PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculation using conventional regression formulae or the American Society of Cataract and Refractive Surgery (ASCRS) IOL power calculator for previous corneal refractive surgery. METHODS: We retrospectively reviewed 96 eyes from 68 patients that had undergone cataract surgery after keratorefractive surgeries. We calculated the formula with two approaches: IOL powers using the ASCRS IOL power calculator and IOL powers using conventional formulae with previous refractive data (Camellin, Jarade, Savini, and clinical history method) or without prior data (0, 2 and, 4 mm total mean power in topography, Wang-Koch-Maloney, Shammas, Seitz, and Maloney). Two conventional IOL formulae (the SRK/T and the Hoffer Q) were calculated with the single K and double K methods. Mean arithmetic refractive error and mean absolute error were calculated at the first postoperative month. RESULTS: In conventional formulae, the Jarade method or the Seitz method, applied in the Hoffer Q formula with the single K or double K method, have the lowest prediction errors. The least prediction error was found in the Shammas-PL method in the ASCRS group. There was no statistically significant difference between the 10 lowest mean absolute error conventional methods, the Shammas-PL method and the Barrett True-K method calculated with using the ASCRS calculator, without using preoperative data. CONCLUSIONS: The Shammas-PL formula and the Barrett True-K formula, calculated with the ASCRS calculator, without using history, were methods comparable to the 10 most accurate conventional formulae. Other methods using the ASCRS calculator show a myopic tendency.
Cataract ; Humans ; Lenses, Intraocular* ; Methods ; Refractive Errors ; Refractive Surgical Procedures* ; Retrospective Studies

PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
Astigmatism ; Autografts* ; Bevacizumab ; Cicatrix ; Edema ; Follow-Up Studies ; Granuloma, Pyogenic ; Humans ; Male ; Medical Records ; Postoperative Complications ; Pterygium* ; Recurrence ; Tissue Donors ; Transplants ; Visual Acuity

A case with typical skin lesions of incontinentia pigmeti showed progressing retinal vascular abnormalities. So cryotherapy was done on avascular peripheral retina, and retinal vascular changes ceased. We propose that cryotherapy may be a good treatment method for progressing retinal vascular lesions of incontinentia pigmenti.
*Cryosurgery ; Female ; Fundus Oculi ; Humans ; Incontinentia Pigmenti/*surgery ; Infant, Newborn ; Retinal Diseases/*surgery

We reviewed the long-term results of implantation of posterior chamber intraocular lens (PC IOL) by suture fixation in 23 patients without zonular or capsular support. In terms of preoperative state, 15 were aphakic, 5 had cataracts and 3 were aphakic with concurrent corneal opacity. The latter had penetrating keratoplasty as well at the time of surgery. They were followed up for more than 1 year, and the best corrected vision remained the same or improved in all cases after surgery. The transscleral suture fixation-related complications included vitreous hemorrhage, hyphema and retinal detachment.
Adult ; Cataract Extraction ; Female ; Follow-Up Studies ; Humans ; *Lenses, Intraocular ; Longitudinal Studies ; Male ; Middle Aged ; Postoperative Complications ; *Suture Techniques ; Treatment Outcome ; Visual Acuity

To determine the effect of apraclonidine hydrochloride on the acute intraocular pressure (IOP) rise after argon laser iridotomy (ALI), a double-masked comparative study was carried out. Twenty-nine eyes (20 patients) with angle-closure glaucoma underwent ALI. Eighteen eyes were treated with apraclonidine, and the remainder received a placebo 1 hour before and immediately after ALI. The mean IOP increase in the apraclonidine group was lower than that in the placebo group at each postlaser interval (p < 0.01). Although the average value of the maximal increases of IOP after ALI in the apraclonidine group was 4 mmHg, that in the placebo group was 16 mmHg. In the placebo group, 27.3% (3 out of 11 eyes) experienced an IOP rise > or = 10 mmHg. However, that kind of IOP rise was not found in the apraclonidine group (0 out of 18 eyes) (p < 0.01). Ocular or systemic side effects were not found in a series of examinations in both groups. Therefore, apraclonidine proved to be effective in lowering the IOP rise after ALI.
Acute Disease ; Adrenergic alpha-Agonists/*pharmacology ; Adult ; Aged ; Clonidine/*analogs & derivatives/therapeutic use ; Double-Blind Method ; Female ; Glaucoma, Angle-Closure/drug therapy/*surgery ; Humans ; Intraocular Pressure/*drug effects ; Iris/drug effects/*surgery ; *Laser Therapy ; Male ; Middle Aged ; Postoperative Complications/prevention & control ; Prospective Studies

Measuring the tear meniscus height (TMH) is easy after fluorescein installation, but the TMH after fluorescein instillation is higher than the TMH before fluorescein instillation. Therefore, we measured the time that the TMH after fluorescein instillation became the same with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. The TMH 0.19 +/- 0.05 mm in the normal eyes and 0.10 +/- 0.04 mm in the dry eyes, and there was a significant difference between the 2 groups. The time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation was 2.19 +/- 0.81 min. in the normal eyes and 2.29 +/- 0.73 min. in the dry eyes. Within 4 min. after fluorescein instillation, the TMH became the same with the TMH before fluorescein instillation in all cases and the height persisted until 7 min. after fluorescein instillation. Therefore, measuring the TMH will be easy if it is measured at 4-7 min. after fluorescein instillation.
Dry Eye Syndromes/*diagnosis ; Fluorescein ; Fluoresceins/*diagnostic use ; Humans ; Tears/*chemistry

The 6 eyes of 6 patients operated on using keratoconic epikeratoplasty are evaluated, and the mean 11-month postoperative results are reported. Uncorrected visual acuities improved in 4 patients and were maintained in 1 patient. One patient revealed a decrease of uncorrected visual acuity in the postoperative 6th month. Two patients showed an improvement of over 2 Snellen lines. Two patients showed the same corrected visual acuity, and that of 2 patients decreased within the postoperative 6-months follow-up. There was a significant decrease of myopia in terms of spherical equivalent. As a result, 4 cases showed a postoperative refractive error from +1.0 to -2.5D. Two cases were myopic deviated, -4.0 and -5.0D, and need further observation. In all cases, there was an effective flattening of the protruding cone with a mean decrease of over 11D of keratometry readings. Complete reepithelization occurred within 12 days, (average 7.5 days) and a moderate pressure patch was used as a routine procedure to promote the reepithelization.
Adolescent ; Adult ; *Corneal Transplantation ; Female ; Follow-Up Studies ; Humans ; Keratoconus/*surgery ; Male ; Retrospective Studies ; Treatment Outcome ; Visual Acuity ; Wound Healing

Three hundred patients who have congenital colour vision deficiencies were examined at the author's eye clinic for 3 years (1987-1990) using 5 types of colour vision tests: Hahn's, TMC's, Okuma's (new), H-R-R's colour vision tests and Double 15 Hue Test (Hahn). The results obtained from each test were quite different in type and grade, and the summarized results were considered to be the best: Type: protan 23.3%, deutan 76.0%, unclassified 0.7% Grade: mild 20.3%, medium 25.3%, strong 54.4% The frequency of coincidence both in type and grade between the summarized results and those of each test were compared, and the highest was 62.3% in Double 15 Hue Test. The efficiency of the author's colour vision test and Double 15 Hue Test were evaluated with the data in this clinical trial, and they were found to be useful for classifying the type and estimating the grade of the congenital and also acquired colour vision deficiencies.
Adolescent ; Adult ; Child ; Color Perception Tests ; Color Vision Defects/*congenital/diagnosis ; Evaluation Studies as Topic ; Female ; Humans ; Male ; Middle Aged

Strabismus surgery results in the permanent interruption of anterior ciliary blood flow, predisposing the eye to anterior segment ischemia (ASI). A primate model was used to assess the effectiveness of a new muscle-scleral tuck for preserving anterior ciliary artery circulation. The model consisted of removing 3 rectus muscles from both eyes of 2 rhesus monkeys, then performing a tuck on the inferior rectus (IR) right eye while leaving the left IR as a control. Four weeks later, a modified tuck was performed on the virgin left IR. Fluorescein iris angiograms of both eyes were obtained, and preoperative angiograms at 5-15 sec. showed normal 360 degrees perfusion. Postoperative follow-up angiograms showed segmental superior temporal filling defects and preservation of perfusion in the distribution of the IR. Comparison of fellow eyes tucked vs control IR showed no difference in the filling pattern in both monkeys. Comparison of the same eye before and after tuck also showed essentially the same filling pattern in all 4 eyes with preservation of inferior circulation. Our conclusion is that the modified tuck preserves the anterior ciliary blood flow and may be useful as a muscle-strengthening procedure in patients predisposed to developing ASI.
Animals ; Anterior Eye Segment/*blood supply ; Ciliary Body/*blood supply ; Disease Models, Animal ; Fluorescein Angiography ; Follow-Up Studies ; Iris/blood supply ; Ischemia/*prevention & control ; Macaca mulatta ; Oculomotor Muscles/physiology/*surgery ; Perfusion

When the oculomotor nerve is completely paralyzed, the affected eye shows severe outward displacement and poor cosmetic appearance. Past results of many surgical procedures for oculomotor palsy have been generally unsatisfactory. We tried a new surgical approach experimentally, in which the disinserted lateral rectus muscle was used as an adductor by medial transposition of the muscle. Five adult cats underwent disinsertion of the medial rectus muscle of both eyes to induce iatrogenic medial rectus paralysis. The disinserted medial rectus was removed as far back as possible to prevent reattachment. Then, the right lateral rectus muscle was disinserted and passed beneath the superior rectus muscle and resutured to the sclera 4mm superoposterior to the medial rectus insertion site. After excision of the bilateral medial rectus, a large exotropia of an average 47.6 delta (42.0-55.5 delta) was induced. The medial transposition of the right lateral rectus produced an average 36.6 delta (24.8-45.8 delta) correction of the exotropia. A satisfactory cosmetic result was achieved by this procedure.
Animals ; Cats ; Exotropia/etiology ; Oculomotor Muscles/*surgery ; Oculomotor Nerve Diseases/physiopathology/*surgery ; Vision Disparity