Granular corneal dystrophy type 2 (GCD2) is an autosomal dominant corneal stromal dystrophy that is caused by p.Arg124His mutation of transforming growth factor β induced (TGFBI) gene. It is characterized by well demarcated granular shaped opacities in central anterior stroma and as the disease progresses, extrusion of the deposits results in ocular pain due to corneal epithelial erosion. Also, diffuse corneal haze which appears late, causes decrease in visual acuity. The prevalence of GCD2 is high in East Asia including Korea. Homozygous patients show a severe phenotype from an early age, and the heterozygote phenotype varies among patients, depending on several types of compound heterozygous TGFBI mutations. In the initial stage, conservative treatments such as artificial tears, antibiotic eye drops, and bandage contact lenses are used to treat corneal erosion. Different surgical methods are used depending on the depth and extent of the stromal deposits. Phototherapeutic keratectomy removes anterior opacities and is advantageous in terms of its applicability and repeatability. For deeper lesions, deep anterior lamellar keratoplasty can be used as the endothelial layer is not always affected. Recurrence following these treatments are reported within a wide range of rates in different studies due to varying definition of recurrence and follow-up period. In patients who have undergone corneal laser vision-correction surgeries such as photorefractive keratectomy, LASEK, or LASIK including SMILE surgery, corneal opacity exacerbates rapidly with severe deterioration of visual acuity. Further investigations on new treatments of GCD2 are necessary.

PURPOSE: To analyze the long-term clinical outcomes after use of fibrin glue using a modified mini-flap technique for pterygium surgery. METHODS: This study is a retrospective, clinical outcome study of 148 subjects that underwent the modified mini-flap technique with fibrin glue from January 2014 to August 2015. We analyzed the recurrence rate and surgical time of modified mini-flap surgery with fibrin glue. We also analyzed associating factors between the recurrence group and non-recurrence group who underwent the same surgery technique. RESULTS: Mean age was 60.2 ± 1.1 (ranging from 29 to 86) years, and mean surgical time was 11.8 ± 5.8 (ranging from 5 to 36) minutes. The recurrence rate of pterygium patients who underwent the fibrin glue using a modified mini-flap technique was 4.0% (6/148), and the re-operation rate was 0.6% (1/148). From the comparison of associating factors between recurred and non-recurred groups, the recurred group was younger, had more severe disease, and had a higher rate of bilaterality than the non-recurred group (p < 0.05). CONCLUSIONS: The new approach using fibrin glue with a modified mini-flap technique shows a low recurrence rate compared to the other type of pterygium surgery. The use of fibrin glue shortened operation time and decreased patient discomfort due to fewer remnant sutures. Fibrin glue use in a modified mini-flap technique can be considered as a feasible surgical option for pterygium patients.
Fibrin Tissue Adhesive* ; Fibrin* ; Humans ; Operative Time ; Outcome Assessment (Health Care) ; Pterygium* ; Recurrence ; Retrospective Studies ; Sutures

PURPOSE: The purpose of the present study is to compare Nd:YAG capsulotomy rates between spherical and aspheric intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery by a single surgeon between March 1, 2006 and October 31, 2009. Patients included in the study were implanted with SA60AT spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 66 eyes), SN60AT spherical intraocular lenses (Alcon, 48 eyes; a total of 114 eyes), or SN60WF aspheric intraocular lenses (Alcon, 187 eyes). The Nd:YAG capsulotomy rates were compared between the two groups 6 months after the operation. Ten patients who were implanted with a spherical intraocular lens in one eye and an aspheric intraocular lens in the contralateral eye were analyzed separately. RESULTS: Nd:YAG capsulotomy was performed in 2 of 114 eyes (1.8%) in the spherical intraocular lens group and 7 of 187 eyes (3.2%) in the aspheric intraocular lens group; no significant difference was found (p = 0.359). Among the 10 patients who were implanted with 2 different intraocular lenses, Nd:YAG capsulotomy was performed in only 1 eye in the aspheric intraocular lens group; no significant difference was found (p = 0.500). CONCLUSIONS: The design of the intraocular lens, especially the shape of the posterior optic, does not influence the rate of Nd:YAG capsulotomy.
Cataract ; Eye ; Humans ; Lenses, Intraocular ; Retrospective Studies

Calcinosis cutis involves the inappropriate deposition of calcium within the dermis layer of the skin, and is often associated with rheumatoid disease. A 42-year-old woman presented for evaluation of a hard palpable mass on the left upper eyelid. After everting the eyelid, a large papillomatous mass with a broad base was identified on the superior area of the tarsus. The lesion was partially excised posteriorly under local anesthesia, and pathologists identified the mass as calcinosis cutis. The patient had no systemic or trauma history, and the serum levels of calcium and phosphorous were normal. Idiopathic calcinosis cutis should be included in the differential diagnosis for a protruding papillomatous mass of the tarsal plate, and surgical debulking could be a viable option for large protruding lesions, although more follow-up is necessary to monitor regrowth.
Adult ; Calcinosis/*pathology/surgery ; Eyelid Diseases/*pathology/surgery ; Female ; Humans ; Skin Diseases/*pathology/surgery

Astigmatism ; Coma ; Corneal Topography ; Corneal Wavefront Aberration ; Humans ; Linear Models ; Lotus ; Myopia ; Refractive Surgical Procedures ; Retrospective Studies ; Visual Acuity

Purpose: To assess the clinical efficacy of microblepharoexfolication using BlephEx™ (Scope Ophthalmics, London, UK) in meibomian gland dysfunction (MGD) patients. Methods: We performed a prospective study involving 48 eyes of 24 patients who were diagnosed with MGD. All patients were treated with BlephEx™ for 8-10 minutes, and the ocular surface disease index (OSDI), tear break-up time (TBUT), Schirmer’s I test, corneal staining score, lid margin abnormality, MGD score, and lipid thickness layer using the Lipiview II (TearScience, Morrisville, NC, USA) were assessed before treatment and after one month. Results: Significant changes were observed after microblepharoexfoliation using BlephEx™. The TBUT improved from 2.65 ± 1.16 to 3.77 ± 1.80 after 1 month (p < 0.001) and the OSDI improved from 38.83 ± 17.13 to 18.67 ± 15.01 after 1 month (p < 0.001). Before and after 1 month of treatment, the lid margin abnormalities were 2.98 ± 1.16 and 2.50 ± 1.01 (p < 0.001) and the MGD scores were 21.60 ± 6.95 and 18.02 ± 6.68 (p = 0.001), respectively. Conclusions BlephEx™ improved the patients’ ocular surface symptoms, MGD score, and TBUT. Using steroid eye drops, there was a synergistic effect in improvement. Therefore, using BlephEx™ may be suggested as a treatment option for MGD patients.

Purpose: To evaluate the biomechanical properties of corneas using a dynamic Scheimpflug analyzer (Corvis ST) after penetrating keratoplasty (PKP) and Descemet’s membrane stripping keratoplasty (DSEK). Methods: The medical records of 11 eyes that had undergone PKP (PKP group) and 11 eyes that had undergone DSEK (DSEK group) from March 2017 to March 2018 and the results were compared with 20 eyes of the control group. All patients’ corneal biomechanical properties, including a deformation amplitude ratio of 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (IntInvRad), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizon meridian (ARTh) were measured and compared with those of the normal control group. In addition, biomechanically corrected intraocular pressure (bIOP) measured by the Corvis ST was compared with intraocular pressure measured by a Tono-Pen Applanation Tonometer (IOP-Tono-Pen). Results: In the PKP group, the biomechanical properties using the Corvis ST showed a significantly lower DA ratio 2.0 mm, SP-A1, ARTh, and IntInvRad, compared with those of the control group. However, in the DSEK group, only ARTh was significantly lower than that of the control group. Conclusions Corvis ST can be used to measure the change of corneal biomechanical properties after corneal transplantation.