When nasolacrimal duct obstruction in children cannot be treated with probing, the fracture of inferior turbinate and/or silicone intubation can be performed, prior to dacryocystorhinostomy So far, there have been many reports and controversies regarding the methods and duration of intubation. The authors report the clinical results of treatment with silicone intubation on the nasolacrimal duct obstruction in children. In seven eyes of seven cases with nasolacrimal duct obstruction, the silcone intubation was performed. In four eyes of four cases, the fracture of infeior turbinate was accompanied by silicone intubation. The ages of the patients ranged from 1 to 9 years, and the duration of intubation ranged from 2 weeks to 5.5 months, averaging 3 months. The follow-up period ranged from 1 to 26 months after the tube removal. In 6 eyes of 6 cases(86%), the symptoms were resolved. The authous recommend that the tube be removed within 3 months after insertion.
Child* ; Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Duct Obstruction ; Nasolacrimal Duct* ; Silicones* ; Turbinates

A tectonic keratoplasty was performed with a keratoprosthesis using expanded polytetrafluoroethylene as a supporting skirt, on the left eye of a 23-year-old woman who needed an emergency corneal transplantation due to corneal perforation. The keratoprosthesis implanted, consisted of a supporting skirt which was made of expanded polytetrafluoroethylene (PTFE), and an optic portion which was made of polymethylmethacrylate (PMMA). The optic portion and the supporting skirt were attached by cyanoacrylate tissue adhesive (Histoacryl(R)). Two months post-operatively, the keratoprosthesis was extruded, leaving an opacified, vascularized cornea. A penetrating keratoplasty was performed 1 month later. The excised cornea was composed of granulation tissue. To our knowledge, this is the first case of tectonic keratoprosthesis using expanded PTFE as a supporting skirt in humans.
Adult ; Cornea/pathology/*surgery ; Corneal Opacity/pathology ; Female ; Granuloma/pathology ; Humans ; *Keratoplasty, Penetrating ; *Polytetrafluoroethylene ; *Prostheses and Implants ; Reoperation

In congenital third nerve palsy, the function in four of the six extraocular muscles is compromised, and its treatment is the most difficult problem in paralytic strabismus. In general, either large recession and resection on horizontal rectus muscles or superior oblique muscle transposition is used for treatment. We compared the results of the two methods of surgical therapy. A Total of nine eyes in nine cases underwent surgical correction for ocular alignment in the primary position, In four eyes of four cases horizontal rectus muscle surgery was performed. In five eyes of five cases superior oblique muscle transposition was performed. Postoperatively, one of four cases who underwent horizontal rectus muscle surgery and four of five cases who underwent superior obique muscle transposition resulted in acceptable ocular alignment, in which the angle of deviation at the primary position was within 2 delta. Therefore, in the treatment of congenital third nerve palsy, superior oblique muscle transposition is more effective than horizontal rectus muscle surgery for the correction of ocular alignment.
Muscles ; Oculomotor Nerve Diseases ; Oculomotor Nerve* ; Strabismus*

Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Adult ; Choroid Diseases/*surgery ; Choroidal Neovascularization/etiology/*surgery ; Diagnostic Techniques, Ophthalmological ; Female ; Human ; Interferometry ; Laser Coagulation/*adverse effects ; Light ; Male ; Retinal Diseases/*surgery ; Tomography ; Treatment Outcome ; Visual Acuity

PURPOSE: To evaluate the risk factors and prevalence of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants and very low birth weight (VLBW) infants. METHODS: All babies were screened for ROP at a postconceptional age of 31 weeks or at 4 weeks of chronological age. We divided the infants into two groups according to birth weight < 1000 g (ELBW) and 1000~1500 g (VLBW), to compare the incidence of ROP and photocoagulation, and to retrospectively evaluate the risk factors. RESULTS: Three hundred eight consecutive infants were included in the data analysis. The incidences of ROP were 70.5% (79/112) in ELBW infants and 36.7% (72/196) in VLBW infants (p<0.0001). 31 of 79 ELBW infants (39.2%) and 17 of 72 VLBW infants (23.6%) had undergone photocoagulation (p<0.0001). Among the various risk factors, mechanical ventilation (p=0.039) and surfactant (p<0.000) were the independent risk factors associated with ROP in all infant groups by logistic regression analysis. In the ELBW group, however, surfactant injection was the only factor independently associated with ROP (p=0.008). The use of surfactant, the only risk factor in ELBW infants, was attributed with the initiation of ROP. However, it did not act as an aggravating factor. CONCLUSIONS: ELBW was associated with a higher incidence of ROP and laser photocoagulation. The results of this study emphasize that more special attention is needed for immature infants when ventilators and surfactants are used.
Birth Weight ; Humans ; Incidence* ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Light Coagulation ; Logistic Models ; Prevalence ; Respiration, Artificial ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors* ; Statistics as Topic ; Surface-Active Agents ; Ventilators, Mechanical

PURPOSE: To investigate the clinical characteristics and treatment of intermediate uveitis under new diagnostic standards. METHODS: Medical records of patients diagnosed with pars planitis or intermediate uveitis were followed for more than 6 months, and retrospectively reviewed. RESULTS: A total of 90 patients and 117 eyes were enrolled in the study. The mean age was 40.1 years, and the mean follow-up period was 43.0 months. Thirty percent of cases were bilateral. The most common initial symptom was decreased visual acuity. Snowbank was detected in 39.3%, snowballs in 15.4%, vitritis in 96.6%, and vasculitis in 56.4%. Common complications includedcystoid macular edema (57.3%), cataracts (43.6%), and epiretinal membrane (36.8%). Therapies included topical steroids (82.9% of cases), posterior sub-Tenon steroid injection (45.3% of cases), systemic steroid administration (67.8% of cases), and immunosuppressants (28.7% of cases). Vitrectomy was performed in 11.1% of patients due to complications such as epiretinal membrane and traction retinal detachment. The mean initial and final visual acuities were 0.67 and 0.74, respectively. CONCLUSIONS: The patients in this study experienced various courses of symptoms that required different treatment plans. Future investigations may corroborate these results.
Cataract ; Epiretinal Membrane ; Eye ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Macular Edema ; Medical Records ; Pars Planitis ; Retinal Detachment ; Retrospective Studies ; Steroids ; Traction ; Uveitis, Intermediate ; Vasculitis ; Visual Acuity ; Vitrectomy

It is known that CD95 (APO-1/Fas) is expressed on the cell surface, and apoptotic cell death can be induced by the CD95 ligation in the cultured, proliferating human retinal pigment epithelial (RPE) cells. However, little is known about CD95 on the non-proliferating RPE cells. In this study, human RPE cells were cultured up to 4 weeks after they reached the confluence, to simulate the non-proliferating RPE cells in situ. There was no significant difference in CD95 expression on the cell surface between the predominantly proliferating, preconfluent cells and predominantly non-proliferating, postconfluent cells in flow cytometric assays. However, unlike proliferating cells, no cellular death occurred in the predominantly non-proliferating cells after the treatment of agonistic anti-CD95 antibody with cycloheximide, pretreated with interferon-gamma. Our results suggest that the CD95/CD95L system probably plays a physiologic role in vivo to remove the abnormal, proliferating RPE cells, and factors other than the surface expression of CD95 may determine the sensitivity to the CD95 signals.
Antigens, CD95/*pharmacology ; Apoptosis/*physiology ; Cells, Cultured ; Human ; Pigment Epithelium of Eye/cytology/*drug effects/*physiology ; Sensitivity and Specificity

Clinical features and prognosis of HLA-B27 positive anterior uveitis (AU) were assessed compared with HLA-B27 negative AU in a Korean population, based on the medical records of AU patients seen at a university hospital. Twenty-seven HLA-B27 negative, idiopathic AU patients (group I) and 55 HLA-B27 positive AU patients (group II) were studied. HLA-B27 positive group was further divided into 29 with associated systemic disease (seronegative spondyloarthropathy) (group IIA) and 26 without associated systemic disease (group IIB). Significantly more severe anterior chamber inflammation in terms of anterior chamber cells (P=0.006) and hypopyon formation (P=0.034) was observed with higher frequency of AU attacks (P=0.007) in the HLA-B27 positive group than in the HLA-B27 negative group. Systemic/periocular steroids were required in significantly more patients in the HLA-B27 positive group than in the HLA-B27 negative group (P=0.015). However, no significant differences were observed for final ocular and visual outcomes between these two groups. Associated systemic disease made no significant difference in the clinical features and prognosis in the HLA-B27 positive AU patients. In conclusion, despite more severe inflammation and a higher recurrence rate, HLA-B27 positive AU shows similar good final ocular and visual outcomes compared to HLA-B27 negative, idiopathic AU in a Korean population.
Adolescent ; Adult ; Aged ; Alleles ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Asian Continental Ancestry Group ; Case-Control Studies ; Female ; HLA-B27 Antigen/genetics/*metabolism ; Humans ; Immunosuppressive Agents/therapeutic use ; Korea ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Steroids/therapeutic use ; Uveitis, Anterior/*diagnosis/drug therapy/metabolism ; Visual Acuity

PURPOSE: To evaluate the factors contributing to the visual outcome of patients with culture-proven bacterial endophthalmitis. METHODS: We reviewed medical records of all eyes with infectious endophthalmitis between January 1996 and June 2005. The causative bacteria were identified in 18 of 90 eyes, for which we evaluated their clinical features and factors influencing their visual prognosis. RESULTS: Bacterial endophthalmitis occurred after cataract surgery in 6 of 18 eyes, after trabeculectomy or glaucoma implant surgery in 4 eyes, after trauma in 3 eyes, after intravitreal triamcinolone injection in 1 eye, and after endogenous endophthalmitis in 4 eyes. The culture results were similar between gram positive and gram negative organisms. Final vision was 0.1 or better in 6 of the 18 eyes. Final visual acuities showed statistically significant correlation with causative organisms (p=0.018). CONCLUSIONS: For effective management of bacterial endophthalmitis and prediction of prognosis, we recommend thorough bacterial culture. Also, further investigation with a large population is needed.
Bacteria ; Cataract ; Endophthalmitis* ; Glaucoma ; Humans ; Medical Records ; Prognosis* ; Trabeculectomy ; Triamcinolone ; Visual Acuity

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.
Choroid ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Incidence* ; Intraoperative Complications ; Mitomycin ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Trabeculectomy ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage