The authors experienced a case of anterior uneitis associated with secondary glaucoma caused by a cycitsercosis cellulosae in the anterior chamber of the left eye of a 39-year-old Korean male. The cyst appeared from the posterior surface of the iris through the pupillary margin of 10-o'clock position and grew larger and larger with automatic active movements, filling finally the nasal upper one third of the anterior chamber, but the cyst did not change the position to the 6-o'clock chamber angle. The cysticercus grown for almost four months was extracted successfully with a teethless, serrated, curved forceps with some resistance after opening the anterior chamber from 7~11-o'clock position without iris prolapse and any damage to the anterior lens capsule. The extracted cyst with the size of 8 mm X 6 mm X 3 mm was confirmed as a cysticercus cellulosae by parasitological examinations (Fig. 2,3). After the extraction of the cysticercus the uveitis and the increased intraocular tension subsided completely, remaining some brownish fine keratic precipitates, pigment masses on the anterior surface of the lens and irregularly somewhat dilated pupil due to partial posterior synechia. The naked vision O.S., however, was 20/25 using pin hole, and the eye has been still quiet during last 3 and half years following surgical extraction. In addition the authors have recently seen three cases of subconjunctival cystiticercosis cellulosae. In the first case the cysticercus with the size of 8 mm X 7 mm X 4 mm appeared at the nasal superior part of the bulbar conjunctiva O.D. of a three-year-old Korean male. In the second case the cyst with the size of 7 mm X 5 mm X 3 mm was seen at the nasal inferior part of the bulbar conjunctiva O.S. of a 12-year old Korean female. In the last case the cyst with the size of 10 mm X 8 mm X 5 mm was located beneath the plica semilunaris of 3-o'clock position O.D. of a 58-year-old Korean female. All the cysts were extracted successfully without any rupture, and they were confirmed as the cysticercus cellulosae histologically.
Adult ; Anterior Chamber* ; Child ; Conjunctiva ; Cysticercosis* ; Cysticercus* ; Female ; Glaucoma ; Humans ; Iris ; Male ; Middle Aged ; Prolapse ; Pupil ; Rupture ; Surgical Instruments ; Uveitis

PURPOSE: To evaluate the efficacy of arteriovenous (AV) sheathotomy with internal limiting membrane peeling for persistent or recurrent macular edema after intravitreal triamcinolone injection and/or laser photocoagulation in branch retinal vein occlusion. METHODS: Twenty-two eyes with branch retinal vein occlusion (BRVO) with recurrent macular edema underwent vitrectomy with AV sheathotomy and internal limiting membrane peeling. All eyes had previous intravitreal triamcinolone injection and/or laser photocoagulation for macular edema. The best corrected visual acuity (BCVA), fluorescein angiography and optical coherence tomography (OCT) before and after surgery were compared. RESULTS: The mean preoperative BCVA (log MAR) were 0.79+/-0.29 and postoperative BCVA (log MAR) at 3 months was 0.57+/-0.33. And improvement of visual acuity > or =2 lines was observed in 10 eyes (45%). The mean preoperative fovea thickness measured by OCT was 595.22+/-76.83 micrometer (510-737 micrometer) and postoperative fovea thickness was 217.60+/-47.33 micrometer (164-285 micrometer). CONCLUSIONS: Vitrectomy with AV sheathotomy can be one treatment option for the patients with recurrent macular edema in BRVO.
Treatment Outcome ; Tomography, Optical Coherence ; Retrospective Studies ; Retinal Vein Occlusion/*complications/diagnosis/surgery ; Ophthalmologic Surgical Procedures/*methods ; Middle Aged ; Male ; Macular Edema, Cystoid/diagnosis/etiology/*surgery ; Macula Lutea/*surgery ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Female

This study was undertaken to investigate the effect of premedieants, diazepam and atropine sulfate in ten surgical patients by determining human plasma insulin. Also Insulin-Riakit was utilized as a kit for the detertrmination of insulin levels in the blood by radioimmunoassay (double antibody system). The plasma insulin level before administration of premedicants was 1:1. 1+/-1. 55 um/mL and 12. 6+/-2. 02um/ml. at 60 minutes after administration of premedicants so that the clinical significance of the results was absent. Sex ratio between male and female patients was 1: 1, mean age 39. 2+/-12. 1 and average body weight(kg) 55. 5+/-58.3. Consequently, there was no significant change in plasma insulin one hour after premedication and its result was within normal limits.
Atropine* ; Diazepam* ; Female ; Humans* ; Insulin ; Male ; Plasma* ; Premedication ; Radioimmunoassay ; Sex Ratio

Zinc is essential for the survival of all cells. Retinal pigment epithelium(RPE)and chorioretinal complex contains unusually high concentration of zinc. Recently, zinc has received special attention of clinicians for its possible association with certain ocular diseases such as age-related macular degeneration(ARMD). However, the cellular and molecular pathological correlates of zinc deficiency in retinal cells and RPE are scanty. Thus, we examined zinc deficiency-induced RPE pathology using a cell-permeant zinc chelator, TPEN. Exposure of human RPE cultures to TPEN induced death of RPE between 1 micrometer to 2 micrometer concentrations within 48h exposure. TPEN-induced cell death was completely blocked by coaddition of zinc. Addition of a broad-spectrum caspase inhibitor, zVAD-fmk and a caspase 3 inhibitor, DEVD-fmk markedly attenuated TPEN induced RPE death.Addition of a protein synthesis inhibitor cycloheximide attenuated TPEN-induced RPE death significantly. On the other hand, EGF, IGF-1, PDGF, MK-801, or trolox did not show any protective effect. Additionally, TUNEL and Hoechst staining revealed conspicuous internucleosomal DNA fragmentation. Furthermore, ultrastructural changes supported that TPEN-induced RPE death was apoptosis. The present study using human RPE cells provides a model for zinc depletion-induced apoptosis. Considering the clinical importance of ARMD, the model may provide useful insights into the pathogenic mechanisms of zinc deficiency-related degenerative eye conditions.
Apoptosis* ; Caspase 3 ; Cell Death ; Cycloheximide ; Dizocilpine Maleate ; DNA Fragmentation ; Epidermal Growth Factor ; Epithelial Cells* ; Hand ; Humans* ; In Situ Nick-End Labeling ; Insulin-Like Growth Factor I ; Pathology ; Retinal Pigment Epithelium ; Retinaldehyde* ; Zinc*

We analysed a series of cataract surgery cases into two groups. double horizontal suture group and shoelaces running suture group. We modified horizontal suture technique putting two separate sutures before opening the anterior chamber. Shoelaces running suture group showed early with-the-rule astigmatism about 2 diopter, which decayed over time reaching breakout point at 8 weeks, then very little change. Double horizontal suture group also showed early with-the-rule astigmatism, but the amount was less than half a diopter, which decayed over time, reaching break point at 4 yveek, stabilizing thereafter. After 8 weeks there was no statistical difference between two groups. In summary, double horizontal suture results in less astigmatism and therefore better visual acuity immediatedly after the surgery (p<0.005, student t-test) and for the first 2 months compared to shoelaces running suture.
Anterior Chamber ; Astigmatism* ; Cataract Extraction* ; Cataract* ; Humans ; Running ; Suture Techniques ; Sutures* ; Visual Acuity

We analysed a series of cataract surgery cases into two groups. double horizontal suture group and shoelaces running suture group. We modified horizontal suture technique putting two separate sutures before opening the anterior chamber. Shoelaces running suture group showed early with-the-rule astigmatism about 2 diopter, which decayed over time reaching breakout point at 8 weeks, then very little change. Double horizontal suture group also showed early with-the-rule astigmatism, but the amount was less than half a diopter, which decayed over time, reaching break point at 4 yveek, stabilizing thereafter. After 8 weeks there was no statistical difference between two groups. In summary, double horizontal suture results in less astigmatism and therefore better visual acuity immediatedly after the surgery (p<0.005, student t-test) and for the first 2 months compared to shoelaces running suture.
Anterior Chamber ; Astigmatism* ; Cataract Extraction* ; Cataract* ; Humans ; Running ; Suture Techniques ; Sutures* ; Visual Acuity

Purpose: We sought risk factors for the development of persistent or recurrent central serous chorioretinopathy (CSC) in patientsunder long-term follow-up (>1 year) after photodynamic therapy (PDT). Methods: We retrospectively reviewed the medical records of patients who received PDT to treat CSC from January 2005 toFebruary 2016. CSC was considered persistent if subretinal fluid (SRF) was evident for longer than 3 months or if additionaltreatment was required before 3 months. Also, CSC was regarded as recurrent when SRF re-appeared after initial completeresorption. Results: We enrolled 73 patients (77 eyes). The mean follow-up period was 48.9 ± 31.3 months (12 to 144 months). The persistentgroup consisted of 10 eyes (13%) and the recurrent group 17 eyes (22%). The mean time to recurrence was 39.8 ± 23.3months, ranging from 3 to 91 months. Fifty patients (52 eyes) were enrolled in the treatment-naive group. The persistent groupconsisted of four eyes (8%) and the recurrent group 10 eyes (19%). The mean time to recurrence was 48.4 ± 30.0 months. Onchi-squared analysis of recurrence risk factors in all patients, the odds ratio for eyes with a history of both focal laser and anti-vascular endothelial growth factor treatments prior to PDT was 2.94 (p = 0.031). Conclusions CSC patients with histories of other treatment are likely to exhibit persistent or recurrent disease after PDT.

We report the result of surgical removal of subfoveal choroidal neovascular membranes[CNVM] in patients older than 50 years. Eleven eyes treated consecutively by submacular surgery were included. Etiology of CNVM was age-related macular degeneration in 7 eyes, myopia in 2 eyes, and idiopathic in 2 eyes. All the eyes had vision of 20/200 or worse and had undergone surgeries within 3 months from the onset of visual symptom. After creation of posterior vitreous detachment, neovascular membranes were completely dissected and removed through 36Gsize retinotomies. No laser photocoagulation was placed to the retinotomies, and air bubble of 30% volume of vitreous cavity was left for tamponade at the end of the surgery. Within one month postoperatively, fluorescein angiogram was obtained and confirmed the absence of residual CNVM in all cases. One eye developed a recurrent CNVM 6 months following surgery and was lasered successfully. At the mean follow-up period of 6.4 months, visual acuity was improved in 6 eyes[55%], unchanged in 4 eyes[36%], and worsened in 1 eye[9%] which suffered from diffuse RPE loss during surgery. Although the visual outcome of submacular surgery is expected to be poor in older patients, surgical approach may be beneficial in carefully selected cases with CNVM for improvement or preservation of vision.
Choroid ; Fluorescein ; Follow-Up Studies ; Humans ; Light Coagulation ; Macular Degeneration ; Membranes* ; Myopia ; Visual Acuity ; Vitreous Detachment

PURPOSE: To investigate the diurnal variation of subjective visual symptoms of diabetic patients and to evaluate its correlation with visual acuity, blood pressure, blood glucose and OCT-measured macular thickness. METHODS: Fifty-five diabetic patients (56 eyes) who were hospitalized for the operation of the fellow eye were enrolled in the study. They underwent optical coherence tomography (OCT) measurements of macular thickness with retinal mapping protocol of OTI/SLO OCT at 5PM, 8PM on operation day, and at 7AM, 10AM on following day. Visual acuity (log MAR), refraction, intraocular pressure, blood glucose and blood pressure were also measured at each time. We surveyed the patients' symptomatic visual variation and its pattern if there is any change over a day. RESULTS: Thirteen patients (25%) had reported changes in their subjective visual symptom over a day according to their blood glucose level. Among twenty-four cases with changes in their subjective visual acuity throughout the exam, only ten showed their real visual acuity change in accordance with their symptoms. CONCLUSIONS: One fourth of our diabetic patients stated fluctuation in their vision according to their blood glucose level, but there were no correlations between visual acuity, blood glucose level and macular thickness.
Blood Glucose ; Blood Pressure ; Diabetic Retinopathy ; Eye ; Humans ; Intraocular Pressure ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity

PURPOSE: To compare 23-gauge transconjunctival sutureless vitrectomy (TSV) and sutured vitrectomy in the aspect of intraocular pressure (IOP) changes and complications. METHODS: Through a retrospective chart review, 45 sutureless patients (48 eyes) and 48 sutured patients (52 eyes) who had undergone 23-gauge transconjunctival vitrectomy by one surgeon (J.H. Sohn) were compared. IOP was measured routinely pre-operativley, at 1 day, 1 week, and 1 month post-operatively. Postoperative IOP, hypotony (IOP<7 mmHg) rates and complications associated with hypotony were assessed respectively. In addition, the cases involving intraocular air or gas tamponade or cataract extraction were compared. RESULTS: One day after the surgery, 3 eyes of the sutureless group developed hypotony,which persisted in 2 eyes through postoperative 1 week. Two eyes of the sutureless group developed hypotony 1 week after the surgery. Most of the hypotony cases were transient, but choroidal detachment occurred in 2 cases, and retinal detachment occurred in 1 case. In contrast, none of the sutured group developed hypotony. Intraocular air or gas tamponade significantly raised IOP 1 day after the surgery. When the operation was combined with cataract extraction, IOP was reduced postoperative 1 week and 1 month. CONCLUSIONS: The well-known risk factor of 23-gauge sutureless vitrectomy is postoperative hypotony. The present study showed postoperative hypotony can result in retinal detachment as a complication in contrast to previous studies. The authors conclude that suturing the wound for the prevention of hypotony is better, especially in cases with high risk of hypotony or definite wound leakage.
Cataract Extraction ; Choroid ; Eye ; Humans ; Intraocular Pressure ; Retinal Detachment ; Retrospective Studies ; Risk Factors ; Vitrectomy