1.Pulsatile Ocular Blood Flow Measurements in Ocular Trauma Patients.
Helen LEW ; Seok Ho BYUN ; Sang Yeul LEE
Journal of the Korean Ophthalmological Society 2000;41(1):244-250
The objective of this study was to ascertain the elationship between the various ocular traumas and the change of pulsatile ocular blood flow[POBF] measured with Ocular Blood Flow Tonograph[OBF Laboratories, UK Ltd.]. We tested POBF with Ocular Blood Flow Tonograph 3 times repeatedly within 48 hours after trauma in the 33 ocular trauma patients.In all the trauma eyes, heart rate[HR]and intraocular pressure[IOP]were higher and pulse amplitude [PA], pulse volume[PV], POBF were lower than in all the fellow eyes.In the hyphema group, HR, IOP, PA, PV, POBF were higher, especially IOP and OBF%S.D.were statically significant, than in non-hyphema group.In the orbital fracture group, only POBF and OBF%S.D.were higher than those of in non-fracture group. Therefore, these results show the change of POBF after various ocularinjuries in the ocular trauma patients.The further studies to follow up the serial change of POBF are necessary.
Heart
;
Humans
;
Hyphema
;
Orbital Fractures
2.Clinical Evaluation on the Consecutive Esotropia after Exotropia Surgery.
Helen LEW ; Jong Bok LEE ; Sueng Han HAN ; He Seong PARK
Journal of the Korean Ophthalmological Society 1999;40(12):3482-3490
We reviewed the clinical characteristics and surgical results of patients who had consecutive esotropia after exotropia surgery with at least 6 months of follow-up. The number of transient esotropic cases with more than 10 prism diopter postoperatively was 105[9%] in total 1128 cases and persistent esotropic cases at least for six months after surgery was 24[2%]. Significant correlations were found between the development of consecutive esotropia and the presence of amblyopia[p=0.04], poor stereopsis[p=0.02], suppression of the Worth 4-dot test[p<.01], and recession-resction surgery[p=0.02]. The corrective surgery for consecutive esotropia was performed on 12 cases[1.1%] with unilateral lateral rectus advancement[7 cases], bilateral lateral rectus advancement[3 cases], unilateral medial rectus recession[1 case] and bilateral medial rectus recession[1 case]. All of them showed good results.
Esotropia*
;
Exotropia*
;
Follow-Up Studies
;
Humans
3.Microbial Flora of The Conjunctival Sac in Prosthesis Wearers.
Helen LEW ; Sang Yeul LEE ; Hong Bok KIM
Journal of the Korean Ophthalmological Society 1995;36(6):938-943
Persistent physical stimulation and foreign body contact in prosthesis wearers may develop secondary infection, frequent conjunctival injection and responses such as giant papillary conjunctivitis. In 77 patients wearing prostheses, the bilateral conjunctival flora was studied and compared with the expect of conjunctival floral change. The predominent organisms were essentially the same in both sides: Staphylococcus epidermidis, Staphylococcus aureus followed by streptococcus. The incidence of bacterial isolation on the anophthalmic side (67.5%) was significantly higher than on the healthy side (32.5%). Especially the incidence of potential pathogenic bacterial isolation(Staphylococcus aureus, Streptococcus, Gram negative bacilli)(27.9%) was significantly higher on the anophthalmic side than on the healthy side(6.5%). The conjunctival smear study showed the higher incidence of polymorpho nucleoleukocyte and bacteria on the anophthalmic side. The isolation rates of the moderate to marked responded conjunctiva(46.9%) was lower than on the mild responded conjunctiva(69.2%) . The wearing time of the prostheses, the frequency of cleaning of prostheses, type of cleaner and topical drops used did not effect the incidence of bacterial isolation of conjunctival sac. Therfore these results showed that persistent physical stimulation and foreign body contact with prosthesis wearing may alter the microbial flora of the conjunctival sac.
Bacteria
;
Coinfection
;
Conjunctivitis, Allergic
;
Foreign Bodies
;
Humans
;
Incidence
;
Physical Stimulation
;
Prostheses and Implants*
;
Staphylococcus aureus
;
Staphylococcus epidermidis
;
Streptococcus
4.Comparison of Surgical Results Between Bilateral Rectus Muscle Recessions and Lateral Rectus Muscle Recession and Medial Rectus Muscle Resection in Exotropia.
Helen LEW ; Jong Bok LEE ; Tae Kyun KIM
Journal of the Korean Ophthalmological Society 1995;36(1):115-119
In this study we reviewed the results of 215 operations for intermittent and alternating exotropia of the total, 120 cases had a bilateral rectus muscle recessions and 95 cases had lateral rectus muscle recession and medial rectus muscle resection. The patient in the bilateral rectus muscle recessions group ranged from 2 to 31 years of age, averaging 9.8 years, and the follow up period after operation ranged from 2 months to 25 months averaging 5.4 months. The patient in the latral rectus muscle recession and medial rectus muscle resection group ranged from 4 to 53 years of age, averaging 18.6 yeras, and the post-operative follow up period ranged from 2 to 30 months, averaging 5.8 months. The success rate of operation in bilateral rectus muscle recessions group was 83.3%(100/120), and that in lateral rectus muscle recession and medial rectus muscle resection group was 88.8%(84/95). This difference in success rate between two groups was not statistically significant.
Exotropia*
;
Follow-Up Studies
;
Humans
5.The Effect of Botulinum Toxin Chemodenervation in Chronic Paralytic Strabismus.
Sueng Han HAN ; Joon Gyoon JUNG ; Helen LEW
Journal of the Korean Ophthalmological Society 2000;41(3):751-757
Botulinum toxin chemodenervation is widely used for the treatment of acute paralytic strabismus. We reviewed the effect of botulinum toxin chemodenervation for the treatment of chronic paralytic strabismus. Between 1996 and 1998, 13 patients with chronic paralytic strabismus were treated with botulinum toxin chemodenervation. The palsy of extraocular muscle persisted for at least 6 months. Each patient received an injection of 1.25 to 5 units of botulinum toxin[Botox]to the antagonist muscle of the paralytic muscle and two patients received injections two times. The follow-up was more than 6 months [mean 7.62 months].2 patients were treated with surgery of horizontal muscles and 3 patients were treated with muscle transposition surgery before injection. The mean preinjection deviation was 36.7PD and the mean strabismus angle after injection was 19.2PD and improving rate of the strabisbismus angle was 47.6%. The final deviations of 6 patients were within 10PD[46.2%]and 4 of 7 patients with final deviation above 10PD were treated with surgery later. Ptosis occurred in 4 patients[30.8%]and hypertropia occurred in 4 patients[30.8%]. In addition to the prevention of muscle contracture with botulinum toxin injection, it is likely that the therapeutic effect of botulinum toxin is produced by permanent alteration in the muscle and influence on the peripheral and central nervous system. Therefore botulinum toxin chemodenervation can be considered as a primary therapy or a subsequent therapy of surgery for chronic paralytic strabismus and further study is needed.
Botulinum Toxins*
;
Central Nervous System
;
Contracture
;
Follow-Up Studies
;
Humans
;
Muscles
;
Nerve Block*
;
Paralysis
;
Strabismus*
6.The Clinical Evaluation on the Patients Complaining of Epiphora.
Helen LEW ; Sang Yeul LEE ; Sung Joo KIM
Journal of the Korean Ophthalmological Society 2000;41(5):1112-1117
The clinical analysis on the etiologies was done along with frequency of the patient's complaints of epiphora.The etiologies of the fifty-four patients screened by fluorescein dye disappearance test were classified by the causative location of the lacrimal pathway. The average of the patient's ages was 48.7 years old and average duration of symptom was 26.1 months.The causative locations were punctum[35.2%], nasolacrimal duct, lacrimal pump and nasal cavity in following order.The most common causes of each group were senile lid laxity[5.6%] for lacrimal pump, conjunctivochalasis and punctual atresia[11.1%]for lacrimal pump, idiopathic narrowing[9.3%]for canaliculus and idiopathic narrowing[16.6%]for nasolacrimal duct.Probing was the most common past history[18.5%]and the kinds of treatment were dacryocystorhinostomy, punctoplasty, lid tightening, probing, and conjunctivod acryocystorhinostomy. These data are expected to be a useful guide of rapid diagnosis and appropriate treatment for the epiphora patients without complicate processes and discomfort.
Dacryocystorhinostomy
;
Diagnosis
;
Fluorescein
;
Humans
;
Lacrimal Apparatus Diseases*
;
Nasal Cavity
;
Nasolacrimal Duct
7.Dacryoendoscopic Findings of Patients with Lacrimal Drainage Obstruction Associated with Cancer Treatment
Korean Journal of Ophthalmology 2022;36(6):509-517
Purpose:
To compare the diagnosis and treatment outcome of lacrimal drainage obstruction of patients who underwent systemic chemotherapy (CTx) or radioactive iodine treatment (RAI) by using dacryoendoscopy and at the same time performing dacryoendoscopy-guided silicone tube insertion (STI) to treat epiphora.
Methods:
From July 2017 to December 2020, the medical records of 11 patients (16 eyes) were diagnosed with lacrimal drainage obstruction after CTx or RAI and underwent dacryoendoscopy-guided STI were reviewed retrospectively. We tried to count the number of obstructive sites in total patients using slit-lamp examination and dacryoendoscopic findings.
Results:
A total of 11 patients, 16 eyes, were enrolled in this study. The onset of epiphora in the CTx group (3.0 ± 4.0 months) was significantly shorter than that in the RAI group (52.6 ± 36.5 months, p = 0.001). There were total 32 obstructive sites including 28 obstructive sites of dacryoendoscopic findings and four sites of punctual stenosis in total 16 cases. Using dacryoendoscopy, granulation findings was dominant in RAI patients (p = 0.038) and mucus finding was frequent mostly in lacrimal sac and canaliculus. In the CTx group, mucosal edema finding was dominant (p = 0.038) and fibrotic membrane finding was frequent in all levels of lacrimal drainage system. Regarding the obstructive location, lacrimal sac was the most frequently obstructed site in the two groups (p = 0.038).
Conclusions
The onset of epiphora in the CTx group was significantly earlier than in the RAI group. In the CTx group, mucosal edema finding was frequent in all levels of lacrimal drainage system. In the RAI group, granulation finding was frequent mostly in lacrimal sac and canaliculus. Since the clinical outcome was satisfactory, intervention with dacryoendoscopy-guided STI could be a treatment of choice in patients with epiphora after CTx or RAI.
8.Dacryoendoscopic Findings in the Failed Silicone Tube Intubations without Dacryoendoscopy
Korean Journal of Ophthalmology 2022;36(6):486-492
Purpose:
To investigate the clinical characteristics and dacryoendoscopic findings and clinical efficacy of silicone tube intubation (STI) in the patients who referred to our center due to failed with conventional STI.
Methods:
We retrospectively reviewed the medical records of 61 cases from 50 patients who underwent STI or endoscopic dacryocystorhinostomy using dacryoendoscopy from January 2016 to May 2021. Clinical characteristics, tear meniscus height, lacrimal irrigation test, dacryocystographic findings, dacryoendoscopic findings and surgical outcomes were evaluated.
Results:
The study included 12 male and 38 female patients (mean age, 64.1 ± 13.2 years). In the preoperative lacrimal irrigation test, passage was found in 33 eyes (54.1%) and no passage in 28 eyes (45.9%). The causes of lacrimal duct obstruction were in the order of stenosis (31.1%), mucus (27.9%), membrane (24.6%), granulation (13.1%), and stone (3.3%), and the location were in the order of nasolacrimal duct (39.3%), lacrimal sac (36.1%), canaliculus (21.3%), and inferior meatus (3.3%). As for the characteristics of obstruction, the secretory type was 21 eyes (34.4%), and structural change type was 40 eyes (65.6%). The STI group consisted of 57 eyes (93.4%) and endoscopic dacryocystorhinostomy consisted of four eyes (6.6%). The overall success rate was 83.9%. Clinical results were correlated with dacryoendoscopic finding (p = 0.015), but not with lacrimal irrigation test or dacryocystography. The structural change type had a higher surgical success rate than the secretory type (84.4% vs. 66.7%, p = 0.015). In particular, the structural change type showed higher success rate than the secretory type below the lacrimal sac (95.5% vs. 61.9%, p = 0.034).
Conclusions
STI using dacryoendoscopy has a higher surgical success rate than conventional STI since dacryoendoscopy provides direct visualization of nasolacrimal duct obstruction. It could be useful in increasing the surgical success rate in patients with structural changes below lacrimal sac.
9.Postoperative Stereopsis Changes in Various Types of Strabismus Patients Over 10 Years of Age
Journal of the Korean Ophthalmological Society 2020;61(11):1322-1330
Purpose:
To evaluate the postoperative stereopsis changes in strabismus patients over 10 years of age after surgical correction.
Methods:
We reviewed, retrospectively, the medical records of 193 patients (99 men and 94 women) who underwent strabismus surgery from March 2002 to August 2019 at our hospital. Patients were classified into an exotropia group, an esotropia group, or a combined strabismus group (having horizontal and vertical strabismus simultaneously), according to their strabismus type. These groups were further divided into three groups based on pre-operative stereopsis findings classified as poor (above 4,000 seconds [s] of arc), fair (between 4,000 to 100 s of arc), or good (below 100 s of arc). The stereopsis conditions before and after surgery were compared.
Results:
Overall, the stereopsis of patients over 10 years of age who underwent surgery improved from 2.45 ± 0.69 logarcsec to 2.85 ± 0.58 logarcsec (p < 0.001) after surgery regardless of strabismus type. Stereopsis in exotropia patients was 2.33 ± 0.71 logarcsec before surgery and improved to 2.15 ± 0.56 logarcsec (p < 0.001) after surgery. Stereopsis in esotropia patients was 0.85 ± 0.58 logarcsec before surgery and 2.48 ± 0.11 logarcsec after surgery (p = 0.002). Stereopsis of combined strabismus patients was 2.44 ± 0.76 logarcsec before surgery versus 2.20 ± 0.54 logarcsec after surgery (p = 0.133). The degree of stereopsis improvement was highest for the esotropia, group followed by the combined strabismus, and exotropia groups.
Conclusions
Surgical correction of various types of strabismus may be helpful for binocular function in patients over 10 years of age.
10.Postoperative Stereopsis Changes in Various Types of Strabismus Patients Over 10 Years of Age
Journal of the Korean Ophthalmological Society 2020;61(11):1322-1330
Purpose:
To evaluate the postoperative stereopsis changes in strabismus patients over 10 years of age after surgical correction.
Methods:
We reviewed, retrospectively, the medical records of 193 patients (99 men and 94 women) who underwent strabismus surgery from March 2002 to August 2019 at our hospital. Patients were classified into an exotropia group, an esotropia group, or a combined strabismus group (having horizontal and vertical strabismus simultaneously), according to their strabismus type. These groups were further divided into three groups based on pre-operative stereopsis findings classified as poor (above 4,000 seconds [s] of arc), fair (between 4,000 to 100 s of arc), or good (below 100 s of arc). The stereopsis conditions before and after surgery were compared.
Results:
Overall, the stereopsis of patients over 10 years of age who underwent surgery improved from 2.45 ± 0.69 logarcsec to 2.85 ± 0.58 logarcsec (p < 0.001) after surgery regardless of strabismus type. Stereopsis in exotropia patients was 2.33 ± 0.71 logarcsec before surgery and improved to 2.15 ± 0.56 logarcsec (p < 0.001) after surgery. Stereopsis in esotropia patients was 0.85 ± 0.58 logarcsec before surgery and 2.48 ± 0.11 logarcsec after surgery (p = 0.002). Stereopsis of combined strabismus patients was 2.44 ± 0.76 logarcsec before surgery versus 2.20 ± 0.54 logarcsec after surgery (p = 0.133). The degree of stereopsis improvement was highest for the esotropia, group followed by the combined strabismus, and exotropia groups.
Conclusions
Surgical correction of various types of strabismus may be helpful for binocular function in patients over 10 years of age.