PURPOSE: To report the distribution of ocular higher-order aberrations in candidates for refractive surgery measured by Zywave(R) II aberrometer. METHODS: The present study included 232 eyes of 116 subjects. Ocular aberration data were obtained by measurements per eye using Zywave(R) II aberrometer. The mean Zywave spherical equivalent (SE) and higher order aberrations (HOAs) calculated in the central 6-mm zone and expressed as root mean square (RMS) values were analyzed. Correlation analysis was performed to assess the association between ocular HOAs and gender, age, SE refractive error, or central corneal thickness (CCT) and investigate the aberration symmetry between right and left eyes. RESULTS: The average SE was-4.67 +/- 1.83 diopters (D). The mean RMS values of total HOA, 3rd, 4th or 5th summated HOAs, coma, trefoil and spherical aberration (SA) were 0.421 +/- 0.201 microm, 0.346 +/-0.206 microm, 0.202 +/- 0.105 microm, 0.087 +/- 0.048 microm, 0.241 +/- 0.172 microm, 0.225 +/- 0.154 microm and 0.136 +/- 0.102 microm, respectively. There was no significant differences of the mean total HOA, summated HOAs, coma, trefoil and SA between genders, age and refractive errors, but the 3rd order trefoil was strongly related with myopia (r = -0.900, p = 0.008). There was symmetry of ocular aberrations between both eyes and the ocular aberrations were not correlated with CCT. CONCLUSIONS: Herein, we report the normative distribution of ocular aberrations in the myopic Korean population measured by Zywave(R) II aberrometer. The 3rd order trefoil and myopia were correlated and mirror symmetry was observed between right and left eyes.
Aniline Compounds ; Coma ; Lotus ; Myopia ; Refractive Errors ; Refractive Surgical Procedures*

PURPOSE: To evaluate the correlation between nuclear density measured using the Pentacam(R) (Oculus Optikgerate GmbH, Wetzlar, Germany) Scheimpflug imaging system and phacoemulsification parameters. METHODS: The nuclear density was measured using maximal nuclear density with ImageJ, Pentacam(R) nucleus staging (PNS), average value and maximal value in lens densitometry. Intraoperatively, effective phaco time (EPT) and balanced salt solution (BSS) used were noted and compared with the nuclear density calculation methods. As an index of corneal endothelial cells, the changes in cell density (CD) were compared with the nuclear density. RESULTS: Regarding EPT, maximal nuclear density with ImageJ (r = 0.379, p < 0.01) and PNS (r = 0.367, p < 0.01) were correlated positively, but the other methods were not correlated. Concerning BSS used, maximal nuclear density with ImageJ (r = 0.279, p = 0.03) and PNS (r = 0.286, p = 0.04) were positively correlated, but the other methods were not correlated. The specular microscopy showed that as the nuclear density increased, the postoperative CD tended to decrease, but without statistical significance. CONCLUSIONS: Preoperative nuclear density measurements using maximal nuclear density with ImageJ or PNS were correlated with phacoemulsification parameters.
Cell Count ; Densitometry ; Endothelial Cells ; Microscopy ; Phacoemulsification*

PURPOSE: The present study evaluated the clinical results of phototherapeutic keratectomy (PTK) for refractory recurrent corneal erosion (RCE). METHODS: A total of 12 eyes from 11 RCE patients who had been initially treated with conservative therapy but suffered from recurrence, were treated using PTK with 193 nm excimer laser. The preoperative and postoperative best corrected visual acuity (BCVA), spherical equivalent, average keratometric value, re-epithelialization time, corneal haze, complications and recurrence were investigated. RESULTS: PTK was combined with photorefractive keratectomy in 1 eye. The mean follow-up time was 11.42 months. All 12 eyes were successfully treated and had no recurrence during the follow-up except 1 eye where the symptoms recurred 9 months postoperatively. Postoperative BCVAs were all better than the preoperative BCVAs. Mild myopic change (average -0.20 diopter) and increased average keratometric values (average 0.27 diopter) were noted in 11 eyes which were treated using PTK alone. The average re-epithelialization time was 5.63 days. No specific complication except mild corneal haze was found. CONCLUSIONS: PTK is a safe and effective treatment for refractory RCE in short-term follow-up.
Eye ; Follow-Up Studies ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy ; Re-Epithelialization ; Recurrence ; Visual Acuity

Purpose: To report a case of episcleral capillary hemangioma.Case summary: A 17-year-old woman with a left conjunctival mass since the age of 4 years visited our clinic with lesion growth that began 4 months prior. At the initial visit, the patient presented with a subconjunctival hemangiomatous mass of 3.5 × 4.5 mm in size and firmly adhered to the underlying sclera, with a feeding vessel on the temporal side of the left eye. Excisional biopsy of the mass and amniotic membrane transplantation were performed. The biopsy showed many enlarged, congested blood vessels involving subconjunctival and episcleral tissue, consistent with capillary hemangioma, as confirmed by immunohistochemical staining. There was no evidence of other hemangiomatous lesions in the eye or other areas of the body. To date, the patient has been without hemangioma recurrence for 1 year. Conclusions We noted a solitary episcleral capillary hemangioma and successfully treated the lesion.

Purpose: This study analyzed the microorganisms identified in donor corneas and their clinical significance. Methods: The medical records of 94 patients (114 eyes) who underwent keratoplasty and microbiological tests of the donor corneas from October 2008 to December 2020 at our hospital were reviewed retrospectively. During keratoplasty, we conducted microbiological tests of the corneoscleral rim of the donor cornea and preserving solution Optisol™-GS (Bausch & Lomb, Rochester, NY, USA), and examined the antibiotic susceptibility of bacterial isolates from the cultures. Results: Some isolates of domestic donor corneas revealed bacteria, but none of the imported corneas did. Gram-negative bacilli were detected from the corneoscleral rim in three eyes (2.6%): two cases of Acinetobacter baumannii/haemolyticus and one case of Pseudomonas aeruginosa. In one case (0.9%), Acinetobacter baumannii/haemolyticus was identified from preserving solution, with no bacteria found in the corneoscleral rim. Antibiotic susceptibility tests showed multi-drug resistance, except to colistin. In all cases where bacteria were detected, there was no keratitis or endophthalmitis after corneal transplantation. Conclusions Although rare, bacteria can be identified from donor corneas or the preserving solution used in corneal transplantation. Therefore, caution is needed in all processes dealing with donor corneas. Empirical antibiotics that have sufficient antimicrobial activity to suppress multi-drug resistant bacteria should be selected in corneal transplantation.

Purpose: To report a case of conjunctival fibroma after excision of a recurrent pterygium.Case summary: A 44-year-old male was referred with pterygium recurrence. The patient had undergone pterygium surgery on his left eye 7 years prior. Examination of the conjunctiva revealed fibrovascular proliferative tissue that had grown onto the cornea at the medial limbus in his left eye. The patient underwent pterygium excision, amniotic membrane transplantation, and intraoperative 0.02% mitomycin C soaking. Pterygium was confirmed histologically. Two years after surgery, a 5 × 3 mm semi-translucent, white conjunctival mass at the medial limbus was found in the left eye. The best-corrected visual acuity was 1.0 in both eyes and the intraocular pressure was within normal limits. Suspecting recurrent pterygium, the patient underwent excision of the conjunctival mass, conjunctival autograft, and 0.02% mitomycin C soaking during surgery. Under histologic examination, paucicellular substantia propria with abundant collagen and scattered fibroblasts was observed; the mass was diagnosed as conjunctival fibroma. No sign of recurrence was evident 2 years postoperatively. Conclusions Although conjunctival mass after pterygium excision is likely to be recurrent pterygium in most cases, there is the rare possibility of conjunctival fibroma; thus, histologic examination should be performed for differential diagnosis.

Purpose: We analyzed the clinical efficacy, retention rates, and complications after inserting two types of silicone plugs in dry eye patients. Methods: The medical records of 73 patients (133 eyes) whose lacrimal puncta were occluded with the SuperEagle Punctum Plug™ (EagleVision, Denville, NJ, USA) or the Parasol Punctum Plug™ (Beaver-Visitec International, Inc. Waltham, MA, USA) were analyzed. Conventional indices for dry eye disease and tear meniscus height (TMH) using optical coherence tomography were used to determine the clinical efficacy. The overall retention rates and complications were investigated and those of each plug were compared between the two groups during the first 6 months after insertion. Results: The average age was 52.52 ± 13.66 years (13-82 years). Group A included 79 eyes and group B included 54 eyes. TMH tended to increase after 6 months regardless of plug loss or removal due to complications. Schirmer Ⅰ test value differences before and 6 months after plug insertion were positively correlated with the TMH differences in study subjects (p = 0.007). Plug loss was the most frequent complication in both groups. The retention rate of the Parasol plug was higher than the SuperEagle plug (44.4% and 24.1% respectively) (p = 0.012) and the retention rate of medium-sized plugs was higher than small-sized plugs (p = 0.027). Also, the plug retention rate decreased with age at 6 months (p = 0.032). Conclusions Punctal occlusion with a silicone punctal plug was effective, regardless of the plug type or complication. The retention rate of the Parasol plug was higher than the SuperEagle plug.

Purpose: To report a case of conjunctival fibroma after excision of a recurrent pterygium.Case summary: A 44-year-old male was referred with pterygium recurrence. The patient had undergone pterygium surgery on his left eye 7 years prior. Examination of the conjunctiva revealed fibrovascular proliferative tissue that had grown onto the cornea at the medial limbus in his left eye. The patient underwent pterygium excision, amniotic membrane transplantation, and intraoperative 0.02% mitomycin C soaking. Pterygium was confirmed histologically. Two years after surgery, a 5 × 3 mm semi-translucent, white conjunctival mass at the medial limbus was found in the left eye. The best-corrected visual acuity was 1.0 in both eyes and the intraocular pressure was within normal limits. Suspecting recurrent pterygium, the patient underwent excision of the conjunctival mass, conjunctival autograft, and 0.02% mitomycin C soaking during surgery. Under histologic examination, paucicellular substantia propria with abundant collagen and scattered fibroblasts was observed; the mass was diagnosed as conjunctival fibroma. No sign of recurrence was evident 2 years postoperatively. Conclusions Although conjunctival mass after pterygium excision is likely to be recurrent pterygium in most cases, there is the rare possibility of conjunctival fibroma; thus, histologic examination should be performed for differential diagnosis.

Purpose: We analyzed the clinical efficacy, retention rates, and complications after inserting two types of silicone plugs in dry eye patients. Methods: The medical records of 73 patients (133 eyes) whose lacrimal puncta were occluded with the SuperEagle Punctum Plug™ (EagleVision, Denville, NJ, USA) or the Parasol Punctum Plug™ (Beaver-Visitec International, Inc. Waltham, MA, USA) were analyzed. Conventional indices for dry eye disease and tear meniscus height (TMH) using optical coherence tomography were used to determine the clinical efficacy. The overall retention rates and complications were investigated and those of each plug were compared between the two groups during the first 6 months after insertion. Results: The average age was 52.52 ± 13.66 years (13-82 years). Group A included 79 eyes and group B included 54 eyes. TMH tended to increase after 6 months regardless of plug loss or removal due to complications. Schirmer Ⅰ test value differences before and 6 months after plug insertion were positively correlated with the TMH differences in study subjects (p = 0.007). Plug loss was the most frequent complication in both groups. The retention rate of the Parasol plug was higher than the SuperEagle plug (44.4% and 24.1% respectively) (p = 0.012) and the retention rate of medium-sized plugs was higher than small-sized plugs (p = 0.027). Also, the plug retention rate decreased with age at 6 months (p = 0.032). Conclusions Punctal occlusion with a silicone punctal plug was effective, regardless of the plug type or complication. The retention rate of the Parasol plug was higher than the SuperEagle plug.

PURPOSE: To evaluate the clinical results of anterior stromal puncture (ASP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for refractory recurrent corneal erosion (RCE). METHODS: Ten eyes of eight patients with RCE showing poor response to conservative therapy who were treated with Nd:YAG laser ASP and followed up for at least 4 months were studied. The cause and duration of erosions, times, and total energy of the laser were recorded. The preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, complications, and recurrence were reviewed. RESULTS: The mean follow-up time was 9.6 months. The laser energy setting was 0.2 or 0.3 mJ per shot. The average total laser energy was 6.2 mJ. Two of 10 eyes received another Nd:YAG laser treatment. All 10 eyes were successfully treated and had no recurrence after the operation during follow-up. Postoperative BCVAs were equal to or better than the preoperative BCVAs. No significant complications except faint corneal haze were observed. CONCLUSIONS: Nd:YAG laser ASP is an effective and safe procedure to treat refractory RCE in short-term follow-up.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Punctures* ; Recurrence ; Viperidae ; Visual Acuity