In the aphakic eye of no posterior capsular support, the posterior chamber intracoular lens implantation with suture fixation of the haptics to the sclera at the ciliary sulcus have been popular method. But there are difficulty to know whether the hclptics are exactly fixated in the ciliary sulcus or not and more surgical techniques are required. We have devised a simple and safe methods -4 step test (Guiding up test, Spring test, Knocking test, Lifting and rotating test) for implantation of posterior chamber intraocular lenses in the absence of capsular support with or without suture fixation. We have used this surgical technique for implantation of posterior chamber intraocular lenses in 41 eyes with no capsular support at Kim's eye clinic from July, 1989 to December, 1990. The patients were devided into 3 group-without scleral fixation group (Group A), with superior one point scleral fixation group (Group B), with two point scleral fixation groups (Group C). The results were as followed: 1. Follow up ranged from 6 months to 15 months. 2. The postoperative visual acuity was maintained or improved in 11 eyes (91.6%) of Group A, 9 eyes (69.2%) of Group B, and 12 eyes (75%) of Group C. 3. The most common complication was cystoid macular edema and the others were decentration, hyphema, retinal detachment, ocular hypertension in that order.
Aphakia ; Exercise Test* ; Follow-Up Studies ; Humans ; Hyphema ; Lenses, Intraocular* ; Lifting ; Macular Edema ; Ocular Hypertension ; Retinal Detachment ; Sclera ; Sutures ; Visual Acuity

Waldenstrom's macroglobulinemia is a low- grade lymphoproliferative disorder with monoclonal IgM protein. It is characterized by normocytic, normochromic anemia and lymphoplasmacytic marrow infiltration. Chemotherapy with alkylating agents and steroids has been the standard therapy for patients with symptomatic macroglobulinemia. The purine nucleoside analogues, either alone or in combination with other chemotherapeutic agents are increasingly used, and approximately 40% of patients who have received prior therapy with alkylating agents responded. We experienced a case of Waldenstrom's macroglobulinemia suc-cessfully treated with three courses of cladribine, who had previously received unsuccessful therapy using an alkylating agent, steroid and plasmapheresis. Treatment was well tolerated except for frequent upper respiratory infections with severe pancytopenia. A marked and sustained bone marrow suppression occurred in this patient but resolved in three months without any severe infection.
Alkylating Agents ; Anemia ; Bone Marrow ; Cladribine* ; Drug Therapy ; Humans ; Immunoglobulin M ; Lymphoproliferative Disorders ; Pancytopenia ; Plasmapheresis ; Respiratory Tract Infections ; Steroids ; Waldenstrom Macroglobulinemia*