We observed the changes of IOP after contact transscleral cyclophotocoagualtion with Diode laser which emit 810mm beam and we tride to investigatethe suitable level and range of energy when Diode laser was applied to the refractory glaucoma patients. Fifteen eyes underwent contact transscleral cyclophotocoagulation with energy 3J(Group A, 6eyes), 4J(Group B, 9eyes) separately and intraocular pressure(IOP) was measured at 1 day, 1 week, 1 month, 2 month, 3 month, 4month, 5month, 6month, postoperatively. The intraocular pressure(IOP) decreasing rate was 83.02% in A group and 64.72% in B group. The success rate was 50% in A group and 66.7% in B group at 6 month postoperatively. It is suggested that contact transscleral cyclophotocoagulation with Diode laser si useful in lowering IOP in refractory glaucoma patients.
Glaucoma* ; Humans ; Lasers, Semiconductor*

PURPOSE: To investigate the effects of a delay in finger temperature recovery rate on the hand cold provocation test (HCPT) and a nocturnal dip greater than 10% (dipper) on the progression of glaucomatous visual field (VF) defects in open-angle glaucoma patients when the intraocular pressure (IOP) was well controlled lower than the target pressure. METHODS: 30 patients (58 eyes) with normal tension glaucoma (NTG) and 13 patients (24 eyes) with primary open angle glaucoma, and 12 normal controls (24 eyes) were retrospectively enrolled in this study. We performed HCPT, 24 hour ambulatory blood pressure monitoring (24-hr ABPM), Goldmann applanation tonometer measurements, and VF tests on all subjects. The delay in finger temperature recovery rate was defined as a delay longer than 15% of the mean finger temperature of normal controls over 2 intervals among 5, 10, 15, and 20 minutes after the immersion of cold water. We examined the relationships among the delay in finger temperature recovery rate, dipper, and the progression of glaucomatous VF defects. RESULTS: The finger temperature recovery rate in NTG patients was significantly delayed more than that of normal controls at 5, 10, and 15 minutes after the immersion. The delay in finger temperature recovery rate significantly correlated with dipper in NTG patients. Glaucomatous VF defects were significantly progressed in the presence of dipper in NTG patients. Delay in finger temperature recovery rate was significantly related to the progression of glaucomatous VF defects in NTG patients. In the binary logistic regression test, delay in finger temperature recovery rate was the only factor that was strongly related to the progression of glaucomatous visual field in NTG patients. CONCLUSIONS: When glaucomatous VF defects progressed despite the IOP being well controlled, 24-hr ABPM and HCPT for detecting vascular dysregulation might be helpful for diagnosis and treatment of glaucoma.
Blood Pressure Monitoring, Ambulatory ; Diagnosis ; Fingers* ; Glaucoma* ; Glaucoma, Open-Angle ; Hand ; Humans ; Immersion ; Intraocular Pressure ; Logistic Models ; Low Tension Glaucoma ; Retrospective Studies ; Visual Fields ; Water

Penetrating ocular injuries with intraretinal foreign body(IRFB) are increasing and may result in significant visual morbidity. We evaluated retrospectively 22 eyes of 22 patients who had undergone pars plana vitrectomy for removal of IRFB at Dong-a University Hospital from July 1990 to June 1996. The majority of patients were adult male(95.5%). The nature of all IRFB was magnetic property and the causes of injury were hammering and cutting work(77.3%). Preoperatively, eyes were complicated with vitreous hemorrhage and opacity(59.1%), traumatic cataract(45.%), retinal detachment(36.4%), and corneal opacity(22.7%). Postoperative complications included vitreous hemorrhage and opacity(36.4%), retinal detachment(22.7%), and proliferative vitreoretinopathy(18.2%). In our study, poor visual prognosis was obtained in cases of corneal entrance site, IRFB larger than 2mm in size, IRFB located posterior to equator and IRFB associated with retinal detachment.
Adult ; Foreign Bodies* ; Humans ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Vitrectomy* ; Vitreous Hemorrhage

Mitomycin C (MMC) is an antimetabolite, antibiotic which prevents the proliferation of fibroblast and fibrosis by inhibition of DNA-dependent RNA synthesis. It has been used to increase the success rate of filtering surgery. We performed trabeculectomy and peripheral iridectomy with 0.4 mg/ml MMC application for 3 minutes in poor prognostic glaucoma patient, 26 eyes of 24 patients from February 1992 to December 1994. The postoperative change of intraocular pressure (IOP) and complications were followed up from 3 to 30 months (mean 12.4 months). The preoperative and postoperative mean IOP after 24 months were 32.3 +/- 11.4 mmHg and 12.7 +/- 3.1 mmHg, respectively. The decrease rate of IOP was 60.7% and the success rate was 71.7%. The postoperative complications were 15 eyes including 5 eyes of shallow anterior chamber, 5 eyes of hyphema, 2 eyes of conjunctival wound leakage, one eye of bleb rupture, one eye of choroidal detachment, and one eye of cataract formation.
Anterior Chamber ; Blister ; Cataract ; Choroid ; Fibroblasts ; Fibrosis ; Filtering Surgery ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Iridectomy ; Mitomycin* ; Postoperative Complications ; RNA ; Rupture ; Trabeculectomy* ; Wounds and Injuries

It has been known that ultraviolet B(UVB) light made an oxidative damage to lens proteins, lipids and nucleic acids to induce lens opacity. The aim of the study was to investigate the effect of bendazac lysine salt (Bendaline) tot the experimental cataract developed by UV irradiation. Forty rats were exposed to 0.1mW/cm2 of UVB radiation in the range 300-320 mm for 24 hours per day. Five control rats were not exposed UVB radiation. During the investigative period, we measured lens opacity with Scheimpflug camera every other week. Rats were divided into 9 groups according to the duration of UV radiation and initial time of bendazac lysine medication. Bendazac lysine was administered orally by 25mg/kg per day for 2 months. The opacities on anterior cortex, nucleus and posterior capsule began to appear 4 months after UVB irradiation. The longer duration of radiation, the more severe opacity of lens was observed, especially at the layers of posterior supranucleus, posterior cortex and posterior capsule and in the opacity area by retroillumination image. After UVB induced cataract was developed, the lens opacity was not changed nevertheless stop the UV irradiation. Lens opacity of bendazac lysine-treated groups was not severer than that of no medication groups. There were less opacities on 4 month irradiated group rather than 6 month irradiated group at the layers of nucleus and posterior cortex and in the opacity area. Anticataract action of bendazac lysine was effective in earlier cataract. In the group of bendazac lysine medication with UVB irradiation on same time, the prophylactic evidence of bendazac lysine was not observed.
Animals ; Cataract* ; Crystallins ; Lysine* ; Nucleic Acids ; Rats*

The purpose of this study is to evaluate the effects of 2% dorzolamide(Trusopt(R)) on the ocular blood flow and retinal microcirculation. To creat an experimental glaucoma model in rabbits and to study the effects of elevated intraocular pressure(IOP), ocular blood flow, retinal effects of elevated intraocular pressure(IOp), ocular blood flow, retinal microcirculation on rabbits eyes, we treated trabecular meshwork of 6 adult pigmented rabbits with Q-switched Nd;YAG laser. And then we investigated the IOP lowering effect, ocular blood flow, and the microcirculation on retina of 2% dorzolamide(Trusopt(R)) in experimental glaucoma model. The IOP, ocular blood flow and the microcirculation were measured with applanation pneumotonography(Alcon, Texas), pneumotonometric probe linked to Langham ocular blood foow system(OBF, Blue mountain) and Heidelberg Retina Flowmeter(HRF). During sustained IOP elevation, 2% dorzolamide(Trusopt(R)) was instilled in one eye and normal saline in the fellow eye. The IOP and ocular blood flow were measured 1, 2, 4 and 8 hours after instillation. The retinal microcirculation was measured 2 and 8 hours after instillation. The retinal microcirculation was measured 2 and 8 hours after instillation at 200micrometer apart from the superior optic disc margin. There were statistically significant reductions in IOP in both 2% dorzolamide(Trusopt(R)) and normal saline-treated eyes(P<0.05). Maximal reduction of IOP was observed 2 hours after single-drop of 2% dorzolamide(Trusopt(R)), with significant reduction of IOP up to 4 hours duration(P<0.05) There was no statistically significant incrsment in ocular blood for even though incrsment was observed 2 hours after single-drop of 2% dorzolamide(Trusopt). There were no change in volume, flow and velocity of blood flow in the peripapillary retina after single-drop of 2% dorzolamide(Trusopt(R))(P>0/1). From the above results, we concluded that 2% dorzolamide(Trusopt(R)) reduced the IOP but did not alter ocular blood flow and peripapillary retinal microcirculation.
Adult ; Glaucoma* ; Humans ; Intraocular Pressure ; Microcirculation ; Rabbits* ; Retina ; Retinaldehyde ; Trabecular Meshwork

The hydroxyapatite has been used as an orbital implant for reconstruction after enucleation or evisceration. It has been known to be a biocompatible and nontoxic implant with good fibrovascular ingrowth, few postoperative complications, excellent prosthesis motility, and good cosmesis. We performed 36 cases of hydroxyapatite implantation with enucleation or evisceration from July 1992 to August 1994. The mean follow-up period was 7.4 months(range, 4 to 13 months). There were nine cases of implant exposure. three cases of peg extrusion, three cases of superficial conjunctival wound dehiscence, and one case of granulation tissue overgrowth. There was no infection of implant. Improving the postoperative results and reducing the postoperative complications, it requires proper surgical techniques including the selection of adequate implant size and good doctor-patient relationship.
Durapatite* ; Follow-Up Studies ; Granulation Tissue ; Orbital Implants ; Postoperative Complications ; Prostheses and Implants ; Wounds and Injuries

PURPOSE: The aim of this prospective study was to analyze anorectal physiologic and clinical outcomes of the colonic J-pouch-anal anastomosis compared with the traditional straight colorectal anastomosis after ultra-low anterior resection in patients with rectal cancer, thus to define if this method of modified reconstruction has a functional superiority. METHODS: After total mesorectal excision for mid or low rectal cancers, patients were randomized to either a straight (n=23) or a colonic J-pouch anastomosis (n=24) to the lowermost rectum or anal canal. Functional outcomes were compared between two groups using an anorectal manometry performed before and 1 year after surgery and a bowel function questionnaire administered 6 months and 1 year postoperatively. RESULTS: Except the arithmetic level of anastomosis which was significantly higher in straight group than in pouch group (5.1 +/- 1.2 cm vs. 3.8 +/- 0.9 cm; P=0.0001), the two groups were well matched for demographic distribution, pathologic stage, colonic segment used for neorectum and use of adjuvant therapies. Patients with colonic J-pouch anastomosis showed functional superiority in terms of frequency of bowel movements, degree of urgency at 6 months (P<0.0001 and =0.03, respectively) and 1 year postoperatively (P<0.0001 and <0.05, respectively). Functional parameters, including incontinence to liquid stool and impaired discrimination between gas and stool were more pronounced in straight group after 6 months (P=0.04, and <0.05, respectively), but the differences were not statistically significant after 1 year. Sensation of incomplete evacuation was not different statistically between groups at 6 months, but more common in J-pouch group at 1 year (39.1% vs. 8.3%; P=0.04). As well as the length of high pressure zone and presence of rectoanal inhibitory reflex, there was no difference in sphincter pressure parameters between groups either before or 1 year after surgery. Maximal tolerable volume of the neorectum in J-pouch group was 110.2 +/- 16.7 ml, which was significantly larger than that of 74.1 +/- 14.9 ml in straight group (P<0.0001), and the neorectum in J-pouch group was significantly more compliant than that in straight group (6.1 +/- 1.9 vs. 3.3 +/- 2.1; P<0.0001) in 1 year after surgery. CONCLUSIONS: Construction of a colonic J-pouch as a substitute for the rectum restores neorectal volume and compliance. Clinically it offers patients superior anorectal function compared with straight anastomosis. To minimize evacuation difficulty associated with the pouch, optimal size of the pouch should be defined, thus to achieve an ideal balance between stool frequency/urgency and evacuation problems through larger prospective studies.
Anal Canal ; Colon* ; Colonic Pouches* ; Compliance ; Discrimination (Psychology) ; Humans ; Manometry ; Prospective Studies* ; Surveys and Questionnaires ; Rectal Neoplasms* ; Rectum ; Reflex ; Sensation

PURPOSE: To investigate the effect of nocturnal dip influence on the progression of glaucomatous visual field defect. METHODS: We performed 24hr ABPM and V/F tests on patients diagnosed with NTG (140 patients, 280 eyes) and POAG (84 patients, 168 eyes). Nocturnal dips below 10% were classified as non-dippers, and those above 10% were noted as dippers. The correlations among nocturnal dip, progression of glaucomatous visual field defect, and hypertension treatment were examined. RESULTS: In NTG, dippers in both systolic and diastolic blood pressure furthered glaucomatous visual field defects, with a relative risk of approximately three times that of non-dippers. Hypertension treatment was not influenced by the progression of glaucomatous visual field defect but was influenced by dips in the systolic and diastolic pressures in NTG and in diastolic pressure in POAG. Nocturnal dips were more frequent in the group with progression of the visual field compared to those in the group with non-progression of the visual field in NTG. CONCLUSIONS: Dipper caused a progression of glaucomatous visual field defects in NTG and was influenced by hypertension treatment in NTG and POAG. Performing 24hr ABPM should be helpful for glaucoma patients with progression of a glaucomatous visual field defect even when the IOP is less than the target pressure. In addition, hypertension treatment should be considered an important factor in the treatment of glaucoma.
Blood Pressure ; Glaucoma ; Humans ; Hypertension ; Salicylates ; Visual Fields

PURPOSE: We evaluated the thickness of RNFL and optic nerve head parameters with age in normal eyes using Spectral-Domain Optical Coherence Tomography (SD-OCT). METHODS: A total of 128 normal Korean volunteers in different age groups were recruited (age range, 20-70 years). RESULTS: A significant negative correlation in average RNFL thickness with increasing age was found. The inferior areas (130.31 +/- 3.33 micrometer) were significantly thicker than other areas (superior area 119.05 +/- 2.12 micrometer, nasal area 71.80 +/- 0.57 micrometer, temporal area 77.72 +/- 0.16 micrometer). The average C/D ratios (mean 0.38 +/- 0.14) and vertical C/D ratios (mean 0.35 +/- 0.11) both showed significant increases with age, and the vertical C/D ratio correlation coefficient was higher (average C/D ratio r = 0.249, vertical C/D ratio r = 0.537). However, rim area, disc area, and cup volume were not correlated with age. CONCLUSIONS: From these findings, we conclude that, in normal Koreans, the mean RNFL thickness decreases and the C/D ratio increases with age, with the increase in the vertical C/D ratio being greater.
Eye ; Humans ; Optic Disk ; Tomography, Optical Coherence