PURPOSE: To investigate the influence of additional postoperative individualized teaching on the anxiety levels and self-care compliance of postoperative care in patients after one-day cataract surgery. METHODS: The present study included 80 cataract patients who underwent phacoemulsification and posterior intraocular lens insertion performed by a single operator between January 2011 and February 2011. The control group consisted of patients who received postoperative education from an ophthalmology coordinator based on previous hospital policy. The experiment group consisted of patients who received additional individualized postoperative education from an operator in the recovery room. Trait anxiety on operation day, state anxiety on postoperative day 1, and self-care compliance and postoperative satisfaction at postoperative 1 month were evaluated. RESULTS: There were no significant differences of trait anxiety levels on operation day or state anxiety on postoperative day 1 between the control and experiment groups. The experiment group revealed a higher score on the postoperative self-care compliance questionnaire, especially regarding care of the operation site. CONCLUSIONS: Individualized postoperative education increases self-care compliance level and contributes to improve postoperative recovery after one-day cataract surgery.
Anxiety ; Cataract ; Compliance ; Humans ; Lenses, Intraocular ; Ophthalmology ; Phacoemulsification ; Postoperative Care ; Surveys and Questionnaires ; Recovery Room ; Self Care

PURPOSE: To report the results of scleral suture fixation using a hydrophilic acrylic intraocular lens (IOL) with 3 hollow haptics through a small corneal incision, the Triple Cow-Hitch Method. CASE SUMMARY: Three-point suture fixation of a XL Stabi ZO IOL was performed in 5 eyes of 5 patients with aphakia after penetrating keratoplasty (PKP), vitrectomy and subluxated lens extraction. Postoperatively, the corrected distance visual acuity and spherical equivalent improved in all measured eyes. There were no cases of pigment dispersion or cystoid macular edema (CME). CONCLUSIONS: In this preliminary study, the triple cow-hitch method of suturing a hydrophilic acrylic IOL is an alternative to the conventional 2-point scleral fixation of sutured IOLs.
Aphakia ; Eye ; Humans ; Keratoplasty, Penetrating ; Lenses, Intraocular ; Macular Edema ; Sutures ; Visual Acuity ; Vitrectomy

PURPOSE: To investigate mean keratometric and refractive value after penetrating keratoplasty according to the difference between donor and recipient cornea size. METHODS: In a retrospective study, Keratoconus patients who underwent penetrating keratoplasty for keratoconus from January 2005 to July 2008 were examined. Preoperatively, axial length was measured using applanation ultrasonography and anterior chamber depth, white to white diameter were also measured using the corneal topography. The trephine size of donor and recipient during the surgery were recorded. Preoperatively, 6, 12, and 24 months postoperatively refraction and keratometric value were evaluated in groups divided according to corneal trephine size difference. RESULTS: Among the 41 eyes of 41 patients, there was a mean age at transplant of 26.4 years. After surgery, the decrease of anterior chamber depth could contribute to the decrease of myopic change. However, the differences between donor and recipient cornea size do not have a significant affect on postoperative keratometric or refractive value. CONCLUSIONS: There is no significant difference between the postoperative keratometric value and the corneal trephine size difference in keratoconus patients.
Anterior Chamber ; Cornea ; Corneal Topography ; Corneal Transplantation ; Eye ; Humans ; Keratoconus ; Keratoplasty, Penetrating ; Retrospective Studies ; Tissue Donors ; Transplants

PURPOSE: To report the optical coherence tomography (OCT) findings of three cases in various stages of juvenile-onset vitelliform macular dystrophy (Best disease). CASE SUMMARY: Medical records of six eyes from three patients diagnosed with Best disease were reviewed retrospectively. We evaluated the clinical features of the fundus, the electro-oculogram, and the optical coherence tomography (OCT) results. In the fundi of the three patients with Best disease, the characteristic stages of vitelliform, pseudohypopyon, and scrambled egg appearance were identified. Optical coherence tomography findings in the eyes of the patients with Best disease showed two types of outer retina-choroid complex (ORCC) changes, including splitting with intervening hyporeflective areas and elevation over hyporeflective area. CONCLUSIONS: The OCT findings showed variable patterns according to the progression of Best disease. In the pseudohypopyon stage, both neurosensory detachment and retinal pigment epithelial detachment appearance were identified. The exact location of the resulting lesions seems to depend on the relative impediment of fluid movement caused by the mutation of bestrophin.
Eye ; Humans ; Medical Records ; Ovum ; Retinal Detachment ; Retrospective Studies ; Tomography, Optical Coherence ; Vitelliform Macular Dystrophy

PURPOSE: To compare the effectiveness and safety of the hyperpulse phaco mode based on the custom control software with those of the conventional continuous phaco mode. METHODS: This study included 560 eyes of 496 patients, which were divided into 2 groups according to the mode of phacoemulsification. Each group was further stratified into 4 groups according to their nuclear opacity. The following parameters were compared between groups having the same degree of nuclear opacity: the best corrected visual acuity preoperatively, at 1 day and 2 months postoperatively, the change of endothelial cell count and hexagonality preoperatively and at 2 months postoperatively, as well as the total phaco energy used in the operation. RESULTS There were no significant differences in visual acuity between control and experiment groups. As for change in endothelial cell count, there were also no statisticallysignificant differences. Hexagonality was significantly higher in the nuclear opacity groups 3 and 4 of the hyperpulse mode than those of the continuous mode. The absolute phaco time was significantly less in the nuclear opacity groups 1, 2 and 3 of the hyperpulse mode than those of the continuous mode. CONCLUSIONS: Phacoemulsification using the custom control software showed an advantage decrease in the total phaco energy and corneal endothelial cell damage. This result will improve the postoperative prognosis.
Cataract* ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Humans ; Phacoemulsification ; Prognosis ; Visual Acuity

PURPOSE: To compare the effectiveness and safety of the hyperpulse phaco mode based on the custom control software with those of the conventional continuous phaco mode. METHODS: This study included 560 eyes of 496 patients, which were divided into 2 groups according to the mode of phacoemulsification. Each group was further stratified into 4 groups according to their nuclear opacity. The following parameters were compared between groups having the same degree of nuclear opacity: the best corrected visual acuity preoperatively, at 1 day and 2 months postoperatively, the change of endothelial cell count and hexagonality preoperatively and at 2 months postoperatively, as well as the total phaco energy used in the operation. RESULTS There were no significant differences in visual acuity between control and experiment groups. As for change in endothelial cell count, there were also no statisticallysignificant differences. Hexagonality was significantly higher in the nuclear opacity groups 3 and 4 of the hyperpulse mode than those of the continuous mode. The absolute phaco time was significantly less in the nuclear opacity groups 1, 2 and 3 of the hyperpulse mode than those of the continuous mode. CONCLUSIONS: Phacoemulsification using the custom control software showed an advantage decrease in the total phaco energy and corneal endothelial cell damage. This result will improve the postoperative prognosis.
Cataract* ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Humans ; Phacoemulsification ; Prognosis ; Visual Acuity

PURPOSE: We report a case of herpes zoster ophthalmicus in a 7-year-old child. METHODS: A 7-year-old boy presented with acute onset of vesiculopapular rash covering his left forehead, upper eyelid, and side of the nose. He was admitted via the pediatrics clinic and was referred to ophthalmology clinic for ophthalmologic examinations. RESULTS: On admission zoster ophthalmicus was limited to his skin and conjunctiva, but the disease progressed to zoster keratitis, uveitis, and meningitis. The patient was treated with topical, oral, and intravenous acyclovir. He had an uneventful recovery and was discharged. CONCLUSIONS: We experienced a case of zoster ophthamicus and meningitis in a patient without an apparent history of chickenpox.
Acyclovir ; Chickenpox ; Child* ; Conjunctiva ; Exanthema ; Eyelids ; Forehead ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Humans ; Keratitis ; Male ; Meningitis ; Nose ; Ophthalmology ; Pediatrics ; Skin ; Uveitis

PURPOSE: We report a case of orbital B-cell lymphoblastic lymphoma in a 7-year-old boy. METHODS: A 7-year-old boy presented with proptosis and periorbital swelling of his left eye following a periorbital blunt trauma 1-month prior. During the course of routine ophthalmologic and radiologic examinatinos, the swelling spontaneously subsided without specific treatment. An outpatient follow-up was planned, but the swelling recurred 6 months later. An orbital CT and MRI showed an irregular mass with an indistinct margin in the left orbit, for which an incisional biopsy was performed. RESULTS: The orbital mass consisited of monotonous small to medium sized lymphoid cells with evenly dispersed open chromatin, thin nuclear membrane and inconspicuous nucleoli. Immunohistochemistry revealed that the cells were positive for CD79a and TdT, but negative for CD3 and CD5. These findings were compatible with a diagnosis of B cell lymphoblastic lymphoma. CONCLUSIONS: Lymphoblastic lymphoma of the orbit should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.
B-Lymphocytes* ; Biopsy ; Child ; Chromatin ; Diagnosis ; Diagnosis, Differential ; Exophthalmos ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Nuclear Envelope ; Orbit* ; Outpatients ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Epidemic keratoconjunctivitis is the most common type of infectious conjunctivitis, and is caused by adenoviruses. The mode of transmission is mainly through direct contact with ocular secretions. Epidemic keratoconjunctivitis is generally diagnosed based on a patient's clinical features, and additional measures, such as cell cultures, polymerase chain reaction, and rapid antigen detection tests, can further confirm the diagnosis. The most common symptoms include a foreign body sensation, tearing, and photophobia. The symptoms are usually expressed unilaterally in the initial phase, but gradually become bilateral. Frequently occurring complications include pseudomembrane formation and subepithelial infiltrates. Currently, no antiviral agent has been proven effective to alter the natural course of the disease, and treatment merely has a supportive role instead of a curative role. Therefore, preventive measures in medical offices and in the community are the most important methods of controlling the propagation of this disease.
Adenoviridae ; Adenovirus Infections, Human ; Cell Culture Techniques ; Conjunctivitis ; Conjunctivitis, Viral ; Diagnosis ; Foreign Bodies ; Humans ; Keratoconjunctivitis* ; Photophobia ; Polymerase Chain Reaction ; Sensation ; Tears

PURPOSE: Anti-vascular endothelial growth factor (VEGF) agents have been used for the last 10 years, but their safety profile, including cytotoxicity against various ocular cells such as retinal pigment epithelial (RPE) cells, remains a serious concern. Safety studies of VEGF agents conducted to date have primarily relied on healthy RPE cells. In this study, we assessed the safety of three anti-VEGF agents, namely, ranibizumab, bevacizumab, and aflibercept, on senescent RPE cells. METHODS: Senescent human induced pluripotent stem cell-derived RPE cells were generated by continuous replication and confirmed with senescence biomarkers. The viability, proliferation, protein expression, and phagocytosis of the senescent RPE cells were characterized 3 days after anti-VEGF treatment with clinical doses of ranibizumab, bevacizumab, or aflibercept. RESULTS: Clinical doses of ranibizumab, bevacizumab, or aflibercept did not decrease the viability or alter proliferation of senescent RPE cells. In addition, the anti-VEGF agents did not induce additional senescence, impair the protein expression of zonula occludens-1 and RPE65, or reduce the phagocytosis capacity of senescent RPE cells. CONCLUSIONS: Clinical dosages of ranibizumab, bevacizumab, or aflibercept do not induce significant cytotoxicity in senescent RPE cells.
Aging ; Bevacizumab* ; Biomarkers ; Endothelial Growth Factors ; Epithelial Cells* ; Humans ; Phagocytosis ; Ranibizumab* ; Retinaldehyde* ; Vascular Endothelial Growth Factor A