Internal lenticonus is a very rare morphologic abnormality of crystalline lens which has been reported in only several cases in the literature. We herein reported the clinical characteristics and surgical findings of the anterior internal lenticonus accompanied by congenital nuclear cataract. Cataract extraction accompanied with intraocular lens implantation was uneventfully performed, and a good visual outcome was achieved in this case. Viral infection during embryonal and fetal period might account for the formation of the anterior internal lenticonus and congenital nuclear cataract in our case.
Cataract Extraction ; methods ; Humans ; Lens Diseases ; surgery ; Lens Implantation, Intraocular ; methods ; Lens, Crystalline ; abnormalities ; surgery ; Male ; Middle Aged ; Visual Acuity

PURPOSE: The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.
Anterior Eye Segment/injuries ; Aphakia, Postcataract/*surgery ; Cataract/*etiology/physiopathology ; Child ; Child, Preschool ; Endophthalmitis/etiology ; Eye Injuries/*complications ; Female ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular/*methods ; Male ; Postoperative Period ; Retrospective Studies ; Sclera/*surgery ; *Suture Techniques ; Visual Acuity

To investigate the presence of apparent accommodation in monocular pseudopakic eyes and contact lens wearing monocular aphakic eyes, we measured it in 54 monocular pseudophakic eyes (54 patients) and 40 contact lens wearing monocular aphakic eyes (40 patients). The mean apparent accommodation was 1.68+/-1.25 diopters in monocular pseudophakic eyes and 1.74+/-0.73 diopters in contact lens wearing monocular aphakic eyes, and there was no statistically significant difference between them. Apparent accommodation was not related either to type of intraocular lenses or pupil size in pseudophakic eyes and not related to target size in aphakic eyes, but it was influenced by pupil size in aphakic eyes. In the group of patients aged between 45 and 55, accommodation in phakic eyes was significantly greater than apparent accommodation in contralateral contact lens wearing monocular aphakic eyes.
*Accommodation, Ocular ; Adolescent ; Adult ; Aged ; Aphakia, Postcataract/*physiopathology ; Child ; *Contact Lenses ; Humans ; Middle Aged

Survey of causes of blindness on 45,400 eye patients of various hospitals(total 16 in number) in 1970 is attempted. Blindness is defined as visual acuity for distance of 0.1 (20/200) or less in the better eye with best correction. Representation of diagnosis of ocular affection is based on exmination of ophthalmologists and the Standard Classification of Causes of Blindness recommended from the International Association for the Prevention of Blindness (revised) is applied. Estimated number of blindness is 1,162(2.6%). Distribution of blindness cases by age group, is: in male - under 5(2.7%), 6~19(8.2%), 20~44(17.3%), 45~64(12.0%), 65~74(6.4%), 75 and over (3.3%) and in female - under 5(1.8%), 6~19(5.2%), 20~44(11.4%), 45~64(13.6%), 65~74(11.7%), 75 and over(6.4%). Proportion of blindness by causes indicates: Senile cataract (29.7%), Injury and poisoning (13.3%), Refractive errors (11.8%), Infectious diseases (11.3%), Systemic diseases (11.1%), Others (6.5%), Glaucoma (5.4%), and Congenital diseases (2.2%), etc. Rate of blindness by site and type of affection is shown as: Lens diseases (cataract) (38.5%), Optic nerve diseases (12%), Refractive errors (11.6%), Corneal diseases (7.6%), Retinal diseases (7.3%), Glaucoma (6.4%), Atrophia bulbi (3.9%), and Others (3.4%), etc. Some comparisons with different statistics of inland and foreign countries are made. Evaluation of results and problems for a better reliable survey in future are briefly discussed in comment. (Specia] thanks go to our colleagues in ophthalmology at hospitals namely - Drs. Won Shik Yoon, Jung Ja Park, Wun Ho Park, Joon Sup Oh, Sung Koo Choe, Tae Wung Oh, Jae Myung Kim, Yung Tae Jung, In Sang Yoo, Byung Kook Park, Byung II Park, Sung Min Hong, and Bong Yul Kim).
Blindness* ; Cataract ; Classification ; Communicable Diseases ; Corneal Diseases ; Diagnosis ; Female ; Glaucoma ; Humans ; Korea* ; Lens Diseases ; Male ; Ophthalmology ; Optic Nerve Diseases ; Poisoning ; Refractive Errors ; Retinal Diseases ; Visual Acuity

The study was conducted on 20 patients with bilateral lens luxation (40 eyes) and 30 patients with lateral lens luxation (30 eyes), total 70 eyes. All patients were under 25 years old. The results showed that using the vitrectomy Erbe device in lens luxation removal is application of advanced achievements in our condition. It allows achieving the best surgical outcome for lens luxation, giving facilities for inserting artificial lens in later and contributing to regaining the vision of patients. This technique can be applied in facilities where the vitrectomy devices are available for all patients with lens luxation who have indication of operation
Cataract ; Lens Subluxation ; surgery ; therapeutics

PURPOSE: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. METHODS: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. RESULTS: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. CONCLUSIONS: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.
Adult ; Aged ; Aged, 80 and over ; Cataract Extraction ; Female ; Humans ; Iris Diseases/*surgery ; Lasers, Solid-State/*therapeutic use ; Lens Capsule, Crystalline/*surgery ; Lens Diseases/*surgery ; Male ; Middle Aged ; Postoperative Complications/*surgery ; Retrospective Studies ; Tissue Adhesions/surgery ; Visual Acuity

PURPOSE: To report the results of a new technique for intraocular lens scleral fixation of temporary haptic externalization and four-point fixation for enhanced stability. METHODS: Two 10–0 polypropylene strands were fixed at two points 2 mm apart on each haptic of a conventional three-piece intraocular lens, using our previously reported method of temporary haptic externalization after injector implantation. Postoperative refractive outcome and stability were evaluated. RESULTS: Although the intraocular lens was fixed at a total of four points, no intraoperative difficulties were observed during the process. Patients showed successful fixation of the intraocular lens postoperatively. The fixed intraocular lens showed good centering and minimal tilting. When compared to the two-point fixation technique, postoperative astigmatism was significantly smaller in the four-point fixation group (1.80 ± 0.84 vs. 1.00 ± 0.0.50, p = 0.033). Lens-induced astigmatism calculated from subtraction of corneal astigmatism from total astigmatism was also significantly smaller in the four-point fixation group (2.23 ± 0.98 vs.1.17 ± 0.0.70, p = 0.043). No postoperative complications were identified during a mean follow-up period of 14.8 months (range, 10 to 19 months). CONCLUSIONS: By fixing the intraocular lens at two points on each side of the haptics, this method minimizes the tilting of the intraocular lens and thus decreases postoperative lens-induced astigmatism. Also, the possibility of intraocular lens dislocation in the long term might be decreased by this two-point fixation technique.
Aphakia ; Astigmatism ; Cataract ; Dislocations ; Follow-Up Studies ; Humans ; Lens Subluxation ; Lenses, Intraocular ; Methods ; Polypropylenes ; Postoperative Complications

OBJECTIVE: To evaluate the therapeutic efficacy of suture-fixation of foldable intraocular lens for non-posterior-capsular aphakia. METHODS: Akreos intraocular lens (from Bausch-Lamb Company) were selected for operation in aphakia with non-posterior-capsule or less capsule supporting intraocular lens. Complications and visual acuity were observed. RESULTS: There was no significant complication in the operation. Choroidal detachment occurred in 2 eyes postoperatively. Visual acuity of 0.3 accounted for 56.67%, 76.67%, 86.67%, and 90% respectively on the first day, at 1 week, 1 month and 3 months after the operation. CONCLUSION Suture-fixation of Akreos intraocular lens is a good choice for non-posterior-capsular aphakia.
Adult ; Aged ; Aphakia ; surgery ; Aphakia, Postcataract ; surgery ; Female ; Humans ; Lens Implantation, Intraocular ; methods ; Lenses, Intraocular ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; methods ; Suture Techniques

Homocystinuria is an inborn error of methionine metabolism and has several causes. Among the causes, cystathionine-b-synthase deficiency is the most common. The major clinical manifestations are ectopia lectis skeletal deformities, mental retardation and occlusive vascular disease A 16 year old girl was admitted with generalized seizure. She had a history of bilateral lens dislocation and thoracic scoliosis. Her brain MRI and MRA showed mass-like lesions at both frontal area and diffuses, stenosis of the right internal carotid artery She underwent a stereotaxic brain biopsy and cerebral angiography. Two days, after angiography, she was suddenly aggravated to show stuporous mentality and quadriplegia. FoIlow-up brain MRI showed newly developed acute ischemic lesions at both parietal area MR venography confirmed superior sagittal sinus thrombosis. Methionine and homocystine were markedly elevated in plasma and 24 hour urine. She recovered with anticoagulation and vitamin supplementation(folate and pyridoxine). Homocystinuria should be suspected in stroke patients of young age, especially if thy have nontraumatic lens dislocation or marfanoid features. We report a patient with homocystinuria complicated by cerebral venous sinus thrombosis which was aggrevated after cerebral angiography.
Adolescent ; Angiography ; Biopsy ; Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Congenital Abnormalities ; Constriction, Pathologic ; Female ; Homocystine ; Homocystinuria* ; Humans ; Intellectual Disability ; Lens Subluxation ; Magnetic Resonance Imaging ; Metabolism ; Methionine ; Phlebography ; Plasma ; Quadriplegia ; Rabeprazole ; Scoliosis ; Seizures ; Sinus Thrombosis, Intracranial ; Stroke ; Stupor ; Superior Sagittal Sinus* ; Thrombosis* ; Vascular Diseases ; Vitamins

Homocystinuria is an inborn error of methionine metabolism and has several causes. Among the causes, cystathionine-b-synthase deficiency is the most common. The major clinical manifestations are ectopia lectis skeletal deformities, mental retardation and occlusive vascular disease A 16 year old girl was admitted with generalized seizure. She had a history of bilateral lens dislocation and thoracic scoliosis. Her brain MRI and MRA showed mass-like lesions at both frontal area and diffuses, stenosis of the right internal carotid artery She underwent a stereotaxic brain biopsy and cerebral angiography. Two days, after angiography, she was suddenly aggravated to show stuporous mentality and quadriplegia. FoIlow-up brain MRI showed newly developed acute ischemic lesions at both parietal area MR venography confirmed superior sagittal sinus thrombosis. Methionine and homocystine were markedly elevated in plasma and 24 hour urine. She recovered with anticoagulation and vitamin supplementation(folate and pyridoxine). Homocystinuria should be suspected in stroke patients of young age, especially if thy have nontraumatic lens dislocation or marfanoid features. We report a patient with homocystinuria complicated by cerebral venous sinus thrombosis which was aggrevated after cerebral angiography.
Adolescent ; Angiography ; Biopsy ; Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Congenital Abnormalities ; Constriction, Pathologic ; Female ; Homocystine ; Homocystinuria* ; Humans ; Intellectual Disability ; Lens Subluxation ; Magnetic Resonance Imaging ; Metabolism ; Methionine ; Phlebography ; Plasma ; Quadriplegia ; Rabeprazole ; Scoliosis ; Seizures ; Sinus Thrombosis, Intracranial ; Stroke ; Stupor ; Superior Sagittal Sinus* ; Thrombosis* ; Vascular Diseases ; Vitamins