abnormalities were seen in the children of 133 mothers with rheumatoid disease treated with hydroxychloroquine during pregnancy. Another teratogen associated with anterior segmental dysplasia, 2-Chloro-2’-deoxyadenosine, is known to induce microphthalmia and keratolenticular dysgenesis in mice. Additionally, there have been reports of Peters anomaly due to fetal alcohol exposure. By far, there is only one case report which describes the possible relationship between Peters anomaly and hydroxychloroquine treatment, although the case was superimposed with the concomitant exposure to methotrexate as well. Hydroxychloroquine is an antimalarial agent and there is no e","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"273-274"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/4b/kjo-2023-0007.PMC10270777.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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