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*

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

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

No abstract available.
Phenylketonurias*

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

Cell cultures of adults bovine retinal pigment epithelium(RPE) were propagated from central and peripheral regions of the same eyes to study the topographical differences in cell growth and to compare the differences in growth rate between two areas. The results obtained were as follows: A regional variation in the morpholgy was observed between the RPE from central and that from peripheral regions. Retinal pigment epithelium from central region attached to culture dish more slowly(average 4 days) than those from peripheral region(average 3.5 days) The growth rate of retinal pigment epithelium declined with serial passage in culture. The growth rate of retinal pigment epithelium from peripheral region at the first generation was highest. And there was a statistical difference in growth rate with passing in generation(P<0.05). This study reveals that growth rate and cell activity of RPE from central region are lower than from peripheral region.
Adult ; Cell Culture Techniques ; Humans ; Macular Degeneration ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Serial Passage

IOP was measured with 3 different tools, namely, the Pulsair peumotonometer(A), the Oculab Tono-pen(B), and the Goldmann applanation tonometer(C), in order to evaluate the clinical usefulness of each. 174 eyes without corneal opacity and corneal edema were measured. The results were as follows; 1. The correlation coefficient was 0.85(P<0.005) between A and C, 0.82(P<0.005) between B and C and 0.83(P<0.005) between A and B. The correlative formulas between the measurements of IOPs were produced to be: A = 0.73 X C + 5.49, B = 0.76 X C + 5.33, A = 0.78 X B + 3.87. 2. At low IOPs(<10 mmHg) as Measured by C(11 eyes), the correlation Coefficient was 0.81(P<0.05) between B and C. However, A and B valuse tended to be highter than C value. 3. At relatively high IOPs(>20 mmHg)as measured by C(56 eyes), the correleation coefficient was 0.83 between A and C(P<0.0001) and 0.82(P<0.0001) between B and C. However, A and B values tended to be lower than c value. 4. At relatively high IOPs(>20 mmHg)as measurde by C, the sensitivity of A was 60.53% and that of B was 73.68%. According to this study, no significant difference could be found among these three tools. However, at low IOPs(<10 mmHg), the Oculab Tono-pen and Pulsair pneumotonometer tended to show higher values than the Goldmann applanation tonometer. In case of relatively high IOPs(>20 mmHg as measured by the Goldman tonometer), the Oculab Tono-pen and Pulsair pneumotonometer tended to show lower values than the Goldmana applanation tono meter and the sensitivity of the Oculab Tono-pen showed higher than that of the Pulsair pneumotonomer.
Corneal Edema ; Corneal Opacity ; Intraocular Pressure

PURPOSE: To evaluate the effectiveness of graded (adjustable intraoperatively) partial vertical rectus muscle tenotomy at the insertion in correcting small degrees of hypertropia. METHODS: All patients with best corrected visual acuity of better than 6/30 in both eyes who had undergone only partial tenotomy of vertical rectus muscle(s) over a 30-month period were included. Improvement was evaluated 6 weeks postoperatively as the change in alignment in prism diopters (PD) in primary gaze and in the field of action of the affected rectus muscle(s). Binocular function was evaluated by Titmus stereoacuity and the Worth 4-light tests. RESULTS: All 24 patients who met the inclusion criteria had diplopia preoperatively, and this had resolved in 17 (71%) postoperatively (P<0.005). Prisms were used by 6 preoperatively vs. 2 postoperatively (P<0.05). The average vertical deviation in primary gaze decreased from 8 PD to 2 PD (P<0.005). In the field of action of the treated rectus muscle, hypertropia decreased from an average of 8 PD to 3 PD (P<0.005). For the available pre- and post-operative assessments, stereoacuity improved after 10 of the 18 (56%) procedures and Worth 4-light testing showed improvement or maintenance of fusion after 13 of 19 procedures (68%). CONCLUSIONS: Graded vertical rectus partial tenotomy can effectively reduce small degrees of hypertropia and associated diplopia, improve binocular function, and reduce or eliminate the need for prism correction.
Diplopia ; Humans ; Muscles* ; Strabismus* ; Telescopes ; Tenotomy* ; Visual Acuity

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