A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the traumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the posttraumatic tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.
Dilatation ; Dyspnea ; Edema ; Emergencies ; Humans ; Middle Aged ; Motor Vehicles ; Rupture ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

PURPOSE: To assess the refractive change and prediction error after temporary intraocular lens (IOL) removal in temporary polypseudophakic eyes using IOL power calculation formulas and Gills' formula. METHODS: Four consecutive patients (7 eyes) who underwent temporary IOL explantation were enrolled. Postoperative refractions calculated using IOL power calculation formulas (SRK-II, SRK-T, Hoffer-Q, Holladay, and the modified Gills' formula for residual myopia and residual hyperopia) were compared to the manifest spherical equivalents checked at 1 month postoperatively. RESULTS: The mean ages of temporary piggyback IOL implantation and IOL removal were 6.71 +/- 3.68 months (range, 3 to 12 months) and 51.14 +/- 18.38 months (range, 29 to 74 months), respectively. The average refractive error was -13.11 +/- 3.10 diopters (D) just before IOL removal, and improved to -1.99 +/- 1.04 D after surgery. SRK-T showed the best prediction error of 1.17 +/- 1.00 D. The modified Gills' formula for myopia yielded a relatively good result of 1.47 +/- 1.27 D, with only the variable being axial length. CONCLUSIONS: Formulas to predict refractive change after temporary IOL removal in pediatric polypseudophakia were not as accurate as those used for single IOL implantation in adult eyes. Nonetheless, this study will be helpful in predicting postoperative refraction after temporary IOL removal.
Cataract/*congenital ; *Cataract Extraction ; *Device Removal ; Female ; Humans ; Hyperopia/etiology/*surgery ; Infant ; Lens Implantation, Intraocular/*methods ; Lenses, Intraocular ; Male ; Myopia/etiology/*surgery ; Prospective Studies

PURPOSE: To assess the refractive change and prediction error after temporary intraocular lens (IOL) removal in temporary polypseudophakic eyes using IOL power calculation formulas and Gills' formula. METHODS: Four consecutive patients (7 eyes) who underwent temporary IOL explantation were enrolled. Postoperative refractions calculated using IOL power calculation formulas (SRK-II, SRK-T, Hoffer-Q, Holladay, and the modified Gills' formula for residual myopia and residual hyperopia) were compared to the manifest spherical equivalents checked at 1 month postoperatively. RESULTS: The mean ages of temporary piggyback IOL implantation and IOL removal were 6.71 +/- 3.68 months (range, 3 to 12 months) and 51.14 +/- 18.38 months (range, 29 to 74 months), respectively. The average refractive error was -13.11 +/- 3.10 diopters (D) just before IOL removal, and improved to -1.99 +/- 1.04 D after surgery. SRK-T showed the best prediction error of 1.17 +/- 1.00 D. The modified Gills' formula for myopia yielded a relatively good result of 1.47 +/- 1.27 D, with only the variable being axial length. CONCLUSIONS: Formulas to predict refractive change after temporary IOL removal in pediatric polypseudophakia were not as accurate as those used for single IOL implantation in adult eyes. Nonetheless, this study will be helpful in predicting postoperative refraction after temporary IOL removal.
Cataract/*congenital ; *Cataract Extraction ; *Device Removal ; Female ; Humans ; Hyperopia/etiology/*surgery ; Infant ; Lens Implantation, Intraocular/*methods ; Lenses, Intraocular ; Male ; Myopia/etiology/*surgery ; Prospective Studies

PURPOSE: To evaluate clinical results of AT-45. METHODS: In a prospective study, 24 eyes of 21 patients had phacoemulsification and AT-45 implantation. Clinical data included distance visual acuity, near visual acuity, complication, during the 6-months follow-up period. RESULTS: Result analysis was performed with 22 eyes of 19 patients, except 2 complicated eyes. 6-months after operation, 22 eyes (100%) and 19 eyes (86.4%) were achieved best corrected visual acuity 20/25 and 20/20 or better respectively. 21 eyes (95.4%) and 7 eyes (31.8%) were achieved best distance corrected near visual acuity 20/40 and 20/25 or better respectively. Posterior capsular opacity was developed in 5 eyes (22.7%) and posterior synechia was developed in 1 eye (4.5%). CONCLUSIONS: Clinical result of cataract surgery with AT-45 was relatively satisfactory. Long term follow-up is recommended.
Cataract ; Follow-Up Studies ; Humans ; Phacoemulsification ; Prospective Studies ; Visual Acuity

PURPOSE: To evaluate the effect of axial length (AXL) and anterior chamber depth (ACD) on the accuracy of the Haigis formula in comparison to its effect on other 3rd generation IOL power calculations. The possibility of measurement error in ACD using either method was also investigated. METHODS: A study was performed on 137 eyes of 98 patients who underwent cataract surgery in our hospital. AXL and ACD were measured using IOL Master, and IOL power was calculated using the Haigis, SRK/T, Hoffer Q, and Holladay 1 formulas. ACD was also measured using Pentacam. Patients were divided into 3 groups based on ACD and AXL. Mean numeric error and mean absolute error were analyzed 1 month after surgery. RESULTS: Five formulae showed no significant difference in refractive error in the 3 groups based on AXL. In contrast, the Haigis formula showed statistically significant differences in the group with shallow ACD, in which hyperopic shift was also demonstrated. The difference in ACD between using IOL Master and using Pentacam was significant in the shallow ACD group, with IOL Master showing more shallow measurement. However, the other groups based on ACD showed no significant difference in the refractive error from the Haigis formula, and in the difference in ACD between measurements. CONCLUSIONS: Errors in ACD measurement should be taken into consideration for discrepancy between the Haigis formula measurement and other formula measurements. The authors of the present study suggest that ACD-driven refractive error should be considered in determination of IOL.
Anterior Chamber ; Cataract ; Eye ; Humans ; Refractive Errors

PURPOSE: To evaluate the change in anterior chamber depth and refraction after AT-45 implantation METHODS: Twenty-two eyes from 22 patients were enrolled in this prospective study. After phacoemulsification, AT-45 (11 eyes) and SA60AT (11 eyes) were implanted. Clinical data included anterior chamber depth and refractive error at 1 week, 1 month, 2 months and 6 months postoperatively. The correlation between anterior chamber depth change and spherical equivalent change was also evaluated. RESULTS: In the AT-45 implanted group, the mean anterior chamber depth was 4.56+/-0.59 mm at 1 week postoperative, 4.70+/-0.69 mm at 1 month postoperative, 4.78+/-0.71 mm at 2 months postoperative and 4.76+/-0.69 mm at 6 months postoperative. The mean spherical equivalent was -0.53+/-0.48D, -0.37+/-0.42D, -0.27+/-0.47D, and -0.33+/-0.44D respectively. When analyzed using the Mann-Whitney U test, p-values of anterior chamber depth differences between the 2 groups were P=0.52 at 1 week to 1 month, P=0.32 at 1 month to 2 months, P=0.89 at 2 months to 6 months, and P=0.02 at 1 week to 6 months, showing a deeper anterior chamber in the AT-45 implanted group. P-values (Mann-Whitney U test) of spherical equivalent differences between the 2 groups were P=0.33, P=0.56, P=0.94, and P=0.19, respectively, showing more hyperopic change in the AT-45 implanted group. The correlation between anterior chamber depth change and spherical equivalent change in the AT-45 implanted group at 1 week to 6 months was not statistically significant (Spearman correlation analysis, P=0.223). CONCLUSIONS: Anterior chamber depth deepening and associated hyperopic refractive change were observed after AT-45 implantation, especially at 1 month after the surgery.
Anterior Chamber* ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Prospective Studies ; Refractive Errors

PURPOSE: To compare the clinical outcome of AT-45 implantation between high myopic eyes and non-high myopic eyes. METHODS: Retrospective, non-randomized, comparative trial. The medical charts of 28 patients with 35 eyes who had phacoemulsification and AT-45 implantation were retrospectively reviewed. 13 eyes of 10 patients were included in the high myopic group (axial length > or = 26.0 mm) and 22 eyes of 18 patients were included in the non-high myopic group. The clinical data included unilateral best-corrected visual acuity (BCVA) and distance-corrected near visual acuity (DCNVA) at 6 months follow-up after the surgery. The results were compared between the two groups. RESULTS: In the non-high myopic group, 22 eyes (100%) and 19 eyes (86.4%) achieved a BCVA of 20/25 and 20/20 or better respectively. For the high myopic group, the results were 13 eyes (100%) and 12 eyes (92.3%) respectively, at 6 months after the surgery. In the non-high myopic group, 21 (95.4%) and 7 eyes (31.8%) achieved a DCNVA of 20/40 and 20/25 or better. For the high myopic group, the results were 13 (100%) and 4 eyes (30.8%) respectively, at 6 months after the surgery, the differences between the two groups for a BCVA of 20/25 or better and 20/20 or better and a DCNVA 20/40 or better and 20/25 or better were not statistically significant. CONCLUSIONS: Six months clinical outcome of cataract surgery with an AT-45 for the high myopic eyes was satisfactory; it was not significantly different from that of the non-high myopic eyes.
*Accommodation, Ocular ; Adult ; Aged ; Female ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Middle Aged ; Myopia, Degenerative/*surgery ; Phacoemulsification ; Retrospective Studies ; Visual Acuity/physiology