PURPOSE: To evaluate the efficacy of vitrectomy in patients with diabetic macular edema. METHODS: The results of pars plana vitrectomy in 10 eyes were analyzed. Major outcome measurements were preoperative and postoperative best corrected visual acuity, fundus findings of macula, and postoperative complications. All eyes had at least 4 months of follow- up after surgery. RESULTS: The improvement of visual acuity up to 2 lines on the chart was found in 5 eyes (50%) after the surgery and six eyes (60%) showed improvement in macular edema. The complications after surgery were vitreous hemorrhage in 1 eye and submacular exuadates in 1 eye. CONCLUSIONS: Vitrectomy may be beneficial for patients with diabetic macular edema.
Humans ; Macular Edema* ; Postoperative Complications ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

We analysed a retrospective study of 22 aphakic bullous keratopathy patients (22 eyes) with penetrating keratoplasty for 5 years from January 1987 to December 1991 in the Department of Ophthalmology at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Of the 22 eyes with aphakic bullous keratopathy 16 eyes (72.7%) had previously undergone intracapsular cataract extraction, 6 eyes (27.3%) had extracapsular cataract extraction. 2. The mean time from cataract extraction to aphakic bullous keratopathy to penetrating keratoplasty was 13.8 months. 3. After keratoplasty, the visual acuity of 20 among the 22 transplants (90.9%) were significantly improved compared to the preoperative levels, however that of 2 among the 22 transplants were worse than the preoperative levels. The factors limiting postoperative visual acuity were senile macular degeneration and graft failure. 4. Postoperative complications were glaucoma (2 eyes, 9.1%), cystoid macular edema (1 eye, 4.6%) and graft failure (1 eye, 4.6%).
Cataract Extraction ; Corneal Transplantation ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Macular Degeneration ; Macular Edema ; Ophthalmology ; Postoperative Complications ; Retrospective Studies ; Transplants ; Visual Acuity

We analysed a retrospective study of 22 aphakic bullous keratopathy patients (22 eyes) with penetrating keratoplasty for 5 years from January 1987 to December 1991 in the Department of Ophthalmology at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Of the 22 eyes with aphakic bullous keratopathy 16 eyes (72.7%) had previously undergone intracapsular cataract extraction, 6 eyes (27.3%) had extracapsular cataract extraction. 2. The mean time from cataract extraction to aphakic bullous keratopathy to penetrating keratoplasty was 13.8 months. 3. After keratoplasty, the visual acuity of 20 among the 22 transplants (90.9%) were significantly improved compared to the preoperative levels, however that of 2 among the 22 transplants were worse than the preoperative levels. The factors limiting postoperative visual acuity were senile macular degeneration and graft failure. 4. Postoperative complications were glaucoma (2 eyes, 9.1%), cystoid macular edema (1 eye, 4.6%) and graft failure (1 eye, 4.6%).
Cataract Extraction ; Corneal Transplantation ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Macular Degeneration ; Macular Edema ; Ophthalmology ; Postoperative Complications ; Retrospective Studies ; Transplants ; Visual Acuity

PURPOSE: To determine whether the use of prophylactic vancomycin in the irrigating solutions during cataract surgery is associated with increased incidence of cystoid macular edema METHODS: We underwent a study from November 1, 1999 to May 31, 2000 by inserting hydrophilic acryl-IOL after phacoemulsification to patients diagnosed with senile cataract over 60 years of age, without systemic and ocular disease. The patients were divided into two groups, one is the use of prophylactic vancomycin in the irrigating solutions and the other is no use of prophylactic vancomycin. A randomized prospective study on the respective 50 subjects who did not have complications such as intraoperative posterior capsular rupture or other postoperative complications was conducted. We checked ophthalmologic examinations and fluorescene angiography for cystoid macular edema of the two gruops in 1 month and 4 months after surgery. RESULTS: The incidences of clinical or angiogenic cystoid macular edema in postoperative 4 months are 2 (4%), 7 (14%) in vancomycin group and 0 (0%), 2 (4%) in control group respectedly. (p=0.4095), (p=0.0999) There was no statically significant difference between two groups but slightly higher in the vancomycin group than that in control group. Visual recovery had no significant difference between two groups. CONCLUSIONS: There was no statically significant relationship between the use of preventive intracameral vancomycin during cataract surgery and the incidence of cystoid macular edema, but need further study to clear up the relationship of them.
Angiography ; Cataract ; Endophthalmitis ; Humans ; Incidence ; Macular Edema* ; Phacoemulsification ; Postoperative Complications ; Prospective Studies ; Rupture ; Vancomycin*

PURPOSE: To evaluate the clinical efficacy and safety of short-term application of mitomycin C and releasable scleral flap sutures. METHODS: The clinical outcome and complications were evaluated in 62 eyes undergone glaucoma triple procedure(Group A: with mitomycin C and releasable suture, Group B: with mitomycin C only, Group C: with releasable suture only, Group D: without mitomycin C and releasable suture). RESULTS: The mean postoperative intraocular pressure was relatively lower in group A and B than that of group C and D(p=0.868). The most common complication was posterior capsular opacity, and other complications were cystoid macular edema, hypotony, choroidal detachment and bleb leakage. CONCLUSIONS: The glaucoma triple procedure using mitomycin C and releasable suture could be recommended to be safe and effective on controlling the early postoperative and long-term intraocular pressure for treating the patients with coexisting cataract and glaucoma, and the use of releasable suture could lower the incidence of postoperative complications such as hypotony.
Blister ; Cataract ; Choroid ; Glaucoma* ; Humans ; Incidence ; Intraocular Pressure ; Macular Edema ; Mitomycin* ; Postoperative Complications ; Sutures*

We evaluated preoperative characteristics, intraoperative problems, and postoperative complications among the patients who underwent phacoemulsification and posterior chamber intraocular lens implantation by one surgeon. Eyes with postoperative visual acuity was lower than preoperatively or less than 0.4 on Han`s visual acuity chart were designated Group A, 68 eyes (16.4%), and the remaining eyes were Group B, 46 eyes (83.6%). Preoperative characteristics in Group A were uveitis (16.2%), diabetic retinopathy (13.2%), glaucoma (11.8%), macular abnormality (11.8%), etc. Intraoperative complications, posterior capsule reptures with vitreous loss occurred in 21 eyes (5.1%). 8 eyes (11.8%) of the 21 eyes were Group A, 13 eyes (3.8%) were Group B, and the difference between both groups were statistically significant (p<0.01). Postoperatively, cystoid macular edema was occurred in 12 eyes (2.9%). 11 eyes (16.2%) of 12 eyes were Group A, 1 eye (0.3%) was Group B, and the difference between both groups were statistically significant (p<0.01) and 4 eyes were preceded by posterior capsule rupture. From the above results, we recognized the importance of avoiding posterior capsule rupture with vitreous loss. If it does occur, we recommend that meticulous anterior vitrectomy be performed. Following these guidlines should reduce the rate of unsuccessful cataract sugery.
Cataract* ; Diabetic Retinopathy ; Glaucoma ; Humans ; Intraoperative Complications ; Lens Implantation, Intraocular ; Macular Edema ; Phacoemulsification ; Postoperative Complications ; Rupture ; Uveitis ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate the outcomes of posterior chamber lens (PCL) exchange in patients with opacified foldable PCLs. METHODS: This study consisted of 31 patients (35 eyes) who had received phacoemulsification and implantation of foldable intraocular lenses in the bag or sulcus and developed late opacification of the PCL. All patients reported a reduction of visual acuity and deterioration in vision. The PCLs were explanted and replaced with new PMMA lenses. The perioperative complications and the best corrected visual acuities (BCVAs) before and after surgery were evaluated. RESULTS: The mean visual acuities (logMAR value) before and after IOL exchange were 0.59+/-0.80 and 0.21+/-0.27, respectively. The difference was statistically significant (p=0.005, paired t-test). Intraoperative complications included posterior capsule rupture in six patients, zonular dehiscence in three patients, and both in one patient. Postoperative complications included intraocular pressure elevation in five patients and cystoid macular edema in two patients. One patient showed hypopyon at 6 days postoperatively, which lasted for 3 months, but she showed good visual acuity. CONCLUSIONS: Intraocular lens exchange was a safe and effective treatment for patients whose PCLs were opacified.
Humans ; Intraocular Pressure ; Intraoperative Complications ; Lenses, Intraocular ; Macular Edema ; Phacoemulsification ; Polymethyl Methacrylate ; Postoperative Complications ; Rupture ; Vision, Ocular ; Visual Acuity

OBJECTIVETo explore the relationship between the classification and degree of diabetic macular edema (DME) and the stages of diabetic retinopathy (DR), diabetic duration, classification of diabetes, use of insulin, and visual loss.

METHODSWe retrospectively analyzed the stages of DR, diabetic duration, classification of diabetes, use of insulin, and visual loss in 1 172 DR patients with fundus fluorescein angiography (FFA). The occurrence of DME in DR in each stage and the relationships between its related factors were analyzed.

RESULTSIn 1 172 patients, 633 eyes in 394 patients had DME (33.62%), including 265 (41.86%) with focal DME and 368 (58.14%) with diffuse DME. There were 246 (38.86%) eyes with mild DME, 189 (29.86%) with moderate DME, and 198 (31.28%) with severe DME. Significant correlations exhisted among the classification of DME (r = 0.975, P = 0.025), the degree of DME (r = 1.000, P = 0.000), and the stage of DR. DME deteriorated with the increase of the stages of DR. The visual loss significantly correlated with the degree of DME (r = -0.984, P = 0.003). The visual acuity was lower in patients with diffuse DME than those with focal DME. The diabetic duration significantly correlated with the classification and degree of DME (r = 0.962, P = 0.009). DME was mostly seen in patients with a disease course of six years or longer, and its severity and incidence increased along with the prolonged period. Also, The incidence of DME increased in patients with type 2 diabetes and patients who used insulin.

CONCLUSIONThe classification and degree of DME correlates with the stages of DR, diabetic duration, the classification of diabetes, the use of insulin, and visual loss.

Diabetic Retinopathy ; classification ; complications ; epidemiology ; Humans ; Insulin ; therapeutic use ; Macular Edema ; classification ; epidemiology ; etiology ; Retrospective Studies ; Vision Disorders ; complications ; epidemiology

PURPOSE: This study evaluated the effect of tissue plasminogen activator (TPA) on adhesion between the internal limiting membrane and the vitreous cortex in patients with diabetic macular edema. METHODS: This retrospective study included 14 eyes of 14 patients with diabetic macular edema without posterior vitreous detachment. The fourteen eyes were divided into two groups. In the first group, vitrectomy and internal limiting membrane (ILM) removal were performed after intravitreal TPA 0.1 cc (50 ug) injection the day before vitrectomy and in the second group, vitrectomy and ILM removal were performed without previous injection of TPA. We observed the ILM using electron microscopy and verified the effects of the TPA. RESULTS: Spontaneous posterior vitreous detachment occurred in 3 of 7 eyes in the first group. Internal limiting membranes removed by vitrectomy showed a smooth surface in 4 of 7 eyes in the first group and in 1 of 7 eyes in the second group. Seven eyes of the first group and 6 eyes of the second group revealed decreased foveal thickness and increased visual acuity 90 days postoperatively. CONCLUSIONS: Preoperative intravitreal TPA injection was helpful for achieving posterior vitreous detachment and for decreasing possible postoperative complications involving in remnant vitreous cortex in patients with diabetic macular edema.
Eye ; Humans ; Macular Edema ; Membranes ; Microscopy, Electron ; Postoperative Complications ; Retrospective Studies ; Tissue Plasminogen Activator ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased vision in her left eye. She had a pale retina with macular edema consistent with BRAO. An extensive workup was performed to determine an etiologic factor. All test results were within normal limits except for her factor VIII activity. Her visual acuity improved from finger counting to 20/30 over 2 months without any treatment. RESULTS: This case suggests that BRAO can occur in healthy patients without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy patients without any systemic or ocular disorders, despite an extensile evaluation.
Adult ; Factor VIII/analysis ; Female ; Humans ; Macular Edema/etiology ; Pregnancy ; *Pregnancy Complications, Hematologic ; Retinal Artery Occlusion/*etiology ; Vision Disorders/etiology