PURPOSE: In the present study, we introduced and evaluated the effectiveness of eyelid margin splitting combined with cilia rotation suture performed in simplified steps resulting in minimized complications in diffuse trichiasis. METHODS: A retrospective review of medical records was performed on 31 eyelids of 21 patients with diffuse trichiasis. The patients had trichiasis of more than 1/3 of eyelid margin and received eyelid margin splitting combined with cilia rotation suture at our hospital. The patients did not have eyelid or lid margin abnormalities and were followed up more than 6 months after surgical correction. A telephone survey of the surgical outcomes including cosmetic satisfaction and recurrence was conducted in patients who did not visit at postoperative 12 months. Success was defined as complete resolution of symptoms and acceptable cosmesis at final visit. RESULTS: The patients included 2 males (3 eyes) and 19 females (28 eyes) with an average age of 54.5 ± 18.3 years (range, 19.2–82.4 years). The mean follow-up period was 15.3 ± 5.6 months (range, 10–35 months). Cornea or conjunctiva irritation symptoms by misdirected eyelash were resolved in all eyelids; 3 eyelids with recurred trichiasis required additional electrolysis to remove irritating cilia resulting in an overall success rate of 90.3%. CONCLUSIONS: For patients with diffuse trichiasis, an eyelid margin splitting combined with cilia rotation suture performed in simplified surgical steps showed excellent results resolving irritating symptoms with very low recurrence rate and high cosmetic satisfaction.
Cilia* ; Conjunctiva ; Cornea ; Electrolysis ; Eyelids* ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Sutures* ; Telephone ; Trichiasis*

PURPOSE: To compare the accuracy and clinical usefulness of various devices by measuring axial length, keratometry, and white-to-white. METHODS: In 64 eyes of 56 cataract patients, axial length was measured using Galilei™, Lenstar®, and A-scans, and keratometry was measured using Galilei™, Lenstar®, and ARK. In 86 eyes of 74 cataract patients, white-to-white was measured using Galilei™ and Lenstar®. RESULTS: The average axial length measurements using Galilei™, Lenstar®, and A-scans were significantly correlated (p < 0.001), but without a statistically significant difference (p = 0.611). The 95% agreement range was the smallest at 0.22 mm for the Lenstar® and A-scans. The average mean K using Galilei™, Lenstar®, and ARK were significantly correlated (p < 0.001), but without a statistically significant difference (p = 0.657). The 95% agreement range was relatively small at 1.83 D for Lenstar® and ARK. The average white-to-white using Galilei™ and Lenstar® were significantly correlated (p < 0.001), with a statistically significant difference (p = 0.011). The 95% agreement range was 2.20 mm. CONCLUSIONS: Axial length, keratometry, and white-to-white measured by different devices were highly correlated and were not statistically different; however, agreement was low between measurements. It is therefore important to consider these findings when using them equally.
Cataract ; Humans

PURPOSE: To report a case of irregular astigmatism caused by a free flap during laser-assisted in situ keratomileusis (LASIK) surgery that was treated with a flap rotation based on postoperative topography. CASE SUMMARY: A 21-year-old female underwent LASIK, which was complicated by a free cap on her right eye. Because the gentian violet markings were no longer present, the exact orientation of the cap was unknown. At 3 months after surgery, the astigmatism of the right eye was −3.00 diopters (D) with an uncorrected visual acuity (UCVA) of 0.4, and the astigmatism of the left eye was −0.75 D with an UCVA of 1.0. The corneal topography was analyzed in order to return to the existing position. Free cap repositioning was performed and irregular astigmatism was corrected to improve the UCVA to 1.0. CONCLUSIONS: If the preoperative markings cannot be identified on a free flap during LASIK, secondary postoperative corneal topographic analysis can be performed to restore the corneal free flap to its original position to minimize astigmatism with good visual outcomes.
Astigmatism ; Corneal Topography ; Female ; Free Tissue Flaps ; Gentian Violet ; Humans ; Keratomileusis, Laser In Situ ; Visual Acuity ; Young Adult

Purpose: We used anterior segment optical coherence tomography (AS-OCT) to measure the pterygial subepithelial invasion length and thickness before and after surgery, and to evaluate the corneal epithelium and the extent of astigmatism. Methods: This was a retrospective study. Ten eyes that underwent pterygial excision surgery were analyzed. We used corneal topographic data to assess astigmatism before surgery and employed AS-OCT to measure corneal epithelial thickness and the length of subepithelial invasion. We measured the relative pterygial length, width, and area on anterior segment photographs. Corneal topographic assessment and AS-OCT were repeated 1 month after surgery. Multiple regression and Pearson correlation analyses were used to analyze the relationships between normalization of astigmatism and the size and thickness of the excised pterygium. Results: The mean With-the-Rule proportion of preoperative astigmatism was 2.9 ± 2.3 D and the mean corneal epithelial thickness 269.60 ± 84.17 µm. The mean thickness of the excised pterygia was 210.73 ± 80.36 µm. Pterygial thickness was significantly associated with the extent of preoperative With-the-Rule astigmatism and the normalized With-the-Rule astigmatism after pterygial excision. These correlations were stronger than those of the relative pterygial length, width, and area. The mean subepithelial invasion length was 595.00 ± 310.32 µm. Conclusions An increase in pterygial epithelial thickness influenced the extent of With-the-Rule astigmatism to a much greater extent than did the relative pterygial length, width, and area. AS-OCT measurement of the subepithelial invasion length identifies the required excisional area prior to surgery.

Candidemia is increasing cause of mortality, especially in intensive care unit patients. And Candida endophthalmitis, developed with or without symptoms, has poor outcome. Prompt use of antifungal agents and early diagnosis of Candida endophthalmitis are clinically important to treat candidemia. In this study, we compared clinical, microbiological, ophthalmological characteristics and treatment outcomes whether infectious disease (ID) specialists mediate candidemia or not in a tertiary hospital by retrospective chart review. Group A includes patients who had candidemia at least one time from January 2012 to July 2013, without ID specialists mediation. Group B includes patients who had candidemia at least one time from August 2013 to December 2014, with ID specialists surveillances and mediations. We compared clinical manifestations of candidemia, uses of antifungal agent, ophthalmologic evaluations and treatment outcomes between two groups. In group A, rate of ophthalmologic evaluations was 4.4% and mean duration was 64.60 hours from blood culture to use of antifungal agents. In group B, the rate of ophthalmologic evaluations was 43.2% and mean duration was 50.15 hours. There was no statistically significant difference in clinical characteristics and 30-day mortality between two groups. Increasing rate of ophthalmologic evaluations and decreasing mean duration from blood culture to use of antifungal agents was shown in surveillance and mediation group.
Antifungal Agents* ; Candida ; Candidemia* ; Communicable Diseases ; Early Diagnosis ; Endophthalmitis ; Humans ; Intensive Care Units ; Mortality ; Negotiating ; Retrospective Studies ; Specialization ; Tertiary Care Centers

Objectives: This study aimed to analyze the outcomes of the Comprehensive Health and Social Need Assessment (CHSNA) system, which identifies community residents’ health and social needs, and to link these needs with the International Classification of Functioning, Disability, and Health (ICF). Methods: Adult community residents in a metropolitan city in Korea were recruited. They were asked to assess their health and social needs via the CHSNA system, which was integrated into an online community-care platform. Three assessment steps (basic health assessment, needs for activities of daily living, and in-depth health assessment) associated with five ICF components were used to evaluate physical health impairment, difficulties in activities and participation, and environmental problems. The final list of health and social needs was systematically linked to the domains and categories of the ICF. Only data from participants who completed all three assessment steps were included. Results: Wide ranges of impairments and difficulties regarding the daily living activities, physical health, and environmental status of the community were recorded from 190 people who completed assessments of their health and social needs by the CHSNA system. These participants reported various health and social needs for their community life; common needs corresponded to the ICF components of body functions and activities/participation. Conclusions The ICF may be suitable for determining the health-related problems and needs of the general population. Possible improvements to the present system include providing support for completing all assessment steps and developing an ICF core set for an enhanced understanding of health and social needs.

OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.
Classification ; Community Health Services ; Decision Support Techniques ; Delivery of Health Care ; Methods ; Needs Assessment ; Patient-Centered Care ; Social Work ; Social Workers

Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes.