Photorefractive keratectomy (PRK), Keratomileusis In Situ (KM), Laser Assisted In Situ Keratomileusis (LASIK), and clear lens extraction have been performed for high myopic patients. Among the above surgical procedures KM and LASIK are applied to young patients in general. However, comparison of clinical results of these two procedures was not reported yet in Korea. To evaluate the clinical results of KM (n=16) and LASIK (n=11) for high myopic patients between -15 diopter (D) and -23 diopter (D), spherical equivalent (S.E) and uncorrected visual acuity were studied for more than ten months, retrospectively. The mean S.E. was changed from -17.36 D before operation to -3.70 D ten months after operation in KM, whereas it was from -17.41 D to -0.31 D in LASIK. At ten months after operation, uncorrected visual acuity equal or better than best corrected visual acuity before operation was 43. 8% in KM and 63. 6% in LASIK. This results show that the clinical result of LASIK were superior to that of KM for high myopia.
Humans ; Keratomileusis, Laser In Situ ; Korea ; Myopia* ; Photorefractive Keratectomy ; Retrospective Studies ; Visual Acuity

We performed the deep lamellar keratoplasties in which stroma about 90% in thickness were removed on 15 patients(12 males and 3 females). The patients included in this study showed deep corneal opacity preserving endothelium intact. During the operation, we experienced microperforation in 3 cases, but no complications were found with immediate closure. After the operation, all patients acquired the corneal clarity except one whose cornea was opaque as the Grade II by the slit lamp examination. The patients had visual improvement of two lines or more in Snellen chart. Three patients had no change of visual acuity and one patient bad astigmatism more than 3D. Only one patient suffered the stromal rejection raction, but improved with the use of oral steroid and topical steroid eye drops.
Astigmatism ; Cornea ; Corneal Opacity ; Corneal Transplantation* ; Endothelium ; Humans ; Male ; Ophthalmic Solutions ; Visual Acuity

Authors decided to test whether differences occurred in automated and subjective refraction in untreated, PRK, and LASIK-treated eyes. Ninety six eyes of 50 patients(96 eyes) who underwent PRK(57 eyes) or LASIK(39 eyes) for myopia and myopic astigmatism were routinely autorefracted with the CANON RK-3 before subjective refraction was done, using several parameters. This two procedures were done preoperation and 3 months after operation. In comparing the postoperative(PRK, LASIK) results, automated refraction showed more myopia and higher cylinder power, without significant difference in refractive axis, than those of subjective measurement. The difference of cylinder power were found in the cases of large ablation depth(above 100micrometer), high degree of eccentric ablation(above 0.25 mm), LASIK operation. The significant differences of cylinder power and axis were found in the cases of high degree of eccentric ablation(above 0.25 mm). So we recommend the method of subjective refraction before PRK and LASIK operation instead of using automated refraction. Postoperatvely, we also should evaluate the postoperative status of the patient by subjective refraction. And we should decide the amount of ablation in case of retreatment by subjective refraction, instead of autorefraction. We have to be cautious of evaluating the automated refraction results after operation, especially in cases of large ablation depth, high degree of eccentric ablation, and LASIK.
Astigmatism ; Axis, Cervical Vertebra ; Humans ; Keratomileusis, Laser In Situ ; Myopia ; Retreatment

It is known that intraocular pressure becomes elevated over 65 mmHg when using a suction ring or fixation ring during LASIK. We intended to find out if transient elevation of IOP alters the microcirculation of the optic disc and retina. 10 patients were enrolled in this study. LASIK was performed on one eye using a suction ring and fixation ring. The other eye was used as a control. Heidelberg Retina Flowmetry[HRF] was performed preoperatively, postoperatively 1 day, 1 week, 3 weeks, and 3 months, respectively and analysis was done at the nasal and temporal neuroretinal rim, peripapillary retina, and optic cup. There was a statistically significant increase of flow at all sites on postoperative 1 day. Furthermore, increased flow was continued until postoperative 3 weeks at the temporal neuroretinal rim. However, the flow was normalized to the preoperative level by 3 months in all measured areas. No differences of flow were found when compared to the control eyes in each site.
Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ ; Microcirculation ; Optic Nerve* ; Retina* ; Suction

To evaluate the differences and factors to be considered when measuring intraocular pressure after photorefractive keratectomy[PRK]and laser in situ keratomileusis[LASIK], we prospectively reviewed the medical records of myopic eyes between -4~-7 diopters. Among them, 14 patients, 22 eyes underwent PRK and 10 patients, 18 eyes recieived LASIK. We measured intraocular pressures by Goldmann applanation tonometry preoperatively, 1 month, 3 months and 6 months postoperatively in each group. Corneal curvatures, central corneal thicknesses were measured and compared when measuring intraocular pressure. The postoperative intraocular pressure was lower than the preoperative value in both groups[p<0.01], and the decreased amount of IOP were not statistically different in both groups[p=0.29]. Targeted ablation depth[p=0.19]and ablation diameter[p=0.16]did not show statistically significant correlation to postoperative IOP decrease. In measuring intraocular pressure after PRK or LASIK, attention should be given to the pressure and its interpretation.
Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Medical Records ; Prospective Studies

To evaluate the differences and factors to be considered when measuring intraocular pressure after photorefractive keratectomy[PRK]and laser in situ keratomileusis[LASIK], we prospectively reviewed the medical records of myopic eyes between -4~-7 diopters. Among them, 14 patients, 22 eyes underwent PRK and 10 patients, 18 eyes recieived LASIK. We measured intraocular pressures by Goldmann applanation tonometry preoperatively, 1 month, 3 months and 6 months postoperatively in each group. Corneal curvatures, central corneal thicknesses were measured and compared when measuring intraocular pressure. The postoperative intraocular pressure was lower than the preoperative value in both groups[p<0.01], and the decreased amount of IOP were not statistically different in both groups[p=0.29]. Targeted ablation depth[p=0.19]and ablation diameter[p=0.16]did not show statistically significant correlation to postoperative IOP decrease. In measuring intraocular pressure after PRK or LASIK, attention should be given to the pressure and its interpretation.
Humans ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Medical Records ; Prospective Studies

Bacterial endophthalmitis, which is a devastating complication of intraocular surgery or eye trauma, has a poor prognosis. Intravitreal injection of antimicrobial agents has become a part of the standard treatment of endophthalmitis. The authors investigate the pharmacokinetics of intravitreal liposome-encapsulated tobramycin as a possible method of prolonging the duration of therapeutic concentrations. Tobramycin was encapsulated into liposomes of phosphatidylcholine, phosphatidic acid, and alpha-tocopherol by the reverse phase evaporation method. The final liposomal suspension contained tobramycin, 7.0 mg/ml, 60.5% encapsulated. One eye received an intravitreal injection of either liposome-encapsulated tobramycin (LET), tobramycin phosphated-buffered saline (TS) or a mixture of tobramycin and liposome-encapsulated saline (TEL), and the results were as follows: 1. Concentrations of free tobramycin were significantly lower with LET than with TS or TEL at 1 hour after intravitreal injection. 2. Concentrations of free and total tobramycin were significantly higher with LET than with TS or TEL at 5 and 8 days after intravitreal injection. Concentrations of free tobramycin with TS were lower than the minimal inhibitory concentration(MIC) of tobramycin for Pseudomonas aeruginosa at 8 days after intravitreal injection, while those with LET were higher than the MIC of tobramycin for Pseudomonas aeruginosa 18 days after injection.
Animal ; Delayed-Action Preparations ; Injections ; Liposomes ; Rabbits ; Tobramycin/administration & dosage/*pharmacokinetics ; Vitreous Body/*metabolism

Superior limbic keratoconjunctivits (SLK) is a chronic, recurrent keratoconjunctivitis of unknown etiology, which is clinically characterized by papillary hypertrophy of upper tarsus, redness of the superior bulbar conjunctiva, thickening and keratinization of the superior limbus, epithelial keratitis. recurrent filaments formation, and superior micropannus. This. disease may be bilateral and usually common in females between 20 and 60 years of age. Superior limbic keratoconjunctivitis does not respond to topical antibiotics, antivirals, nor corticosteroids. A 28 year old Korean male was found to have characteristic clinical signs of superior limbic keratoconjunctivitis O.U. which was confirmed on the scraping by demonstrating keratinizing and degenerating epithelial cells of the limbus. No thyroid disease was seen in association with superior limbic keratoconjunctivitis. Application of 0.5% silver nitrate solution improved the condition of superior limbic keratoconjunctivitis.
Adrenal Cortex Hormones ; Adult ; Ankle ; Anti-Bacterial Agents ; Antiviral Agents ; Conjunctiva ; Epithelial Cells ; Female ; Humans ; Hypertrophy ; Keratitis ; Keratoconjunctivitis ; Male ; Silver Nitrate ; Thyroid Diseases

Laser-assisted in situ keratomileusis(LASIK) theoretically provide less corneal haze and more accurate correction. In the LASIK. however, photo refractive keratectomy(PRK) will be done on the stromal surface exposed after removal of the 130 micrometer thick lenticule. Deep stromal ablation after removal of 130 micrometer thick lenticule may result in endothelial damage. We observed endothelial cytoskeletal changes after deep PRK to evaluate the endothelial safety in rabbit. PRK was performed on the rabbit cornea without removing the epithelium with VISX 20/20 (160mj/cm2/pulse, 5Hz) to correct 6, 9, 12, and 15 diopters of myopia by single or multiple zone. Seven days after ablation, the rabbit was euthanized, corneas excised and endothelial F-actin was stained with NBD-phallacidin to demonstrate any cytoskeletal changes. No F-actin changes were observed in corneas after either single zone, 6 or 9 diopter correction, and multiple zone ablation. However, 12 diopters or higher correction in a single zone resulted in pleomorphism and polymegethism on focal areas. In the LASIK procedure, the endothelium might be damaged and further investigation for the endothelial preservation during the procedure is needed in human.
Actins* ; Cornea ; Endothelium ; Endothelium, Corneal ; Epithelium ; Humans ; Keratomileusis, Laser In Situ ; Myopia ; Photorefractive Keratectomy

Hydroa vacciniforme is a rare, chronic disease that is characterized by recur rent erythema and vesicles on uncovered skin within several days of sun exposure and is followed by healing with scarring. We have experienced a case of hydroa vacciniforme which involved the cornea, and we performed a penetra ting keratoplasty with a good result. We report this case with a review of the literature.
Chronic Disease ; Cicatrix ; Cornea ; Corneal Transplantation ; Erythema ; Hydroa Vacciniforme* ; Keratoplasty, Penetrating ; Skin ; Solar System ; Tolnaftate