PURPOSE: To investigate the long-term follow-up results of arcuate keratotomy in femtosecond laser-assisted cataract surgery. METHODS: The medical records of 78 patients (99 eyes) with corneal astigmatism >0.5 diopters (D) who underwent arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery were retrospectively reviewed. Uncorrected and corrected visual acuities and keratometric and higher order aberration outcomes were compared preoperatively and 2 years postoperatively. RESULTS: The mean uncorrected visual acuities and corrected visual acuities changed from 0.55 ± 0.31 D and 0.33 ± 0.26 D, preoperatively to 0.13 ± 0.19 D and 0.07 ± 0.09 D, 2 years postoperatively. The mean preoperative corneal astigmatism was −1.15 ± 0.66 D. This was reduced to −0.79 ± 0.38 D at 1–2 days after surgery (p < 0.001), followed by no significant change for 2 years. The mean target-induced astigmatism was 1.15 ± 0.66 D preoperatively, and the mean surgically-induced astigmatism and difference vector were 0.69 ± 0.43 D and 0.83 ± 0.48 D, 2 years postoperatively. The mean correction index was 0.68 ± 0.45, 2 years postoperatively. There was no significant difference in higher order aberrations except 4 mm and 6 mm total higher order aberrations and 6 mm trefoil between preoperatively and 2 years postoperatively. CONCLUSIONS: Arcuate keratotomy concurrent with femtosecond laser-assisted cataract surgery is a safe and effective way to reduce corneal astigmatism which remained stable over 2 years of follow-up with below moderate astigmatism.
Astigmatism ; Cataract ; Follow-Up Studies ; Humans ; Lotus ; Medical Records ; Retrospective Studies ; Visual Acuity

Purpose: To investigate the clinical results of femtosecond laser-assisted cataract surgery (FLACS) in eyes previously implanted with a posterior chamber phakic intraocular lens (PIOLs). Methods: The medical records of 27 eyes were retrospectively reviewed. Each eye had history of implantation of posterior chamber PIOLs and newly got FLACS. Complications of intraoperative anterior capsulotomy and lens fragmentation were investigated. Uncorrected and corrected visual acuities (UCVA and BCVA), keratometric and manifest refraction (MR) values were compared preoperatively and postoperatively 1 day, 2 months and 6 months. Results: All eyes completed anterior capsulotomy without any intraoperative complication. However, 13 eyes out of 18 eyes experienced incomplete lens fragmentation. Vaultings of 5 eyes with complete lens fragmentation were 460.40 ± 199.11 μm (0.84 ± 0.35 corneal thickness [CT]) and vaultings of the other 13 eyes with incomplete lens fragmentation were 225.85 ± 151.2 μm (0.43 ± 0.29 CT). 2 eyes with vaultings of 460 μm and 412 μm failed to complete lens fragmentation due to corneal opacity. All eyes could be completed whole surgery without additional complications. Conclusions FLACS in eyes with posterior chamber PIOLs is useful to execute anterior capsulotomy. However, there is a limitation in doing lens fragmentation because of bubble accumulated under PIOLs.

Purpose: To observe results in drusen patients with epiretinal membrane after a vitrectomy and membrane peeling. Methods: This retrospective, observational study included drusen patients diagnosed with epiretinal membrane after vitrectomy with membrane peeling. Twenty eyes had epiretinal membrane with drusen (group 1) and 112 eyes had epiretinal membrane without drusen (group 2). At the 6 month follow-up, central foveal thickness and changes in best-corrected visual acuity (BCVA) were evaluated. In Group I, the results with drusen size <65 μm and size >65 μm were compared. The largest drusen size change was measured and compared according to the existence of preoperative intraretinal cysts or ellipsoid zone disruption. Results: Preoperatively and at 6 months postoperatively, the average size of the largest drusen was 198.23 ± 27.34 and 192.23 ± 26.12 μm, respectively, and there was no significant change during the follow-up period. Group I patients with intraretinal cysts and ellipsoid zone disruption experienced low BCVA during the preoperative period; the BCVA had improved postoperatively at 6 months, but with limitations. Conclusions Postoperatively at 6 months, no significant change was observed in the largest drusen size after vitrectomy and membrane peeling. Thus, drusen patients with epiretinal membrane, as well as intraretinal cysts or ellipsoid zone disruption can expect an extended recovery period and slow BCVA improvement.

PURPOSE: To present differences in visual acuity and macular structure before and after surgery in patients with idiopathic epiretinal membrane (ERM) according to the presence of retinoschisis. METHODS: This retrospective observational study included 324 eyes with idiopathic ERM, that underwent pars plana vitrectomy with ERM and internal limiting membrane peeling, and were followed for more than 6 months. Subjects were classified into two groups according to the presence of retinoschisis using preoperative optical coherence tomography (OCT; group 1, ERM with retinoschisis; group 2, ERM without retinoschisis). Preoperative and postoperative macular structure changes and surgical outcomes were compared. RESULTS: Group 1 included 61 eyes, and group 2 included 263 eyes. Group 1 had a significantly higher preoperative and final postoperative best-corrected visual acuity compared with group 2 (p = 0.01, p = 0.02). Preoperative disorganization of retinal inner layers (DRIL) was significantly less in group 1 than group 2 (p = 0.01). Preoperative central macular thickness was not significantly different between the two groups. However, postoperative central macular thickness was significantly lower in group 1 than group 2 (p = 0.02, p = 0.01, p < 0.01). The ratio of the inner or outer layer in the total retinal thickness before surgery was significantly smaller in group 1 than in group 2 (p = 0.02, p = 0.04). CONCLUSIONS: Preoperative visual acuity was better and the occurrence of DRIL was less in idiopathic ERM with retinoschisis than without retinoschisis. Postoperative visual and structural outcome was better in idiopathic ERM with retinoschisis than without retinoschisis. Retinoschisis may have played a role in reducing the tractional force given to the inner and outer retina.
Epiretinal Membrane ; Humans ; Membranes ; Observational Study ; Retina ; Retinaldehyde ; Retinoschisis ; Retrospective Studies ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy

Purpose: To observe results in drusen patients with epiretinal membrane after a vitrectomy and membrane peeling. Methods: This retrospective, observational study included drusen patients diagnosed with epiretinal membrane after vitrectomy with membrane peeling. Twenty eyes had epiretinal membrane with drusen (group 1) and 112 eyes had epiretinal membrane without drusen (group 2). At the 6 month follow-up, central foveal thickness and changes in best-corrected visual acuity (BCVA) were evaluated. In Group I, the results with drusen size <65 μm and size >65 μm were compared. The largest drusen size change was measured and compared according to the existence of preoperative intraretinal cysts or ellipsoid zone disruption. Results: Preoperatively and at 6 months postoperatively, the average size of the largest drusen was 198.23 ± 27.34 and 192.23 ± 26.12 μm, respectively, and there was no significant change during the follow-up period. Group I patients with intraretinal cysts and ellipsoid zone disruption experienced low BCVA during the preoperative period; the BCVA had improved postoperatively at 6 months, but with limitations. Conclusions Postoperatively at 6 months, no significant change was observed in the largest drusen size after vitrectomy and membrane peeling. Thus, drusen patients with epiretinal membrane, as well as intraretinal cysts or ellipsoid zone disruption can expect an extended recovery period and slow BCVA improvement.

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

OBJECTIVE: To describe the classification and prognosis of the patients with spinal muscular atrophy (SMA). METHOD: The medical records of thirty one patients, who were diagnosed as SMA by electromyography or muscle biopsy from January 1987 to December 1999, were reviewed retrospectively. Classification of SMA was mainly based on age at onset and achieved milestones. RESULTS: Patients with SMA type I, II and III were 17 (54.8%), 7 (22.6%) and 3 (9.7%) respectively. Four patients were unclassifiable due to functional improvements. Two patients who were classified as SMA type I, had achieved ability to sit unaided at last follow up (at 20 months and 24 months old). Two patients who were classified as SMA type II, could walk independently at last follow up (at 34 month and 26 years old). In three of SMA type I patients, functional improvements of rolling over and head control were achieved. CONCLUSION: Classification of SMA based on age at onset and achieved milestones was helpful in prediction of prog nosis. But 12.9% of SMA patients were not classifiable due to unexpeceted functional improvement.
Biopsy ; Classification* ; Electromyography ; Follow-Up Studies ; Head ; Humans ; Medical Records ; Muscular Atrophy, Spinal* ; Prognosis ; Retrospective Studies

We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms revealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardio- pulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.
Aged ; Aneurysm ; Aneurysm, Dissecting ; Aortic Aneurysm, Thoracic* ; Cardiopulmonary Bypass ; Cerebral Infarction ; Constriction ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Diaphragm ; Heart ; Humans ; Hypoxia, Brain ; Rupture ; Saphenous Vein ; Shock ; Subclavian Artery ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Transplants

No abstract available.
Hematocrit* ; Humans ; Renal Dialysis*

Anomalous origin of left coronary artery from pulmonary artery(ALCAPA) is a rare fatal congenital anormaly that needs early surgical intervention. Many reports say that the choice of operative procedure is reimplantation of the left coronary artery into the ascending aorta. We experienced the surgical management of a case of the ALCAPA. The patient was 44 days old and 3.45 kg weighed female baby who had a symptom of congestive heart failure. She underwent implantation of coronary artery on the aorta with cardiopulmonary bypass and recovered without any complications.
Aorta ; Bland White Garland Syndrome ; Cardiopulmonary Bypass ; Coronary Vessels* ; Female ; Heart Failure ; Humans ; Pulmonary Artery* ; Replantation ; Surgical Procedures, Operative