Aged ; Anterior Eye Segment ; pathology ; Female ; Glaucoma ; therapy ; Humans ; Pseudophakia ; therapy ; Tomography, Optical Coherence ; methods

Pseudoexfoliation syndrome is characterized by the presence of gray-white flakes on the pupillary borders and anterior lens capsule, increased trabecular meshwork pigmentation, and association with glaucoma. We describe 3 patients with this syndrome seen at Asan Meidcal Center Department of Ophthalmology in 1989, and we focus on their clinical features and management. We believe that patients with this syndrome are not as rare in Korea as has been thought, judging by scant report of cases in the past.
Aged ; Aged, 80 and over ; Anterior Eye Segment/*pathology ; Eye Diseases/*pathology ; Female ; Glaucoma, Angle-Closure/complications ; Glaucoma, Open-Angle/complications ; Humans ; Lens Diseases/pathology ; Male

PURPOSE: To evaluate the changes in anterior chamber depth (ACD) and angle width induced by phacoemulsification and intraocular lens (IOL) implantation in normal eyes using anterior segment optical coherence tomography (AS-OCT). METHODS: Forty-five eyes (45 patients) underwent AS-OCT imaging to evaluate anterior chamber configuration before and 2 days after phacoemulsification and IOL implantation. We analyzed the central ACD and angle width using different methods: anterior chamber angle (ACA), trabecular-iris angle (TIA), angle opening distance (AOD), and trabecular iris surface area (TISA) in the nasal and temporal quadrants. Comparison between preoperative and postoperative measurement was done using paired t-tests and each of the angle parameters was analyzed with Pearson correlation testing. Subgroup analyses according to the IOL and axial length were performed with a general multivariate linear model adjusted for age. RESULTS: Before surgery, the mean anterior chamber angle widths were 23.21 +/- 6.70degrees in the nasal quadrant and 24.89 +/- 7.66degrees in the temporal quadrant. The mean central ACD was 2.75 +/- 0.43 mm. After phacoemulsification and IOL implantation, the anterior chamber angle width increased significantly to 35.16 +/- 4.65degrees in the nasal quadrant (p = 0.001) and 36.03 +/- 4.86degrees in the temporal quadrant (p = 0.001). Also, central ACD increased to 4.14 +/- 0.31 mm (p = 0.001). AOD, TISA, and TIA increased significantly after cataract surgery and showed positive correlation with ACA. CONCLUSIONS: After cataract surgery, the ACD and angle width significantly increased in eyes with cataract. AS-OCT is a good method for obtaining quantitative data regarding anterior chamber configuration.
Adult ; Aged ; Aged, 80 and over ; Anterior Chamber/*pathology ; Anterior Eye Segment/pathology ; *Cataract Extraction ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Tomography, Optical Coherence/*methods

A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

PURPOSE: To analyze healing changes of corneal wounds of different corneal incision sizes with or without stromal hydration in cataract surgery using anterior segment optical coherence tomography. METHODS: Cataract surgeries were performed by a single surgeon and 2.2- and 2.8-mm corneal incisions were made using a diamond blade (ME-759; Meyco, Biel-Bienne, Swiss). Patients were divided into four groups according to incision size (2.2 and 2.8 mm), and with/without stromal hydration. Fifteen eyes were assigned to each group and incision wounds were measured using anterior segment optical coherence tomography at 2 hours, 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal thickness, incision length and incision angle were measured and existence of epithelial, endothelial gaping and Descemet's membrane detachment was evaluated. RESULTS: Incision thickness was greater in the group with stromal hydration than in the group without on operation day (p < 0.05). Stromal hydration exerted greater influence in the 2.2-mm incision group than in the 2.8-mm incision group. Corneal thickness decreased more rapidly in the stromal hydration group than in the group with no hydration (p = 0.022). Endothelial gaping was greater in the 2.2-mm incision group than in the 2.8-mm incision group 1 day, 1 month, and 3 months after surgery (p = 0.035, p = 0.009, and p = 0.008, respectively). No other statistical significance was observed between the two groups (2.2 and 2.8 mm) during follow-up regarding corneal thickness, epithelial gaping and Descemet's membrane detachment. CONCLUSIONS: Corneal wounds with a smaller incision could be more vulnerable to external stimuli such as stromal hydration and are less stable than those with a larger incision.
Aged ; Anterior Eye Segment ; Cataract Extraction/*methods ; Corneal Stroma/pathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Surgical Wound Dehiscence/diagnosis/*prevention & control ; Tomography, Optical Coherence/*methods ; *Wound Healing

Axenfeld-Rieger syndrome (ARS) is associated with ocular and systemic anomalies. PITX2 is known to be a major controlling gene in the pathogenesis of ARS and is associated with differentiation in both the neural crest and mesoderm during eye development. A 4-year-old girl with bilateral ARS had 20 prism diopters (PD) of exotropia with 30PD of A- pattern deviation, more than 20PD of dissociated vertical deviation (DVD), and severe superior oblique overaction (SOOA). During surgery we observed that the SO inserted more posteriorly than normal. We believe this finding is one of the abnormal manifestations of the development of the extraocular muscles in ARS.
*Abnormalities, Multiple ; Anterior Eye Segment/*abnormalities ; Child, Preschool ; Eye Abnormalities/*diagnosis/surgery ; Eye Movements ; Female ; Follow-Up Studies ; Humans ; Oculomotor Muscles/*abnormalities/surgery ; Ophthalmologic Surgical Procedures/*adverse effects ; Optic Nerve/abnormalities ; Postoperative Complications ; Sclera/*pathology/surgery ; Syndrome ; Tooth Abnormalities/*genetics

Alveolar Process ; pathology ; Anodontia ; diagnostic imaging ; etiology ; pathology ; Anterior Eye Segment ; abnormalities ; Cleidocranial Dysplasia ; complications ; Eye Abnormalities ; complications ; Hallermann's Syndrome ; complications ; Humans ; Malocclusion ; complications ; Prosthodontics ; Radiography ; Tooth Abnormalities ; complications

Axenfeld-Rieger syndrome (ARS) is characterized by anomalies of the anterior segment of the eye and systemic abnormalities. Mutations in the FOXC1 and PITX2 genes are underlying causes of ARS, but there has been few reports on genetically confirmed ARS in Korea. We identified a novel PITX2 mutation (c.300_301delinsT) in 2 Korean patients from a family with ARS. We expand the spectrum of PITX2 mutations and, to the best of our knowledge, this is the first confirmed family of PITX2-related ARS in Korea.
Adult ; Anterior Eye Segment/*abnormalities/pathology ; Base Sequence ; Child, Preschool ; Eye Abnormalities/*genetics/pathology ; Female ; Heterozygote ; Homeodomain Proteins/chemistry/*genetics ; Humans ; Mutation ; Pedigree ; Republic of Korea ; Transcription Factors/chemistry/*genetics

PURPOSE: We report on 15 cases of suspected toxic anterior segment syndrome after uneventful phaco surgery. METHODS: We retrospectively reviewed the charts of patients who had developed toxic anterior segment syndrome (TASS) after uneventful phacoemulsification for senile cataracts between April and December of 2005. Clinical features and all possible causes were investigated including irrigating solutions or drugs, surgical instruments or intraocular lenses, sterilization techniques for instruments, or any other accompanying disease. RESULTS: The patients consisted of 2 males and 13 females with an average age of 64.7+/-10.9 years. Five different surgeons had performed their phaco surgeries. No abnormal preoperative or operative findings were reported. Nevertheless, all 15 patients developed a moderate degree of corneal edema. Ordinary treatments were not helpful. We suspect that lack of sterilization resulted in the development of the syndrome, because after ethylene oxide gas sterilization was replaced with autoclaving, no such incidents have occurred. CONCLUSIONS: Toxic anterior segment syndrome requires special attention and thorough management, including sterilization of reused surgical instruments.
Aged ; Aged, 80 and over ; Anterior Eye Segment/*pathology ; Corneal Edema/*etiology/pathology/surgery ; Endophthalmitis/*etiology/pathology/surgery ; Endotoxins/adverse effects ; Female ; Humans ; Keratoplasty, Penetrating ; *Lens Implantation, Intraocular ; Male ; Middle Aged ; *Phacoemulsification ; *Postoperative Complications ; Retrospective Studies ; Syndrome