PURPOSE: To investigate the long-term results and complications of orbital wall fracture reconstruction using the bioabsorbable orbital implant, Macropore(R) orbital floor liner. METHODS: This retrospective study included patients who underwent the reconstruction of an orbital wall fracture using Macropore(R) orbital floor liner and completed a postoperative follow-up longer than 6 months. The enophthalmic values as well as the data of ocular movement and diplopia was collected from the medical records of each patient and analyzed. RESULTS: A total of 35 patients were evaluated with an average follow-up period of 14.0 months. The average enophthalmic value of 29 patients, whose reconstruction was primarily indicated from enophthalmic tissue, was 0.90 mm at the last follow-up. No significant progression of enophthalmos was observed at postoperative 12, 18 and 24 months when compared with the enophthalmic value at postoperative 6 months. All 15 patients who have had the limitation of ocular movement or diplopia preoperatively resolved completely or improved to the degree that no clinically significant limitation or diplopia further existed. No complications such as dislocation of implant, infection, and aggravation of ocular limitation were observed during the follow-up period. CONCLUSIONS: Macropore(R) orbital floor liner may be regarded as a useful implant in reconstruction of orbital wall fracture with no significant implant-related complications during its absorption.
Absorption ; Diplopia ; Dislocations ; Enophthalmos ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Medical Records ; Orbit ; Orbital Implants ; Retrospective Studies

PURPOSE: To compare the exposure rates of two wrapping materials for hydroxyapatite (HA) ocular implants (Tutoplast(R) vs. vicryl mesh). METHODS: We reviewed the medical records of 137 eyes of 137 patients who had received intraorbital HA implantation from March 1997 to March 2001. RESULTS: We used Tutoplast(R) in 72 patients and vicryl mesh in 65 patients. The mean follow-up period was 22.1 months. Implant exposure developed in four cases of eyes using vicryl mesh. No case of exposure occurred in eyes using Tutoplast(R). The mean period from operation and implant exposure was 3.5 weeks (1.5~5 weeks). CONCLUSIONS: When vicryl mesh was used as the wrapping material for HA intraorbital implant it is advisable to pay more attention to the possible postoperative implant exposure than when Tutoplast(R) was used.
Durapatite* ; Follow-Up Studies ; Humans ; Medical Records ; Orbit* ; Orbital Implants* ; Polyglactin 910*

PURPOSE: To evaluate the influence of a silicone tube on tear drainage in patients with a healed rhinostomy site after dacryocystorhinostomy. METHODS: The subjects of the present study included the patients for whom the removal of a silicone tube was performed after dacryocystorhinostomy for acquired nasolacrimal duct obstruction. The silicone tube was removed after the rhinostomy site was completely healed. The tear drainage function was evaluated using the fluorescein dye disappearance test at the following 3 time points: immediately before, immediately after, and 1 month after silicone tube removal. In addition, a Schirmer test was performed and tear break-up time was measured at each time point. To study the correlation between the measured values and subjective tearing symptoms, self-report questionnaires were given to each patient at his/her last visit. RESULTS: The 3 measured values showed no statistical difference between the 3 time points, immediately before, immediately after, and 1 month after silicone tube removal. When the patients were divided into groups according to their subjective symptomatic changes after silicone tube removal, no group showed statistically significant difference in the 3 measured values before, between, and after silicone tube removal. CONCLUSIONS: In patients with a healed rhinostomy site after dacryocystorhinostomy, the removal of the silicone tube did not induce a change of tear drainage function. Therefore, based on the results from the present study, a silicone tube may not have influence on tear drainage functions.
Dacryocystorhinostomy ; Drainage ; Fluorescein ; Humans ; Nasolacrimal Duct ; Surveys and Questionnaires ; Silicones ; Tears

PURPOSE: The purpose of this study is to investigate the effect on intraocular pressure (IOP) of sutureless clear corneal phacoemulsification with foldable posterior intraocular lens implantation. METHODS: We measured the IOP using both a non-contact pneumotonometer and a Goldmann applanation tonometer preoperatively and postoperatively (1, 3, 10, 30, 60 and 90 days). In operation, the incision site was determined depending on the axis of preoperative corneal astigmatism and divided into two groups: Temporal (Group 1) and Superior clear corneal incision (Group 2). It is postulated that if there is more damage to the surrounding tissue in superior incision group due to poorer surgical accessibility than temporal group, it may affect on postoperative IOP. RESULTS: The mean preoperative IOP of Group 1 (59 eyes) and Group 2 (41 eyes) were 14.6 mmHg and 14.3 mmHg respectively. At postoperative 1 day, the IOP decreased in both groups by 14.2 mmHg and 14.0 mmHg respectively (p>0.05), and at 3 days, 13.1 mmHg and 13.2 mmHg respectively (p<0.05). And from then on, there was no statistically significant change to 3 months. The mean IOP of postoperative 3 months was 12.9 mmHg in both groups; decreased to 1.7 mmHg and 1.4 mmHg respectively compared to preoperative value (p<0.05). In all periods of this study, there was no significant difference between two groups and between two methods of measurement. CONCLUSIONS: These results suggest that in case of uncomplicated senile cataract, sutureless clear corneal phacoemulsification with foldable posterior intraocular lens implantation reduces the IOP in short term follow up period.
Astigmatism ; Axis, Cervical Vertebra ; Cataract Extraction ; Cataract* ; Follow-Up Studies ; Intraocular Pressure* ; Lens Implantation, Intraocular ; Phacoemulsification

PURPOSE: To report the results of surgical repairing of inferomedial orbital wall fractures accompanied with loss of bony strut by an overlapping method using Resorb X(R) plates (poly(D,L)-lactic acid). METHODS: To repair inferomedial orbital wall fractures with loss of bony strut, we bent the medial aspect of the plate for floor fracture according to the anatomical structure and then inserted the floor implant, which was supported by anterior, posterior and lateral margins of the floor fracture. Then, the medial implant, which was supported by the bent medial edge of the floor implant, was inserted. Postoperatively, we analyzed the outcomes of 21 patients regarding postoperative enophthalmos, limitation of eye movement (LOM) and diplopia. The diagonal lengths of the orbit in the operated side were compared with the non-traumatized side based on the coronal view of the postoperative CT scans to determine the success or failure of the reconstruction. RESULTS: The average postoperative enophthalmic value was 0.5 mm, and no significant differences between the orbital diagonal lengths of the operated and non-operated eyes were observed. The LOM shown in 7 out of 8 patients was completely resolved during the postoperative follow-up period. All patients with diplopia, including one patient who showed partial remission of LOM, experienced complete symptom resolution. No other complications related to the implant were recorded. CONCLUSIONS: Inferomedial orbital wall fractures with the loss of bony strut can be successfully repaired by the overlapping method using Resorb X(R) implants.
Diplopia ; Enophthalmos ; Eye ; Eye Movements ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Orbit ; Orbital Implants

PURPOSE: To compare postoperative recurrence rates between conjunctival autograft transplantation alone and conjunctival autograft transplantation with amniotic membrane transplantation in primary pterygium surgery. METHODS: The authors conducted a retrospective analysis of 66 eyes from 62 patients who underwent primary pterygium surgery from January 2001 to May 2009. Twenty three eyes underwent conjunctival autograft transplantation alone, 43 eyes underwent conjunctival autograft transplantation with amniotic membrane transplantation. RESULTS: Recurrence of pterygium was observed in 5 of 23 eyes that received conjunctival autograft transplantation alone. There were 2 cases of recurrence of 43 eyes that received conjunctival autograft transplantation and amniotic membrane transplantation. No major complications such as necrotizing scleritis, sclera ulcer, or corneal perforation were observed in either group after surgery. CONCLUSIONS: The present study showed that receiving both conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery has a lower recurrence rate than conjunctival autograft transplantation alone.
Amnion ; Corneal Perforation ; Eye ; Humans ; Membranes ; Pterygium ; Recurrence ; Retrospective Studies ; Sclera ; Scleritis ; Transplants ; Ulcer

PURPOSE: To investigate the role of gangliosides in the differentiation of orbital fibroblasts into adipocytes, a component in the pathogenesis of Graves' ophthalmopathy. METHODS: Orbital tissues were obtained during orbital surgery for subjects without Graves' ophthalmopathy or other inflammatory orbital disease, and orbital fibroblasts were primarily cultured from each obtained tissue. Morphological examination of orbital fibroblasts was performed after treatment with commercially available gangliosides mixture (Gmix) comprised of several subtypes. To determine the effect of Gmix on the differentiation of orbital fibroblasts into adipocytes and the differentiation-related genes, Oil Red-O staining and RT-PCR were performed. RESULTS: The treatment with Gmix induced the morphological changes, which at least in part were explained with the differentiation of orbital fibroblasts into adipocytes in accordance with the increase of mRNA level of genes known to be related to adipogenesis, whereas dermal fibroblasts and preadipocytes were irresponsive to the same treatment. CONCLUSIONS: The results from the present study suggest gangliosides may have a role in pathologic mechanisms of Graves' ophthalmopathy by the induction of differentiation of orbital fibroblasts into adipocytes.
Adipocytes ; Adipogenesis ; Fibroblasts ; Gangliosides ; Orbit ; Orbital Diseases ; RNA, Messenger

PURPOSE: The purpose of this study is to investigate the effect of the suction time in forming the corneal flap with microkeratome on the corneal flap thickness. METHODS: Thirty porcine eyes were randomly assigned into 3 groups according to suction duration: group 1(10 sec), group 2(35 sec) and group 3(60 sec). The Hansatome microkeratome with 160 plate and a suction ring with 8.5mm diameter were used to create corneal flap. The thickness of central cornea was measured with automated ultrasound pachymeter before the procedure. And after making the flap, the remained corneal thickness was measured with the same method. Then, the difference between the two values was thought to be the corneal flap thickness. RESULTS: The mean corneal flap thickness in group1, 2, and 3 were 91.0+/-24.1 micromiter, 110.1+/-8.9 mu m and 127.2+/-6.1 mu m, respectively. The difference was significant among the three groups(p=0.010), and the longer suction duration made the flap thicker. CONCLUSIONS: These results suggest that in forming the corneal flap with microkeratome, the suction duration has an effect on the corneal flap thickness and an increase of suction duration makes the flap thicker in porcine eyes.
Cornea ; Suction* ; Ultrasonography

PURPOSE: To investigate the outcome of frontalis suspension surgery congenital blepharoptosis with poor levator palpebral muscle function using preserved fascia lata with direct tarsal and frontalis fixation method. METHODS: Twelve congenital ptosis patients (fourteen eyes) who underwent frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method between July 1999 and June 2002 with the mean follow-up time of 54.8 months (31 months~78 months) included. And the postoperative results were obtained from medical records retrospectively. RESULTS: The desired lid height was achieved in eight out of twelve patients (71.4%) after surgery. In four patients (4 eyes) (28.6%), adjustment was required due to under-correction within one month postoperatively. At a mean follow-up period of 54.8 months, all twelve patients had good final results with no postoperative complications. CONCLUSIONS: Frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method provided cosmetically pleasing results with a low rate of ptosis recurrence and complication related to procedures. This method using preserved facia lata could be considered as alternative to the use of autogenous facia lata for the repair of ptosis.
Blepharoptosis ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Medical Records ; Postoperative Complications ; Recurrence ; Retrospective Studies

PURPOSE: To investigate the outcome of frontalis suspension surgery congenital blepharoptosis with poor levator palpebral muscle function using preserved fascia lata with direct tarsal and frontalis fixation method. METHODS: Twelve congenital ptosis patients (fourteen eyes) who underwent frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method between July 1999 and June 2002 with the mean follow-up time of 54.8 months (31 months~78 months) included. And the postoperative results were obtained from medical records retrospectively. RESULTS: The desired lid height was achieved in eight out of twelve patients (71.4%) after surgery. In four patients (4 eyes) (28.6%), adjustment was required due to under-correction within one month postoperatively. At a mean follow-up period of 54.8 months, all twelve patients had good final results with no postoperative complications. CONCLUSIONS: Frontalis suspension using preserved fascia lata with direct tarsal and frontalis fixation method provided cosmetically pleasing results with a low rate of ptosis recurrence and complication related to procedures. This method using preserved facia lata could be considered as alternative to the use of autogenous facia lata for the repair of ptosis.
Blepharoptosis ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Medical Records ; Postoperative Complications ; Recurrence ; Retrospective Studies