When the oculomotor nerve is completely paralyzed. the affected eye shows severe outward displacement and poor cosmetic appearance. The results of many surgical procedures for oculomotor palsy have been generally unsatisfactory. We tried a new surgical approach experimentally. in which the disinserted lateral rectus muscle was used as an adductor by medial transposition of the muscle. Five adult cats underwent tenectomy of the medial rectus muscle of the eyes to induce iatrogenic medIal rectus paralysis. The segment of the medial rectus was removed as far back as possible to prevent reattachment. Then, right lateral rectus muscle was disinserted and passed beneath the superior rectus muscle and resutured to the sclera 4mm superoposterior to the medial rectus insertion site. After tenectomy of bilateral medial rectus. large exotropia of an average of 47.6 delta (42.0 delta - 55.5 delta) was induced. The medial transposition of the right lateral rectus produced an average 36.6 delta (24.8 delta - 45.8 delta) of correction of exotropia. A satisfactory cosmetic result was achieved by this procedure. It may be a good alternative procedure in difficult cases of oculomotor nerve palsy with severe outward deviation.
Adult ; Animals ; Cats ; Exotropia ; Humans ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis* ; Sclera

The whole retina, except for the medullary fiber zone in a rabbit eye, is supplied by choroidal circulation. Therefore, the histopathological changes of the sensory retina due to choroidal circulatory disturbance in rabbits may be comparable to that of the human sensory retina in the case of ophthalmic artery occlusion. This study was carried out to evaluate the histopathological changes of the ischemic retina secondary to the occlusion of choroidal circulation. The experimental occlusion of all posterior ciliary arteries and anterior ciliary arteries in the horizontal rectus muscle of rabbit eyes was performed and the subsequent histopathological changes of the sensory retina were observed by transmission electron microscopy. The morphological changes of the sensory retina following the occlusion of the ciliary arterial system are as follows: severe loss of the inner and outer segments of the photoreceptor, mild to moderate degeneration of the ganglion cells, and excellent preservation of the Muller's cell fibers and the extension of the cytoplasmic villous processes to the cytoplasmic vacuolar spaces of other degenerated cells. These findings indicate that the Muller's fibers in the ischemic condition of retina might contribute to the formation of gliosis or scarring of a damaged retina.
Animals ; Arterial Occlusive Diseases/*complications ; Arteries ; Choroid/*blood supply ; Ciliary Body/*blood supply ; Ischemia/*etiology/pathology ; Rabbits ; Retina/*ultrastructure ; *Retinal Vessels

We examined the fibronectin (FN) secretion of cultured trabecular meshwork (TM) cells in a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM, which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In the tissue culture of TM, the TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Adolescent ; Adult ; Antibodies, Monoclonal ; Cells, Cultured ; Fibronectins/biosynthesis/*metabolism ; Fluorescent Antibody Technique ; Humans ; Male ; Microscopy, Immunoelectron ; Trabecular Meshwork/*metabolism/ultrastructure

Reoperation of Photorefractive keratectomy(PRK) may be considered for regression, corneal haze, topographic irregularity, and a combination of these complications. We have studied the results of reoperation after myopic PRK in 113 eyes. Between 1992 and 1994, we observed 3,053 eyes of 1,583 patients who underwent PRK over year follow-up. We analysed 113 eyes which showed regression with or without opacity and underwent reoperation over one year follow-up. For reoperation, we used the VixX Twenty/Twenty excimer laser. Of the 72 eyes on regression, 53 eyes(73.6%) showed successful result(spherical equivalent within +/-1.0D), but 19 eyes(24.6%) showed repeated regression after the reoperation. Of the 33 eyes with corneal opacity and regression, 14 eyes(42%) showed good results. Of the 8 eyes with a central island, the results was good in all of the cases. No complications were observed. In conclusion, the reoperation rate was 3.7%(113/3053). The main cause of reoperation was regression, and the best result of reoperation was central island. 75 eyes out of 113 eyes(66%) showed good results(spherical equivalent within +/-1D). Reoperation may be considered for regression with or without corneal haze and central island in PRK.
Corneal Opacity ; Follow-Up Studies ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy* ; Reoperation*

We examined the fibronectin(FN) secretion by cultured trabecular meshwork(TM) cells from a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In tissue culture of TM, TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Animals ; Cell Wall ; Endothelial Cells ; Extracellular Matrix ; Fibronectins* ; Fluorescent Antibody Technique, Indirect ; Frozen Sections ; Goats ; Humans ; Immunoglobulin G ; Mice ; Microscopy, Immunoelectron ; Rupture ; Trabecular Meshwork*

This study was performed to observe the influence of the feeder layer on the culture of the human uveal melanoma cell. Two types of melanoma cells which were obtained from the patients with choroidal melanoma were implanted into the culture flask. The melanoma cell was seeded onto the culture dish covered with conjunctival fibroblast, Vero cell, and culture dish which did not contain the feeder layer respectively. The growth pattern of the melanoma cell was observed with phase contrast microscopy upto 30 days after seeding. There was no definite difference in growth pattern between each group. These results may indicate that the feeder layer is not an essential factor in the culture of uveal melanoma cell.
Choroid ; Feeder Cells ; Fibroblasts ; Humans ; Melanoma* ; Microscopy, Phase-Contrast ; Vero Cells

Allergic conjunctivitis is commonly encountered in the office parctice of ophthalmology. However, diagnosis is not easy because allergic conjunctivitis shows nonspecific ocular symptoms and signs. And for accurate diagnosis, conjunctival scraping for eosinophils, tear levels of specific IgE, skin testing to aeroallergens, and ocular challenge with allergens are available but these methods are much time and cost consuming. So we evaluate the usefulness of the detection of eosinophils by conjunctival impression cytology. Conjunctival impression cytology was done on 44 eyes of 44 patients who were diagnosed as allergic conjunctivitis. 7 eyes of 7 normal subjects and 14 eyes of 14 patients with epidemic keratoconjunctivits were used as control. Scoring system was defined according to the past history, symptom, sign, and slit lamp finding ranged from +1 to +5. Eyes of score +1 or +2 were defined as allergy suspect group, and eyes of score +3 to +5 defined as allergy group. The sensitivities of the impression dytology were 59% in allergy suspect group, 86% in definite allergy group and 72%in total, The specificity was 95%. According this study, we conclude that impression cytology is a simple, non-invasive and cheap method with high sensitivity and specificity for the diagnosis of allergic conjunctivitis.
Allergens ; Conjunctivitis, Allergic* ; Diagnosis ; Eosinophils* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Ophthalmology ; Sensitivity and Specificity ; Skin Tests

This study was conducted to investigate whether fibronectin, type IV collagen, and concanavalin A(Con A) were present in human Bruch's membrane. We used monoclonal antibodies to localize extracellular matrix(ECM) of Bruch's membrane in 10 enucleated human eyes by indirect immunofluorescent method. Posterior chorioretinal tissues were excised and embedded. Fibronectin and type IV collagen antibodies and Con A antibody were added to each section, and then FITC conjugated goat anti-mouse IgG was added. The appearance of tissue preparations were examined by fluorescence microscope. Bruch's membrane showed strong positive reaction to anti-fibronectin and antitype IV collagen antibody, but the staining for Con A was not seen or weakly posItive in reaction. These results indicate that fibronectin and type IV collagen are major compon ents of ECM of Bruch's membrane. On the other hand, Con A does not contribute to the major component of the matrix of Bruch's membrane.
Antibodies ; Antibodies, Monoclonal ; Bruch Membrane* ; Collagen ; Collagen Type IV* ; Concanavalin A* ; Extracellular Matrix ; Fibronectins* ; Fluorescein-5-isothiocyanate ; Fluorescence ; Goats ; Hand ; Humans* ; Immunoglobulin G

There are many reports which show that contraction of the extraocular muscles results in an increase in intraocular pressure(IOP). Goldmann tonometer was used to record IOP after Tensilon injection in 22 patients, 10 myasthenics and 12 patients with other neurologic disease. There was a significant difference in IOP measured at 30 seconds after injection between two groups; 1-7(mean: 3.4) mmHg increase in myasthenics but no change, or 1-6 (mean: 1.7) mmHg decrease in patients with other neurologic disease. It is concluded that Tensilon tonometry is a valuable, sensitive and objective method in the diagnosis of myasthenia gravis.
Diagnosis* ; Edrophonium* ; Humans ; Manometry* ; Muscles ; Myasthenia Gravis*

Internuclear ophthalmoplegia(INO) is characterized by the adduction deficit on lateral gaze associated with dissociated nystagmus of an abducting eye and caused by the lesion in the medial longitudinal fasciculus(MLF). It occurs unilaterally or bilaterally in infarction of brain stem and multiple sclerosis. Ocular myasthenia is a localized form of myasthenia involving extraocular, levator palpebrae perioris, and/or orbicularis oculi muscles. It is frequently confused with a variety of ocular mortility disorders including INO. We experienced 2 patients who had bilateral wall-eyes and diplopia. One was a true bilateral INO due to hypertensive brain stem infarction(Wall-eyed bilateral INO) and the other was a myasthenic bilateral pseudo-INO. Diagnosis was made by Tensilon test, repetitive nerve stimulation test of orbicularis oculi muscles, and serum antibody assay in latter case.
Brain Stem ; Diagnosis ; Diplopia ; Edrophonium ; Exotropia* ; Humans ; Infarction ; Multiple Sclerosis ; Muscles ; Nystagmus, Pathologic ; Ocular Motility Disorders ; Ophthalmoplegia*