The changes of corneal curvatures were measured in 63 cataract cases before and 2 months after cataract extraction with the aid of ophthalmometer and photo keratoscope. The change of the cornea in the vertical curvature was shown to be greater than that of horizontal curvature, in cases of conventional large corneal incision(120-170 degrees) of cataract surgery. Vertical curvature of the cornea was decreased and horizontal curvature was increased. The corneal astigmatism before and 2 months after surgery were respectively 0.67D. and 1.56D. showing the difference of 0.89D.
Astigmatism ; Cataract Extraction* ; Cataract* ; Cornea

I analyzed the changes of visual function of 49 eyes of 38 patients with low-tension glaucoma (LTG) who underwent trabeculectomy and had been followed for at least 3 years at Wills Eye Hopsital. The results were as follows: 1. Average IOP was 18.1 mmHg preoperatively and decreased by 5.0, 4.9 and 4.4 mmHg respectively at 1, 3 and 5 years postoperatively. 2. Postoperative visual acuity decreased in 9 eyes (23%) and 7 eyes (35%) respectively at 3 and 5 years. 3. Postoperative visual field improved in 18 eyes (42%) and 5 eyes (22%) respectively at 1 and 5 years. However it progressed in 9 eyes (23%) and 9 eyes (39%) respectively at 3 and 5 years. 4. In terms of postoperative complications, choroidal detachment developed in 3 cases (6%), cataract requiring extraction in 11 cases and there were no cases requiring reoperation during 3 years after operation. From these results, whereas lOP decreased continually by 25% for 5 years, visual field progressed in 39% of cases at 5 years. However in light of low rate of both complication and reoperation together with high visual field improvement, if LTG persists despite medication, trabeculectomy is recommended to stop the progression of visual field.
Cataract ; Choroid ; Glaucoma* ; Humans ; Postoperative Complications ; Reoperation ; Trabeculectomy* ; Visual Acuity ; Visual Fields

The aim of this study was to evaluate the degree of tolerance of the rabbit's eye when UNI-IOL, prototype of posterior intraocular lens, manufactured in Korea was implanted into the rabbit's eye in comparison with that of the rabbit's eye when IOLAB-IOL manufactured in U.S.A. was implanted. Twenty two eyes of 22 rabbits were operated with extracapsular lens extraction using Healon(R). IOLAB-IOL was implanted into the 11 eyes(Group 1) while UNI-IOL was implanted into another 11 eyes(Group 2). Clinical observation was performed for 5 months and corneal thickness and endothelial cell density were measured. Several eyes were enucleated and their ultrastructural changes were observed with light and electron microscopes. The results are as follows: 1. Clinical observation by slit lamp biomicroscope revealed that inflammatory reaction in the anterior chamber in group 1 and 2 decreased gradually until post operative 10th day and almost disappeared by the post-operative 14 th day. With regard to postoperative complication, there were 2 cases of hyphema in group 1 and 1 case in group 2 and 1 case of wound leaking in group 2 in the early stage. In the later stage, 2 cases of posterior synechia in each group and 1 case of anterior displacement of optic of PCL in group 2 were observed. 2. Corneal thickness of group 1 and 2 increased by 33.5% and 35.9% respectively on the postoperative 1st day and increased most on the postoperative 3 rd day. Then it began to decrease and reached the level of 17.2% and 21.7% respectively on the postoperative 7th day. After 28 days after the operation it decreased to 5.5% and 7.7%, 3 months after the operation 1.5% and 2.4% and 5 months after the operation 1.3% and 2.1% which are almost normal levels. 3. Decreasing rate of endothelial cell density in group 1 and 2 showed 20.2% and 22.7% on the post-operative 4th day, 5.3% and 5.2% on the postoperative 28 th day, 2.8% and 2.7% after 3 months and after 5 months 1.5% and 1.3% respectively. 4. The changes in the corneal thickness and loss of endothelial cell density were not significant statistically between group 1 and 2. 5. Light microscopic finding showed mild chronic inflammatory infiltrates in the stroma of iris and ciliary body in both groups. 6. Scanning electron microscopic finding showed normal hexagonal cell shape with some edema in both groups on the postoperative 14th day while both groups showed normal cell shape without edema 28 days, 3 months and 5 months after the operation. 7. Transmission electron microscopic finding showed no changes in internal structure of endothelial cells 14 days, 28 days, 3 months and 5 months after the operation. In conclusion, the implantation in rabbits eyes of the UNI-IOL showed little difference in clinical and histopathologic findings compared with that of IOLAB-IOL and was well tolerated.
Anterior Chamber ; Cell Shape ; Ciliary Body ; Edema ; Endothelial Cells ; Endothelium, Corneal* ; Hyphema ; Iris ; Korea ; Lenses, Intraocular ; Postoperative Complications ; Rabbits ; Wounds and Injuries

PURPOSE: To evaluate the expression of the Na(+)-K(+)-2Cl(-)-cotransporter 2 (NKCC2) in the ischemic rat retina. METHODS: Retinal ischemia was induced by pressures 90 to 120 mmHg, above systemic systolic pressure. Immunohistochemistry and western blot analysis were performed. RESULTS: NKCC2 is expressed in the normal retina and its expression is increased by ischemia caused by intraocular pressure elevation. NKCC2 immunoreactivity was observed mainly in axon bundles of ganglion cells and horizontal cell processes in the retina. NKCC2 expression continuously increased with a peak value 3 days (to 415% of normal levels) after ischemic injury, and then gradually decreased to 314% of controls until 2 weeks post injury. The mean density of NKCC2-labeled ganglion cells per mm2 changed from 1,255 +/- 109 in normal retinas to 391 +/- 49 and 185 +/- 37 at 3 days and 2 weeks after ischemia, respectively (p < 0.05), implying cell death of ganglion cells labeled with NKCC2. CONCLUSIONS: Taken together, these results suggest that NKCC2, which is expressed in retinal ganglion and horizontal cells, may contribute to cell death by ischemic injury in the retina, although the molecular mechanisms involved remain to be clarified.
Animals ; Blotting, Western ; Disease Models, Animal ; Immunohistochemistry ; Intraocular Pressure ; Ischemia/etiology/*metabolism ; Male ; Microscopy, Confocal ; Ocular Hypertension/*complications/metabolism/physiopathology ; Rats ; Rats, Sprague-Dawley ; Retinal Diseases/etiology/*metabolism ; Retinal Ganglion Cells/*metabolism/pathology ; Sodium-Potassium-Chloride Symporters/*biosynthesis

Viscoelastic substance or Mitomycin C(MMC)is not necessarily used in trabeculectomy. Hence, the authors investigated the rate of cataract development or progression after trabeculectomy related with using of the viscoelastic substance or MMC. The authors evaluated 119 eyes undergoing trabeculectomy and divided these eyes into 4 groups :group 1, 2, 3, and 4. In group 1, viscoelastic substance or MMC was not used(27 eyes). In group 2, only viscoelastic substance was used(35 eyes). In group 3, only MMC was used(15 eyes). In group 4, both viscoelastic substance and MMC were used(42 eyes). The cataract development or progression was examined with slit-lamp biomicroscope at postoperative 6 months and defined as the decrease of visual acuity more than 2 lines. The rate of cataract development or progression at postoperative 6 months was 18%in group 1, 14%in group 2, 40%in group 3, and 19%in group 4.The use of MMC without viscoelastic substance in trabeculectomy influenced cataract development or progression extremely. In conclusion, the results of this study suggest that the viscoelastic substance may reduce the rate of cataract development or progression after trabeculectomy in which MMC is used besides.
Cataract* ; Mitomycin* ; Trabeculectomy* ; Visual Acuity

Choroidal detachment has frequently been found to be a complication following trabeculectomy. However there remain many controversies about the indication and the timing as to when to perform choroidal drainage. Of 131 cases of trabeculectomy from July 1990 to to June 1991 choroidal detachment was developed in 5 eyes of 4 patients with glaucoma. Among them, 2 cases were treated medically and 3 cases surgically. We classified anterior chamber depth according to grading system and made it the guideline for treatment. As choroidal detachment developed, we used medical therapy including more frequent topical application of cycloplegics and steroids, and observed anterior chamber reformation. When grade III anterior chamber the situation where central cornea touches on lens surface persisted 12 to 24 hours, we performed anterior chamber reformation, sclerotomy and choroidal drainage During the follow-up period (mean, 7 months), all cases except one were controlled without medication, but 1 case developed hypermature cataract 1 month after choroidal drainage, with increased intraocular pressure and conjunctival bleb disappeared. Once choroidal detachment develops, rapid medical treatment is necessary. If medical therapy fails, prompt surgical reformation of the anterior chamber along with drainage of any suprachoroidal fluid is needed in grade Ill anterior chamber.
Anterior Chamber ; Blister ; Cataract ; Choroid* ; Cornea ; Drainage ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mydriatics ; Steroids ; Trabeculectomy*

The small-incision cataract surgery by phacoemulsification with foldable posterior chamber lens implantation have recently permitted new options for combined trabeculectomy with cataract extraction. In the present study, we performed phacoemulsification and foldable intraocular lens implantation using small clear corneal incision in 20 patients with 22 glaucomatous eyes who had previously undergone trabeculectomy and determined its effects on visual acuity, intraocular pressure, the number of medications applied, and status of the filtering blebs. The mean follow-up period was 10.1 months and the mean time interval between the two surgeries was 14.7 months. The mean best corrected visual acuity was 0.19 preoperatively and 0.60 postoperatively and the postoperative visual acuity had improved in 19 eyes(86.4%). The mean(+/-standard deviation, SD) preoperative IOP was 16.7+/-5.88 mmHg and the mean(+/-SD) postoperative IOP at final visit was 15.5+/-4.07 mmHg. Postoperatively, the IOPs remained well controlled in 20 eyes(90.9%) without additional ocular hypotensives and required additional medications for control in 2 eyes(9.09%). And the funictioning bleb failures occurred in 5 eyes(22.7%). We found the procedure to be effective in restoring vision while controlling intraoperative pressure and preserving the filtering blebs.
Blister* ; Cataract Extraction ; Cataract* ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular ; Phacoemulsification ; Trabeculectomy ; Visual Acuity

We studied the effect of 1% apraclonidine (Iopidine(R)) on the ocular hypotensive action and its ocular side effects following laser surgery for glaucoma. One hundred twenty patients with primary angle closure glaucoma underwent argon laser peripheral iridotomy and 40 patients with primary open angle glaucoma were treated with laser trabeculoplasty. Mean lOP of eyes instilled with 1% apraclonidine fell by 16% 3 hours after instillation in laser iridotomy cases and by 28% 3 hours after instillation in trabeculoplasty cases. lOP elevation greater than lO mmHg was found in 18 eyes (30%) of the control group in iridotomy cases and 4 eyes (40%) in trabeculoplasty cases, but none in the apraclonidine group in both treated cases for the first three hours. Apraclonidine reduced the incidence and magnitude of potentially harmful lOP elevations after laser irdotomy and trabeculoplasty.
Argon* ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Incidence ; Intraocular Pressure* ; Laser Therapy ; Trabeculectomy*

Several kinds of non-contact tonometers have been used since the first non-contact tonometer was introduced in the 1970's in order to measure intraocular pressure with easiness and accuracy. However several problems were still remained because of:he inaccuracy of the non-contact tonometer in high and low range of intraocular pressure. A new non-contact tonometer (Model CT-20, Japan) was recently introduced by Topcon Company to evaluate the clinical efficacy of the non-ccntact tonometers. The authors measured the intraocular pressure with Topcon tonometer, AO tonometer and Pulsair non-contat tonometer and compared the results with those measured with Goldmann tonometer. The results were as follows: 1) The correlation coefficient between Goldmann and Topcon tonometer was 0.8452 (p=0.001), Goldmann and Pulsair tonometer was 0.7084 (p=O.OOl) and Goldmann and AO tonometer was 0.6048 (p=O.OOl) in the normal eyes. 2) The correlation coefficient between Goldmann and Topcon tonometer was 0.8651 (p=0.0001) in the ocular hypertensive or open angle glaucoma eyes. 3) The correlation coefficient between Goldmann and Topcon tonometer was 0.6987 (p=0.000l) in the low lOP eyes. 4) The correlation coefficient between Goldmann and Topcon tonometer was 0.6829 (p=0.0001) in the high myopic eyes. As above, a new-contact tonometer (Model CT-20, Japan) made by Topcon Company was relatively accurate in measuring not only the intraocular pressure of normal eyes but that of ocular hypertensive, low IOP and high myopic eyes.
Glaucoma, Open-Angle ; Intraocular Pressure

PURPOSE: In this study, we evaluated systemic hemodynamic factors of normal tension glaucoma. METHODS: Forty patients with normal tension glaucoma and thirty healthy people were investigated with regard to hemoglobin, hematocrit, RBC count, WBC count, platelet count, fasting glucose, HbA1c, total cholesterol, triglycerides, LDL, HDL, and high-sensitivity C-reactive protein (hsCRP). Also, ET-1 and MCP-1 were measured using enzyme-linked immunosorbent assay kits. RESULTS: The results of the blood examinations showed no statistically significant differences in hemoglobin, hematocrit, RBC count, WBC count, platelet count, fasting glucose, HbA1c, total cholesterol, LDL, HDL, and hsCRP. Only triglycerides showed a statistically significant difference between the groups (P=0.03). The level of serum ET-1 was significantly higher in the normal tension glaucoma group (P=0.007). The results of MCP-1 showed no statistically significant difference. CONCLUSIONS: We conclude that normal tension glaucoma Is associated with an increased level of triglycerides and that the level of ET-1 could be a hemodynamic cause of normal tension glaucoma.
C-Reactive Protein ; Cholesterol ; Cholesterol, LDL ; Endothelin-1 ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glaucoma ; Glucose ; Hematocrit ; Hemodynamics ; Hemoglobins ; Humans ; Low Tension Glaucoma ; Platelet Count ; Triglycerides