PURPOSE: To evaluate the histopathologic changes after insertion of polymer made of poly- glycolic acid(PGA) and poly(lactic acid-co-glycolic acid)(PLGA)/5-FU following filtering surgery in the rabbit. METHOD: A polymer with 0.3 mm thickness made of PGA and PLGA/5-Fluorouracil(5-FU, 10% by weight) composite were made in a size of 3 x 7 mm. After full-thickness filtration surgery performed, PGA was inserted under the conjunctiva in group I, PLGA/5-FU was inserted in group II and none in control group. Twelve rabbit eyes were enrolled in each group. RESULT: Postoperatively, no serious complication was found in anterior segment. In the control eyes inflammatory cell reaction was minimal at 2 weeks after surgery and decreased thereafter. While severe fibrovascular tissue reaction with loss of conjunctival filtration space was noted at 2 and 4 weeks after surgery in group I, the filtration space was well maintained without fibrovascular tissue reaction until 4 weeks after surgery in group II. At 8 weeks after surgery, fibrous tissue reaction was observed in group I, but not in group II and contol. The polymer was not found and the filtration space was obliterated at 8 weeks after surgery in group I and II. CONCLUSION: PLGA/5-FU may be used as an effective adjunct to improve the success rate of the filtration surgery, without inducing serious fibrous tissue reaction. PGA was not suitable.
Conjunctiva ; Filtering Surgery* ; Filtration ; Polymers*

OBJECTIVE: To find a safe, effective, simple and low-cost method of anesthesia delivery in large-incision cataract surgery that will avoid all the complications of Retrobulbar, Peribulbar and Periocular anesthesia METHODS: 150 eyes underwent ECCE with posterior capsule lens utilizing only topical and subconjunctival anesthesia using a mixture of 2% Lidocaine and a drop of Epinephrine 1:1000. For akinesia, the Modified Van-Lint technique was used with 2% lidocaine RESULTS: Not one patients complained of pain during the procedure even when iridectomies were done. Immobilization of the globe and exposure of the "working area" (superior limbus was satisfactory using fixation sutures in the nasal and temporal bulbar conjunctiva in lieu of a superior rectus bridle suture which was eliminated from the procedure because of the pain CONCLUSION: Our new method of anesthesia delivery in large-incision cataract surgery leads to the following information: 1) no need for superior rectus bridle suture; 2) even without ciliary ganglion anesthesia, no pain is elicited with iridectomies; 3) no need for an expensive mixture of anesthetics; 4) no need for the anesthetic to enter even an mm into the orbit. (Author)
Human ; ANESTHESIA, SURGERY, BULBAR CONJUNCTIVA, LIDOCAINE, EPINEPHRINE

The anatomy of Korean eyelid is different from that of Caucasians. The cosmetic or reconstructive eyelid surgery is also different from that of Caucasians. Cosmetic eyelid surgery is one of the most popular forms of aesthetic surgery of the Korean face. For proper cosmetic eyelid surgery, plastic surgeon must to master the anatomy of eyelid of Koreans. The eyelids are complex specialized facial adaptations designed to protect, moisten, and clean the ocular surfaces. These components are modified by structures as skin, orbicularis oculi muscle, orbital septum and fat, levator palpebral superioris, Muller muscle, tarsal plate and conjunctiva. All of the complex structures of upper eyelid are morphologically and functionally connected with each other. And it is very important to understand these connections to perform the plastic surgery. However, it is difficult to find references an books that mentioned precise anatomy of Koreans. To get good result in cosmetic eyelid surgery in Koreans, we must have deep, precise knowledge of anatomy in Korean eyelid. We hope that this article offer to better understanding of complex eyelid anatomy and helpful to plastic surgeon for cosmetic eyelid surgery in Korean eyelid.
Conjunctiva ; Eyelids* ; Hope ; Orbit ; Skin ; Surgery, Plastic

No abstract available.
Aged ; Amnion/*transplantation ; Conjunctiva/*surgery ; Female ; Glaucoma/surgery ; Humans ; Intraoperative Complications/*surgery ; Trabeculectomy/*adverse effects

OBJECTIVETo investigate the treatment of minor exophthalmos by enlargement of orbital volume through conjunctive approach.

METHODSThrough the conjunctive approach medial to the eye ball, the dissection was performed subperiosteally to expose the ethmoid bone at the medial orbital wall. The exposure bone was 2.5-3.0 cm in length and 2.0-2.5 cm in width. Then the ethmoid bone was fractured to enlarge the orbital volume. From June 2006 to April 2008, 3 cases were treated.

RESULTSThe patients recovered in a short time with no visible skin scar. The technique was mini-invasive, and didn't affect the function of eyeball.

CONCLUSIONIt is easy and effective way to correct the minor exophthalmos by enlargement of orbital volume through conjunctive approach.

Adult ; Conjunctiva ; surgery ; Exophthalmos ; surgery ; Female ; Humans ; Orbit ; surgery ; Treatment Outcome ; Young Adult

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; CONJUNCTIVA/TRANSPLANTATION ; CONJUNCTIVA/SURGERY ; TRANSPLANTATION, AUTOLOGOUS ; OPHTHALMOLOGIC SURGICAL PROCEDURES ; PTERYGIUM/SURGERY ; HUMAN ; MALE ; FEMALE

During filtration surgery for glaucoma, the conjunctival incision site is sutured watertightly with a suture material like 10-0 nylon. However, this suture material may cause the infiltration of inflammatory cells, and the proliferation and migration of fibroblasts and collagen fibers at the junction of the conjunctiva and episclera. Subsequently, the arrangement of collagen fiber in episclera would be disrupted and the outflow of aqueous humor could be occluded. In the search for a more suitable suture material, the fibrin glue(Tisseel(R)) was introduced recently. It is claimed to be simple to use and safe, causes less damage and less inflammatory reaction than nylon. The authors used 10-0 nylon(control group) on the right eye and fibrin glue(Tisseel(R))(experimental group) on the left eye of a white rabbit's conjunctival suture. We compared and evaluated the clinical and histological effects of the suture material on the suture site as well as on the intraocular region. The results were as follows; 1. In the experimental group, conjunctival injection and chemosis were mild and disappeared rapidly. 2. The filtering bleb was macroscopically well formed and maintained from the third postoperative day in both groups, but, thereafter, it decreased in size in two cases of the control group. 3. There was no difference in the inflammatory reaction in anterior chamber in both groups postoperatively. 4. In the experimental group, there was loosening of the fibroblasts proliferation and lesser infiltration of inflammatory cells at the postoperative second and fourth week. And the arrangement of collagen fibers in episclera was intact. The above findings strongly suggest fibrin glue(Tisseel(R)) as a suture material in the filtration surgery of glaucoma is clinically promising.
Anterior Chamber ; Aqueous Humor ; Blister ; Collagen ; Conjunctiva ; Fibrin* ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma ; Nylons ; Rabbits* ; Sutures

The effect of mitomycin on the corneal endothelial cell density was evaluated between the mitomycin group of 23 eyes who underwent trabeculectomy with mitomycin and the control group of 20 eyes who underwent trabeculectomy. The mitomycin(0.2 mg/ml) was applied under the scleral flap, Tenon's capsule or conjunctiva during trabeculectomy for 2-5 minutes(average: 4 minutes) and was irrigated with 50ml of balanced salt solution. Average central endothelial cell loss in the mitomycin group was 10.1 +/- 7.1% and 8.4 +/- 8.3% in the control group(P>0.05, t-test). A shallow anterior chamber with iridocorneal touch(Spaeth's grade 1 and 2) was developed in 12(52%) of 23 eyes in the mitomycin group and 9(45%) of 20 eyes in the control group(P>0.05, chi-square). The average central endothelial cell loss was 12.7 +/- 8.3% in 21 eyes with iridocorneal touch and 5.9 +/- 5.4% in 22 eyes that maintained their anterior chamber(P<0.05, t-test). In 21 eyes with iridocorneal touch average central endothelial cell loss was 12.6 +/- 7.8% in the mitomycin group, and 12.8 +/- 9.5% in the control group(P>0.05, t-test). In 22 eyes that maintained their anterior chamber, average loss was 7.1 +/- 5.4% in the mitomycin group, and 4.8 +/- 5.4% in the control group(P>0.05, t-test). These findings suggest that intraoperative use of mitomycin(0.2 mg/ml) during trabeculectomy is unlikely to cause profound corneal endothelial cell loss and iridocorneal touch after the filtering surgery is associated with greater loss of endothelial cells.
Anterior Chamber ; Conjunctiva ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Filtering Surgery ; Mitomycin* ; Tenon Capsule ; Trabeculectomy*

The conjunctival wound leakage that occurs often afterglaucoma filtering surgery may predispose to the development of hypotony, infection, and bleb failure, so primary resuturing is tried to prevent them usually. Recently, because of the friable conjunctiva due to the use of mitomycin C(MMC) during the glaucoma filtering surgery, re-leakage is frequent after resuturing. We thought of the method that compress the leaking site without direct injury to leaking conjunctival wound and tried to the 4 patients, 6 eyes with the conjunctival wound leakage who had received the MMC trabeculectomy with fornix based conjunctival flap. We performed the suture posterior to the leaking sithe across the conjunctival flap with the nonabsorbing suture material after local anesthesia for the block of leakage due to the compression. Postoperatively, the sutures were removed at the time of no leakage and complete healing at conjunctival wound. And we had a good results in all 6 eyes in recent 2 years. The method of compression using this suture is one adequate method of management in conjunctival wound leakage after glaucoma filtering surgery.
Anesthesia, Local ; Blister ; Conjunctiva ; Filtering Surgery ; Glaucoma ; Humans ; Mitomycin ; Suture Techniques* ; Sutures* ; Trabeculectomy ; Wounds and Injuries*

Here, we report a large, overhanging cystic bleb that compromised vision and induced a foreign body sensation in a patient who underwent a trabeculectomy surgery with anti-metabolite therapy 4 years prior. Ultrasound biomicroscopy revealed multiple loculations with thin septa inside the bleb and a high risk of damage to the bleb was anticipated with a straight forward surgical excision. We injected autologous blood and placed a compression suture 6 weeks prior to surgical excision of the overhanging portion of the bleb. The operation was successful in preserving excellent bleb function, restoring visual acuity, and alleviating symptoms in our patient with up to 9 months of follow-up.
Blister/pathology/*surgery ; Blood Transfusion, Autologous/*methods ; Conjunctiva/pathology/surgery ; Glaucoma/*surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications/*surgery ; *Suture Techniques ; Trabeculectomy/*adverse effects