PURPOSE: To compare the effect of femtosecond laser-assisted cataract surgery with conventional cataract surgery on effective phacoemulsification time (EPT). METHODS: This study included 66 patients 100 eyes who underwent femtosecond laser-assisted cataract surgery and 68 patients 100 eyes who underwent conventional cataract surgery. Both groups underwent phacoemulsification using pulsed ultrasound energy and EPT was evaluated. The groups were further analyzed according to preoperative Lens opacities classification system (LOCS) III grading. Patients who had femtosecond laser-assisted cataract surgery underwent lens fragmentation with quadrant, hybrid, or grid pattern and the EPT was respectively evaluated. RESULTS: The mean EPT was 5.85 +/- 4.31 seconds in the femtosecond laser-assisted cataract surgery group and 10.34 +/- 6.61 seconds in the conventional group. Overall, EPT was statistically significantly lower in the femtosecond laser-assisted cataract surgery group compared to the conventional group. When the groups were analyzed according to LOCS III grading, this result was consistent for all cataract grades and the reduction in EPT was increased with the higher LOCS III grade. When the groups were analyzed according to lens fragmentation patterns, the mean EPT was lower with 350 microm grid pattern than the quadrant or hybrid pattern. CONCLUSIONS: The femtosecond laser-assisted system in cataract surgery can be an efficient cataract surgery using lower EPT compared to the conventional procedure. Additionally, significant differences were observed in the mean EPT of cataract surgery using the femtosecond laser-assisted system among the 3 lens fragmentation pattern groups.
Cataract* ; Classification ; Humans ; Phacoemulsification* ; Ultrasonography

A case of contact dermatitis due to herb onintment is described in a 24 year-old female patient. After topical application of herb ointment, she developed erythematous papules and plaques on the face and neck. Patch test revealed positive reactions to ammoniated mercury, thimerosal, and the herb ointment. Energy-dispersive X-ray microanalysis of the herb ointment showed a striking peak for mercury.
Dermatitis, Contact* ; Electron Probe Microanalysis ; Female ; Humans ; Neck ; Patch Tests ; Strikes, Employee ; Thimerosal ; Young Adult

PURPOSE: To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes. METHODS: Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations. RESULTS: Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828). CONCLUSIONS: Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.
Dacryocystorhinostomy ; Granuloma ; Humans ; Intubation ; Lasers, Semiconductor ; Membranes ; Recurrence ; Retrospective Studies ; Silicones*

BACKGROUND: Atopic dermatitis (AD) is primarily influenced by environmental factors including exposure to pollutants and indoor allergens (particularly, house dust mites). Al-though house dust mite antigens are the most prevalent components of indoor allergens in Korea, cockroaches also can be considered to act as an important allergen. OBJECT: This study was done to evaluate the differences in three different atopic patch test (APT) techniques, and the relationship between APT and skin prick test, total IgE, and specific serum IgE level using cockroach allergen. Methods: We performed patch test in 57 patients with AD and 30 normal controls on clinically lesional and normal appearing skin with German cockroach (GC) allergens (extract, as is) in three different techniques (standard, scratch, DMSO). Reactions were evaluated after 48hours, and compared with the results of skin prick test, total and specific IgE levels. Detailed atopy history and severity scoring were taken. RESULTS: In the GC (whole body) prick test positive group, there was 1263.02 IU/ml of total IgE, and this amount was significantly higher than GC (whole body) prick test negative group who had 549.46 IU/ml (P<0.05). The positive reaction rate to whole body of American cock-roach (AC) was significantly higher in the patient group than control group (p<0.05), but the positive rate to whole body of GC was high, but not significantly high in the patient group (p=0.053). There were significant differences in positive patch test reactions to either Ext or As is between patient group and control group (p<0.05). The positive rate to As is was significantly higher than to Ext in either lesional skin or non-lesional skin in patient group (p<0.05). But there were no considerable differences in positive reactions to either Ext or As is between 3 different methods (standard, scratch, DMSO mix) in both lesional and non-lesional areas (p>0.05). There was no significant relationship between the positive reactions to patch test and prick test to Ext and As is antigen. The APT results showed no significant concordances with skin prick test and RAST for cockroach antigens. CONCLUSIONS: APT seems to be a different dimension of atopic skin inflammation and may pro-vide further diagnostic information in addition to a patient's history, skin prick test, and RAST results.
Allergens ; Blattellidae ; Cockroaches* ; Dermatitis, Atopic* ; Dimethyl Sulfoxide ; Dust ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Inflammation ; Korea ; Patch Tests ; Pyroglyphidae ; Skin

The beneficial effects of a hydrophilic contact lens of the corneal lesions, such as bandage or splint effect and prolonged delivery of drugs from a soaked hydrophilic contact lens were well informed by the previous reports. The authors investigated the effectiveness of the soft contact lens soaked with antibiotics for the treatment of experimentally induced bacterial corneal ulcer of the rabbits. In group 1, corneal defects of both eyes were made with a trephine of 5mm in diameter and 0.2mm in depth in 6 rabbits. A sterilized soft contact lens was inserted into one eye of each animal and lens was changed everyday. The other eye was not treated. The mean duration for the epithelial coverage of the defects were 7.4 days in the lens inserted eyes and 7.2 days in the untreated eyes. There were no significant statistical differences in the healing rate between the lens imerted eyes and control ones. In group 2, seven rabbits were inoculated with staphylococcus aureus suspension, which was susceptible to chloramphenicol (CM). Corneal ulcers developed 24 hours later. The soft contact lens soaked with 1% CM solution was placed in one eye of each animal for 24 hours and changed everyday. The other eye was treated with 1% CM solution dropping 4 times daily. The ulcer began to heal about 6 days later. Evaluation of the heaJing was performed by measurement of the size of ulcer for the first 12 days and grading of the healed cornea by modified Wiggins grading system at the end of the experiment. In grout 3, corneal ulcer developed in 7 rabbits 48 hours later after inoculation of pseudomonas aeruginosa. One eye of each animal was treated with soft contact lens soaked with 1% gentamicin solution and the lens was changed everyday. The other eye was treated with 1% gentamicin solution dropping 4 times daily. The mean duration of healing of the corneal ulcer in group 2 was 15.2 days in the lens inserted eyes and 13.7 days in the control ones. By the modified Wiggins grade the outcome of the infection revealed better results in the eyes treated with 1% CM solution dropping. In group 3, the mean duration of healing of the corneal ulcer was 16.2 days in the lens ineerted eyes and 15.7 days in the control eyes. The modified Wiggins grade showed no significant statistical differences between the lens inserted eyes and control ones.
Animals ; Anti-Bacterial Agents ; Bandages ; Chloramphenicol ; Contact Lenses, Hydrophilic* ; Cornea ; Corneal Ulcer* ; Gentamicins ; Pseudomonas aeruginosa ; Rabbits ; Splints ; Staphylococcus aureus ; Ulcer

PURPOSE: To compare the characteristics of optical coherence tomography in eyes with treatment-naïve typical neovascular age-related macular degeneration (typical nAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP). METHODS: One hundred fifty-three eyes newly diagnosed with exudative AMD were retrospectively collected. All study eyes were classified into three subtypes: typical nAMD, PCV, and RAP. Subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Central macular thickness (CMT) and other OCT features including intraretinal cystoid fluid and subretinal fluid were also evaluated in all eyes. SFCT, CMT and other OCT features were compared among the three subtypes of exudative AMD. RESULTS: Seventy-four eyes with typical nAMD, 55 eyes with PCV, and 24 eyes with RAP were included. SFCT was significantly thickest in PCV and thinnest in RAP (p < 0.001). RAP showed the thickest CMT and the highest frequency of intraretinal cystoid fluid (p = 0.004, p < 0.001, respectively). CONCLUSIONS: In patients with exudative AMD, different characteristics of OCT were observed according to the three subtypes. Identification of OCT characteristics could help differentiate the subtypes of exudative AMD.
Choroid ; Humans ; Macular Degeneration* ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Tomography, Optical Coherence*

Two percent dorzolamide, a topical carbonic anhydrase inhibitor (CAI), was developed to reduce the side effects associated with systemic CAI such as fatigue, anorexia, dysesthesia, etc. and to effectively reduce the elevat-ed intraocular pressure(IOP). This study was designed to evaluate the effectiveness and safety of 2%dorzolamide in Korean patients with primary open-angle glaucoma or ocular hypertension. In this randomized, double-blind, placebo-controlled clinical study, 2%dorzolamide or placebo was given three times a day to the patients with primary open-angle glaucoma or ocular hypertension (22mmHg < or =IOP < or =30mmHg)to evaluate the hypotensive effect and safety of dorzolamide during the period of 6 weeks. After 1,3, and 6 weeks treatment, the mean percent decrease of IOP from baseline in the dorzolamide group (16.3 +/-8.9%,17.9 +/- 9.8%,and 18.2 +/-8 .7 %, respectively) was significantly larger (p<0.01)than that in the placebo group (7.5 +/- 6.8%, 8.5 +/-9.5%, 10.4 +/-10.4%, respectively). The decrease of IOP was also significant in each group(p<0.01)compared to the pre-treatment IOP. During the period of treatment, burning sensation was more frequent in the dorzolamide group (p<0.05). In conclusion,this study has shown that the topical application of 2% dorzolamide effectively reduces IOP without serious adverse effects in Korean patients with primary open-angle glaucoma or ocular hypertension.
Anorexia ; Burns ; Carbonic Anhydrases ; Fatigue ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Ocular Hypertension ; Paresthesia ; Sensation

Purpose: To report a case of late-onset bleb-associated endophthalmitis caused by streptococcus cristatus (S. cristatus) after trabeculectomy.Case summary: A 59-year-old woman presented with left ocular pain and visual disturbance. She had undergone trabeculectomy of the left eye 2 years ago. At the initial visit, she was only able to count fingers from the left eye. Whitish thin bleb, conjunctival injection, and inflammation were observed in the left anterior chamber, and the fundus could not be visualized. Despite administering topical and systemic antibiotics, the chamber reaction worsened, and hypopyon and inflammatory membrane were noticed the next day. Vitrectomy with phacoemulsification and intravitreal antibiotic injection was performed, and the intravitreal antibiotic injections were repeated over the next two days. Bacterial culture of vitreous fluid showed a growth of S. cristatus 5 days after the surgery, and inflammation improved after 7 days. One month later, she was still only able to count fingers from the left eye, but there were no signs of endophthalmitis. Conclusions Postoperative endophthalmitis after glaucoma filtering surgeries caused by S. cristatus has not been reported previously from Korea. To the best of our knowledge, this is the first Korean case of late-onset bleb-associated endophthalmitis caused by S. cristatus. If gram-positive cocci are grown in samples from the patients with endophthalmitis after trabeculectomy, resident oral microflora such as S. cristatus should be considered as the causative pathogen.

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

PURPOSE: To evaluate the visual outcome and optical quality in eyes with diffractive multifocal intraocular lens (DMIOL) implantation after myopic refractive surgery. METHODS: Nineteen eyes (15 patients) were implanted with AcriSof ReSTOR(R) SN6AD1, the aspheric DMIOL after myopic refractive surgery (laser-assisted in situ keratomileusis [LASIK] 14 eyes, photorefractive keratectomy [PRK] 4 eyes, laser-assisted subepithelial keratomileusis [LASEK] 1 eye). Preoperative and postoperative visual acuities and manifest refraction were measured. Preoperative corneal higher-order aberrations (HOAs) were measured using Hartmann-Shack (H-S) aberrometer in dilated pupils, and optical qualities were measured 1 month postoperatively using H-S aberrometer and a double-pass system under mesopic conditions. Patient satisfaction was investigated using a questionnaire at 2 months postoperatively. RESULTS: Uncorrected distant and near visual acuities at postoperative 2 months were 0.11 +/- 0.19, and 0.19 +/- 0.12 (log MAR), respectively. Postoperative spherical equivalent (SE) of 16 eyes (84.2%) was within +/-0.50 diopters (D) and all eyes were within +/-1.00 D from emmetropia. Preoperative corneal and postoperative ocular spherical aberrations in a 4.0 mm pupil diameter were 0.08 +/- 0.08 and 0.07 +/- 0.07 (microm), respectively. Objective scatter index was 3.42 +/- 1.71 and modulation transfer function (MTF) cut-off value was 21.03 +/- 12.37 cpd. General satisfaction score was 3.52 +/- 0.96 points out of 5, and 8 patients (11 eyes) were not satisfied with DMIOL implantation. CONCLUSIONS: After DMIOL implantation in the eyes with previous myopic refractive surgery, postoperative SE was close to the target D, but optical qualities and patient satisfaction were poor.
Emmetropia ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Lenses, Intraocular ; Patient Satisfaction ; Photorefractive Keratectomy ; Pupil ; Surveys and Questionnaires ; Refractive Surgical Procedures* ; Visual Acuity