PURPOSE: To compare the effect of combined recession and resection on ocular position. METHODS: We designed a study with three groups of white rabbits. A recession was performed by differing the amount, 9 mm, 12 mm and 15 mm, according to the group, after 12 mm resection on superior rectus muscle. Before and 1 week after the operation, distance from lower margin to upper corneal limbus was measured using photographs. RESULTS: In 12 mm recession group, the distance before and after the operation was 9.44 mm and 9.19 mm respectively, showing no statistically significant change (P=0.2344). In 15 mm recession group, the ocular position showed significant depression, from 9.13 to 7.87 mm (P=0.0017), whereas in 9 mm recession group ocular position showed significant elevation from 9.11 to 10.85 mm (P=0.0078). CONCLUSIONS: The result of this study showed that when combined resection and recession on the same extraocular muscle were made in the same amount, eye alignment at primary ocular position was kept. Furthermore this procedure enables adjustable surgery to be considerable in incomitant strabismus.
Depression ; Limbus Corneae ; Rabbits ; Strabismus

PURPOSE: This research was performed to investigate if the insertion site of the rectus muscle and the type of the insertion anatomically correspond for both eyes in Korean cadavers. METHODS: Thirty-four eyes from seventeen cadavers were anatomized for this research. We measured minimum distances from the insertion of each muscle to the tangential lines passing through the corneal limbus using a vernier caliper. Center, temporal, and nasal portions are used as an insertion for the vertical muscle, while center, upper, and lower portions are used as an insertion for the horizontal muscle. The average values of those minimum distances were compared for both eyes. Moreover, the type of the insertion of the rectus muscle is observed to determine whether it is identical for both eyes. RESULTS: Anatomical data does not show a significant difference between the right and left eyes except for the distance from an insertion of the inferior and lateral rectus muscle to the corneal limbus. With regard to the morphologic type of the insertion, the most common types are oblique and nonspecific shapes in the vertical muscles, and straight and concave shapes in the horizontal muscles. CONCLUSIONS: Although there was not a significant difference between the eyes, precautions should still be taken during eye operations due to possible anatomical differences between the eyes.
Adult ; Cadaver ; Eye ; Humans ; Limbus Corneae ; Muscles

Dermoid is a kind of choristoma and rare congenital benign tumor. It is ugly in appearance and especially dermoid appears at corneal limbus. The above 2 cases which we report invade cornea and it is especially giant compared with the report which has been reported untill now.
Choristoma ; Cornea ; Dermoid Cyst* ; Limbus Corneae

A case of intraepithelial epithelioma involving the corneal limbus at 3 to 9 o'clock directions spreading broadly over to the pupillary margin and bulbar conjunctiva is presented. As the intraepithelial epithelioma is one of rare tumor and it is needed to be listed for differential diagnosis with pterygium, leukoplakia, pannus and nutritional deficiency etc. The tumor mass was removed successfully by resection method and diagnosis was confirmed histopathologically.
Carcinoma* ; Conjunctiva ; Diagnosis ; Diagnosis, Differential ; Leukoplakia ; Limbus Corneae ; Malnutrition ; Pterygium

The anterior chamber paracentesis has its history about 4 centuries long in the ophthalmic operations. Author recently applied this method to 31 clinical cases consisting of hypopyon, hyphema, juvenile cataract and foreign body in anterior chamber. Attempt was made via the subconjunctival route on the cases of hyphema and lens material in the anterior chamber, in contrast with the ordinary corneal limbus puncture on the discission of anterior lens capsule, or irrigation of hypopyon. Application of paracentesis in my series was selected on the cases of blood over a half of anterior chamber, and large amount of hypopyon, etc., and the favorable rasults were achieved.
Anterior Chamber* ; Cataract ; Foreign Bodies ; Hyphema ; Limbus Corneae ; Paracentesis* ; Punctures

PURPOSE: This study examines the change in distance from the corneal limbus to the insertion of the rectus muscles before and after disinsertion and retraction with a pair of fixation forceps during strabismus surgery. METHODS: In 38 strabismus patients, on 30 medial rectus muscles and 38 lateral rectus muscles, before and after disinsertion and retraction with a pair of fixation forceps, the distances from the corneal limbus to the upper, middle and lower parts of the insertion of the medial and lateral rectus muscles marked with methylene blue solution were measured. RESULTS: The distances between the corneal limbus and upper, middle and lower parts of the insertion after the disinsertion were reduced on, average 0.23 mm, 0.28 mm, and 0.18 mm, for the medial rectus muscle, respectively, and 0.21 mm, 0.28 mm, and 0.15 mm, for the lateral rectus muscle, respectively (P<0.05). The percentage of cases in which the advance from the corneal limbus to the insertion was greater than 0.5 mm was 33.3% for the medial rectus muscle, and 21.1% for the lateral rectus muscle. The lateral rectus muscle was disinserted, fixed with a pair of forceps, and subsequently, the distance from the upper, middle and lower parts to the corneal limbus were reduced to 0.36 mm, 0.43 mm, and 0.30 mm, respectively (P<0.05). The percentage of cases that advanced more than 1.0 mm was 13.2 %. The changes in distance from the upper, middle, and lower parts of insertion toward the limbus after disinsertion and retraction were 0.15 mm 0.15 mm, 0.16 mm, respectively (P<0.05). CONCLUSIONS: When performing the recession of the lateral rectus muscle, disinsertion of the rectus muscle, may result in a change of the site of insertion, which in turn might influence the outcome of strabismus surgery.
Humans ; Limbus Corneae ; Methylene Blue ; Muscles* ; Strabismus ; Surgical Instruments

The authors have recently treated a case of intraepithelial epithelioma(Bowen's disease) of the cornea and conjunctiva. This 66 year old male had a gray whitish elevated smooth mass on the lateral area of the corneal limbus and bulbar conjunctiva. Simple surgical excision was indicated since the lesion is benign but it recurred in 10 months. The recurrent lesion was excised again surgically. The histopathological features of previous specimen showed simple proliferation of one of the normal conjunctival and corneal epithelial cells in the epithelial layer, rather then an alteration in the chracter of the cells as the case in other malignant neoplasm. The second excised specimen showed marked proliferated epitheloid cells, keratosis, and chronic inflammatory cell infiltration but the lesion was limited to the epithelial layer without any evidence of invasion into the stroma.
Aged ; Conjunctiva* ; Cornea* ; Epithelial Cells ; Humans ; Keratosis ; Limbus Corneae ; Male

PURPOSE: To investigate the characteristics and the results of long-term follow-up of limbal epithelial cells cultivated in vivo on amniotic membranes (LIVAM) in corneal limbal deficiency. METHODS: Twenty-two eyes of twenty-two patients diagnosed with corneal limbal deficiency underwent transplantation of in vivo cultivated corneal limbal epithelial cells on the amniotic membrane. Biopsy and immunohistochemical staining (AE5, MUC5AC) of the amniotic membrane cultivated for one week were performed to verify that the cultivated epithelial cells on the amniotic membrane were corneal epithelial cells. Impression cytology was performed to evaluate the characteristics of the transplanted corneal limbal epithelial cells at postoperative 1 week, 3 months, 6 months, and 1 year. RESULTS: Successful epithelial growth was observed on the amniotic membrane at one week. The epithelial cells were confirmed to be corneal epithelial cells by immunohistochemical staining. Transplanted in vivo cultivated corneal epithelial cells were confirmed to have corneal specificity by impression cytology and immunohistochemical staining at postoperative 1 week, 3 months, 6 months, and 1 year. CONCLUSIONS: In vivo cultured corneal epithelial cells showed morphological and immunohistochemical findings similar to those of normal corneal epithelial cells. Transplanted in vivo cultivated corneal epithelial cells were maintained and showed the characteristics of corneal epithelial cells. Transplantation of in vivo cultivated corneal limbal epithelial cells can be performed to reconstruct the corneal limbus in treating corneal limbal deficiency.
Amnion ; Biopsy ; Epithelial Cells ; Eye ; Follow-Up Studies ; Humans ; Limbus Corneae ; Sensitivity and Specificity ; Transplants

PURPOSE: To report a case of isolated subconjunctival juvenile xanthogranuloma invading the corneal limbus in a patient with neurofibromatosis. METHODS: A 2-year-old boy visited the hospital with a conjunctival yellow-brown, non-tender mass of the left eye, which had been found 2 months earlier. Anterior segment examination revealed a 9 x 7 mm-sized subconjunctival elevated mass with an ill-defined border, invading the supero-temporal limbus. Additional ophthalmic examinations did not show any abnormal findings. In the trunk and extremities, there were multiple soft nodules and brown macules. An excisional biopsy of the subconjunctival mass, histopathologic and immunohistochemical examinations were performed. RESULTS: The mass was adhered to the episcleral tissue, without scleral or conjunctival involvement. The histological examination showed a granulomatous lesion consisting of multiple lipid-laden macrophages and other inflammatory cells. The immunohistochemical study showed positive staining for CD68 and negative staining for S100 protein. The multiple soft nodules and brown macules in the trunk and extremities were identified as neurofibromas and caf -au-lait macules by a dermatologist, and the patient was diagnosed with neurofibromatosis. CONCLUSIONS: We report a rare case of subconjunctival juvenile xanthogranuloma involving the limbus, associated with neurofibromatosis.
Biopsy ; Child, Preschool ; Extremities ; Humans ; Limbus Corneae ; Macrophages ; Male ; Negative Staining ; Neurofibroma ; Neurofibromatoses* ; Xanthogranuloma, Juvenile*

The retraction of the upper eyelid is associated with thyroid dysfunction, facial palsy, trauma, and overcorrection of ptosis and also occurs iatrogenically after eyelid or orbital surgery. In this condition, corneal exposure leads to discomfort, epiphora, and corneal irritation. Moreover increased showing of sclera above corneal limbus is considered one of cosmetic defect. Treatment modalities may be either medical or surgical. The medical treatments consists of control of thyroid dysfunction, steroid, sympatholytics. Many authors described surgical correction; recession of levator palpebral muscle or M ller muscle and graft matrix. The difficulties in surgical treatment consist of unpredictability of levator-M ller muscle manipulation, and healing of grafted material. Two patients have been operated with using of septal cartilage-mucosa composite graft. nasal septal cartilage-mucosa composite graft is autologous, firm, thin and harvested easily. The result was satisfactory functionally and aesthetically.
Eyelids* ; Facial Paralysis ; Humans ; Lacrimal Apparatus Diseases ; Limbus Corneae ; Orbit ; Sclera ; Sympatholytics ; Thyroid Gland ; Transplants*