No abstract available.
Ophthalmology*

Here, we report 3 cases of mixed tumor of the lacrimal gland. The age of the patients were 43, 26 and 35 respectively. The two of these were male and one female. The most outstanding complaint was exopthalmos. A mass was palpated on the orbit and eye ball deviation in downward position was present in all cases. Pathologic findings were mixed tumor of the lacrimal gland with no evidence of malignancy. These tumors were well encapsulated and any evidence of involving bone and soft tissue was not found. Modified Kroenlein-Berke operation was performed and tumor mass was removed entirely with finger dissection in all cases. The vision was not improved but the cosmetic result was satisfactorr.
Female ; Fingers ; Humans ; Lacrimal Apparatus* ; Male ; Orbit

There were many instances in which glaucoma, esp. primary, combined with hearing disturbance. The etiology of these cases has not been known until now. We had 15 primary glaucoma patients for whom pure tone audiometry wa~ performed, and could find the hearing defect in high tone in 5 cases (1/3 among those patients). The audiometric curve was similar to that in the presbycusis, but severer in degree than that occured within the normal physiological aging process. The average age was 62.4 year in the group with the hearing defect, and 45.6 year in the group without the hearing defect. There were no relationship between the hearing defect and intraocular tension, visual field change, glaucomatous cupping, and duration of glaucoma. These results may support the opinion of the authors that the hearing disturbance in glaucomatous patients is related to the arterioscIerotic changes which aggrevate the presbycusis, and not related to glaucoma itself. On the otherhand, however, it is stilI impossible for us to rule out that the pleiotropic and multifactorial genetic factors may play as a common important role in the hearing disturbances and glaucoma. And further studies would be necessary for these problems.
Aging ; Audiometry ; Glaucoma* ; Hearing* ; Humans ; Presbycusis ; Visual Fields

The tension lowering effects of Diamox and other carbonic anhydrase inhibitors are well known and they are widely used against a various forms of glaucomas. This paper deals with the clinical experiences in normal and glaucomatous human eyes with Diamox-Sequels, kindly supplied by Lederle Laboratories and Yuhan Corp. MATERIALS AND METHODS: Normal healthy persons, 15 females and 20 males, were studied on their 45 eyes. Glaucomatous disease had been ruled out by careful examinations of intraocular pressure, visual fields and fundus. They had been also checked for the diurnal variations of intraocular pressure during the daytime. One capsule (500mg) of Diamox Sequels was given to each individual and the changes in the intraocular pressure were studied at various time intervals up to 53 hours after the administration. Tonometry was carried out by the Goldmann's applanation tonometer. The effects of Diamox Sequels on the glaucomatous eyes were studied in the same way. The glaucomatous eyes included 10 eyes of 7 chronic simple glaucoma patients, 5 eyes of 3 chronic narrow-angle glaucoma patients and 5 eyes of 5 secondary glaucoma subjects. They received one capsule of Diamox Sequels and the intraocular pressure was measured one or two times daily. The results of long-term treatment were also studied by daily administration of one capsule of Diamox Sequels, follow-up periods being from 3 to 19 days. No medication, oral or local, of antiglaucomatous drugs were allowed for at least 3 days prior to this study. The differences due to age, sex and type of glaucoma were not considered here. At the same time, the effects of a single 500mg of ordinary Diamox tablet were studied in normal ~md glaucomatous eyes. RESULTS: (1) Normal eyes. The intraocular pressure began to fall 1 hour after the administration. The tension gradually fell and the maximal reduction of tension occurred after 9.8 hours and the extent of maximal fall was 4.5mm Hg on the average, 29.4 % of the original intraocular pressure. The tension gradually rose and returned to the original level between 23~50 hours (average 43 hours). Side effects were noted in 4 cases, e.g., 11.4 %. (2) Glaucomatous eyes. The effects were noted within the first 1~2 hours and became maximal after 13 hours, the extent of the maximal fall 40.1 % of the original pressure, e.g., 16.2 mmHg. The original tension was restored after 30 hours. By long-term administration of Diamox Sequels, 8 eyes(40 %) showed excellent results, their intraocular pressure maintained below 21 mmHg. Sede-effects were noted in 3 cases(20.0 %). COMMENTS: The effects of Diamox Sequels and Diamox tablet on normal and glaucomatous subjects were summarized in table 1. As shown, Diamox Sequels has the longer duration of hypotensive actions and the time of maximal fall of intraocular pressure delayed considerably, as compared with Diamox tablet. In almost all cases, its action continued for more than 24 hours. In glaucomatous eyes, the time of maximal reduction of ocular tension was slightly later and the maintenance of low tension was slightly shorter than those in normal eyes. The extent of the maximal fall, however, was almost the same after administration of Diamox Sequels and Diamox. Side effects were encountered in 11~20% of cases by Diamox Sequels, and in 40-60% of cases by Diamox. This is one of the most striking advantages of Diamox Sequels over Diamox. Thus it is concluded that Diamox Sequels has the longer hypotensive actions and fewer side effects.
Acetazolamide* ; Carbonic Anhydrase Inhibitors ; Female ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Male ; Manometry ; Strikes, Employee ; Visual Fields

I reviewed charts of 26 patients with superior oblique palsy who had been treated surgically. Diagnosis of superior oblique palsy was based on the Bielschowsky head tilt test(BHT) and overacting inferior oblique muscle. Four patients(15%) were diagnosed as having bilateral superior oblique palsy, and 22 patients(85%) were diagnosed as monocular superior oblique palsy. After myectomy of the overacting inferior oblique muscle, 6(27%) out of 22 patients initially diagnosed as monocular superior oblique palsy deveioped findings of superior oblique palsy on the opposite eye; these patients were considered as having masked bilateral superior oblique palsy. Among the 16 patients with unilateral superior oblique palsy, 11 patients(69%) showed negative BHT, 4 patients(25%) showed equivocal BHT and 1 patient(6%) still showed positive BET after surgery. Among the 14 patients who could be followed up for more than 3 months after the operation, 11 patients(79%) showed negative BHT, 2 patients(14.%) showed equivocal BHT, and 1 patient(7%) showed positive BHT. According to these results, the overacting inferior oblique muscle in superior oblique palsy plays a very important role in the elevation of the eye on ipsilateral head tilt, and the mechanism of the BHT classically described should be reconsidered. The primary operation was inferior oblique myectomy and secondary or tertiary operations were inferior oblique myectomy, marginal myotomy or superior rectus recession on the same or the other eye.
Butylated Hydroxytoluene ; Diagnosis ; Head ; Humans ; Masks ; Paralysis*

Inferior oblique myectomies or Z-myotomies were performed on 159 eyes of 121 patients who had an overacting inferior oblique muscle or muscles. The results were as follows; 1. Success rates were 95.5% in myectomy and 71.4% in Z-myotorny. 2. Recurrence rates were 2.7% in myectomy and 14.3% in Z-myotomy. 3. There were no other complications to include the adherence syndrome.
Adolescent ; Age Factors ; Child ; Child, Preschool ; Eye Diseases/*surgery ; Follow-Up Studies ; Humans ; Infant ; Oculomotor Muscles/*surgery ; Strabismus/complications

Strabismus surgeries using n-butyl-2-cyanoacrylate and 6-0 vicryl suture material were performed in 16 albino rabbits. Both eyes of 16 rabbits were used. The superior and inferior rectus muscles were recessed and resected 5 mm. In 12 rabbits, n-butyl-2-cyanoacrylate was used and those rabbits were divided into 3 groups, each group (4 rabbits, 8 eyes) was sacrificed 1, 2, and 3 weeks after operation respectively. The eyes were enucleated to examine the tensile strength and pathologic findings of the attached area. In 4 rabbits, 6-0 vicryl suture material was used as a control group in this study. This group was sacrificed and examined 3 weeks following the operation. In the cyanoacrylate groups, there were statistically significant differences and a chronologically increasing tendency of tensile strength between groups. Between the cyanoacrylate and the suture material group at 3 weeks post operation, there was no statistically significant differences in the tensile strength. Pathelogicallyr extraocular muscle bundles revealed patchy areas of interstitial inflammatory infiltration and fibrosis in the cyanoacrylate groups. Capillary telangiectasia and muscle fiber regeneration were commonly observed. The findings in specimens 3 weeks after operation revealed rather mild changes, suggesting healed lesions. In the suture material group, mild inflammatory reactions were found.
Animals ; Enbucrilate/*therapeutic use ; Rabbits ; Strabismus/pathology/*surgery ; Tensile Strength

The upshoot or downshoot that occurs when an eye is adducted in Duane's retraction syndrome is believed to be related to a taut lateral rectus muscle. When an eye is adducted, the lateral rectus muscle is slipped over the globe, producing this abnormal eye movement. Seven patients with Duane's retraction syndrome demonstrated this findings and underwent an Y-splitting operation on the lateral rectus muscle. Y-splitting and recession of the lateral rectus muscle is safe and simple procedure. All 7 patients demonstrated markedly decrease in the upshoot or downshoot after surgery.
Duane Retraction Syndrome ; Eye Movements ; Humans

Authors reviewed 53 infantile esotropia patients in 218 patients who had undergone surgery for esotropia from January, 1986 to March, 1988. Of 53 patients, male were 29(54.7%) and female were 24(45.3%). Age when first seen by us ranged from 6 months to 12 years and 4 months. Patients with age below 2 years old were 28(52.7%). 32 patients(60.4%) had alternate fixation and 21 patients(39.6%) had monocular fixation. Angle of deviation over 35 prism diopters was found in 41 patients(77.4%). By cycloplegic refraction, of 106 eyes, 81 eyes(76.4%) were low hyperopes(plano - +3.0D). Associated clinical findings were inferior oblique overactions in 37 patients(69.8%), dissociated vertical divergences in 18 patients(34.0%), latent nystagmus in 3 patients(5.7%), superior oblique overaction in 1 patient(1.9%). The monocular recession and resection was performed as an initial surgical procedure. If a second procedure was required, same procedure was performed in the fellow eye. In the patients with inferior oblique overaction, inferior oblique myectomy was performed. Mean age at the time of operation was 4 years and 2 months. After surgery, of 53 patients, 45 patients were followed up for 6 months or over. Of 45 patients, postoperative angle within 10 prism diopters of orthophoria was found in 16(35.6%) after initial operation and in 33(73.3%) after reoperation. In patients with large angle of esodeviation(greater than 40 prism diopters), 6mm recession seemed to provide better results than 5mm recession after initial recess-resect procedure.
Child, Preschool ; Esotropia* ; Female ; Humans ; Male ; Reoperation

There have been many problems in the treatment of exotropia. Especially, recurrence is very often while overcorrection is troblesome problem in the correction of recurrent exotropia. Considering less change in postoperative divergence at reoperation than at first operation, we performed unilateral lateral rectus recession in recurrent exotropia. Among the 40 patients who underwent recession and resection of horizontal recti in one eye and then unilateral lateral rectus recession in fellow eye because of recurrent exotropia greater than 15 delta, the cases who were followed more than three months were analyzed retrospectively. Forty patients were eligible. The male to female ratio was 13:27. The mean angle of recurrence was 21.4 delta regardless of the angle of first operation, and mean recurrence time was 18.8 months. The amount of divergence from postoperative 1 day to 3 or 4 month was 11.7 delta at first operation, 0.0 delta at second operation. Sixty five percents at 3 or 4 month. 60.9% at 6 or 8 month, and 55.6% at 12 or 14 month postoperatively showed stability within 10 delta. Among the 18 cases who were able to be tested fusion, 10 cases showed fusion with Worth 4-dot test(55.6%).
Exotropia* ; Female ; Humans ; Male ; Recurrence ; Reoperation ; Retrospective Studies