Many patients complain of near vision difficulty after PRK surgery. In the prospective study, we report the effect of PRK surgery for myopia on accommodation and binocular vision. 45 myopic eyes (39 patients, 9 males, 30 females) underwent PRK for myopia. Mean preoperative amplitude of accommodation in moderate degree myopia (group 1 < OR = -6.00D in shperical equivalent : range -2.45 ~ -6.00D) was 7.01+/-1.25D, mean preoperative amplitude of accommodation in high degree myopia (group 2 > -6.00D in spherical equivalent : range -6.10 ~ -10.75D) was 6.85+/-1.41D. Mean postoperative amplitude of accommodation of group 1 was 8.13+/-1.38D, mean postoperative amplitude of accommodation of group 2 was 7.80+/-1.33D, the difference of both groups were statistically significant(p>0.05). Mean preoperative amplitude of accommodation of all patients was 6.91+/-1.35D, mean postoperative amplitude of accommodation was 7.93+/-1.36D, the difference are statistically significant (p>0.01). 12 of 39 patients complained of near vision difficulty while reading after PRK surgery on their one eye, but 3 of them who underwent PRK surgery on their the other eye noticed the disappearance of near vision difficulty. Stereopsis was tested and 15 of 36 patient lost more than 50 sec/arc of streoacuity. Near vision difficulty was not related to the amount of myopia corrected, not related to the stereoacuity change but seemed to related to their adaptability or their reaction time of accommodation with their operated eyes.
Depth Perception ; Humans ; Lasers, Excimer* ; Male ; Myopia ; Photorefractive Keratectomy* ; Prospective Studies ; Reaction Time ; Telescopes* ; Vision, Binocular*

We evaluated preoperative characteristics, intraoperative problems, and postoperative complications among the patients who underwent phacoemulsification and posterior chamber intraocular lens implantation by one surgeon. Eyes with postoperative visual acuity was lower than preoperatively or less than 0.4 on Han`s visual acuity chart were designated Group A, 68 eyes (16.4%), and the remaining eyes were Group B, 46 eyes (83.6%). Preoperative characteristics in Group A were uveitis (16.2%), diabetic retinopathy (13.2%), glaucoma (11.8%), macular abnormality (11.8%), etc. Intraoperative complications, posterior capsule reptures with vitreous loss occurred in 21 eyes (5.1%). 8 eyes (11.8%) of the 21 eyes were Group A, 13 eyes (3.8%) were Group B, and the difference between both groups were statistically significant (p<0.01). Postoperatively, cystoid macular edema was occurred in 12 eyes (2.9%). 11 eyes (16.2%) of 12 eyes were Group A, 1 eye (0.3%) was Group B, and the difference between both groups were statistically significant (p<0.01) and 4 eyes were preceded by posterior capsule rupture. From the above results, we recognized the importance of avoiding posterior capsule rupture with vitreous loss. If it does occur, we recommend that meticulous anterior vitrectomy be performed. Following these guidlines should reduce the rate of unsuccessful cataract sugery.
Cataract* ; Diabetic Retinopathy ; Glaucoma ; Humans ; Intraoperative Complications ; Lens Implantation, Intraocular ; Macular Edema ; Phacoemulsification ; Postoperative Complications ; Rupture ; Uveitis ; Visual Acuity ; Vitrectomy

Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.
Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Nails ; Orthopedics

PURPOSE: To determine the clinical characteristics and visual prognosis of intraocular foreign bodies (IOFBs). METHODS: We analyzed the patients with surgical removal of IOFB and follow-up of 4 months or longer. RESULTS: Of all 126 eyes of 126 patients, 118 patients (93.6%) were men and mean age was 42.7 years. The cause was lawn mower in 49 eyes (38.9%). Metal composition was in 114 eyes (90.5%), corneal inlet was present in 101 eyes (80.2%) and posterior location was in 97 eyes (73.0%) were there. Visual acuity was worse than 0.04 in 77 eyes (61.1%) before operation and in 36 eyes (28.6%) at the final visit. The final visual acuity was significantly related with initial visual acuity (criterion: 0.1, P=0.001), wound length (criterion: 3 mm, P< 0.001), location (anterior vs. posterior location, P< 0.001) and size (criterion: 3mm, P< 0.001) of IOFB, traumatic cataract (P=0.011), vitreous hemorrhage (P=0.001) and retinal tear (P< 0.001), respectively. CONCLUSION: Lawn mower is the main cause of IOFB and the countermeasure should be needed for it. Initial visual acuity, location and size of IOFB, wound length, vitreous hemorrhage and retinal tear may be the important factors on visual prognosis of IOFB.
Bays ; Cataract ; Follow-Up Studies ; Foreign Bodies* ; Humans ; Male ; Prognosis* ; Retinal Perforations ; Visual Acuity ; Vitreous Hemorrhage ; Wounds and Injuries

Spondylolisthesis, named by Kilian in 1854, is a major cause of low back pain and numerous methods were designed for its treatment. The 80 cases out of 132 spondylolysis and spondylolisthesis were analysed and evaluated the result cf their treatment. The results are summerized as follows. 1. The most common type of spondylolisthesis was isthmic type (58 cases, 72.5%). 2. The most common site of incidence was L5 and L4, L3 were next to it. 3. All of the dysplastic type were in L5, isthmic type were in L3, L4 and the degenerative type were most common in L4, and followed L5,L3 consecutively. 4. The 67 cases out of 80 were treated conservatively and rest of cases had operative care with six cases of anterior fusion and seven cases of posterior fusion. 5. The results of tretment was evaluated and graded more than good in all cases of operative care and 51 cases (76.2%) in conservative management.
Incidence ; Low Back Pain ; Spondylolisthesis ; Spondylolysis

The mechanism of back pain arising from change in intervertebral disc has not been clearly defined. So that the diagnosis and treatment were variable. The 26 cases of herniated intervertebral discs, treated by surgically, were analysed and evaluated as follows. 1 In 26 cases of herniated intervertebral discs, 18 cases (69%) were male and 8 cases (31%) was female. 2. The most common age group was 30 to 40 years old. 3. The most common site of incidence was L4-5 with 15 cases (57%) and L5-S1 10 cases (38%). 4. The over all followup result to surgical treatment was evaluated as 80% (21 cases) in excellent & good. 5. The end results correlated with myelographic findings was that the lateral indentation and asymmetry of nerve sleeve sleeve groups were better than the hour-glass appearance group.
Back Pain ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Male

The Kuntscher nail has been used widely for the treatment of femoral shaft fracture with the advantage of early weight bearing and early joint movement. But it has some disadvantages that are harmful in bone-union by the wide intramedullary reaming, and rotation and bending of the device. Schneider devised four flanged nail to be able to eliminate the disadvantage of the Kiintscher nail. The author have experienced the 16 cases of Schneider nailing in the fractures of femoral shaft at the Department of Orthopaedic Surgery, Ewha Womans University Hospital from Feb., 1982 to Apr., 1984. The following results were obtained. 1. There were common in male (14 cases) and active ages (13 cases). 2. The most common cause was trauma with 14 cases and the other was pathological fracture. 3. Indications of Schneider nailing were wide than those of Kiintscher nailing. 4. Usual intervals between the injury and operation was one week. 5. Mean operating time was one hour and 25 minutes, and blood loss during the operation was 410cc. 6. After treatment, we usually permitted the exercises of quadriceps setting and non-weight bering walking within 1 week, partial-weight bearing walking within 4 weeks and full weight bearing walking within 4 months. 7. The results of 13 cases among 15 cases were better than good. 8. There were no complications such deformities as rotation, shortening and angulation because of specialized structure of Schneider nail. Also, Schneider nailing could prevent the nonunion and infection because there was need of reaming the medullary canal.
Congenital Abnormalities ; Exercise ; Female ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Joints ; Male ; Walking ; Weight-Bearing

Kyphotic deformity of thoracic or lumbar spine is generally developed as a consequence of Scheuerman's kyphosis, ankylosing spondylitis, congenital kyphosis, tuberculous kyphosis, spinal tumor, senile kyphosis, trauma and extensive laminectomy etc. The method of treatment is usually conservative. However, in severe kyphosis, gross abnormaility and neurologic complications, and the compression of cardiopulmonary system are resulted and then surgery may be indicated. Since the report of spinal osteotomy by Smith-Peterson, several treatment options have been reported. Despite improved techniques for treating spinal kyphotic deformities, correction of severe and acutely angled deformities are less effective and resulting many complications. We propose the use of a new method of posterior closing spinal osteotomy for the treatment of severe and acutely angled kyphotic deformity to minimize the complications and for effective correction. We report the technique and results of this method in two cases of tuberculous kyphosis and a case of ankylosing spondylitis.
Congenital Abnormalities ; Kyphosis ; Laminectomy ; Methods ; Osteotomy ; Spine ; Spondylitis, Ankylosing

Nerve Conduction studies are used not only in diagnosis of compression neuropathy, but also as a prognostic evaluation after is treatment. Authors analyzed the changes of nerve conduction studies in the 21 hands of 19 patients of carpal tunnel syndrome which was confirmed by clinical and electrodiagnostic methods, and treated by surgical release of transverse carpal ligament. The changes of nerve conduction and clinical studies were completed just before surgery, and at 2-week, 1-month, 3-month and 6-month of postoperative periods, and summarized as follows; 1. The distal sensory and motor latencies were significantly(P < 0.05) improved at the 3-month of postoperative periods, respectively. 2. The sensory conduction velocities across the carpal tunnel was significantly(P < 0.05) improved at the 6-month of postoperative periods. 3. The distal motor amplitude was significantly(P < 0.05) improved at the 6-month of postoperative periods. 4. The changes in sensory conduction studies were more sensitive value for evaluation of patients with carpal tunnel syndrome. 5. The distal latencies reflected the progress of clinical improvement, accurately. These conduction studies are considerable value in the evaluation of the post-carpal tunnel release patient.
Carpal Tunnel Syndrome ; Diagnosis ; Hand ; Humans ; Ligaments ; Neural Conduction ; Postoperative Period

PURPOSE: To evaluate the clinical characteristics of the intermediate uveitis with prominent snowbank, METHODS: We retrospectively reviewed the records of the patients with intermediate uveitis characterized by the snowbank larger than half a quadrant. RESULTS: Of all 49 patients, 67 eyes, the mean age was 37.3 years. Male patients was 31, and eighteen patients (36.7%) were bilateral. Snowbank was at the inferior in 56 eyes (83.6%), and larger than two quadrant in 16 eyes (23.9%). Mean follow-up was 27 months. Final visual acuity improved in 40 eyes (59.7%), worsened in 4 eyes (6.0%), and more than 0.5 in 51 eyes (76.1%). Complications were cystoid macular edema (23 eyes, 34.3%), retinal detachment (22 eyes, 32.8%), and vitreous hemorrhage (11 eyes, 16.4%). Procedures were barrier laser photocoagulation (45 eyes, 67.2%), pars plana vitrectomy(12 eyes, 17.9%), scleral buckling(2 eyes, 3.0%), cataract surgery (9 eyes, 13.4%), trabeculectomy(6 eyes, 9.6%), and cryopexy (1 eye, 1.5%). Statistically, there was no significant relationship in the final visual acuity and gender, bilaterality, initial visual acuity of 0.5 or above, snowbank larger than two quadrants, and barrier laser photocoagulation. However, pars plana vitrectomy showed a significant relationship (p<0.001). CONCLUSIONS: Intermediate uveitis with prominent snowbank seems to show the similar clinical prognosis to generally-reported intermediate uveitis, and the prognosis of pars plana vitrectomy is good.
Cataract ; Follow-Up Studies ; Humans ; Light Coagulation ; Macular Edema ; Male ; Pars Planitis* ; Prognosis ; Retinal Detachment ; Retrospective Studies ; Uveitis, Intermediate ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage