PURPOSE: To report an experience of improving symptoms through treatment with electrocauterization and subconjunctival bevacizumab injection in two patients with keratitis accompanied by corneal neovascularization and opacity. CASE SUMMARY: (Case 1) A 20-year-old woman visited our institution complaining of binocular blurred vision and congestion for the previous 3 years. Her best corrected visual acuity (BCVA) was 0.07 in the right eye and 0.4 in the left eye (Han Chun-suk visual acuity chart, decimal). The diagnosis was bilateral rosacea keratitis. Antibiotics, steroid eye drops and oral antibiotics were administered, but no improvement was observed. Electrocauterization was performed at the origin of the neovascularization of the cornea and bevacizumab was injected at the peripheral subconjunctiva in the right eye. Thereafter the corneal neovascularization did not recur, corneal opacity was reduced, and BCVA improved to 0.5. (Case 2) A 19-year-old woman visited complaining of left eye congestion for the previous 3 years. Her BCVA was 1.0 in the right eye and 0.08 in the left eye.The diagnosis was phlyctenular keratitis of the left eye. Antibiotics, steroid eye drops and oral antibiotics were administered, but no improvement was observed. Therefore, electrocauterization and subconjunctival bevacizumab injection were performed in the cornea of the left eye, after which corneal neovascularization and opacity decreased. CONCLUSIONS: In these cases, we report improvement of symptoms after treatment with electrocauterization and subconjunctival bevacizumab injection after failed treatment of palpebral sanitation, antibiotic and steroid.
Anti-Bacterial Agents ; Bevacizumab* ; Cornea ; Corneal Neovascularization* ; Corneal Opacity ; Diagnosis ; Electrocoagulation ; Estrogens, Conjugated (USP) ; Female ; Humans ; Keratitis ; Ophthalmic Solutions ; Rosacea ; Sanitation ; Telescopes ; Visual Acuity ; Young Adult

PURPOSE: To evaluate differences between dominant and non-dominant eyes by analyzing angle kappa in dominant and non-dominant eyes. METHODS: Fifty-seven subjects who had best corrected visual acuity 20/20 in the better-seeing eye and no underlying ocular disease were recruited. Ocular dominance was determined using the hole-in-the-card test. Corneal topography, refractive error, intraocular pressure (IOP), and axial length were evaluated in both eyes. RESULTS: On corneal topography examination, the angle kappa and white-to-white measurements were significantly smaller in the dominant eye than the non-dominant eye (p = 0.013 and p = 0.045, respectively). However, no significant differences in sim K's' astigmatism (p = 0.210), central corneal thickness (p = 0.533), and anterior chamber depth (p = 0.216) were observed. In addition, cylindrical powers of the subjects measured by autorefraction (AR) were significantly lower in the dominant eye (p = 0.026); however no differences in spherical equivalent measured by AR (p = 0.061), IOP measured using pneumonic tonometer (p = 0.536), or axial length measured using laser biometry (p = 0.093) were observed. CONCLUSIONS: In this study, we found the angle kappa a new factor in determining the dominant and non-dominant eye. Difference in axial length and spherical equivalent between dominant and non-dominant eye may be associated with the difference in angle kappa.
Anterior Chamber ; Astigmatism ; Biometry ; Corneal Topography ; Dominance, Ocular ; Intraocular Pressure ; Refractive Errors ; Visual Acuity

PURPOSE: To report a case of successful treatment of Alternaria species infection after corneal tattooing using penetrating keratoplasty corneal perforation. CASE SUMMARY: A 65-year-old male underwent corneal tattooing for corneal opacity of the left eye. One month later, epithelial defect and necrosis of the left eye were observed, thus a smear and culture were performed and Alternaria species were cultured. He was treated with 0.3% amphotericin B-fortified eyedrops and Itraconazole oral medication; however, 3 weeks later, corneal perforation of the left eye was observed and penetrating keratoplasty was performed. Postoperatively, due to persistent increased intraocular pressure, trabeculectomy was performed. Two months later, donor cornea was well-grafted and recurrent keratitis was not observed. CONCLUSIONS: Corneal tattooing can cause damage to the corneal epithelium and anterior stroma and increase the risk of infection when using steroids. In the case of infection, detecting and differentiating the type of microorganisms are more difficult. Therefore, proper care and close monitoring for the signs of infection are important during and after the surgery.
Aged ; Alternaria* ; Amphotericin B ; Cornea ; Corneal Opacity ; Corneal Perforation ; Epithelium, Corneal ; Fungi ; Humans ; Intraocular Pressure ; Itraconazole ; Keratitis ; Keratoplasty, Penetrating ; Male ; Necrosis ; Ophthalmic Solutions ; Steroids ; Tattooing* ; Tissue Donors ; Trabeculectomy

Purpose: We assessed changes in ocular biometrics following Ahmed valve implantation. Methods: We conducted a retrospective analysis involving 76 eyes of 76 glaucoma patients who underwent Ahmed valve implantation; these patients were followed up for 6 months. Preoperative data, including age, intraocular pressure (IOP), refractive status, axial length, central corneal thickness, anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior and posterior keratometry, were evaluated preoperatively and at 1 week, 1 month, and 6 months postoperatively. Results: The mean IOP exhibited a significant reduction from 39.17 ± 14.06 mmHg preoperatively to 11.43 ± 3.25 mmHg (p < 0.001), 13.18 ± 4.64 mmHg (p < 0.001), and 12.95 ± 4.37 mmHg (p < 0.001) at 1 week, 1 month, and 6 months postoperatively, respectively. Furthermore, the axial length exhibited a significant post-surgery reduction, measuring 23.74 ± 2.01 mm preoperatively and 23.48 ± 1.86 mm (p < 0.001), 23.57 ± 1.94 mm (p < 0.001), and 23.61 ± 1.98 mm (p = 0.002) at 1 week, 1 month, and 6 months postoperatively, respectively. However, no significant changes were observed in various other parameters, such as anterior and posterior keratometry, refractive status, ACA, ACD, or ACV, at 6 months post-surgery (p > 0.05). Conclusions Ahmed valve implantation resulted in a significant reduction in axial length. Furthermore, it had transient but non-significant effects on keratometry, refractive status, ACA, ACD, and ACV at 6 months after surgery.

Purpose: We report a patient diagnosed with corneal keloid who had laser-assisted in-situ keratomileusis (LASIK).Case summary: A 41-year-old female presented with LASIK 15 years ago. Seven years later, she presented with a growing white corneal mass located in the lower periphery of the right cornea. The best-corrected visual acuity was 0.6 in the right eye and 0.7 in the left eye, and the white lesion was observed in the right cornea at the 5 o’clock position. Anterior segment optical coherence tomography revealed that the mass was invaded by the upper stroma and epithelium, and Bowmans’s membrane was destroyed. Histopathologic examination showed fusiform fibroblasts and disorganized collagen. Taken together, these findings suggested corneal keloids. Conclusions Corneal keloids is a rare disease that develops, sometimes, after LASIK surgery. Although there have been cases of this reported in the literature, there had yet to be a case of LASIK-induced corneal keloids in Korea until this study, reported here.

Purpose: We report a patient diagnosed with corneal keloid who had laser-assisted in-situ keratomileusis (LASIK).Case summary: A 41-year-old female presented with LASIK 15 years ago. Seven years later, she presented with a growing white corneal mass located in the lower periphery of the right cornea. The best-corrected visual acuity was 0.6 in the right eye and 0.7 in the left eye, and the white lesion was observed in the right cornea at the 5 o’clock position. Anterior segment optical coherence tomography revealed that the mass was invaded by the upper stroma and epithelium, and Bowmans’s membrane was destroyed. Histopathologic examination showed fusiform fibroblasts and disorganized collagen. Taken together, these findings suggested corneal keloids. Conclusions Corneal keloids is a rare disease that develops, sometimes, after LASIK surgery. Although there have been cases of this reported in the literature, there had yet to be a case of LASIK-induced corneal keloids in Korea until this study, reported here.

Purpose: We compared visual field progression among patients with primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). Methods: A total of 115 POAG, 123 NTG, and 92 PACG eyes were retrospectively analyzed. Global VF progression was evaluated by calculating the changes of mean deviations. To examine local VF deterioration, scotoma enlargement and deepening were analyzed in the superior, and inferior arcuate, and the central, zones. Results: The mean global rate of change in POAG eyes was -0.52 ± 0.74 dB/year, and -0.35 ± 0.41, and -0.38 ± 0.45 dB/year in NTG and PACG eyes; POAG eyes showed significantly more rapid progression than NTG and PACG eyes (p < 0.01). The superior arcuate zone of POAG eyes, the central zone of NTG eyes, and the inferior arcuate zone of PACG eyes exhibited more scotoma enlargement and scotoma deepening than did other zones. Conclusions The superior arcuate zone of POAG eyes, the central zone of NTG eyes, and the inferior arcuate zone of PACG eyes showed greater VF progression.

Nonsurgical endoscopic or percutaneous dilatation and insertion of an endoprosthesis is the treatment of choice in the majority of patiens with incurabie malignant biliary obsturction. But these palliative treatment of extrahepatic cholestasis with an endoscopic or percutaneous biliary endoprosthesis is limited by clogging. One of the factors thought to be of importance is the diameter of the stent. So in order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. Wallstent is braided in the form of a tubular mesh from surgical grade stainless alloy. This prosthesis is geometrically stable, pliable and self expanding. Its elastic properties are such that its diameter can be substantially reduced by moderate elongation. The stent is constrainded on a small diameter delivery catheter(total outside diameter: 9 French). During the implantation procedure the final position of the partially released endoprosthesis can be adjusted by gradual removal of the delivery catheter. If full expansion to 30 French occurs, the stent will be shortened by approximately 30% to their normal length range between 34-102mm. Now in this article we report a new method for endoscopic retrograde placement of biliary Wallstent in a patient with obsturctive jaundice due to periampullary choangiocacrcinoma.
Alloys ; Catheters ; Cholestasis, Extrahepatic ; Dilatation ; Endoscopes ; Humans ; Jaundice ; Palliative Care ; Prostheses and Implants ; Stents

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.
Cesarean Section ; Child ; Diagnosis ; Dwarfism ; Extremities ; Female ; Humans ; Hypertension ; Liver Failure ; Pelvic Bones ; Pregnancy ; Recurrence ; Renal Insufficiency ; Thorax ; Uremia

PURPOSE: Introduction of phacoemulsification and development of foldable artificial lens has facilitated smaller incisions, even micro-coaxial incisions. However, there have been several studies showing that micro-coaxial incision has no benefit compared with the conventional small incision method. Cases where Ellips ultrasound was used have not yet been reported. Therefore, we compared the postoperative results between 2.2-mm and 2.8-mm incision groups using Ellips ultrasound. METHODS: Among 49 eyes receiving cataract surgery from March, 2012 to August, 2012, 27 eyes in the 2.2-mm group and 22 eyes in the 2.8-mm group were examined to obtain cumulated dissipated energy (CDE), use of balanced salt solution (BSS), best-corrected visual acuity (BCVA), corneal endothelial cell count (ECC), corneal thickness at center and incision site, and keratometric astigmatism before and after surgery. RESULTS: There were no statistically significant differences between the 2.2-mm and 2.8-mm groups in CDE (2.5 +/- 2.0 vs. 2.5 +/- 2.3) and use of BSS (188 +/- 127 vs. 138 +/- 43 mL) during the surgery, BCVA (-0.45 +/- 0.62 vs. -0.55 +/- 0.79 log MAR), ECC (-178 +/- 210 vs. -99 +/- 114 cells/mm2), corneal thickness at center (23 +/- 23 vs. 27 +/- 23 microm) and incision site (24 +/- 19 vs. 27 +/- 19 microm) and keratometric astigmatism before and after the surgery. CONCLUSIONS: A 2.2-mm micro-coaxial incision using Ellips ultrasound showed no statistically significant differences in BCVA, ECC, corneal thickness at center and incision site, and keratometric astigmatism compared with 2.8-mm small incision.
Astigmatism ; Cataract* ; Endothelial Cells ; Phacoemulsification ; Ultrasonography* ; Visual Acuity