Purpose: To evaluate and compare the clinical efficacy of matrix metalloproteinase-9 (MMP-9) immunoassay and tear osmolarity measurement in diagnosing dry eye severity. Methods: Dry eye disease (DED) patients underwent diagnostic tests including MMP-9 assay, tear osmolarity measurement, fluorescein tear breakup time, ocular surface staining, anesthetized Schirmer test, Ocular Surface Disease Index questionnaire, and slit-lamp examination. The dry eye parameters were compared according to positive MMP-9 status and increased tear osmolarity. The correlation between dry eye profiles and MMP-9 positivity and high tear osmolarity was also analyzed. Results: Those who tested positive in MMP-9 immunoassay had significantly higher corneal fluorescein staining score and worse DED severity than those who tested negative. The intensity of MMP-9 positivity showed positive correlation with the corneal staining score and DED severity. However, DED patients with high tear osmolarity above 308 mOsm/L did not show significantly different dry eye signs and symptoms compared to those with lower tear osmolarity values. Tear osmolarity was associated with ocular surface staining score in severe DED patients. Conclusions MMP-9 positivity was associated with ocular surface staining and worse dry eye severity. Therefore, it may be used as a useful indicator of disease severity in conjunction to other diagnostic tests.

Purpose: Lattice corneal dystrophy type 1 (LCD1) typically presents with linear lesions in the corneal stroma. We report an atypical case of a patient with LCD type 1, who exhibited granules and deep lines resembling granular corneal dystrophy type 2 (GCD2) in one eye and maps and dots resembling epithelial basement membrane dystrophy (EBMD) in the contralateral eye.Case summary: A 22-year-old woman presented with progressive visual disturbances. Slit lamp examination revealed subepithelial granular opacities and linear lines in one eye and maps and dots in the other eye. Peripheral blood was collected, and genomic sequencing of transforming growth factor β-induced protein (TGFBI) was performed to identify any mutations. The sequencing revealed a heterozygous Arg124Cys (R124C) mutation, which is diagnostic for LCD1. Serial examinations over the years indicated a spontaneous reduction in the granular deposits and an increase in the lattice component, illustrating the progression of the phenotypic traits associated with LCD. Conclusions Although the R124C mutation of TGFBI is known to be associated with LCD1, it can manifest clinical characteristics similar to GCD2 or EBMD in the early stages of the disease. Genetic testing is recommended for definitive diagnosis in cases of TGFBI-related corneal dystrophies.

Purpose: To report two cases of successful management of infectious corneal ulcer with temporary conjunctival flap.Case summary: Two patients with acute necrotic corneal ulcer with impending perforation were treated with conjunctival flap surgery, which was subsequently removed within 2 weeks. The inflammation subsided, the ulcer healed with mild to moderate corneal opacity, and the patients achieved improved visual acuity. Conclusions Temporary conjunctival flap can prevent corneal perforation and aid in accelerating wound healing in infectious corneal ulcer and may be an effective therapeutic alternative.

No abstract available.
Aged, 80 and over ; Antitubercular Agents/*therapeutic use ; Eyelid Diseases/drug therapy/*physiopathology ; Glucocorticoids/therapeutic use ; Humans ; Male ; Prednisolone/therapeutic use ; Tuberculosis, Ocular/drug therapy/*physiopathology

No abstract available.
Bone Marrow/*pathology/radiography/radionuclide imaging ; Carcinoma, Adenoid Cystic/*diagnosis ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lacrimal Apparatus/*pathology/radiography/radionuclide imaging ; Lacrimal Apparatus Diseases/*diagnosis ; Maxilla ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; *Positron-Emission Tomography ; *Tomography, X-Ray Computed

PURPOSE: To compare postoperative optical qualities between two types of 1-piece aspheric intraocular lenses using the double-pass technique. METHODS: Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and spherical equivalent were evaluated in the subject groups; the first which included 25 eyes implanted with Tecnis(R) ZCB00 and the second which included 16 eyes implanted with Acrysof(R) IQ SN60WF. In addition, modulation transfer function (MTF) cut-off, Strehl ratio, and objective scattering index (OSI) were measured 6 months after cataract surgery in the 2 subject groups using Optical Quality Analysis System (OQAS, Visiometrics S.L., Terrasa, Barcelona, Spain) which is based on the double-pass technique. RESULTS: There were no significant differences in the spherical equivalent, UCVA, BCVA, and OSI between the 2 groups. However, both the MTF cut-off, and Strehl ratio showed statistically significant differences. The MTF cut-off (28.0 +/- 7.79 vs. 20.4 +/- 9.51 c/deg, p = 0.025) and Strehl ratio (0.14 +/- 0.04 vs. 0.12 +/- 0.05, p = 0.042) were higher in the Tecnis(R) ZCB00-implanted group. CONCLUSIONS: The difference in characteristics of intraocular lenses subtly affects the vision quality as measured by values such as MTF cut-off and Strehl ratio after cataract surgery. OQAS based on the double-pass technique is considered useful in more objective estimates of the real retinal image quality after cataract surgery which is difficult to explain simply by measuring visual acuity.
Cataract ; Lenses, Intraocular* ; Retinaldehyde ; Visual Acuity

PURPOSE: To compare the treatment effects of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and conservative management in treatment of recurrent corneal erosion. METHODS: Twenty-three eyes that received Nd:YAG laser treatment and 24 eyes that underwent conservative management including hyperosmotic agent were retrospectively reviewed for the rate and frequency of recurrence, presentation, time to recurrence, final visual acuity and complications. RESULTS: The rate of recurrence in eyes treated with Nd:YAG laser was 56.5% and that in eyes with conservative management was 50.0%. The difference was not statistically significant (p = 0.654). However, 10 of 12 eyes that recurred after conservative treatment presented with macroform erosion at the time of recurrence, whereas 5 of 13 eyes that recurred after Nd:YAG laser had an accompanying epithelial defect (p = 0.041). After the Nd:YAG laser treatment or conservative treatment, 64.1% and 60.5% of the eyes, respectively, remained free from recurrence 1 year after treatment, however the success rate decreased over time (p = 0.649). The final visual acuity in the group that received Nd;YAG laser treatment was 0.05 +/- 0.06 log MAR and 0.09 +/- 0.08 log MAR (p = 0.649) in the group that received conservative management. None of the patients in either group experienced complications of corneal scarring. CONCLUSIONS: The difference in the recurrence rates between Nd:YAG laser treatment and conservative treatment were not statistically different, however, the severity of recurred episodes were milder in the eyes that received Nd:YAG laser treatment.
Cicatrix ; Humans ; Recurrence ; Retrospective Studies ; Visual Acuity

PURPOSE: Our study provides epidemiologic data on the prevalence of refractive errors in all age group ≥5 years in Korea. METHODS: In 2008 to 2012, a total of 33,355 participants aged ≥5 years underwent ophthalmologic examinations. Using the right eye, myopia was defined as a spherical equivalent (SE) less than -0.5 or -1.0 diopters (D) in subjects aged 19 years and older or as an SE less than -0.75 or -1.25 D in subjects aged 5 to 18 years according to non-cycloplegic refraction. Other refractive errors were defined as follows: high myopia as an SE less than -6.0 D; hyperopia as an SE larger than +0.5 D; and astigmatism as a cylindrical error less than -1.0 D. The prevalence and risk factors of myopia were evaluated. RESULTS: Prevalence rates with a 95% confidence interval were determined for myopia (SE <-0.5 D, 51.9% [51.2 to 52.7]; SE <-1.0 D, 39.6% [38.8 to 40.3]), high myopia (5.0% [4.7 to 5.3]), hyperopia (13.4% [12.9 to 13.9]), and astigmatism (31.2% [30.5 to 32.0]). The prevalence of myopia demonstrated a nonlinear distribution with the highest peak between the ages of 19 and 29 years. The prevalence of hyperopia decreased with age in subjects aged 39 years or younger and then increased with age in subjects aged 40 years or older. The prevalence of astigmatism gradually increased with age. Education was associated with all refractive errors; myopia was more prevalent and hyperopia and astigmatism were less prevalent in the highly educated groups. CONCLUSIONS: In young generations, the prevalence of myopia in Korea was much higher compared to the white or black populations in Western countries and is consistent with the high prevalence found in most other Asian countries. The overall prevalence of hyperopia was much lower compared to that of the white Western population. Age and education level were significant predictive factors associated with all kinds of refractive errors.
Adolescent ; Adult ; Age Distribution ; Aged ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Nutrition Surveys ; Prevalence ; Refractive Errors/*epidemiology/physiopathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Visual Acuity/*physiology ; Young Adult

Purpose: To evaluate visual performance after bilateral implantation of an extended depth of focus (EDOF) intraocular lens (IOL). Methods: This multicenter, prospective, observational study included 100 patients who underwent bilateral cataract surgery with a toric or non-toric EDOF IOL (Tecnis Symfony), and 96 patients completed the final assessment at 4 to 6 months. Binocular corrected distance visual acuity and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA), spectacle independence, visual symptoms, and patient satisfaction were evaluated. Results: Mean decimal visual acuity results showed a binocular corrected distance visual acuity of 1.10 ± 0.18, UDVA of 1.04 ± 0.17, UIVA of 0.96 ± 0.16, and UNVA of 0.68 ± 0.18. Binocular UDVA and UIVA were 0.8 (decimal) or better in 98% and 94% of patients, respectively. Binocular UNVA was 0.63 (decimal) or better in 76% of patients. Overall, 76% of the patients achieved spectacle independence across all distances, and more than 85% reported no or mild dysphotoptic phenomena. On a scale of 0 to 10, the median patient satisfaction score was 9 for far, 9.5 for intermediate, and 8 for near vision. Conclusions The Symfony EDOF IOL provided excellent distance, intermediate visual outcome, and functional near visual acuity. The visual results were associated with prominent levels of spectacle independence and patient satisfaction.

Purpose: To evaluate visual performance after bilateral implantation of an extended depth of focus (EDOF) intraocular lens (IOL). Methods: This multicenter, prospective, observational study included 100 patients who underwent bilateral cataract surgery with a toric or non-toric EDOF IOL (Tecnis Symfony), and 96 patients completed the final assessment at 4 to 6 months. Binocular corrected distance visual acuity and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA), spectacle independence, visual symptoms, and patient satisfaction were evaluated. Results: Mean decimal visual acuity results showed a binocular corrected distance visual acuity of 1.10 ± 0.18, UDVA of 1.04 ± 0.17, UIVA of 0.96 ± 0.16, and UNVA of 0.68 ± 0.18. Binocular UDVA and UIVA were 0.8 (decimal) or better in 98% and 94% of patients, respectively. Binocular UNVA was 0.63 (decimal) or better in 76% of patients. Overall, 76% of the patients achieved spectacle independence across all distances, and more than 85% reported no or mild dysphotoptic phenomena. On a scale of 0 to 10, the median patient satisfaction score was 9 for far, 9.5 for intermediate, and 8 for near vision. Conclusions The Symfony EDOF IOL provided excellent distance, intermediate visual outcome, and functional near visual acuity. The visual results were associated with prominent levels of spectacle independence and patient satisfaction.