PURPOSE: To evaluate the efficacy of Optical Quality Analysis System (OQAS(R)) instrument for the assessment of dry eye syndrome. METHODS: Dynamic recording of double-pass (DP) retinal images was performed in 1 eye dry eye patients (20 eyes) and in healthy controls (20 eyes) for 20 seconds after eye blinking. RESULTS: The mean objective scatter Index (OSI) value was 4.53 in dry eyes, 0.67 in healthy eyes and the standard deviation of OSI was 1.20 in dry eyes and 1.18 in healthy eyes. The patients with dry eyes showed significantly higher mean OSI and standard deviation values. Ocular scatter increased over time and significant changes occurred 13.5 seconds after blinking. The difference in OSI value between 0 second and 20 seconds was significantly greater in dry eye patients (4.15) than in controls (0.32). CONCLUSIONS: Ocular scatter increased over time after blinking. The dry eye patients had larger and more variable ocular scatter index than the controls. OQAS(R) may be useful to detect and follow-up tear film-related patient complaints in dry eye syndrome.
Blinking ; Dry Eye Syndromes* ; Humans ; Retinaldehyde ; Tears

PURPOSE: To evaluate the causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted endonasal revision surgery according to the number of silicone tubes. METHODS: Sixty-seven patients (70 eyes) who underwent revision surgery using transcanalicular diode laser for failed primary endonasal DCR at Sungmo Eye Hospital between March 2007 and December 2012 were studied retrospectively. The causes of failed DCR and the time of recurrence were evaluated. The revision surgeries were endoscopic removal of granuloma and membrane and synechiolysis with intubation of 1 or 2 silicone tubes. We compared the results of revision surgery with 1 silicone tube and 2 silicone tube intubations. RESULTS: Recurrence occurred after a mean duration of 4.6 months following the first DCR. The causes of surgical failure were granuloma (35 eyes), membranous obstruction (23 eyes), synechia (7 eyes), and functional obstruction (5 eyes). We performed revision surgery with 1 silicone tube intubation in 45 eyes (group A) and 2 silicone tube intubations in 25 eyes (group B). The final success rates in groups A and B were 75.6% (34/45) and 84% (21/25), respectively (chi-square test, p = 0.828). CONCLUSIONS: Transcanalicular diode laser-assisted endonasal revision surgery with 2 silicone tubes is not recommended.
Dacryocystorhinostomy ; Granuloma ; Humans ; Intubation ; Lasers, Semiconductor ; Membranes ; Recurrence ; Retrospective Studies ; Silicones*

PURPOSE: To evaluate the efficacy and stability of AcrySof Toric intraocular lens (IOL) implants and to analyze the miscorrection that resulted after implantation. METHODS: This retrospective study included 422 eyes of 348 patients who underwent cataract surgery with implantation of the AcrySof toric IOL between December 2011 and June 2013. We evaluated uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry and refraction preoperatively and 3 months postoperatively. The axis of implanted AcrySof Toric IOL was measured using the KR-1W aberrometer before mydriasis. At 3 months postoperatively, patients with a residual cylindrical power of 0.50 diopters (D) or more, and having an IOL rotation of 10 degrees (degrees) or more were considered having miscorrection. RESULTS: UCVA (log MAR) improved from 0.58 +/- 0.35 to 0.18 +/- 0.26. Preoperative corneal astigmatism was 1.46 +/- 0.72 D and postoperative refractive cylindrical power was 0.45 +/- 0.30 D. The postoperative miscorrection was 50.5% in the T3 group, 35.7% in the T4 group, and 27.2% in the T5 group. The incidence of overcorrection was significantly higher in the T3 group than in the T4 and T5 group. In eyes with with-the-rule (WTR) astigmatism, overcorrection was found in 36.4% (32/88 eyes), while in eyes with against-the-rule (ATR) astigmatism, undercorrection was found in 37.6% of cases (44/117 eyes). There were five cases of IOL rotation at 3 months postoperatively. CONCLUSIONS: AcrySof Toric IOL was effective in correcting corneal astigmatism and had good rotational stability. However, the incidence of miscorrection, especially for overcorrection, was higher with lower power toric IOL. Patients with WTR astigmatism tend to have overcorrection, while those with ATR show a tendency toward undercorrection, suggesting that these changes considered at the time of cataract surgery.
Astigmatism ; Axis, Cervical Vertebra ; Cataract ; Humans ; Incidence ; Lenses, Intraocular* ; Mydriasis ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the relationship between the size of internal limiting membrane (ILM) peeling and the elongation of foveal tissue after macular hole (MH) surgery. METHODS: The medical records of 29 patients (29 eyes) who developed elongation of foveal tissue on spectral domain optical coherence tomography (OCT) after vitrectomy with ILM peeling and gas tamponade for idiopathic MH were retrospectively reviewed. These eyes were classified into 3 subgroups by the size of ILM peeling: group A (9 eyes), smaller than 2 disc diameter (DD); group B (12 eyes), larger than 2 DD and within the major temporal vascular arcade, and group C (8 eyes), till the edge of the major temporal vascular arcade. Inter-outer plexiform layer (OPL) distance, representing elongation of foveal tissue, was measured 1, 3, and 6-8 months (only 18 eyes) postoperatively. 'Asymmetric elongation' was defined as non-uniform elongation of the foveal tissue in certain directions. RESULTS: Horizontal/vertical inter-OPL distances 1 month postoperative, in descending order, were: group B, 436.58 +/- 88.54 / 404.92 +/- 78.55 microm; group A, 421.33 +/- 109.97 / 404.14 +/- 120.9 microm; and C group, 389.25 +/- 48.75 / 400 +/- 52.23 microm. Variations in the horizontal/vertical inter-OPL distance 3 months after MH surgery were: group B, 136.83 +/- 65.64 / 103.92 +/- 73.37 microm; group A, 88.11 +/- 41.57 / 75.89 +/- 53.18 microm; and group C, 140.25 +/- 68.51 / 83.63 +/- 56.62 microm. There were no significant differences in inter-OPL distance, variation in inter-OPL distance, or percent asymmetry in both horizontal and vertical directions among these groups. CONCLUSIONS: Elongation of the foveal tissue and asymmetric elongation after MH surgery were not associated with the size of ILM peeling.
Humans ; Medical Records ; Membranes ; Retinal Perforations* ; Retrospective Studies ; Tomography, Optical Coherence ; Vitrectomy

PURPOSE: To evaluate the prognostic factors that predict visual outcome after vitrectomy for lamellar macular hole using optical coherence tomography (OCT). METHODS: This study included 26 eyes that underwent pars plana vitrectomy, epiretinal membrane removal, and internal limiting membrane peeling for lamellar macular hole. The maximum parafoveal thickness, maximum height and diameter of lamellar macular hole, maximum height and diameter of intraretinal splitting, thinnest foveal floor thickness, and inner segment/outer segment disruption length on preoperative OCT image were investigated for prognostic factors that predict visual outcome. RESULTS: The mean follow-up period was 32.2 months and the mean best corrected visual acuity improved significantly after vitrectomy from log MAR 0.47 +/- 0.32 to log MAR 0.23 +/- 0.23. The postoperative visual acuity correlated significantly with preoperative visual acuity, thinnest foveal floor thickness and inner segment/outer segment disruption length, but not with maximum parafoveal thickness, maximum height and diameter of lamellar macular hole and maximum height and diameter of intraretinal splitting. CONCLUSIONS: The thinnest foveal floor thickness and inner segment/outer segment disruption length on preoperative OCT image were significant prognostic factors.
Epiretinal Membrane ; Follow-Up Studies ; Membranes ; Retinal Perforations* ; Tomography, Optical Coherence* ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the relationship between the size of internal limiting membrane (ILM) peeling and the elongation of foveal tissue after macular hole (MH) surgery. METHODS: The medical records of 29 patients (29 eyes) who developed elongation of foveal tissue on spectral domain optical coherence tomography (OCT) after vitrectomy with ILM peeling and gas tamponade for idiopathic MH were retrospectively reviewed. These eyes were classified into 3 subgroups by the size of ILM peeling: group A (9 eyes), smaller than 2 disc diameter (DD); group B (12 eyes), larger than 2 DD and within the major temporal vascular arcade, and group C (8 eyes), till the edge of the major temporal vascular arcade. Inter-outer plexiform layer (OPL) distance, representing elongation of foveal tissue, was measured 1, 3, and 6-8 months (only 18 eyes) postoperatively. 'Asymmetric elongation' was defined as non-uniform elongation of the foveal tissue in certain directions. RESULTS: Horizontal/vertical inter-OPL distances 1 month postoperative, in descending order, were: group B, 436.58 +/- 88.54 / 404.92 +/- 78.55 microm; group A, 421.33 +/- 109.97 / 404.14 +/- 120.9 microm; and C group, 389.25 +/- 48.75 / 400 +/- 52.23 microm. Variations in the horizontal/vertical inter-OPL distance 3 months after MH surgery were: group B, 136.83 +/- 65.64 / 103.92 +/- 73.37 microm; group A, 88.11 +/- 41.57 / 75.89 +/- 53.18 microm; and group C, 140.25 +/- 68.51 / 83.63 +/- 56.62 microm. There were no significant differences in inter-OPL distance, variation in inter-OPL distance, or percent asymmetry in both horizontal and vertical directions among these groups. CONCLUSIONS: Elongation of the foveal tissue and asymmetric elongation after MH surgery were not associated with the size of ILM peeling.
Humans ; Medical Records ; Membranes ; Retinal Perforations* ; Retrospective Studies ; Tomography, Optical Coherence ; Vitrectomy

PURPOSE: To evaluate the prognostic factors that predict visual outcome after vitrectomy for lamellar macular hole using optical coherence tomography (OCT). METHODS: This study included 26 eyes that underwent pars plana vitrectomy, epiretinal membrane removal, and internal limiting membrane peeling for lamellar macular hole. The maximum parafoveal thickness, maximum height and diameter of lamellar macular hole, maximum height and diameter of intraretinal splitting, thinnest foveal floor thickness, and inner segment/outer segment disruption length on preoperative OCT image were investigated for prognostic factors that predict visual outcome. RESULTS: The mean follow-up period was 32.2 months and the mean best corrected visual acuity improved significantly after vitrectomy from log MAR 0.47 +/- 0.32 to log MAR 0.23 +/- 0.23. The postoperative visual acuity correlated significantly with preoperative visual acuity, thinnest foveal floor thickness and inner segment/outer segment disruption length, but not with maximum parafoveal thickness, maximum height and diameter of lamellar macular hole and maximum height and diameter of intraretinal splitting. CONCLUSIONS: The thinnest foveal floor thickness and inner segment/outer segment disruption length on preoperative OCT image were significant prognostic factors.
Epiretinal Membrane ; Follow-Up Studies ; Membranes ; Retinal Perforations* ; Tomography, Optical Coherence* ; Visual Acuity ; Vitrectomy*

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

PURPOSE: To report clinical aspects of children diagnosed with refractive accommodative esotropia after wearing their first glasses to correct hyperopia accompanied with esodeviation. METHODS: The present study included 75 children followed up for at least 24 months. Age, spherical equivalent of refractive error, angle of deviation and presence of amblyopia were analyzed according to the duration between first wearing glasses and control of esotropia within 8 PD (< or =2 months vs. >2 months). RESULTS: The mean age was 4.48 +/- 2.08 years and mean follow-up was 50.17 months. Initial deviation angle without glasses was 25.43 +/- 10.07 PD at far, 27.72 +/- 11.45 PD at near, spherical equivalent was +4.86 +/- 2.41 D in right eyes, +5.05 +/- 1.06 D in left eyes and 8 of 75 patients (10.67%) had < or =2 D of hyperopia. Esotropia was controlled within 8 PD with hyperopic glasses in 61 of 75 children (81.3%) within 2 months, 6 (8%) within 3-6 months, 4 (5.3%) within 6-12 months and 4 (5.3%) after 12 months. In comparison, esotropia was controlled < or =2 months in 61 of 75 children (81.3%); 14 of 75 children (18.7%) requiring >2 months had less hyperopia (+4.02 D vs. 5.17 D), more severe esodeviation both at far (30.79 +/- 10.79 PD vs. 24.17 +/- 9.56 PD, p = 0.03) and at near distance (34.00 +/- 14.20 PD vs. 26.25 +/- 10.31 PD, p = 0.02) and higher initial amblyopia prevalence rates (71.5% vs. 47.5%). CONCLUSIONS: Several patients needed longer follow-up until esotropia was controlled within 8 PD after wearing hyperopic glasses considering the amount of hyperopia and angle of esodeviation.
Amblyopia ; Child ; Esotropia* ; Eyeglasses* ; Follow-Up Studies ; Glass* ; Humans ; Hyperopia ; Prevalence ; Refractive Errors

Second-look ultrasonography (US) is a targeted breast US examination that evaluates suspicious lesions detected on magnetic resonance imaging (MRI). It is a useful tool for determining the probability of malignancy and facilitating US-guided biopsy. Lesions detected on MRI and US should be correlated accurately, which is challenging in some cases. This article documents second-look US and MRI findings that are correlated with the pathology, and suggests helpful approaches for correlating between the two modalities.