PURPOSE: We report the therapeutic effect of ganciclovir gel instead of acyclovir ointment usually used in the case of herpes simplex superficial ocular disease such as herpetic dendritic keratitis and erosive blepharitis. METHODS: Three patients clinically diagnosed with herpes simplex dendritic keratitis and one as erosive blepharitis were treated with the topical ophthalmic gel of 0.15% ganciclovir three times a day for 2 to 4 weeks. Ocular complications and recurrence were evaluated under slit-lamp examination for the follow-up periods. RESULTS: Dendritic keratitis and erosive blepharitis were completely recovered with no recurrence during the 5 months follow-up. There is no respective comparison here. In one case of herpes simplex keratitis, the keratitis wound was repaired after debridement of corneal epithelial layer and application of ganciclovir gel. Complications including burning sensation and superficial punctate keratitis did not develop and visual acuity improved. CONCLUSIONS: Ganciclovir ophthalmic gel should be considered one of the effective therapeutic drugs for the herpes simplex ocular disease.
Acyclovir ; Blepharitis ; Burns ; Debridement ; Follow-Up Studies ; Ganciclovir* ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic ; Recurrence ; Sensation ; Visual Acuity ; Wounds and Injuries

PURPOSE: To evaluate safety and efficacy of intravitreal triamcinolone acetonide (TA) injection at the end of pars plana vitrectomy with silicone oil tamponade. METHODS: Eyes which underwent pars plana vitrectomy with silicone oil placement were enrolled. They were followed up for at least 6 months. Group I (twenty-three consecutive eyes) received an intravitreal injection of 4 mg TA at the end of the surgery, whereas Group II (twenty-six eyes) did not. RESULTS: Postoperative vision improved by 2 lines or more in 9 eyes (39.1%) of Group I and 9 eyes (34.6%) of Group II. The posterior pole was attached in all of Group I (100.0%) and twenty-four eyes (92.3%) of Group II (P=0.17). The postoperative BCVA was 5/200 or better in fifteen eyes (65.2%) of Group I and fourteen eyes (53.8%) of Group II (P=0.51). Eight eyes (34.8%) in Group I and six eyes (23.1%) in Group II had an intraocular pressure higher than 21 mmHg (P=0.36). All of them were controlled with medications. Two eyes in Group II required an additional operation due to recurrence of tractional retinal detachment from the fibrous membrane. Visually significant ocular complications related with TA injections were not noted. CONCLUSIONS: The intravitreal injection of TA into silicone-filled vitrectomized eyes seems safe and efficient. But, a prospective study is necessary to demonstrate the long-term safety and efficacy.
Intraocular Pressure ; Intravitreal Injections* ; Membranes ; Recurrence ; Retinal Detachment ; Silicone Oils* ; Traction ; Triamcinolone Acetonide* ; Triamcinolone* ; Vitrectomy*

PURPOSE: To evaluate surgical outcomes of idiopathic epiretinal membrane (ERM) with good visual acuity. METHODS: We evaluated patients who were diagnosed with idiopathic ERM with best corrected visual acuity (BCVA) greater than 20/40 and who were followed-up for 12 months or longer after vitrectomy and membrane removal. BCVA, metamorphopsia, central subfield macular thickness (CSMT), foveal contour, and status of photoreceptor inner/outer segment (IS/OS) junction were retrospectively assessed based on the medical records and optical coherence tomography (OCT) images. RESULTS: Twenty-four eyes were included in the present study. The mean BCVA (log MAR) did not significantly improve from baseline to 12 months after surgery (0.26 +/- 0.06 and 0.25 +/- 0.19, respectively). Six eyes showed improved vision of two or more lines, and six eyes had decreased vision of two or more lines. Metamorphopsia remained in all four eyes with preoperative symptoms until 12 months postoperatively. CSMT decreased significantly from 418 +/- 86 microm at baseline to 343 +/- 45 microm at 12 months (p < 0.01). Among 17 eyes without foveal depression at baseline, 11 eyes recovered a foveal depression at an average of 6.6 months after surgery. IS/OS status at baseline was intact in 19 eyes, attenuated in three eyes, and disrupted in two eyes and did not change significantly at 12 months. CONCLUSIONS: Surgical treatment for idiopathic ERM with good visual acuity resulted in anatomical but not functional improvement. Choosing surgery for idiopathic ERM with good visual acuity should be considered carefully because decreased visual acuity could result in some patients.
Depression ; Epiretinal Membrane* ; Humans ; Medical Records ; Membranes ; Retrospective Studies ; Tomography, Optical Coherence ; Vision Disorders ; Visual Acuity* ; Vitrectomy

PURPOSE: To evaluate surgical outcomes of idiopathic epiretinal membrane (ERM) with good visual acuity. METHODS: We evaluated patients who were diagnosed with idiopathic ERM with best corrected visual acuity (BCVA) greater than 20/40 and who were followed-up for 12 months or longer after vitrectomy and membrane removal. BCVA, metamorphopsia, central subfield macular thickness (CSMT), foveal contour, and status of photoreceptor inner/outer segment (IS/OS) junction were retrospectively assessed based on the medical records and optical coherence tomography (OCT) images. RESULTS: Twenty-four eyes were included in the present study. The mean BCVA (log MAR) did not significantly improve from baseline to 12 months after surgery (0.26 +/- 0.06 and 0.25 +/- 0.19, respectively). Six eyes showed improved vision of two or more lines, and six eyes had decreased vision of two or more lines. Metamorphopsia remained in all four eyes with preoperative symptoms until 12 months postoperatively. CSMT decreased significantly from 418 +/- 86 microm at baseline to 343 +/- 45 microm at 12 months (p < 0.01). Among 17 eyes without foveal depression at baseline, 11 eyes recovered a foveal depression at an average of 6.6 months after surgery. IS/OS status at baseline was intact in 19 eyes, attenuated in three eyes, and disrupted in two eyes and did not change significantly at 12 months. CONCLUSIONS: Surgical treatment for idiopathic ERM with good visual acuity resulted in anatomical but not functional improvement. Choosing surgery for idiopathic ERM with good visual acuity should be considered carefully because decreased visual acuity could result in some patients.
Depression ; Epiretinal Membrane* ; Humans ; Medical Records ; Membranes ; Retrospective Studies ; Tomography, Optical Coherence ; Vision Disorders ; Visual Acuity* ; Vitrectomy

PURPOSE: To compare anterior levator resection with frontalis sling in congenital ptosis with poor levator function. METHODS: We performed a retrospective review of 19 patients (25 eyes) undergoing anterior levator resection and 25 patients (28 eyes) undergoing frontalis sling for congenital ptosis with poor levator action of 5 mm or less from January 1995 to December 2001. RESULTS: The mean postoperative MRD1 were 2.4+/-0.95 mm in the anterior levator resection group and, 2.6+/-0.94 mm in the frontalis sling group. Surgical outcomes were good, fair and poor in 11, 10, and 4 eyes of the anterior levator resection group and in 14, 9, and 5 eyes of the frontalis sling group, respectively. Success rates were 84.0% and 82.1% in each group. There were no statistically significant differences between the two groups (P>0.05). CONCLUSIONS: In congenital ptosis with poor levator function, the surgical outcomes of anterior levator resection were as good as those of frontalis sling.
Humans ; Retrospective Studies

PURPOSE: To compare anterior levator resection with frontalis sling in congenital ptosis with poor levator function. METHODS: We performed a retrospective review of 19 patients (25 eyes) undergoing anterior levator resection and 25 patients (28 eyes) undergoing frontalis sling for congenital ptosis with poor levator action of 5 mm or less from January 1995 to December 2001. RESULTS: The mean postoperative MRD1 were 2.4+/-0.95 mm in the anterior levator resection group and, 2.6+/-0.94 mm in the frontalis sling group. Surgical outcomes were good, fair and poor in 11, 10, and 4 eyes of the anterior levator resection group and in 14, 9, and 5 eyes of the frontalis sling group, respectively. Success rates were 84.0% and 82.1% in each group. There were no statistically significant differences between the two groups (P>0.05). CONCLUSIONS: In congenital ptosis with poor levator function, the surgical outcomes of anterior levator resection were as good as those of frontalis sling.
Humans ; Retrospective Studies

PURPOSE: To evaluate the clinical outcomes of secondary intraocular lens (IOL) implantation in eyes that underwent pars plana vitrectomy and lens removal due to ocular trauma. METHODS: We retrospectively investigated 40 vitrectomized aphakic eyes that had received secondary IOL from March 2005 to January 2012. Various parameters including pre- and postoperative best corrected visual acuity (BCVA) were reviewed. RESULTS: Incidence was higher in males (n = 35, 89.7%) and highest in the 6th decade of life (n = 13, 33.3%). Mean preoperative refractive error was +9.99 +/- 2.80 D in spherical equivalent, and astigmatism was 1.80 +/- 1.73 D. Mean BCVA (log MAR) was 0.53 +/- 0.51 preoperatively and 0.54 +/- 0.46 at 6 months postoperatively. Postoperative refractive error was -1.28 +/- 1.40 D and the astigmatism was 2.54 +/- 1.52 D. The difference between the target and postoperative refractive error was a myopic shift of -0.63 +/- 1.44 D. Postoperative BCVA had no significant correlation with preoperative factors other than preoperative BCVA (p < 0.001). The most common complication was temporarily increased IOP in 4 eyes. Choroidal detachment, recurrence of retinal detachment, bullous keratopathy, and cystoid macular edema were each found in 1 eye. IOL dislocation was corrected with reoperation in 2 eyes. CONCLUSIONS: Secondary IOL implantation can be performed safely in vitrectomized aphakic eyes due to ocular trauma and can be recommended in patients with good preoperative BCVA. Myopic shift of the postoperative refractive error should be considered when calculating IOL power.
Aphakia ; Astigmatism ; Choroid ; Dislocations ; Eye* ; Humans ; Incidence ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Macular Edema ; Male ; Recurrence ; Refractive Errors ; Reoperation ; Retinal Detachment ; Retrospective Studies ; Visual Acuity ; Vitrectomy

Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME. Conclusions A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

PURPOSE: To investigate the biological effects and cytotoxicity of anti-allergic ophthalmic agents on the cultured conjunctival cells of rabbit in vitro. METHODS: Conjunctival cells of rabbit were exposed to anti-allergic ophthalmic agents. Azelan(R) (Taejoon, Korea), Zaditen(R) (Novartis, USA), Patanol(R) (Alcon, USA) at a concentration 10, 20 and 30% for a period of 30 minutes, 4, 12, and 24 hours respectively. Cell injury assay was performed using lactate dehydrogenase (LDH) leakage assay. We checked the composition, pH, osmolarity of three anti-allergic agents. Light and transmission electron microscopy were performed to compare the cellular damage of rabbit conjunctival cells under various culture treatments. RESULTS: In cultured conjunctival cells of rabbit, the LDH titers increased up to 4 hours after exposure, maintained until 12 hours and then decreased 12 hours after exposed. Azelan(R) and Zaditen(R) showed a higher LDH titer and severe cellular damage of the conjunctival cells, compared with Patanol(R). Of anti-allergic solutions, Azelan(R) and Zaditen(R) revealed markedly lower Na+, Cl- and pH levels than Patanol(R). However, there was no difference in the concentration of preservative or osmolarity of the eye solution among the three anti-allergic agents. CONCLUSIONS: Patanol(R) caused markedly more damage to cultured rabbit conjunctival cells than Azelan(R) and Zaditen(R). If these anti-allergic these agents are clinically used for long periods of time, they may induce the cellular damage of conjunctival cells depending on the composition and pH of anti-allergic drugs.
Anti-Allergic Agents ; Hydrogen-Ion Concentration ; L-Lactate Dehydrogenase ; Microscopy, Electron, Transmission ; Osmolar Concentration

PURPOSE: To report a case of ocular syphilis presenting as occult outer retinopathy. CASE SUMMARY: A 42-year-old female presented with decreased visual acuity for one month in duration in the left eye. Her best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/250 in the left eye. There was no sign of inflammation in the anterior segment. Fundus examination showed no distinct abnormal findings including vitreous cell or haziness except mild diabetic retinopathy and subtle opacity of the macula. Spectral domain optical coherence tomography (OCT) showed a marked distortion of the inner segment-outer segment (IS-OS) junction in the photoreceptor layer without macular edema. Fluorescent angiography revealed diffuse subtle hyperfluorescence with microvasculitis in late phase. Full-field electroretinography (ERG) and multifocal ERG showed decreased amplitude; thus, acute zonal occult outer retinopathy (AZOOR) was considered as the diagnosis. Laboratory work-ups before steroid therapy revealed positive serology for active syphilis. One month after treatment with penicillin G (6 million international units per day for 14 days), best-corrected VA improved to 20/30, and restoration of the IS-OS junction was observed on OCT. CONCLUSIONS: Ocular syphilis may present as occult outer retinopathy resembling AZOOR, and serologic work-up is required to avoid misdiagnosis. In the present case, anatomical and functional recovery were obtained after antibiotic therapy.
Adult ; Angiography ; Diabetic Retinopathy ; Diagnosis ; Diagnostic Errors ; Electroretinography ; Female ; Fluconazole ; Humans ; Inflammation ; Macular Edema ; Penicillin G ; Retinitis ; Syphilis* ; Tomography, Optical Coherence ; Visual Acuity