The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization.
The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan Ⅲ was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted.
In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment.
In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.

Purpose: To evaluate the short-term clinical outcomes of trabeculectomy with amniotic membrane transplantation (AMT) and mitomycinC (MMC) in patients with primary open-angle glaucoma (POAG). Methods: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patientswith POAG who underwent trabeculectomy with AMT and MMC and compared the surgical outcomes according to AMTwith Kaplan-Meier survival analysis. All patients had follow-up of ≥6 months. Surgical success was defined as an intraocularpressure (IOP) ≤18 mmHg and IOP reduction ≥20% without medication. We evaluated the frequency of complications and blebmorphology according to AMT. Results: A total of 95 eyes of 79 patients were included; 52 eyes of 46 patients with AMT (AMT group) and 43 eyes of 33 patientswithout AMT (control group). The cumulative probability of success after trabeculectomy was 94.2% and 85.8% after one year forthe AMT and control groups, respectively (p= 0.121). Mean IOP decreased from 30.2 ± 9.8 mmHg preoperatively to 11.6 ± 4.2mmHg at the final visit in the AMT group (p< 0.001). Mean IOP decreased from 29.7 ± 7.4 mmHg preoperatively to 12.2 ± 4.5mmHg at the final visit in the control group (p< 0.001). Preoperative and final IOP were not significantly different between the twogroups. Complications were comparable between the groups. However, avascular cystic bleb was more frequent in the controlgroup (18.6%) than in the AMT group (0%) (p= 0.002). Conclusions Trabeculectomy with AMT and MMC appears to be a safe and effective procedure for IOP reduction in patientswith POAG, without development of avascular cystic bleb or bleb-related infection.

Purpose: We report a case of macular, serous retinal detachment associated with hypotony in a patient with pachychoroid disease developing after Ahmed valve implantation.Case summary: A 77-year-old male visited our clinic with uncontrolled intraocular pressure (IOP; 32 mmHg) in his left eye despite maximal tolerable medical therapy. A prolapsed vitreous filled the anterior chamber. Swept-source optical coherence tomography (SS-OCT) revealed that the subfoveal choroidal thickness was about 510 μm, indicating pachychoroid. Vitrectomy was performed to remove the prolapsed vitreous. The IOP remained 32 mmHg 3 weeks after vitrectomy. Ahmed valve implantation was performed and hypotony developed 10 days postoperatively. Choroidal detachment was apparent and SS-OCT revealed macular accumulation of subretinal fluid. The subfoveal choroidal thickness increased to a level beyond the SS-OCT measurement range. Partial tube ligation was performed to treat the hypotony 18 days after Ahmed valve implantation; the IOP decreased to 14 mmHg at 6 weeks postoperatively. The macular, serous retinal detachment disappeared and the subfoveal choroidal thickness fell to the preoperative value. Conclusions Hypotony after Ahmed valve implantation can manifest as serous retinal detachment under the fovea accompanied by an increase in choroidal thickness in an eye with underlying pachychoroid.

The funding acknowledgment in this article was partially omitted as published.

The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multiple-trauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and anti-thrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.
Abdominal Pain ; Aged ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Brain ; Coma ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Drainage ; Emergencies ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Iliac Artery ; Multiple Trauma ; Shock ; Sleep Stages ; Subarachnoid Hemorrhage, Traumatic* ; Tomography, X-Ray Computed ; Vital Signs

A 40-year-old female visited our clinic for visual disturbance of the right eye, in which a few creamy-yellow retinal lesions and visual field constrictions were noted. She had been treated for primary CNS lymphoma and was in complete remission. After failure to follow-up for three months, she lost vision in the right eye, at which time active panuveitis was seen. Decreased vision and field constriction was observed in the left eye. Her left eye showed a granular pattern and dye leakage from the vessels and disc on fluorescein angiography and small RPE humps were seen in optical coherence tomography (OCT). Diffuse large malignant B-cells with strong immunoreactivities with CD20 immunostaining were seen in the epiretinal membrane biopsy specimen. Intravitreal injections of methotrexate (MTX) (800 microgram/0.1 ml in the right eye, 400 microgram/0.05 ml in the left eye) were performed twice weekly for one month, once weekly for the following month, once every two weeks for the next month, followed by nine monthly injections. Both eyes were free from malignant cells on vitreous biopsy six months later. There was no leakage seen by angiography, but the granular pattern persisted. Visual field constriction was slightly improved, and the small RPE humpsdetachments seen in OCT disappeared. EOG Arden ratio was decreased in both eyes, and b wave amplitude of scotopic ERG was decreased in the left eye. She was free from recurrence until six months later. No ocular complications except minimal opacity of the crystalline lenses were noted in both eyes.
Adult ; Antimetabolites, Antineoplastic/*administration & dosage ; Drug Administration Schedule ; Eye Neoplasms/*drug therapy ; Female ; Humans ; Injections ; Lymphoma/*drug therapy ; Methotrexate/*administration & dosage ; Treatment Outcome ; Vitreous Body

Purpose: This study aimed to evaluate the 1-year surgical outcomes of XEN45 gel stent implantation with an open conjunctiva approach in patients with open-angle glaucoma (OAG). Methods: This retrospective cohort study included 19 eyes of 19 patients who underwent XEN45 gel stent implantation with an open conjunctival approach. Surgical success was defined by intraocular pressure (IOP) ≤18 mmHg and one of the following: IOP reduction ≥30% or reduction of two glaucoma medications with final IOP if baseline IOP ≤18 mmHg. The cumulative probability of success rate was analyzed using Kaplan-Meier survival analysis. Cox proportional hazard regression analysis was used to assess prognostic factors for surgical failure. Results: IOP reduced from 32.37 ± 12.08 mmHg preoperatively to 15.14 ± 2.25 mmHg at 1 year (p = 0.001). The number of glaucoma medication reduced from 3.89 ± 0.32 preoperatively to 0.86 ± 1.35 at 1 year (p = 0.001). The success rates were 78.9% at 6 months and 73.7% at 1 year. Eyes with bleb horizontal extent ≥2 clock hours at 1 month postoperatively had a significantly higher success rate (log-rank test, p < 0.001). Greater bleb horizontal extent at 2 weeks and 1 month postoperatively was associated with a lower surgical failure rate (2 weeks: hazard ratio, 0.119; p = 0.024; 1 month: hazard ratio, 0.046; p = 0.007). Bleb needling and additional glaucoma surgeries were necessary in 10 (52.6%) and five eyes (26.3%), respectively. Conclusions XEN45 gel stent implantation with the open conjunctiva approach is effective in reducing IOP and glaucoma medication for over 1 year in patients with OAG.

Purpose: To evaluate the 1-year clinical outcome of subsequent trabeculectomy following 25-gauge transconjunctival sutureless vitrectomy in refractory glaucoma with vitreous filling of the anterior chamber. Methods: This study was a retrospective and consecutive case series study. We reviewed the medical records of pseudophakic and aphakic glaucoma patients with vitreous filling of the anterior chamber who underwent subsequent trabeculectomy with mitomycin C (MMC), following 25-gauge transconjunctival sutureless vitrectomy. All patients had been followed up for more than 12 months. Complete surgical success was defined as an intraocular pressure (IOP) ≤18 mmHg and IOP reduction ≥20% without glaucoma medication. Qualified surgical success was defined as IOP ≤18 mmHg and an IOP reduction ≥20% with or without glaucoma medication. Results: Eight eyes of seven patients (four eyes of four patients with pseudophakic glaucoma and four eyes of three patients with aphakic glaucoma) were included in this study. The cumulative probability of qualified success was 87.5%, and the cumulative probability of complete success was 62.5% at 12 months after trabeculectomy. The mean IOP decreased from 28.1 ± 3.5 mmHg preoperatively to 15.0 ± 3.7 mmHg at the final visit (p = 0.012). The mean number of glaucoma medications decreased from 4 ± 0 to 1.5 ± 2.1 at the final visit (p = 0.010). Complications including retinal detachment, vitreous hemorrhage, cystoid macular edema, and vitreous incarceration into the fistula were not observed. Conclusions Transconjunctival sutureless vitrectomy and subsequent trabeculectomy with MMC is an effective method for controlling IOP in pseudophakic and aphakic glaucoma with vitreous filling of the anterior chamber.

Purpose: To evaluate the 1-year clinical outcome of subsequent trabeculectomy following 25-gauge transconjunctival sutureless vitrectomy in refractory glaucoma with vitreous filling of the anterior chamber. Methods: This study was a retrospective and consecutive case series study. We reviewed the medical records of pseudophakic and aphakic glaucoma patients with vitreous filling of the anterior chamber who underwent subsequent trabeculectomy with mitomycin C (MMC), following 25-gauge transconjunctival sutureless vitrectomy. All patients had been followed up for more than 12 months. Complete surgical success was defined as an intraocular pressure (IOP) ≤18 mmHg and IOP reduction ≥20% without glaucoma medication. Qualified surgical success was defined as IOP ≤18 mmHg and an IOP reduction ≥20% with or without glaucoma medication. Results: Eight eyes of seven patients (four eyes of four patients with pseudophakic glaucoma and four eyes of three patients with aphakic glaucoma) were included in this study. The cumulative probability of qualified success was 87.5%, and the cumulative probability of complete success was 62.5% at 12 months after trabeculectomy. The mean IOP decreased from 28.1 ± 3.5 mmHg preoperatively to 15.0 ± 3.7 mmHg at the final visit (p = 0.012). The mean number of glaucoma medications decreased from 4 ± 0 to 1.5 ± 2.1 at the final visit (p = 0.010). Complications including retinal detachment, vitreous hemorrhage, cystoid macular edema, and vitreous incarceration into the fistula were not observed. Conclusions Transconjunctival sutureless vitrectomy and subsequent trabeculectomy with MMC is an effective method for controlling IOP in pseudophakic and aphakic glaucoma with vitreous filling of the anterior chamber.

Purpose: To evaluate the utility of pointwise modeling for predicting visual field (VF) progression in Korean glaucoma patients. Methods: Open-angle glaucoma or glaucoma suspect patients with VFs ≥ 10 times, who were followed-up for ≥ 6 years, wereincluded. Linear, exponential, and polynomial regression of threshold values at each test point against time were performed. Model fit was evaluated based on root mean squared error (RMSE) for the entire longitudinal VF series. To evaluate prediction ability, VFs from the first 5 years were used to estimate model parameters, followed by calculation of threshold values for 1, 2, 3, 5 years to obtain RMSE. Prediction ability was compared regarding initial threshold value and also central and peripheral VF area. Results: Four hundred thirty-nine eyes (280 patients) were included. The mean follow-up duration and number of VF tests were 9.64 years and 13.02, respectively. When fitting the entire VF series, polynomial model had the lowest RMSE (p < 0.001). For 1-year predictions, linear model had the lowest RMSE, while exponential model had the lowest RMSE for 3- and 5-year predictions (p < 0.001). For 1- and 2-year predictions, exponential and linear models had the lowest RMSEs, with initial sensitivities of 0-7 and 20-27 decibel (dB), respectively (p < 0.001). Compared to exponential model, linear model had lower RMSE for 1-year, but higher RMSE for 3- and 5-year at peripheral VF area (p < 0.001). For central VF area, exponential model had lower RMSEs for 2-, 3-, and 5-year predictions compared to linear model (p ≤ 0.015). Conclusions The linear model outperformed the exponential model for short-term predictions, while the exponential model was better for long-term predictions. The prediction performance of the exponential model was superior to that of the linear model for central VFs, and for test points with lower initial sensitivities.