PURPOSE: To evaluate the clinical outcomes of implantable collamer lens (ICL) implantation with simultaneous full thickness astigmatic keratotomy (FTAK) for the correction of moderate to high myopic astigmatism. METHODS: Thirty-two eyes of 16 patients who had an ICL implantation with simultaneous FTAK were studied. Follow-up visits were at 1 week, 1 month, and 3 months. The outcome measures included the uncorrected distance visual acuity (UDVA), refractive error, efficacy, safety, and predictability. RESULTS: After the surgery, astigmatism was reduced by 74.83 ± 13.8%. The proportion of eyes with a spherical equivalent of 0.5 D or less was 87.5%, and all eyes had a spherical equivalent of 1.0 D or less at 3 months after the surgery. The proportion of eyes with a UDVA of 20/25 or better was 100%, and 20/20 or better was 81.25%. Reoperation was needed in one case (3.1%) because of undercorrection of the astigmatism, and no complications were observed. CONCLUSIONS: This study showed that ICL implantation with simultaneous FTAK is effective and safe for the correction of moderate to high myopic astigmatism.
Astigmatism ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Refractive Errors ; Reoperation ; Visual Acuity

The general aim of Korea National Health and Nutrition Examination Survey (KNHANES) was to assess the health and nutritional status in the Korean population. The KNHANES began in 1998 and has been conducting as a series of surveys : 1998(1st), 2001(2nd), 2005(3rd) and 2007-2009(4th). Specific aims were, in a cross-sectional study of nationally representative samples of the noninstitutionalized civilian Korean population aged > or = 1 year (4,600 households each year), to monitor trends the prevalence, awareness, treatment and control of selected chronic diseases, monitor trends in nutritional status and risk behaviors, and analyze risk factors for chronic diseases. For these purposes, with standardized high-quality methods, extensive data on health and nutrition are collected by health interview, health examination (physical examination, clinical measurements and tests) and dietary interview. In 2007, the 4th KNHANES became a continuous annual survey by highly trained field staff. In addition, the 4th KNHANES expanded examination components (addition of oral examination, pulmonary function test and laboratory test items such as ferritin, vitamin D, insulin, manganese, and arsenic), simplified survey procedure, and strengthened quality control. Further works will be focused on the selection of new examination and interview components, planning of KNHANES follow-up survey, continuous training of field staff and quality control, and improvement of dietary survey method.
Chronic Disease ; Cross-Sectional Studies ; Surveys and Questionnaires ; Diagnosis, Oral ; Family Characteristics ; Ferritins ; Follow-Up Studies ; Insulin ; Korea* ; Manganese ; Nutrition Surveys* ; Nutritional Status ; Prevalence ; Quality Control ; Respiratory Function Tests ; Risk Factors ; Risk-Taking ; Vitamin D

PURPOSE: To evaluate the clinical outcomes of small incision lenticule extraction (SMILE) for the treatment of myopia with corneal opacity. METHODS: Thirteen eyes of 13 patients with corneal opacities who underwent SMILE were retrospectively studied. Uncorrected distance visual acuity, spherical equivalence, efficacy index, and safety index were noted at 3 months after the procedure. The density and area of the corneal opacities were measured and compared preoperatively and 3 months postoperatively. RESULTS: All eyes had preoperative corneal opacities within the lenticule formation areas. The mean area and density of corneal opacities were 0.72 ± 0.33 mm2 and 52.46 ± 15.74, respectively. All procedures were uneventful and no intraoperative complications were observed. At 3 months after the procedure, the efficacy and safety indices were 1.01 ± 0.15, and 1.05 ± 0.10, respectively, and the mean densities and areas of corneal opacities were 46.85 ± 14.56 (p = 0.038) and 0.70 ± 0.36 mm2 (p = 0.776), respectively. CONCLUSIONS: The SMILE procedure was effective and safe for the correction of myopic patients with corneal opacities.
Corneal Opacity ; Humans ; Intraoperative Complications ; Myopia ; Retrospective Studies ; Visual Acuity

PURPOSE: To compare the clinical outcome of combined small incision lenticule extraction and collagen cross-linking (SMILE Xtra) with SMILE. METHODS: This study included 30 eyes from 15 patients who had undergone SMILE Xtra and a random sample of 30 eyes from 15 patients receiving SMILE alone during the same period. We obtained the following parameters from all patients: uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), efficacy and safety index, and corneal high-order aberrations. RESULTS: The SMILE Xtra group had higher preoperative SE and thinner central corneal and residual stromal bed thickness and optic zone diameter compared to the control group (p < 0.001). At 6 months, there was no significant difference in UDVA or CDVA between the two groups. The efficacy indices were 0.97 ± 0.16 and 1.05 ± 0.17 in the SMILE Xtra and control groups, respectively (p = 0.044), and there was no significant difference in safety index between the two groups during the follow-up period. Total corneal high-order aberrations numbered 2.59 ± 0.56 and 2.02 ± 0.41 in the SMILE Xtra and control groups, respectively (p < 0.001), and there was significant increase in spherical aberration and horizontal corneal aberration in both groups compared to preoperative results. Corneal haze was observed in 20% of eyes in the SMILE Xtra group, and no complication such as corneal ectasia was observed during the follow-up period. CONCLUSIONS: SMILE Xtra had good early clinical outcome compared to SMILE alone. It appears that SMILE Xtra can be a good modality when the cornea is thin or SE is high. However, postoperative corneal haze should be considered.
Collagen* ; Cornea ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Visual Acuity

PURPOSE: To compare the clinical outcome of combined small incision lenticule extraction and collagen cross-linking (SMILE Xtra) with SMILE. METHODS: This study included 30 eyes from 15 patients who had undergone SMILE Xtra and a random sample of 30 eyes from 15 patients receiving SMILE alone during the same period. We obtained the following parameters from all patients: uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), efficacy and safety index, and corneal high-order aberrations. RESULTS: The SMILE Xtra group had higher preoperative SE and thinner central corneal and residual stromal bed thickness and optic zone diameter compared to the control group (p < 0.001). At 6 months, there was no significant difference in UDVA or CDVA between the two groups. The efficacy indices were 0.97 ± 0.16 and 1.05 ± 0.17 in the SMILE Xtra and control groups, respectively (p = 0.044), and there was no significant difference in safety index between the two groups during the follow-up period. Total corneal high-order aberrations numbered 2.59 ± 0.56 and 2.02 ± 0.41 in the SMILE Xtra and control groups, respectively (p < 0.001), and there was significant increase in spherical aberration and horizontal corneal aberration in both groups compared to preoperative results. Corneal haze was observed in 20% of eyes in the SMILE Xtra group, and no complication such as corneal ectasia was observed during the follow-up period. CONCLUSIONS: SMILE Xtra had good early clinical outcome compared to SMILE alone. It appears that SMILE Xtra can be a good modality when the cornea is thin or SE is high. However, postoperative corneal haze should be considered.
Collagen* ; Cornea ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Visual Acuity

OBJECTIVES: To increase the booster vaccination rate, the Korean government legislated a measles vaccination for elementary school students in 2001, requiring parents to submit a certificate of vaccination upon the admission of the students to elementary school. The purpose of this study was to evaluate the validity of measles vaccination certificates which were issued to parents. METHODS: Using questionnaire survey data of 890 general practitioners and 9,235 parents in 2005, we investigated the evidence for booster vaccination certificates of measles. RESULTS: In the survey of general practitioners, 59.5% of the certificates depended on the medical records of clinic, 13.5% was immunization booklets, 23.7% was re-immunizations, 1.9% was confirmation of record of other clinics, and 1.4% was parents' statements or requests without evidence. In the survey of parents, 36.2% of the certificates depended on the medical records of clinic, 43.4% was immunization booklets, 18.0% was reimmunizations, and 2.4% was parents statements or requests without evidence. CONCLUSIONS: Our findings show that a majority of the booster vaccination certificates of measles was issued on the basis of documented vaccinations and it means that the implementation of the law requiring the submission of elementary school students' vaccination certificates has been very successful in Korea.
Adult ; Aged ; *Certification ; Documentation ; Female ; Humans ; Korea ; Male ; Measles Vaccine/*administration & dosage ; Medical Records ; Middle Aged ; Parents ; Questionnaires ; *Schools ; Vaccination/legislation & jurisprudence/*standards/statistics & numerical data

OBJECTIVES: The purpose of this study was to estimate the incidence of injuries and to identify their causes by classifying injuries according to various categories including age, sex, mechanism of injury, body parts injured, and place of injury. METHODS: This study used data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2016. The KNHDIS is conducted annually by the Korea Centers for Disease Control and Prevention, and its survey population includes all hospitalized patients discharged from medical institutions that have 100 or more beds, such as hospitals, general hospitals, and secondary community health centers. The number of injured cases is weighted and estimated using the mid-year estimated population of each year. RESULTS: The injury discharge rate steadily increased since 2004 (1,505 per 100,000 population in 2004, 2,007 per 100,000 population in 2016) and most injuries were unintentional (annual average of 94.7%). On average, during the 13-year study period, the injury rate for males was 1.5 times as high as for females. The 2 main causes of injury were consistently traffic accidents and falls. Notably, the rate of injuries resulting from falls rose by 1.7-fold from 463 to 792 per 100,000 people, and exceeded the rate of traffic accidents in 2016. CONCLUSIONS The incidence of injuries steadily increased after the survey was first conducted, whereas mortality resulting from injuries mostly remained unchanged. This suggests that effective strategies and interventions should be reinforced to reduce unintentional injuries.

OBJECTIVES: The purpose of this study was to estimate the incidence of injuries and to identify their causes by classifying injuries according to various categories including age, sex, mechanism of injury, body parts injured, and place of injury. METHODS: This study used data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2016. The KNHDIS is conducted annually by the Korea Centers for Disease Control and Prevention, and its survey population includes all hospitalized patients discharged from medical institutions that have 100 or more beds, such as hospitals, general hospitals, and secondary community health centers. The number of injured cases is weighted and estimated using the mid-year estimated population of each year. RESULTS: The injury discharge rate steadily increased since 2004 (1,505 per 100,000 population in 2004, 2,007 per 100,000 population in 2016) and most injuries were unintentional (annual average of 94.7%). On average, during the 13-year study period, the injury rate for males was 1.5 times as high as for females. The 2 main causes of injury were consistently traffic accidents and falls. Notably, the rate of injuries resulting from falls rose by 1.7-fold from 463 to 792 per 100,000 people, and exceeded the rate of traffic accidents in 2016. CONCLUSIONS The incidence of injuries steadily increased after the survey was first conducted, whereas mortality resulting from injuries mostly remained unchanged. This suggests that effective strategies and interventions should be reinforced to reduce unintentional injuries.

PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.
Calculi ; Dental Caries ; Dental Clinics ; Diagnosis ; Diagnosis, Oral ; Humans ; Inflammation ; Mass Screening ; National Health Programs ; Radiography, Dental ; Radiography, Panoramic ; Root Caries ; Sensitivity and Specificity ; Survival Rate ; Tooth ; Tooth Loss

PURPOSE: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. METHODS: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. RESULTS: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. CONCLUSIONS: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.
Aged ; Anemia ; Arthritis, Rheumatoid ; Asthma ; Cerebral Infarction ; Cohort Studies ; Dental Caries ; Dental Implants ; Denture, Complete ; Denture, Partial, Removable ; Dentures ; Health Services for the Aged ; Humans ; Hypertension ; Insurance Benefits ; Insurance Coverage ; Insurance, Dental ; Insurance, Health ; Korea ; National Health Programs ; Osteoporosis ; Periodontal Diseases ; Prevalence ; Retrospective Studies