We report a case of complicated cataract aggravated after taking herbal medication for atopic dermatitis. An 11-yr-old boy was referred for the evaluation of decreased visual acuity in both eyes for 2 months. Past history showed that he had been diagnosed with atopic dermatitis when he was 1 yr old. He had been treated only with herbal medication for a period of 8 months prior to visiting our clinic. He had his visual acuity checked in a local ophthalmic clinic one year before, and the visual acuity was 20/20 in both eyes at that time. When attending our clinic the ophthalmologic examination showed that his best corrected visual acuity was 20/200 in both eyes. Lenses of both eyes had severe posterior subcapsular and posterior capsular opacity. Phacoemulsification, posterior chamber intraocular lens implantation, and posterior continuous curvilinear capsulectomy were performed in both eyes. After 3 months postoperatively, the best corrected visual acuity was recovered to 20/20 in both eyes without any complication. Our case suggests that there may be a risk of aggravation of cataract or development of cataract after treatment with some unidentified herbal medication in a patient with atopic dermatitis.
Cataract/*chemically induced ; Cataract Extraction ; Child ; Dermatitis, Atopic/*drug therapy ; Drugs, Chinese Herbal/*adverse effects ; Humans ; Male ; Visual Acuity/drug effects

Authors analysed the surgical results of superior oblique silicone expander for the treatment of superior oblique overaction in 8 patients (15 eyes) who were operated at St Mary's Hospital, Catholic University Medical College from October 1990 to December 1991. The results were as follows: 1. Preoperatively, the patients demonstrated versions of +2 overaction in 6 eyes (40%) and +3 to +4 overaction in 9 eyes (60%), And demonstrated A-patterns between 20 delta to 55 delta with a mean of 33 delta. 2. Postoperatively, of the 9 eyes with +3 to +4 overaction, 6 eyes (66.7%) showed no overaction and 3 eyes (33.3%) had +1 residual overaction. Of the 6 eyes with +2 overaction, 4 eyes (66.7%) showed no residual overaction, while 2 eyes (33.3%) had +1 residual overaction. 3. Postoperatively. reduction of A-pattern was from 16 delta to 51 delta with a mean of 27 delta. Bases on these results, it appears that the silicone expander technique is useful for the treatment of superior oblique overaction.
Humans ; Silicones* ; Tendons*

To evaluate the effects of early surgical intervention in infantile exotropia on the motor and sensory functions, we reviewed the records of 17 subjects diagnosed with exotropia before the age of 12 months, receiving surgery before the age of 24 months, with a follow-up period greater than one year, between 1996 and 2000. Of the 17 subjects (6 intermittent, 11 constant), 14 (82%) (6 intermittent, 8 constant) had a final horizontal deviation of <10 PD, with 3 (18%) needing a re-operation. Fusion and gross binocularity were developed in 7 (4 intermittent, 3 constant), and 11 (6 intermittent, 5 constant) subjects, respectively. Seven subjects developed stereopsis of 200 seconds or better, and 5 of the 6 with intermittent exotropia (83%) being involved. In conclusion, over 80% of the successful alignments were obtained with surgery before the age of 24 months in infantile exotropia, which was similar to previous studies. Furthermore, early surgical intervention, particularly in the intermittent phase, resulted in more effective sensory function.
Age Factors ; Exotropia/*surgery ; Female ; Human ; Infant ; Male ; Oculomotor Muscles/*surgery ; Reoperation ; Treatment Outcome ; Vision, Binocular ; Visual Acuity

As the coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, there are growing concerns about patients' mental health. We investigated psychological problems in COVID-19 patients assessed with self-reported questionnaires including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, and Impact of Event ScaleRevised Korean version. Ten patients who recovered from COVID-19 pneumonia without complications underwent self-reported questionnaires about 1 month after discharge. Of them, 10% reported depression and posttraumatic stress disorder (PTSD) while 50% had depression during the treatment. Perceived stigma and history of psychiatric treatment affected PTSD symptom severity, consistent with previous emerging infectious diseases. Survivors also reported that they were concerned about infecting others and being discriminated and that they chose to avoid others after discharge. Further support and strategy to minimize their psychosocial difficulties after discharge should be considered.

Purpose: To analyze the intraocular pressure (IOP) lowering effect, prognostic factors, and complications that occurred after iStent inject® or XEN® implantation in South Korea. Methods: We retrospectively analyzed 83 eyes with glaucoma who were followed-up for more than 6 months after iStent inject® or XEN® implantation alone or combination with cataract surgery. The success of surgery was defined as an IOP ≤21 mmHg and IOP reduction ≥20% from preoperative IOP. Results: The average IOP drop rate for 6 months after surgery was 33.80% for iStent inject® (group A, 24 eyes), 24.91% for XEN® (group B, 15 eyes), 20.47% for combined iStent inject® and cataract surgery (group A-1, 32 eyes), and 30.39% for combined XEN® and cataract surgery. The cumulative success rate of 6 months after surgery was 45.5% ± 11.2% for group A, 52.8% ± 15.4% for group B, 51.9% ± 9.0% for group A-1, and 83.3% ± 10.8% for group B-1. The difference in success rates between groups A and B was not statistically significant (p = 0.574), and also between groups A-1 and B-1 (p = 0.079). Conclusions iStent inject® and XEN® both have a significant effect on lowering IOP, regardless of combining cataract surgery. XEN® implantation led to a statistically significant reduction in IOP lowering medications.

The retinal pigment epithelium(RPE) is one of the most important cell layers in the visual system and is vital to the integrity of the rod and cone outer segments. It has many complex functions, such as absorption of light, storage and conversion of vitamin A esters and formation of acid- mucopolysaccharide complex. As serum in the vitreous cavity stimulates the migration and proliferation of RPE cells, serum is necessary to grow RPE cells in culture. Bovine RPE cells were cultured with various concentrations of fetal bovine serum(FBS 0%, 5%, 10%, 20%, 40%) to evaluate their effects on RPE cell growth. FBS stimulated the proliferation of bovine RPE ells in a dose-dependent manner, with maximal proliferation at 20% FBS. This proliferative effect, however, was suppressed at the highest concentration(40% FBS).
Absorption ; Epithelial Cells* ; Esters ; Retinaldehyde* ; Vitamin A

Strabismus fixus is very rare and the convergent form is rarely accompanied by blepharoptosis. We successfully treated one patient with high myopia whose convergent strabismus fixus, accompanied by blepharoptosis, became severe after cataract surgery. We report the case with a discussion of its pathology. We performed levator advancement operation, bilateral lateral rectus 11 mm resection, and bilateral medial rectus 8 mm recession. The suture was removed after maintaining temporary traction suture for 6 days. Blepharoptosis was completely corrected by postoperative 2 months. Esodeviation was 15PD, which was not increased compared with immediately after surgery. Satisfactory cosmetic outcome was obtained.
Aged ; Blepharoptosis/complications/*surgery ; Female ; Humans ; Myopia/complications ; Oculomotor Muscles/*surgery ; Ophthalmologic Surgical Procedures/methods ; Strabismus/complications/*surgery ; Treatment Outcome

We analysed a retrospective study of 22 aphakic bullous keratopathy patients (22 eyes) with penetrating keratoplasty for 5 years from January 1987 to December 1991 in the Department of Ophthalmology at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Of the 22 eyes with aphakic bullous keratopathy 16 eyes (72.7%) had previously undergone intracapsular cataract extraction, 6 eyes (27.3%) had extracapsular cataract extraction. 2. The mean time from cataract extraction to aphakic bullous keratopathy to penetrating keratoplasty was 13.8 months. 3. After keratoplasty, the visual acuity of 20 among the 22 transplants (90.9%) were significantly improved compared to the preoperative levels, however that of 2 among the 22 transplants were worse than the preoperative levels. The factors limiting postoperative visual acuity were senile macular degeneration and graft failure. 4. Postoperative complications were glaucoma (2 eyes, 9.1%), cystoid macular edema (1 eye, 4.6%) and graft failure (1 eye, 4.6%).
Cataract Extraction ; Corneal Transplantation ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Macular Degeneration ; Macular Edema ; Ophthalmology ; Postoperative Complications ; Retrospective Studies ; Transplants ; Visual Acuity

Phenylketonuria is metabolic disorder that results from a deficiency of the hepatic phenylalanine hydroxylase. But among patients with hyperphenylalaninemia, the defect resides in one of the enzymes necessary for production or recycling of tetrahydrobiopterin (BH4). The reduction of BH4 affects not only phenylalanine metabolism but also formation of the tyrosine related neurotransmitter, dopamin and tryptophan related neurotransmitter, serotonin. Administration of L-dopa and 5-hydroxytriptophan seems to be the most effective treatment and may prevent irreversible neurologic damage if started early in life in hyperphenylalaninemia due to deficiency of cofactor BH4. Therefore, all patients with PKU and hyperphenylalaninemia should be tested for BH4 deficiency as early as passible. So we measured reduced forms of biopterin in urines of 19 phenylketonuria patients by Funkushima and Nixon method and 13 of PKU patients measured dihydropterin reductase (DHPR) in white blood cells by modified Narisawa method. We could not find abnormal pterin patterns of cofactor BH4 and normal value of DHPR. All Korean 19 PKU children were classic PKU. A missense mutation has been identified in the phenylalanine hydroxylase (PAH) gene of 16 Koran PKU patients. 5 mutations (IVS4, Y204 C, R243Q, Y356 X, R413 P) have been identified. The frequency of these mutations was found to be 50% of PKU alleles. The IVS4 mutation had a high frequency in Korea and southern China, due to the result of the founder effect and genetic drift. the R413 P mutation, which may have originated in the regions surrounding the Baikal, expanded to northen China and Japan. We were not able to find Caucasian mutations in Korean ptiets. PKU mutations occured after racial divergence between Caucasian and Mongoloids. We observed that PKU patients with Y 204 C and R413 P mutations showed mild mild clinical phenotype but IVS4 mutation had severe mental retardation. the establishment of genotype will therefore aid in the prediction of clinical phenotypes in patients with this disease. So, pterin and DHPR measurement and DNA analsis will be useful for prognosis and proper treatment of PKU patients.
Alleles ; Biopterin ; Child ; China ; DNA* ; Founder Effect ; Genetic Drift ; Genotype ; Humans ; Intellectual Disability ; Japan ; Korea ; Leukocytes ; Levodopa ; Metabolism ; Mutation, Missense ; Neurotransmitter Agents ; Oxidoreductases ; Phenotype ; Phenylalanine ; Phenylalanine Hydroxylase ; Phenylketonurias ; Prognosis ; Recycling ; Reference Values ; Serotonin ; Tryptophan ; Tyrosine

We examined the clinical results of silicone IOL[SI-30NB]for 3 years or more. A total of 50 eyes underwent phacoemulsification and foldable silicone posterior chamber lens implantation through 3.2 millimeter temporal clear corneal incision. Preoperative and post-operative intraocular pressure, visual acuity, corneal astigmatism and complications were evaluated. More than 94%of all cases showed best corrected visual acuity better than 20/40 and intraocular pressure was decreased for 2 months. At 1 day after operation, mean surgically induced astigmatism was minimal[0.64 +/-1.42]and recovered fast. Posterior capsular opacity was found in 26%;however, Nd-YAG laser capsulotomy was performed in 18%. In conclusion, foldable silicone lens implantation through 3.2 millimetertemporal clear corneal incision revealed a low incidence of complication, minimally induced astigmatism, and rapid visual rehabilitation.
Astigmatism ; Follow-Up Studies* ; Incidence ; Intraocular Pressure ; Lasers, Solid-State ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Rehabilitation ; Silicones ; Visual Acuity