PURPOSE: The effect of 0.2% cyclosporin A (CsA) as an adjuvant therapy after glaucoma-filtering surgery was the focus of this study. METHODS: A posterior lip sclerotomy was performed in 16 eyes of 8 rabbits, and 0.2% CsA was administered into the right eyes. The left eyes served as controls. The intraocular pressure (IOP) was measured 1, 3, 5, 7, 14, and 28 days after surgery. Hematoxylin-eosin (HE) and anti-bromodeoxyuridine (BrdU) immunocytochemical staining were performed at 1, 2, 4, and 8 weeks. RESULTS: The IOP at 7 and 14 days after surgery was lower in the 0.2% CsA group and statistically significant (P=0.047, P=0.48; respectively). HE staining did not show any difference between experimental and control eyes, but anti-BrdU staining showed a lower number of positive cells in the experimental eyes at 1 week. The fibroblast proliferation rate was significantly lower 1 week after surgery in the 0.2% CsA group (P=0.003). CONCLUSIONS: An effect of 0.2% CsA on early wound healing was observed. The data suggest that a low concentration of CsA can be useful when employed as adjuvant therapy in glaucoma filtering surgery.
Cyclosporine ; Eye ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Intraocular Pressure ; Lip ; Pilot Projects ; Rabbits ; Wound Healing

PURPOSE: We report a case of ectopic adenoid cystic carcinoma developed on the nasal orbital side adjacent to the nasal cavity. METHODS: A 60-year-old man developed progressive right ocular proptosis and pain for 3 years. The patient had undergone regular medical examination in a hospital but eventually visited our hospital due to aggravated symptoms. Orbit MRI and CT showed a 24 x 36 x 17 mm-sized lower signal mass on the medial side of the right medial rectus muscle and also showed erosion of the orbital bone in the superior and medial orbital walls. An endoscopic biopsy was done after transferring him to the ENT department. A frozen section of the tissue in the operating room showed no malignant evidence, and the mass was excised by endoscopic surgery. The permanent pathological result was adenoid cystic carcinoma. The authors recommended orbital exenteration, but the patient refused the procedure and was seen in follow-up visits after receiving chemotherapy and radiologic therapy. Some orbital mass remained in the posterior orbital area immediately directly after endoscopic excision. The patient underwent his first session of Cyberknife radiosurgery therapy after concurrent chemotherapy and radiologic therapy. CONCLUSIONS: Ectopic adenoid cystic carcinoma should be considered as a differential diagnosis of nasal orbital mass lesions.
Adenoids* ; Biopsy ; Carcinoma, Adenoid Cystic* ; Diagnosis, Differential ; Drug Therapy ; Exophthalmos ; Follow-Up Studies ; Frozen Sections ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Nasal Cavity ; Operating Rooms ; Orbit* ; Radiosurgery

PURPOSE: To compare visual acuity and intraocular straylight after implantation of clear and photochromic intraocular lenses (IOLs) in a mesopic lighting condition. METHODS: Clear IOLs were implanted in 95 eyes of 72 patients (clear IOL group), and photochromic IOLs were implanted in 22 eyes of 16 patients (photochromic IOL group). Best-corrected visual acuity (BCVA) was measured indoors before surgery and 1 month after surgery. Straylight values were measured indoors before surgery and 1 and 2 months after surgery using the C-quant straylight meter (Oculus GmbH, Wetzlar, Germany). RESULTS: There were no significant differences between the 2 groups in BCVA at 1 month postoperatively (p = 0.587). Mean straylight values of clear and photochromic IOL groups were 2.76 +/- 1.89 log (s) and 2.88 +/- 2.04 log (s) preoperatively, 1.39 +/- 0.84 log (s) and 1.32 +/- 0.26 log (s) at 1 month postoperatively, and 1.43 +/- 0.92 log (s) and 1.45 +/- 0.50 log (s) at 2 months postoperatively. There were no significant differences between the 2 groups in indoor straylight values (p = 0.778, 0.709, 0.929, before surgery, 1 and 2 months after surgery respectively). Repeated-measure analysis of straylight values also showed no significant difference between the 2 groups (p > 0.05). CONCLUSIONS: There were no significant differences in BCVA and straylight values between clear and photochromic IOL groups under a mesopic light condition. Therefore, photochromic IOL could be suitable choice for cataract patients who spend significant time under mesopic conditions.
Cataract ; Humans ; Lenses, Intraocular* ; Visual Acuity

PURPOSE: To evaluate the efficacy of a prophylactic posterior sub-Tenon's capsule injection of Triamcinolone acetonide (TA) against macular edema and visual dysfunction by panretinal photocoagulation (PRP) in patients with severe nonproliferative and proliferative diabetic retinopathy. METHODS: Thirty-eight eyes of 19 patients who have diabetic retinopathy without macular edema and whose retinopathy was bilateral and symmetrical were evaluated. Triamcinolone was injected into the posterior sub-Tenon's capsule in one eye of the patients and nothing was injected in the other eye as a control. Two weeks later, PRP was performed every other week for 4 sessions on both eyes in all patients. The clinical course of visual acuity and macular edema was monitored for up to approximately 6 months after the initial PRP. RESULTS: There was no statistically significant difference of visual acuity before PRP in the 2 groups (p>0.05), and there was no macular edema in any patient. For a follow-up period of 6 months, visual dysfunction was more severe in the TA-injected eye than the control. However, the difference was not statistically significant (p>0.05) throughout the follow-up period except at the 20-week time point. On the other hand, macular edema occurred in 2 eyes (10.5%) of the TA-injected group, and in 4 eyes (21.1%) of the control group. IOP elevation as a complication caused by TA-injection occurred in 2 eyes (10.5%). However, IOP was controlled successfully by anti-glaucomatic eye drops. CONCLUSIONS: Posterior sub-Tenon's capsule injection of Triamcinolone is a safe and effective treatment modality for preventing PRP-induced visual dysfunction and macular edema.
Diabetic Retinopathy ; Eye ; Follow-Up Studies ; Hand ; Humans ; Light Coagulation ; Macular Edema ; Ophthalmic Solutions ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity

No abstract available.
Arthroplasty, Replacement, Hip*

PURPOSE: We introduce a new amniotic membrane (AM) for placement during pterygium surgery. CASE SUMMARY: After excision of the pterygium, we measured the size of the defect with reference to the side opposite the defective area and prepared an AM with margins 1.5–2.0 mm greater than the defect size. The AM was first sutured vertically, with reference to the opposite side of the defect. Then we sutured the upper and lower horizontal axes, and positioned the eye, from the front, slightly away from the direction of the opposite side of the defect. The AM was cut by reference to its boundary at the limbus, and three fixation sutures were placed. CONCLUSIONS: Appropriate AM sizing is important in terms of AM transplantation; the AM is non-elastic and easily torn. Our technique transplants a correctly sized AM and anchors it firmly.
Amnion ; Pterygium ; Sutures

Purpose: To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. Methods: We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. Results: The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). Conclusions In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

Purpose: To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. Methods: We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. Results: The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). Conclusions In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

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.

PURPOSE: To evaluate the necessity of lateral translation and the primary stability of the fixation devices in a closed wedge high tibial osteotomy. MATERIALS AND METHODS: The authors studied four pairs of high tibial osteotomy: Pair I, lateral translation with blade plate fixation; Pair II, lateral translation with staple fixation; Pair III, no translation with blade plate fixation; Pair IV, no translation with staple fixation. Four models of bovine tibia were taken and analyzed for stress distribution at the osteotomy site under axial loading. After axial loading, information recorded in pressure sensitive film was transformed to image file. After, by using image analysis software, the mean stress value and maximum stress value was calculated. RESULTS: The mean stress calculated at each osteotomy site is as follows; 3.89 MPa in the first pair; 4.55 MPa in the second pair; 4.62 MPa in the third pair; and 4.67 MPa in the fourth pair. In Group I, stress value was distributed evenly. But in group II, III, IV, the stress was concentrated at posteromedial area of the osteotomy site. CONCLUSION: The primary in the high tibial osteotomy was dependent more on the rigid fixation than on the continuity of the medial cortex. The pairs on which blade plate fixation was used more stable than the pairs on which staple fixation was used regardless of lateral translation.
Osteotomy* ; Tibia