PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.
Abdomen ; Axilla ; Extremities ; Eyelids* ; Fluorometholone ; Humans ; Perineum ; Scrub Typhus* ; Vasculitis

To evaluate the corneal epithelial barrier after exposure to Benzalkonium chloride(BAC) or commonly used eyedrops, we measured corneal uptake of 5, 6-carboxyfluorescein(CF) applied to the corneal epithelium of the albino rabbits(70 eyes). Four BAC solutions (0.001 %, 0.01%, 0.05%, 0.1 %), ofloxacin solutions (Tarivid(R), Octacin(R), Ofloxacin(R)), fluorometholone solutions(Fumelon(R), Fluorometholone(R)), artificial tear solutions (Tears Naturale(R), Tears Naturale II(R), Tears naturale Free(R)) were evaluated. Balanced salt solution was used in control group. As the concentration of BAC increased, corneal epithelial permeability increased. In Octacin(R) group, corneal epithelial permeability increased about 5 times more than in Tarivid(R) and Ofloxacin(R) groups (p<0.01). Fluorometholone(R) group showed less increased permeability than in Fumelon group, but there was no statistical difference between them(p>0.05). Tears Naturale(R) showed the highest permeability among artificial tear solutions and there were no statistical differences between Tears Naturale II(R), Tears Naturale Free(R) and control group(p>0.1). This study showed that the higher concentration of BAC, the more damages to the barrier function of the corneal epithelium, and that clincally used eyedrops containing BAC made destructive influences on the corneal epithelial integrity.
Benzalkonium Compounds* ; Epithelium, Corneal ; Fluorometholone ; Ofloxacin ; Ophthalmic Solutions* ; Permeability ; Tears

PURPOSE: To compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. METHODS: A randomized, prospective clinical study was performed to compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. Sixty-one patients with intermittent exotropia were included in this study. They were told to apply antibiotic eye drops (ED) and either preservative or preservative-free topical 0.1% fluorometholone (F1) three times a day. Measurements of the degrees of conjunctival injection and corneal toxicity were performed at postoperative 1 week and 3 weeks each. RESULTS: Seventeen patients (34 eyes) were included in group 1 (preservative F1) and twenty patients (40 eyes) were included in group 2 (preservative-free F1). The average pixel value (measured via the Image J software) representing the degree of conjunctival injection was 31,732 ± 9,946 in group 1 and 38,347 ± 12,189 in group 2 at postoperative 1 week, while the average pixel value was 10,150 ± 4,493 in group 1 and 11,836 ± 4,290 in group 2 at postoperative 3 weeks. There was a significant difference between the decrease in pixel value for the two groups (p = 0.040). There was no significant difference in the mean value of the Oxford stain score between the two groups at postoperative 3 weeks, however the mean questionnaire scores in group 2 were significantly lower than in group 1 (p = 0.001). CONCLUSIONS: Preservative-free 0.1% fluorometholone ED demonstrated a larger decrease in the degree of conjunctival injection than for preservative ED after strabismus surgery. Therefore, the use of preservative-free steroid ED may be beneficial for decreasing both conjunctival injection and postoperative discomfort following strabismus surgery.
Clinical Study ; Exotropia ; Fluorometholone* ; Humans ; Ophthalmic Solutions ; Prospective Studies ; Strabismus*

It can be speculated that the thinned and flattened central cornea after excimer laser photorefractive keratectomy (PRK) might give a falsely low Goldmann applanation tonometer(GAT) reading. We studied 353 eyes of 264 patients who underwent PRK to determine the effect of excimer laser PRK on the accuracy of Goldmann applanation tonometry. PRK was done with a VISX 20/20 excimer laser and topical fluorometholone was used after PRK. The intraocular pressure(IOP) was measured with the GAT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean ablation depth of the cornea was 71.4 +/- 22.0 micrometer, and the eyes were divided into three groups according to their ablation depths. The mean postoperative IOP measured with the GAT decreased as compared with the mean preoperative IOP(P<0.01). The mean postoperative IOP at 9 or 12 months was lower than that at 1, 3, or 6 months(p<0.05). The mean IOP(11.9 +/- 2.5 mmHg) at 12 months was 2.8 mmHg lower than the mean preoperative IOP(14.7 +/- 2.7 mmHg). There was no statistically significant difference in the amount of postoperative IOP decrease among the three groups.
Cornea ; Fluorometholone ; Humans ; Lasers, Excimer* ; Manometry* ; Photorefractive Keratectomy*

The authors' clinical experience has suggested that the noncontact tonometer (NCT) has a tendency to record a lower intraocular pressure(IOP) than the Goldmann applanation tonometer(GAT) after excimer laser photo refractive keratectomy(PRK). This study was done to verify this tendency. We performed PRK on 177 eyes of 122 patients using a VISX 20/20 excimer laser, and topical fluorometholone was used after PRK. The eyes were divided into three groups according to their ablation depths, and the IOP was measured with the GAT and the Topcon NCT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean postoperative IOP measured with the GAT or the NCT decreased as compared with the mean preoperative IOP(GAT: 1.67 ~ 2.90 mmHg, NCT:5.27 ~ 6.54 mmHg). The mean NCT reading was 1.12 mmHg higher than the mean GAT reading preoperatively, but was 2.48 ~ 2.88 mmHg lower than the mean GAT reading postoperatively. Difference between GAT and NCT measurements postoperatively was more prominent in the group of deeper ablation. These results suggest that we should be cautious of evaluating the IOP measured with the GAT or the NCT after PRK.
Fluorometholone ; Humans ; Intraocular Pressure ; Lasers, Excimer* ; Photorefractive Keratectomy*

PURPOSE: We compared therapeutic efficacy and steroid-induced IOP elevation of 1% rimexolone with that of 0.1% fluorometholone. METHODS: Of all LASIK treated eyes from March of 2001 to December of 2002 in Sungae General Hospital, 46 eyes were treated with 1% rimexolone and 46 eyes were treated with 0.1% fluorometholone. And we measured the degree of myopic regression (1 day, 1 month, 3 month) and intraocular pressure (1 month). RESULTS: Statistically signicant difference in therapeutic efficacy of myopic regression, and no statistically signicant difference in IOP were found. The therapeutic efficacy of 1% rimexolone was higher. CONCLUSIONS: We concluded that application of 1% rimexolone was more useful in myopic regression following LASIK rather than that of 0.1% fluorometholone.
Fluorometholone* ; Hospitals, General ; Intraocular Pressure ; Keratomileusis, Laser In Situ*

PURPOSE: To evaluate the effect of combined medical treatment with anti-glaucoma eyedrops and 0.1% fluorometholone on visual acuity and refractive errors in patients complaining of blurred vision due to myopic regression after laser-assisted in-situ keratomileusis (LASIK) or laser-assisted sub-epithelial keratectomy (LASEK). METHODS: This study comprised 155 patients (155 eyes) who were diagnosed with myopic regression after LASIK or LASEK and received medical treatment from January 2015 to January 2016. The visual acuity and refractive errors were compared before and after medical treatment and evaluated to determine whether the results differ between LASIK and LASEK. RESULTS: The mean time of medical treatment was 64.1 ± 36.8 months after surgery. The responder group whose vision was improved and whose myopic error was decreased after medical treatment was comprised of 63 patients (41%). Their visual acuity in this group improved -0.21 ± 0.11 logMAR, and the amount of myopic error decreased 0.56 ± 0.32 diopters. The full responder group was 24 patients (15%), and the partial responder group was 39 patients (26%). The frequency of response to medical treatment was higher after LASIK than after LASEK, but the difference was not statistically significant. CONCLUSIONS: The combined medical treatment with anti-glaucoma eyedrops and 0.1% fluorometholone was effective in 41% of patients with regard to visual acuity improvement when used for post-LASIK or post-LASEK myopic regression. The medical treatment was effective after both LASIK and LASEK.
Fluorometholone* ; Humans ; Keratectomy, Subepithelial, Laser-Assisted* ; Keratomileusis, Laser In Situ* ; Ophthalmic Solutions* ; Refractive Errors ; Visual Acuity

PURPOSE: To determine the effectiveness of the method for preventing corneal opacity and minimizing the intraocular pressure (IOP) increase after photorefractive keratectomy treated with 0.1% fluorometholone and tranilast (0.5% tranilast, Krix®, JW pharmaceutical, Seoul, Korea), especially in cases with elevated IOP. METHODS: The patients who underwent photorefractive keratectomy from May 2014 to May 2015 were enrolled in the present study. The data of 49 patients (49 eyes) with elevated IOP at 1 month postoperatively and who used 0.1% fluorometholone and tranilast eye drops (tranilast group) were analyzed and compared with the control group consisting of patients who underwent the same surgery from December 2012 to October 2013 but used only 0.1% fluorometholone. RESULTS: The visual acuity at postoperative 6 months was log MAR -0.08 ± 0.05 and log MAR -0.08 ± 0.04 in the tranilast group and control group, respectively. The eye drops were used postoperatively for 17.7 ± 3.3 weeks in the tranilast group and for 20.5 ± 3.7 weeks in the control group (p < 0.01). Anti-glaucoma eye drops were used for 18.4 ± 3.2 weeks and 20.9 ± 3.7 weeks postoperatively in the tranilast group and control group, respectively (p < 0.01). CONCLUSIONS: Adding tranilast eye drops to patients whose IOP was elevated because of 0.1% fluorometholone use after photorefractive keratectomy is an effective method for preventing corneal haze and minimizing IOP elevation.
Corneal Opacity ; Fluorometholone* ; Humans ; Intraocular Pressure ; Ophthalmic Solutions* ; Photorefractive Keratectomy* ; Seoul ; Visual Acuity

To evaluate the effect of topical corticosteroid and nonsteroidal antiinflammatory agents on corneal stromal wound healing after excimer laser keratectomy, each eye of 75 rabbit was ablated by excimer laser and the animals were divided into five groups (15 rabbits in each group). That is, group I of 0.1% dexamethasone, group II of 0.1 % fluorometholone, group III of 0.03 % flurbiprofen, group IV of 0.1 % dexamethasone and 0.03 % flurbiprofen and control group of balanced salt solution. All treatment regiments were instilled four times daily after keratectomy. The animals of each group were killed at 1 week, 1month and 3months after surgery to examine the thickness of newly formed collagen, the keratocyte density and the fine structural alteration in keratocytes and stroma. The results were as follows; 1. The thickness of the new stroma was maximum in control group and minimum in group IV, and significantly different not only between the control and each experimental group but also between experimental groups except between group I and IV (p<0.05). 2. The keratocyte count was maximum in control group and minimum in group IV and the difference was significant between the control group and each experimental groups, but among experimental groups there was significant difference between I and III and between III and IV only. 3. Under transmission electron microscope at 12 weeks, the keratocyte activity and microscopic structural change were markedly subsided in each experimental group but sustainod in control. Basod on these observations, the topically applied steroid and nonsteroidal antiinflammatory drug can modulate the stromal wound healing process after excimer laser keratectomy and the effect, which can be evaluated by the quantitative analysis of the morphologic changes, is the most prominent in Dexamethasone treated group.
Animals ; Anti-Inflammatory Agents, Non-Steroidal* ; Collagen ; Dexamethasone ; Fluorometholone ; Flurbiprofen ; Lasers, Excimer* ; Rabbits* ; Steroids* ; Wound Healing

Intraocular pressures (IOP)were measured following Neodymium (Nd): YAG laser posterior capsulotomy in 51 pseudophakic eyes which had been treated with phacoemulsification and intraocular lens in the bag.Group 1 was no medical treated, group 2 was treated with 0.5%apraclonidine preoperatively, group 3 was treated with fluorometholone postoperatively, and group 4 was treated with 0.5%apraclonidine preoperatively and with fluorometholone postoperatively.IOP was measured preoperatively and 1, 3, 24 hours and 1 week postoperatively.Four eyes (7.8%)had greater than 5 mmHg elevation of IOP (1 eye in group 1, 3 eyes in group 3)and all of them decreased IOP to normal level within 3 hours.In summary, there was no or little IOP elevation without any medical treatment in eyes which had been treated with phacoemulsification and intraocular lens in the bag and had intact posterior lens capsule.
Cataract* ; Fluorometholone ; Intraocular Pressure* ; Lasers, Solid-State* ; Lenses, Intraocular ; Neodymium ; Phacoemulsification ; Posterior Capsulotomy*