OBJECTIVE: This study investigates the morbidity of adnexal surgery through minilapatotomy by comparing with adnexal surgery through laparotomy. METHODS: From January 2000 to December 2001, 84 patients with adnexal diseases were managed through minilaparotomy and 80 patients treated with adnexal surgery through laparotomy. RESULTS: Fifty-three (69.0%) of the adnexal diseases were ectopic pregnancies. Fifty-seven patients (67.9%) were treated with salpingectomy. Other patients were treated with the following operations: salpingotomy (3 cases, 3.6%); salpingostomy (3 cases, 3.6%); fimbrioplasty (2 case, 2.4%); ovarian cyst enucleation (4 cases, 4.8%); ovarian resection (6 cases, 7.1%); parovarian cystectomy (5 cases, 6.0%); salpingooophorectomy (4 case, 4.8%). The average operation time for minilaparotomy was 30.5 +/- 9.2 minutes. The average bowel function recovery time for minilaparotomy was 28.2 +/- 15.6 hours (p<0.05). The average postoperative pain control was 29 cases (34.5%) lower than that of controls (p<0.05). The average postoperative hospital stay for minilaparotomy was 3.4 +/- 1.0 days (p<0.05). The procedure morbidity was lower than that of controls. CONCLUSION: It is suggested that minilaparotomy is a quick, convenient method to decrease patient morbidity and postoperative stay and that it could be considered an alternative to laparotomy for the treatment of adnexal diseases.
Adnexal Diseases ; Cystectomy ; Female ; Humans ; Laparotomy* ; Length of Stay ; Ovarian Cysts ; Pain, Postoperative ; Pregnancy ; Pregnancy, Ectopic ; Recovery of Function ; Salpingectomy ; Salpingostomy

PURPOSE: Using the spectral domain optical coherence tomography (SD-OCT), we studied the difference in the choroidal morphology between the choroidal neovascularization (CNV) area and the area surrounding CNV. METHODS: This retrospective study consisted of 19 patients with myopic CNV lesion in eye; fellow eyes were used as controls. All eyes were analyzed by measuring the choroidal thickness and large choroidal vessel size using SD-OCT. Eyes with CNV were divided into groups; the neovascular lesion was defined as group 1, the surrounding area as group 2. Subfovea of the fellow eye was defined as group 3. RESULTS: The choroidal thickness was 80.00 +/- 68.31 in group 1, 63.44 +/- 67.75 in group 2 and 71.11 +/- 65.69 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.038). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.365, p = 0.314). The large choroidal vessel size was 57.47 +/- 39.78 in group 1, 40.45 +/- 34.69 in group 2 and 45.63 +/- 37.00 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.025). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.123, p = 0.325). CONCLUSIONS: Choroidal thickness and large choroidal vessel size at the center of the CNV were greater than in the area surrounding CNV. The results suggest that although the CNVs were due to a thinned choroid caused by severe choroidal ischemia, the development of CNV requires maintenance of choriocapillaris and large choroid vessels.
Choroid* ; Choroidal Neovascularization* ; Humans ; Ischemia ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To present preoperative macular structure deformities and surgical outcomes in idiopathic epiretinal membrane (ERM) patient according to the presence of vitreomacular traction syndrome (VMTS). METHODS: This retrospective observational study included 54 eyes of 51 patients with idiopathic ERM, who underwent pars plana vitrectomy with ERM and internal limiting membrane (ILM) peeling, and were followed for more than 6 months. Subjects were classified into 2 groups according to the presence of VMTS using preoperative optical coherence tomography (group 1: ERM without VMTS, 29 eyes; group 2: ERM with VMTS, 22 eyes). Preoperative macular structure deformity and surgical outcomes were compared and prognostic factors were analyzed. RESULTS: Group 1 (ERM without VMTS) included 29 eyes, and group 2 (ERM with VMTS) included 22 eyes. Group 2 had a significantly higher occurrence of lamellar macular hole and a significantly lower preoperative best-corrected visual acuity (BCVA) compared to group 1. However, final postoperative BCVAs were not significantly different between the groups because BCVA changed more in group 2. Preoperative macular structure deformities (irregular retinal surface, retinal thickening, lamellar macular hole, and cystoid macular edema) did not affect visual outcomes. The presence of photoreceptor inner segment/outer segment (IS/OS) junction disruption and preoperative BCVA were highly related with visual outcomes. CONCLUSIONS: BCVA significantly improved in idiopathic ERM patients who underwent pars plana vitrectomy with ERM and ILM peeling regardless of the presence of VMTS. There may be a stronger association of IS/OS junction disruption with visual acuity compared to VMTS in idiopathic ERM surgery.
Congenital Abnormalities ; Epiretinal Membrane* ; Humans ; Membranes ; Observational Study ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Traction* ; Visual Acuity ; Vitrectomy

PURPOSE: To present preoperative macular structure deformities and surgical outcomes in idiopathic epiretinal membrane (ERM) patient according to the presence of vitreomacular traction syndrome (VMTS). METHODS: This retrospective observational study included 54 eyes of 51 patients with idiopathic ERM, who underwent pars plana vitrectomy with ERM and internal limiting membrane (ILM) peeling, and were followed for more than 6 months. Subjects were classified into 2 groups according to the presence of VMTS using preoperative optical coherence tomography (group 1: ERM without VMTS, 29 eyes; group 2: ERM with VMTS, 22 eyes). Preoperative macular structure deformity and surgical outcomes were compared and prognostic factors were analyzed. RESULTS: Group 1 (ERM without VMTS) included 29 eyes, and group 2 (ERM with VMTS) included 22 eyes. Group 2 had a significantly higher occurrence of lamellar macular hole and a significantly lower preoperative best-corrected visual acuity (BCVA) compared to group 1. However, final postoperative BCVAs were not significantly different between the groups because BCVA changed more in group 2. Preoperative macular structure deformities (irregular retinal surface, retinal thickening, lamellar macular hole, and cystoid macular edema) did not affect visual outcomes. The presence of photoreceptor inner segment/outer segment (IS/OS) junction disruption and preoperative BCVA were highly related with visual outcomes. CONCLUSIONS: BCVA significantly improved in idiopathic ERM patients who underwent pars plana vitrectomy with ERM and ILM peeling regardless of the presence of VMTS. There may be a stronger association of IS/OS junction disruption with visual acuity compared to VMTS in idiopathic ERM surgery.
Congenital Abnormalities ; Epiretinal Membrane* ; Humans ; Membranes ; Observational Study ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Traction* ; Visual Acuity ; Vitrectomy

PURPOSE: To analyze the anatomical characteristics on spectral-domain optical coherence tomography (SD-OCT) of patients who are legally blind (less than 20/1,000) due to end-stage exudative age-related macular degeneration (AMD) that does not require intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection. METHODS: After anti-VEGF injections (active group), 120 eyes of 103 exudative AMD patients experienced visual acuity improved by at least 2 lines or improvement on SD-OCT. In addition, 55 eyes of 54 end-stage exudative AMD patients who did not respond to treatment or who were legally blind due to foveal scar at the first visit (end-stage group) were evaluated retrospectively. Changes in retinal structures of the 2 groups were analyzed by SD-OCT at the last visit. RESULTS: The mean age of the end-stage group was about 5 years older than the active group. During the follow-up period, subretinal hemorrhage, intraretinal hemorrhage and retinal pigment epithelium tear occurred more frequently in the end-stage group than in the active group (p < 0.05). Intra-retinal fluids and subretinal fluids were more frequently administered in the active group than in the end-stage group, and thick subretinal hyper-reflective materials (SRHRM), fibrovascular pigment epithelial detachment (PED) and extensive inner segment/outer segment (IS/OS) line disruption were observed in all eyes of the end-stage group. The size and thickness of PED, foveal thickness and SRHRM thickness were significantly larger in the end-stage group than in the active group (p < 0.05). Disciform retinal scars were eventually formed in most of the end-stage group. CONCLUSIONS: In end-stage exudative AMD, the presence of retinal hemorrhage and retinal pigment epithelium tear during follow-up, or the findings of thick SRHRM, fibrovascular PED, and extensive IS/OS line disruption on SD-OCT suggest weak expected effect of intravitreal anti-VEGF injection, which can act as a reference for determining the timing of treatment termination.
Cicatrix ; Endothelial Growth Factors* ; Follow-Up Studies ; Hemorrhage ; Humans ; Macular Degeneration* ; Retinal Hemorrhage ; Retinal Pigment Epithelium ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Tears ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To analyze the anatomical characteristics on spectral-domain optical coherence tomography (SD-OCT) of patients who are legally blind (less than 20/1,000) due to end-stage exudative age-related macular degeneration (AMD) that does not require intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection. METHODS: After anti-VEGF injections (active group), 120 eyes of 103 exudative AMD patients experienced visual acuity improved by at least 2 lines or improvement on SD-OCT. In addition, 55 eyes of 54 end-stage exudative AMD patients who did not respond to treatment or who were legally blind due to foveal scar at the first visit (end-stage group) were evaluated retrospectively. Changes in retinal structures of the 2 groups were analyzed by SD-OCT at the last visit. RESULTS: The mean age of the end-stage group was about 5 years older than the active group. During the follow-up period, subretinal hemorrhage, intraretinal hemorrhage and retinal pigment epithelium tear occurred more frequently in the end-stage group than in the active group (p < 0.05). Intra-retinal fluids and subretinal fluids were more frequently administered in the active group than in the end-stage group, and thick subretinal hyper-reflective materials (SRHRM), fibrovascular pigment epithelial detachment (PED) and extensive inner segment/outer segment (IS/OS) line disruption were observed in all eyes of the end-stage group. The size and thickness of PED, foveal thickness and SRHRM thickness were significantly larger in the end-stage group than in the active group (p < 0.05). Disciform retinal scars were eventually formed in most of the end-stage group. CONCLUSIONS: In end-stage exudative AMD, the presence of retinal hemorrhage and retinal pigment epithelium tear during follow-up, or the findings of thick SRHRM, fibrovascular PED, and extensive IS/OS line disruption on SD-OCT suggest weak expected effect of intravitreal anti-VEGF injection, which can act as a reference for determining the timing of treatment termination.
Cicatrix ; Endothelial Growth Factors* ; Follow-Up Studies ; Hemorrhage ; Humans ; Macular Degeneration* ; Retinal Hemorrhage ; Retinal Pigment Epithelium ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Tears ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To evaluate the clinical features and risk factors of hemorrhagic complications in polypoidal choroidal vasculopathy (PCV) using spectral domain-optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA). METHODS: We respectively reviewed the data from 43 patients (45 eyes) diagnosed with PCV who received ICGA between January 2010 and October 2013. The patients were divided into 2 groups: 16 patients (17 eyes) with subretinal hemorrhage (subretinal hemorrhagic PCV group) and 27 patients (28 eyes) without subretinal hemorrhage (control group). Based on the ICGA and SD-OCT findings, the number, morphology, location, size of polyps, pigment epithelial detachment (PED), and serous retinal detachment (SRD) were measured and compared between the 2 groups. We also analyzed systemic diseases and history of antithrombotic agents associated with subretinal hemorrhage in PCV. RESULTS: The size of polyps measured by ICGA was significantly different between the 2 groups (p = 0.006). As the size of polyps increased, the size of subretinal hemorrhage, height of PED, base diameter and height of SRD increased (p < 0.05). No statistical correlation with systemic diseases and antithrombotic agents was observed (p > 0.05). CONCLUSIONS: The patients in the subretinal hemorrhagic PCV group had larger-sized polyps than the patients in the control group. This result suggests that eyes with larger-sized polyps are at risk for hemorrhagic complications and require more careful follow-up and observation in PCV treatment-naive patients.
Angiography ; Choroid* ; Fibrinolytic Agents ; Hemorrhage* ; Humans ; Indocyanine Green ; Polyps ; Retinal Detachment ; Risk Factors

PURPOSE: To evaluate the clinical features and risk factors of hemorrhagic complications in polypoidal choroidal vasculopathy (PCV) using spectral domain-optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA). METHODS: We respectively reviewed the data from 43 patients (45 eyes) diagnosed with PCV who received ICGA between January 2010 and October 2013. The patients were divided into 2 groups: 16 patients (17 eyes) with subretinal hemorrhage (subretinal hemorrhagic PCV group) and 27 patients (28 eyes) without subretinal hemorrhage (control group). Based on the ICGA and SD-OCT findings, the number, morphology, location, size of polyps, pigment epithelial detachment (PED), and serous retinal detachment (SRD) were measured and compared between the 2 groups. We also analyzed systemic diseases and history of antithrombotic agents associated with subretinal hemorrhage in PCV. RESULTS: The size of polyps measured by ICGA was significantly different between the 2 groups (p = 0.006). As the size of polyps increased, the size of subretinal hemorrhage, height of PED, base diameter and height of SRD increased (p < 0.05). No statistical correlation with systemic diseases and antithrombotic agents was observed (p > 0.05). CONCLUSIONS: The patients in the subretinal hemorrhagic PCV group had larger-sized polyps than the patients in the control group. This result suggests that eyes with larger-sized polyps are at risk for hemorrhagic complications and require more careful follow-up and observation in PCV treatment-naive patients.
Angiography ; Choroid* ; Fibrinolytic Agents ; Hemorrhage* ; Humans ; Indocyanine Green ; Polyps ; Retinal Detachment ; Risk Factors

PURPOSE: To compare the short-term clinical outcomes of transscleral fixation intraocular lens (IOL) with two haptics or one haptic. METHODS: We retrospectively reviewed the medical records of 26 patients with transscleral fixation of IOL (11 with one-haptic fixation, 15 with two-haptic fixation) except in patients whose visual acuity is not expected to improve due to retinal problems or ocular trauma. We analyzed the manifest refraction, visual acuity, refractive error preoperatively and postoperatively, preoperative IOL decentration, operating time, and postoperative complications. RESULTS: When comparing the two groups preoperatively, the mean lens decentration in the one-haptic group was 2.73 ± 2.88 mm and 4.59 ± 2.18 mm in the two-haptics group. The decentration in the two-haptic group was greater than in the one-haptic group, but not significantly. Visual acuity and refractive power were not significantly different between the groups. The mean operation time (minutes) was 65.00 ± 22.69 and 93.66 ± 29.54 in the one-haptic and two-haptic groups, respectively. The operation time in the one-haptic group was significantly shorter than in the two-haptic group (p = 0.020). When comparing visual acuity preoperatively and postoperatively, both groups showed significant improvement (p < 0.01). However, refractive error and postoperative IOL decentration were similar between the groups. CONCLUSIONS: The short-term surgical results of transscleral fixation using the two surgical techniques were not different; one-haptic transscleral fixation was preferred due to shorter operation time and lower patient discomfort.
Humans ; Lenses, Intraocular* ; Medical Records ; Postoperative Complications ; Refractive Errors ; Retinaldehyde ; Retrospective Studies ; Visual Acuity

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) interconnected with the perifoveal capillaries in a healthy young female. CASE SUMMARY: A 16-year-old female presented with sudden loss of vision in her left eye. Upon initial examination, her left visual acuity was 0.02 and intraocular pressure was 31 mm Hg. Fundus examination revealed pallid retinal edema of the inferior posterior pole and retinal hemorrhage below optic disc. Ocular massage followed by anterior chamber paracentesis was performed for 30 minutes within 4 hours after the onset of vision loss. Fluorescein angiography (FAG) showed a very slow blood flow in the superotemporal and inferotemporal retinal arteries and a delay in retinal arteriovenous transit time. We performed hemodynamic tests such as blood pressure, echocardiography, and the hematologic test for thrombogenicity and all tests were normal. At three weeks after treatment, vision in the left eye was 0.7 and FAG revealed normal retinal arterial circulation and venous drainage time. CONCLUSIONS: This is the first report regarding acute BRAO in a healthy Korean child without any detectable systemic disorder. Prompt treatment can prevent permanent visual loss in BRAO involving the macular area.
Adolescent ; Anterior Chamber ; Blood Pressure ; Capillaries ; Child ; Drainage ; Echocardiography ; Female ; Fluorescein Angiography ; Hematologic Tests ; Hemodynamics ; Humans ; Intraocular Pressure ; Massage ; Papilledema ; Paracentesis ; Retinal Artery ; Retinal Artery Occlusion* ; Retinal Hemorrhage ; Retinaldehyde ; Visual Acuity