This study reports the vision status of a presbyopic patient who has undergone a corneal inlay procedure. The study hopes to provide optometrists more insight on the procedure and the co-management involved in such a patient. The patient, a 48 years-old Chinese woman with presbyopia underwent the corneal inlay procedure three years ago. She had the inlay implanted in the non-dominant eye to aid near vision i.e. her left eye. The pre and post-operative evaluations include distance and near visual acuity, fundoscopy, tonometry, Schirmer’s test, slit lamp evaluation, corneal topography and corneal pachymetry. Near visual acuity for the left eye improved from N14 to N5 immediately after the procedure. Even after 3 years of post-operative followup, the patient was still able to maintain her near vision. In conclusion, the corneal inlay procedure helped to improve near vision of this presbyopic patient. Optometrist plays a very important role in the co-management of such patients alongside with the ophthalmologist in terms of visual functional assessments pre and post-surgery, counseling of the procedure and managing patients’ expectations.
Corneal Injuries

1,072 cases of ocular injuries, including 271 cases of in-patients, who visited department of ophthalmology of Chungnam National University Hospital from January 1,1981 to December 31, 1985, were clinically analyzed. The results were as follows: 1. The incidence of ocular injuries was 8.1% of all eye patients and 16.0% of all patients admitted to this ophthalmologic department. 2. The incidence was more common in male(82.0%) and in the age of 3rd to 4th decades(53.7%). 3. Monocular injuries accounted for 90.4% of ocular injuries. There was no significant difference in the incidence between the right and left eye. 4. Tho ocular injuries were more common in the spring(27.4%), but in children the incidence was higher during the vacation. 5. The patients who visited this hospital within 24 hours after injury accounted for 89.8%. 6. The most common cause of ocular injuries was fist or finger(15.9%), followed by iron products(12.6%) and traffic accident(10.9%), but the injuries by iron products(32.1%) were most common in the admitted patients. 7. The most common ocular injury was eyelid laceration (15.3%), followed by subconjunctival hemorrhage(12.5%) and conjunctival foreign body(8.6%). In the cases of in-patients, corneal laceration(21.2%) was most common, followed by corneoscleral laceration(14.9%) and lens perforation(10.2%). The corneal perforation was 52.1% of all perforating eye injuries. 8. Surgical procedure included corneal suture(21.1%), lensectomy(12.5%), enucleation or evisceration(11.2%), and others. 9. Visual acuity was improved in most cases by treatment, but the corrected vision after treatment was less than 0.1 in 33.2%, which was mainly due to the perforating eye injuries. 10. The most common complication of ocular injuries after treatment was corneal opacity(36.3%), followed by secondary glaucoma(14.6%) and traumatic cataract(6.4%).
Child ; Chungcheongnam-do ; Corneal Perforation ; Eye Injuries ; Eyelids ; Humans ; Incidence ; Iron ; Lacerations ; Ophthalmology ; Visual Acuity

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.
Adhesives ; Calcium ; Cornea ; Corneal Perforation* ; Fibrin Tissue Adhesive ; Fibrin* ; Fibrinogen ; Fibroblasts ; Humans ; Lacerations ; Thrombin ; Tissue Adhesives ; Wounds and Injuries

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.
Adhesives ; Calcium ; Cornea ; Corneal Perforation* ; Fibrin Tissue Adhesive ; Fibrin* ; Fibrinogen ; Fibroblasts ; Humans ; Lacerations ; Thrombin ; Tissue Adhesives ; Wounds and Injuries

The subject of ocular injuries is of great importance in military surgery, not only for scientific and human reasons but also from an economic standpoint. The authors analysed 59 cases of perforating ocular injuries who were admitted to the Department of Ophthalmology, C.A.F.G.H. The results from these analyses were as follow: 1. The incidence of ocular perforating injuries was 16.4% of all patients who were admitted to the Department of Ophthalmology during last 15 months and was 45% of ocular injuries. 2. The incidence of perforating injuries that involved in one eye was 84.8% and involved in both eye was 15.2%. 3. The perforating ocular injuries were most common in spring(52.5%) and secondly in summer(28.8%). 4. The ocular perforation occured most frequently in the cornea(55.8%), followed by corneosclera(23.5%) and sclera(20.6%). 5. The most common cause of ocular perforating injuries was land mine(28.8%), followed by grenade(23.7%), gun(20.3%), bullet(10.2%) in frequency. 6. The incidence of multiple ocular perforations was relatively higher in land mine, grenade and blast injuries, and single perforations were observed more common in gun, bullet and secondary missile. 7. Other ocular manifestations accompanied by the ocular perforations were hyphema(60%), uveal prolapse(60%), followed by lid laceration, burn, conjunctival laceration, etc. 8. Prolapsed uveal tissue occured the highest frequency in the corneoscleral perforations, on the other ha.nd, intraocular foreign bodies in scleral perforations and traumatic cataracts in the corneal perforations. 9. The location of intraocular foreign bodies was most common in vitreous and outer coat(66.7%), followed by anterior chamber, lens and retroorbital space. 10. Final visual acuity over 20/200 accounted for 47.4% in the corneal perforations, 42.9% in the scleral perforations, 12.5% in the corneoscleral perforations.
Anterior Chamber ; Blast Injuries ; Burns ; Cataract ; Corneal Perforation ; Foreign Bodies ; Humans ; Incidence ; Lacerations ; Military Personnel ; Ophthalmology ; Visual Acuity

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.
Aged, 80 and over ; Cornea/injuries/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Follow-Up Studies ; Humans ; *Tissue Donors ; Visual Acuity

This report is based on a statistical analysis of the records of 116 cases of perforating eye injuries among 39,721 patients who visited the eye department of the National Medical Center from 1971 to 1981. The results were as follows: 1. The incidence of perforating eye injuries was 0.3% of 39,721 patients and 8.7% of the ocular trauma. 2. Of patients with perforating eye injuries, 76.7% were male and 23.3% female. Perforated injuries peaked in the age group 10-19 years, with about 50% of the perforations incurred by patients in the age group 10-29 years. 3. Of perforating eye injuries, 51.7% were found in the right eye, whereas 43.1% were in the left eye. 5.2% had injuries in both eyes. 4. The corneal perforations were 60.3% of the injuries, while the scleral were 25%, and the corneoscleral 14.7%. 5. Of perforating injuries, 16.4% were caused by intraocular foreign bodies, 78.9% of which were magnetic 89.5% of the patients were males. 6. Of perforating eye injuries, 32.8% occurred in the fall and 13.8% in September. 7. The most common material(23.3%) which caused perforating injuries was metal or iron particles. 15.5% of perforating injuries were caused by broken glass, 9.5% by explosives, and 7.8% by wood splinters. 8. Associated ocular manifestations were as follows: subconjunctival hemorrhage 42.2%, prolapse of uveal tissue 37.9%, conjunctival laceration 29.3%, traumatic hyphema 27.6%, tra umatic cataract 25.9% and traumatic uveitis 17.2%. 9. Of perforating eye injuries, 57.4% were treated by surgical procedure, such as primary closure, iridectomy, replacement of the prolapsed iris, lens extraction and removal of intraocular foreign bodies. In 13.9% of injured eyes removal of the eye-ball was performed. 10. Only 19.8% of the injuries were restored to 0.6 or better and 64.0% to 0.1 or less. 11. The location of the perforation was not correlated with visual prognosis. Relatively good vision was restored in scleral perforation cases, while corneal perforations resulted in the worst vision(statistically not significant). 12. The restored visual acuity was better in occupational injuries than in nonoccupational ones(statistically not significant). 13. Better results were obtained in the cases involving magnetic intraocular foreign bodies than in those with non-magnetic ones(statistically not significant). 14. The more complications occurred, the worse vision became. 15. The cases(38) of restoration of visual acuity considered to be poor(< or =0.1) breakdown as fo llows(by cause): phthisis bulbi(18.6%), traumatic cataract(10.5%), corneal opacity(81.0%), and vitreous opacity(3.5%).
Cataract ; Corneal Perforation ; Explosive Agents ; Eye Injuries* ; Female ; Foreign Bodies ; Glass ; Hemorrhage ; Humans ; Hyphema ; Incidence ; Iridectomy ; Iris ; Iron ; Lacerations ; Male ; Occupational Injuries ; Prognosis ; Prolapse ; Uveitis ; Visual Acuity ; Wood

PURPOSE: This study analyzed the efficacy of Scion Image(R)program, the measurement of area of cornea lesion in the process of corneal diseases. METHODS: Photographs were processed digitally from three corneal wound lesions, and the Adobe Photoshop(R) and Scion Image(R) were used to calculate the area. These measured automatically the area of the damaged corneal lesion in numerical values, allowing precise calculation of the ratio of the wounded area to the entire cornea. RESULTS: In the first case of corneal abrasion by contact lenses, we were able to measure the ratio of the lesion, improving from 45% to 9% after two days of treatment. In the second case of the typical corneal ulcer, the infected area was 23.6% of the cornea before treatment, and decreased to 14.5% after treatment. In the third case of the ring shaped corneal ulcer, we were able to measure the lesion accurately using the Scion Image(R) CONCLUSIONS: The Scion Image(R)program may be used for the measurement of corneal surface lesion. It seemed to allow objective and accurate measurement.
Contact Lenses ; Cornea ; Corneal Diseases ; Corneal Ulcer ; Wounds and Injuries

We describe herein a case of an impending corneal perforation with a large descemetocele in a patient with previous penetrating keratoplasty (PKP) that subsequently was treated with an emergent lamellar keratoplasty using frozen preserved cornea. A 76-year-old male patient, who had a PKP, presented with a completely whitish and edematous graft accompanied by large epithelial defects. Although antibiotics and antiviral agents were tried for three days, the corneal stroma abruptly melted, except for the Descemet's membrane and endothelium. Cryopreserved corneal tissue that was kept at -80degrees C was thawed and sutured on top of the remaining Descemet's membrane and endothelium. Pathological and microbiological tests were conducted using the remaining donor and recipient corneal tissues. After tectonic corneal transplantation on top of a large descemetocele, a healthy graft and relatively clear interfaces between graft-host junctions were maintained without serious adverse reactions throughout 6 month follow-up period. Microbiological evaluations of donor tissue at the time of thawing and tissue preparation were done, and the results were all negative. Tissue that was taken intraoperatively from the recipient cornea also showed negative microbiological results. In conclusion, tectonic lamellar keratoplasty, using cryopreserved corneal tissue, only onto the remaining Descemet's membrane and endothelium in an emergent condition, was a safe and effective treatment.
Cornea/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Humans ; Keratoplasty, Penetrating ; Male ; Middle Aged ; *Tissue Donors ; Treatment Outcome ; Visual Acuity

In surgical removal of cataractous lens the following principles should be kept in mind. (1) Remove the lens as completely as possible, without leaving the lens remnants in the pupillary area in order to achieve the best vision as possible. (2) Ocular tissues should suffer the minimum injury during the operation. This precaution can be applied especially to the corneal endothelium and the iris. (3) No derangement of the vitreous surface should occur. (4) Secure the corneo-scleral wound as tight as possible with care not to incarcerate lens tissues nor vitreous. Application of these principles to the individual cases was discussed.
Cataract* ; Endothelium, Corneal ; Iris ; Wounds and Injuries