1.Long-term Effects and Prognostic Factors of Accelerated Cross-Linking with Retention Ring-assisted Riboflavin Application on Keratoconus Progression
Seonghwan KIM ; Won Jong CHOI ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):145-156
Purpose:
To evaluate the long-term efficacy, safety, and prognostic factors of pulsed-light accelerated corneal collagen cross-linking (A-CXL) with continuous riboflavin application to halt keratoconus progression
Methods:
A-CXL with retention ring-assisted continuous riboflavin application for either 10 or 5 minutes was performed in 37 eyes of 33 patients with progressive keratoconus between 2016 and 2020. Successful halting rates and prognostic factors of time-dependent changes in keratometric values, visual acuity, refractive errors, topographic indices, central corneal thickness, thinnest corneal thickness, irregularity at 3- and 5-mm zone, and endothelial cell density were evaluated.
Results:
Survival analysis showed successful halting rates of 71% and 89% in A-CXL with 5- and 10-minute–applied riboflavin, respectively. Best-corrected visual acuity significantly improved after A-CXL in both groups. Maximum keratometry decreased significantly from 52.52 to 50.39 diopters (p < 0.001) in the 10-minute group, while there was no significant decrease in the 5-minute group (52.77–51.80 diopters, p = 0.146). irregularity in 3- and 5-mm zone decreased significantly in the 10-minute group, while there was no difference in 5-minute group. Central corneal thickness and thinnest corneal thickness did not differ, and endothelial cell density changes were within acceptable ranges in both groups before and after the surgery. Among keratometric values, keratometric astigmatism was significantly related to posttreatment corneal flattening effect in multivariate regression analysis.
Conclusions
A-CXL with continuous riboflavin application for 10 minutes is an effective and safe treatment for preventing keratoconus progression. In addition, higher corneal astigmatism showed greater posttreatment corneal flattening effect in successfully treated patients.
2.Long-term Outcome and Related Risk Factors in Implantable Collamer Lens Implantation of High Myopia
Yong Hee KIM ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):134-144
Purpose:
To investigate the long-term efficacy and safety of posterior chamber implantable collamer lens (ICL) implantation in high myopia, and the risk factors associated with endothelial cell loss (ECL) or cataract development.
Methods:
Medical records of 66 eyes of 37 patients who underwent ICL implantation for high myopia were retrospectively analyzed with a mean follow-up of 12 years. Changes in best-corrected visual acuity (logarithm of the minimum angle of resolution), intraocular pressure (IOP), refractive power, and endothelial cell density over time were analyzed with the incidence of cataract and IOP elevation. Risk factors were analyzed for their association with ECL or cataract development.
Results:
At 10 years after surgery, the mean uncorrected visual acuity was 0.06 and the spherical equivalent was –0.90 diopters. By year 10, cataract was present in 13 of 66 eyes (19.7%), whereas glaucoma was found in 1 of 66 eyes (1.5%). Although IOP continuously elevated over time (p < 0.05), it remained within normal limits. The cataract group had a lower vault of ICL and a higher mean age at surgery (p < 0.05). Endothelial cell density remained above 2,000/mm2 in 98.5% of cases, with an average annualized rate of decline of 1.13%. The high annualized rate group (>1.13% loss per year) had a lower mean age than in the low annualized rate group (<1.13% loss per year, p < 0.05).
Conclusions
This indicates that ICL implantation is effective for high myopia, and its main complication is cataract and ECL. It also suggests that ECL and cataract should be regularly monitored although ECL looks stable in long-term follow-up. Age may affect both ECL and cataract, while low-vault ICL may affect cataract.
3.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
4.Long-term Effects and Prognostic Factors of Accelerated Cross-Linking with Retention Ring-assisted Riboflavin Application on Keratoconus Progression
Seonghwan KIM ; Won Jong CHOI ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):145-156
Purpose:
To evaluate the long-term efficacy, safety, and prognostic factors of pulsed-light accelerated corneal collagen cross-linking (A-CXL) with continuous riboflavin application to halt keratoconus progression
Methods:
A-CXL with retention ring-assisted continuous riboflavin application for either 10 or 5 minutes was performed in 37 eyes of 33 patients with progressive keratoconus between 2016 and 2020. Successful halting rates and prognostic factors of time-dependent changes in keratometric values, visual acuity, refractive errors, topographic indices, central corneal thickness, thinnest corneal thickness, irregularity at 3- and 5-mm zone, and endothelial cell density were evaluated.
Results:
Survival analysis showed successful halting rates of 71% and 89% in A-CXL with 5- and 10-minute–applied riboflavin, respectively. Best-corrected visual acuity significantly improved after A-CXL in both groups. Maximum keratometry decreased significantly from 52.52 to 50.39 diopters (p < 0.001) in the 10-minute group, while there was no significant decrease in the 5-minute group (52.77–51.80 diopters, p = 0.146). irregularity in 3- and 5-mm zone decreased significantly in the 10-minute group, while there was no difference in 5-minute group. Central corneal thickness and thinnest corneal thickness did not differ, and endothelial cell density changes were within acceptable ranges in both groups before and after the surgery. Among keratometric values, keratometric astigmatism was significantly related to posttreatment corneal flattening effect in multivariate regression analysis.
Conclusions
A-CXL with continuous riboflavin application for 10 minutes is an effective and safe treatment for preventing keratoconus progression. In addition, higher corneal astigmatism showed greater posttreatment corneal flattening effect in successfully treated patients.
5.Long-term Outcome and Related Risk Factors in Implantable Collamer Lens Implantation of High Myopia
Yong Hee KIM ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):134-144
Purpose:
To investigate the long-term efficacy and safety of posterior chamber implantable collamer lens (ICL) implantation in high myopia, and the risk factors associated with endothelial cell loss (ECL) or cataract development.
Methods:
Medical records of 66 eyes of 37 patients who underwent ICL implantation for high myopia were retrospectively analyzed with a mean follow-up of 12 years. Changes in best-corrected visual acuity (logarithm of the minimum angle of resolution), intraocular pressure (IOP), refractive power, and endothelial cell density over time were analyzed with the incidence of cataract and IOP elevation. Risk factors were analyzed for their association with ECL or cataract development.
Results:
At 10 years after surgery, the mean uncorrected visual acuity was 0.06 and the spherical equivalent was –0.90 diopters. By year 10, cataract was present in 13 of 66 eyes (19.7%), whereas glaucoma was found in 1 of 66 eyes (1.5%). Although IOP continuously elevated over time (p < 0.05), it remained within normal limits. The cataract group had a lower vault of ICL and a higher mean age at surgery (p < 0.05). Endothelial cell density remained above 2,000/mm2 in 98.5% of cases, with an average annualized rate of decline of 1.13%. The high annualized rate group (>1.13% loss per year) had a lower mean age than in the low annualized rate group (<1.13% loss per year, p < 0.05).
Conclusions
This indicates that ICL implantation is effective for high myopia, and its main complication is cataract and ECL. It also suggests that ECL and cataract should be regularly monitored although ECL looks stable in long-term follow-up. Age may affect both ECL and cataract, while low-vault ICL may affect cataract.
6.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
7.Long-term Effects and Prognostic Factors of Accelerated Cross-Linking with Retention Ring-assisted Riboflavin Application on Keratoconus Progression
Seonghwan KIM ; Won Jong CHOI ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):145-156
Purpose:
To evaluate the long-term efficacy, safety, and prognostic factors of pulsed-light accelerated corneal collagen cross-linking (A-CXL) with continuous riboflavin application to halt keratoconus progression
Methods:
A-CXL with retention ring-assisted continuous riboflavin application for either 10 or 5 minutes was performed in 37 eyes of 33 patients with progressive keratoconus between 2016 and 2020. Successful halting rates and prognostic factors of time-dependent changes in keratometric values, visual acuity, refractive errors, topographic indices, central corneal thickness, thinnest corneal thickness, irregularity at 3- and 5-mm zone, and endothelial cell density were evaluated.
Results:
Survival analysis showed successful halting rates of 71% and 89% in A-CXL with 5- and 10-minute–applied riboflavin, respectively. Best-corrected visual acuity significantly improved after A-CXL in both groups. Maximum keratometry decreased significantly from 52.52 to 50.39 diopters (p < 0.001) in the 10-minute group, while there was no significant decrease in the 5-minute group (52.77–51.80 diopters, p = 0.146). irregularity in 3- and 5-mm zone decreased significantly in the 10-minute group, while there was no difference in 5-minute group. Central corneal thickness and thinnest corneal thickness did not differ, and endothelial cell density changes were within acceptable ranges in both groups before and after the surgery. Among keratometric values, keratometric astigmatism was significantly related to posttreatment corneal flattening effect in multivariate regression analysis.
Conclusions
A-CXL with continuous riboflavin application for 10 minutes is an effective and safe treatment for preventing keratoconus progression. In addition, higher corneal astigmatism showed greater posttreatment corneal flattening effect in successfully treated patients.
8.Long-term Outcome and Related Risk Factors in Implantable Collamer Lens Implantation of High Myopia
Yong Hee KIM ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):134-144
Purpose:
To investigate the long-term efficacy and safety of posterior chamber implantable collamer lens (ICL) implantation in high myopia, and the risk factors associated with endothelial cell loss (ECL) or cataract development.
Methods:
Medical records of 66 eyes of 37 patients who underwent ICL implantation for high myopia were retrospectively analyzed with a mean follow-up of 12 years. Changes in best-corrected visual acuity (logarithm of the minimum angle of resolution), intraocular pressure (IOP), refractive power, and endothelial cell density over time were analyzed with the incidence of cataract and IOP elevation. Risk factors were analyzed for their association with ECL or cataract development.
Results:
At 10 years after surgery, the mean uncorrected visual acuity was 0.06 and the spherical equivalent was –0.90 diopters. By year 10, cataract was present in 13 of 66 eyes (19.7%), whereas glaucoma was found in 1 of 66 eyes (1.5%). Although IOP continuously elevated over time (p < 0.05), it remained within normal limits. The cataract group had a lower vault of ICL and a higher mean age at surgery (p < 0.05). Endothelial cell density remained above 2,000/mm2 in 98.5% of cases, with an average annualized rate of decline of 1.13%. The high annualized rate group (>1.13% loss per year) had a lower mean age than in the low annualized rate group (<1.13% loss per year, p < 0.05).
Conclusions
This indicates that ICL implantation is effective for high myopia, and its main complication is cataract and ECL. It also suggests that ECL and cataract should be regularly monitored although ECL looks stable in long-term follow-up. Age may affect both ECL and cataract, while low-vault ICL may affect cataract.
9.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
10.Long-term Effects and Prognostic Factors of Accelerated Cross-Linking with Retention Ring-assisted Riboflavin Application on Keratoconus Progression
Seonghwan KIM ; Won Jong CHOI ; Chang Ho YOON ; Mee Kum KIM
Korean Journal of Ophthalmology 2025;39(2):145-156
Purpose:
To evaluate the long-term efficacy, safety, and prognostic factors of pulsed-light accelerated corneal collagen cross-linking (A-CXL) with continuous riboflavin application to halt keratoconus progression
Methods:
A-CXL with retention ring-assisted continuous riboflavin application for either 10 or 5 minutes was performed in 37 eyes of 33 patients with progressive keratoconus between 2016 and 2020. Successful halting rates and prognostic factors of time-dependent changes in keratometric values, visual acuity, refractive errors, topographic indices, central corneal thickness, thinnest corneal thickness, irregularity at 3- and 5-mm zone, and endothelial cell density were evaluated.
Results:
Survival analysis showed successful halting rates of 71% and 89% in A-CXL with 5- and 10-minute–applied riboflavin, respectively. Best-corrected visual acuity significantly improved after A-CXL in both groups. Maximum keratometry decreased significantly from 52.52 to 50.39 diopters (p < 0.001) in the 10-minute group, while there was no significant decrease in the 5-minute group (52.77–51.80 diopters, p = 0.146). irregularity in 3- and 5-mm zone decreased significantly in the 10-minute group, while there was no difference in 5-minute group. Central corneal thickness and thinnest corneal thickness did not differ, and endothelial cell density changes were within acceptable ranges in both groups before and after the surgery. Among keratometric values, keratometric astigmatism was significantly related to posttreatment corneal flattening effect in multivariate regression analysis.
Conclusions
A-CXL with continuous riboflavin application for 10 minutes is an effective and safe treatment for preventing keratoconus progression. In addition, higher corneal astigmatism showed greater posttreatment corneal flattening effect in successfully treated patients.

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