No abstract available.
Carbon* ; Knee*

The Congenital Ulnar Drift of the fingers is a relatively uncommon and has symmetrical malformations of hand, face and foot characterized by MP joint flexion contracture and ulnarward deviation of the fingers and microstomia, In tarsal deformity, there are clubfoot and congenital vertical talus with rocker bottom deformity. In treatment, the report of the surgical treatment was rare. We experienced congenital ulnar drift of fingers in 2 patients in one family, which were treated by dome resection corrective osteotomy of the metacarpals. Therefore remarkable symptomatic improvement was obtained.
Clubfoot ; Congenital Abnormalities ; Contracture ; Fingers ; Foot ; Hand ; Humans ; Joints ; Metacarpal Bones ; Microstomia ; Osteotomy ; Talus

We compared palpebral fissure height according to horizontal fixation direction in normal subjects, strabismic patients[exotropia, esotropia, abducens nerve palsy], and patients with Duane's retraction syndrome. We respectively measured the palpebral fissure height of 39 normal subjects [78 eyes], 37 exotropia patients[74 eyes], 17 esotropia patients[34 eyes], 6 patients of abducens nerve palsy[6 eyes], and 8 patients with Duane's retraction syndrome[12 eye]. Measurements were obtained from standardized photographs in primary position, 30-degree adduction and abduction and maximum adduction and abduction of both eyes. The palpebral fissure height of normal subjects and exotropia patients was maximal in primary position and minimal in maximum adduction and abduction. On the other side, the palpebral fissure height of esotropia patients was maximal in 30 degree abduction. On the base of the height in primary position, the fissure height of normal subjects was 90%in maximum abduction and 89%in maximum adduction. But the fissure height of Duane's retraction syndrome was 103%in maximum abduction and 69%in maximum adduction. In normal group and exotropia, the fissure narrowed according to the degree of adduction and abduction, and in esotropia and abducens nerve palsy, the palpebral fissure of abducting eye was wider than that of primary position. In Duane's retraction syndrome the palpebral fissure of adducting eye markedly narrowed and the difference between the fissure height in maximum adduction and maximum abduction made diagnostic value in comparison to normal group.
Abducens Nerve ; Abducens Nerve Diseases ; Duane Retraction Syndrome ; Esotropia ; Exotropia ; Humans

PURPOSE: To evaluate the efficacy of anterior segment swept-source optical coherence tomography (SS-OCT) for examining horizontal extraocular muscle thickness, distance from the corneal limbus to the insertion of the horizontal extraocular muscle (limbus to insertion distance), and scleral thickness in Korean pediatric strabismus patients. METHODS: This study included pediatric strabismus patients between 5 and 10 years of age. Children with any ocular disease other than strabismus or a history of ocular surgery were excluded. SS-OCT was used to measure horizontal extraocular muscle thickness, limbus to insertion distance, and scleral thickness. Eyes were classified into subgroups by sex, spherical equivalent of the refractive error (measured with cycloplegic refraction), and fixating/deviating eye. RESULTS: One patient initially included in this study was excluded due to poor cooperation. Of the remaining 35 eyes of 20 patients, 19 eyes (54.3%) were from male patients and 16 eyes (45.7%) were from female patients. The mean patient age was 7.86 ± 1.38 years. Lateral scleral thickness was greater in male eyes than in female eyes (p = 0.048). No other differences were noted between male and female children. Additionally, there were no statistically significant differences between fixating and deviating eyes or among spherical equivalent groups for any parameter examined. CONCLUSIONS: Anterior segment SS-OCT can successfully and comfortably measure horizontal extraocular muscle and scleral anatomy in children. These measurements may be helpful for treatment and follow-up of pediatric strabismus patients.
Child* ; Female ; Follow-Up Studies ; Humans ; Limbus Corneae ; Male ; Oculomotor Muscles ; Refractive Errors ; Sclera ; Strabismus ; Tomography, Optical Coherence*

PURPOSE: The purpose of this study is to compare the surgical outcomes and near stereoacuities after unilateral medial rectus (MR) muscle resection and lateral rectus (LR) recession according to deviation angle in basic intermittent exotropia, X(T). METHODS: Ninety patients with basic type X(T) were included in this study. They underwent unilateral recession of the LR and resection of the MR and were followed postoperatively for at least 12 months. Patients were divided into three groups according to their preoperative deviation angle: group 1 < or =20 prism diopter (PD), 20 PD< group 2 <40 PD, and group 3 > or =40 PD. Surgical outcomes and near stereoacuities one year after surgery were evaluated. Surgical success was defined as having a deviation angle range within +/-10 PD for both near and distance fixation. RESULTS: Among 90 patients, groups 1, 2, and 3 included 30 patients each. The mean age in groups 1, 2, and 3 was 9.4 years, 9.4 years, and 11.0 years, respectively. The surgical success rates one year after surgery for groups 1, 2, and 3 were 80.0%, 73.3%, and 73.3% (chi-square test, p = 0.769), respectively. The undercorrection rates for groups 1, 2, and 3 were 16.7%, 23.3%, and 26.7%, and the overcorrection rates were 3.3%, 3.3%, and 0%, respectively. The mean preoperative near stereoacuities for groups 1, 2, and 3 were 224.3 arcsec, 302.0 arcsec, and 1,107.3 arcsec, and the mean postoperative near stereoacuities were 218.3 arcsec, 214.7 arcsec, and 743.0 arcsec (paired t-test; p = 0.858, p = 0.379, p = 0.083), respectively. CONCLUSIONS: In basic X(T) patients, the amount of angle deviation has no influence on surgical outcomes in unilateral LR recession and MR resection. The near stereoacuities by one year after LR recession and MR resection for intermittent X(T) were not different among patient groups separated by preoperative deviation angle.
Child ; Exotropia/physiopathology/*surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Oculomotor Muscles/physiopathology/*surgery ; *Ophthalmologic Surgical Procedures ; Retrospective Studies ; Treatment Outcome ; Vision, Binocular/physiology ; Visual Acuity/physiology

PURPOSE: The purpose of this study was to compare and differentiate the clinical characteristics of intermittent exotropia (X(T)) in children and adults. METHODS: This study included 398 patients with X(T): 360 children ranging in age from 1 to 14 years and 38 adults over 15 years of age. Patients with neurological abnormalities or developmental delays were excluded. Clinical characteristics of interest included sex, age on first visit, age of onset, type of onset, duration to surgery, family history, chief complaints, type of fixation, refractive errors, sensory tests, angle of deviation, fundus examination, oblique muscle dysfunction, and other associated ocular disorders. RESULTS: In both groups, an insidious onset was more common than a sudden onset (p=0.033). Outward deviation was the most common chief complaint in both groups, followed by photophobia in the childhood group, and diplopia in the adult group. The most common subtype of X(T) was the basic type. The mean near deviation was 23.6+/-7.9 prism diopters (PD) in the childhood group and 30.7+/-12.2 PD in the adult group (p=0.01). The mean distance deviation was 23.4+/-6.1 PD and 28.3+/-11.2 PD in the childhood and adult groups, respectively (p=0.028). The rate of fusion, measured with the Worth 4-dot test at near and distance was higher in the childhood group, as compared to the adult group (p=0.024 and p=0.048, respectively). CONCLUSIONS: Among X(T) patients, the chief complaints, angle of deviation, and Worth 4-dot tests showed significant differences between the childhood and adult groups. Therefore, these are important factors to consider when assessing adults and children with X(T).
Adolescent ; Adult ; Age of Onset ; Chi-Square Distribution ; Child ; Child, Preschool ; Exotropia/*diagnosis/physiopathology/*surgery ; Female ; Humans ; Infant ; Male ; Retrospective Studies

PURPOSE: We studied change of eye position according to surgical amount with strabismus surgery under general anesthesia. METHODS: The 101 horizontal strabismus patients were classified into 5 groups and analyzed according to strabismus type, surgical method, and surgical amount. Group I had less than 7 mm recession in exotropia;, group II, was more than 7 mm recession in exotropia;, group III, was recession and resection in exotropia;, group IV, was less than 5.5 mm recession in esotropia;, group V, was more than 5.5 mm recession in esotropia. We measured eye position, corneal reflex and medial limbus by photographic measurement taken at a distance of 40 cm form the patient in the supine position. RESULTS: The mean amount of convergence in exotropia group I was 8.93+/-2.21PD, exotropia group II was 9.64+/-3.50PD, exotropia group III was 10.77+/-4.11PD. The mean amount of divergence of esotropia group IV was 6.62+/-2.10PD, esotropia group V was 7.88+/-2.90PD. The exotropia and esotropia groups were not statistically different from each other (P>0.05). The correlation coefficient according to surgical amount was 0.18 in exotropia groups, 0.01 in esotropia groups. CONCLUSIONS: The change of eye position according to surgical amount showed a weak positive correlation in exotropia groups, but showed no correlation in esotropia groups. Postoperative mean change in eye position was distributed from 9.26PD to 10.90PD in the exotropia group, from 6.10PD to 7.83PD in the esotropia group with 95% confidence interval and was difficult to expect overcorrection and undercorrection after awaking from anesthesia.
Anesthesia ; Anesthesia, General* ; Esotropia ; Exotropia ; Humans ; Reflex ; Strabismus* ; Supine Position

PURPOSE: Study by result analysis the proper recession amount according to the deviation angle after unilateral lateral rectus recession in exodeviation. METHODS: A retrospective analysis data from 139 patients who underwent unilateral lateral rectus recession with 15~24PD exodeviation and monitored for 12 months or longer was performed. The analyzed patients were divided into 7.5 mm, 8 mm, 8.5 mm, 9 mm, 9.5 mm groups according to the surgical amount of recession and 15~18PD, 19~20PD, 21~24PD groups according to the deviation angle. The strabismus surgery and results analyses were based on distance deviation. Alignment within 4PD of esodeviation and 10PD of exodeviation was considered a surgical success. RESULTS: The success rates were 53.8% for the 15~18PD group and 40% for the 19~20PD group in the 7.5 mm recession group, 77.7% for the 15~18PD group and 66.7% for the 19~20PD group and 63.6% for the 21~24PD group in the 8 mm recession group, 100% for the 15~18PD group and 81.2% for the 19~20PD group and 72.7% for the 21~24PD group in the 8.5 mm recession group, 83.3% for the 15~18PD group and 85.7% for the 19~20PD group and 83.3% for the 21~24PD group in the 9 mm recession group, 100% for the 19~20PD group and 76.9% for the 21~24PD group in the 9.5 mm recession group at 1 year postoperative. The rates of -1 abduction limitation were respectively 3.1%, 12% and 21.4% in the 8.5 mm, 9 mm and 9.5 mm recession groups and the rate of -2 abduction limitation was 14.3% in the 9.5 mm recession group at 1 year postoperative. CONCLUSIONS: Considering the success state and abduction limitaions, the proper surgical amount of recession is 8.5 mm in the 15~18PD group and 9 mm in the 19~20PD and 21~24PD groups.
Esotropia ; Exotropia* ; Humans ; Retrospective Studies ; Strabismus

Postoperative pancreatic fistula (POPF) combined with postoperative fluid collection, bleeding and abscess formation is one of the most critical morbidities after distal pancreatectomy or pancreaticoduodenectomy. Percutaneous catheter drainage has been commonly used for managing for the postoperative management of abnormal fluid collection. Removal of the catheter is rarely associated with occurrence of life-threatening complication such as serious liver damage. Herein, we report a case of unexpected fatal liver injury complicated by percutaneous catheter drainage treatment after distal pancreatosplenectomy in a patient with pancreatic cancer. We suggest that prudent decision for timing of catheter removal and meticulous care during procedure can reduce the possibility of major liver injury in patients with percutaneous transhepatic catheter drainage.
Abscess ; Catheters* ; Drainage* ; Hemorrhage ; Humans ; Liver* ; Pancreatectomy ; Pancreatic Fistula ; Pancreatic Neoplasms* ; Pancreaticoduodenectomy

PURPOSE: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. METHODS: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. RESULTS: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group) to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D, respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. CONCLUSIONS: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism.
Astigmatism ; Eye ; Humans ; Intraocular Pressure ; Lenses, Intraocular ; Myopia ; Patient Satisfaction ; Retrospective Studies ; Visual Acuity