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14 eyes of 11 patients with chronic angle-closure glaucoma(CACG) undergoing extracapsular cataract extraction(ECCE) with posterior chamber intraocular lens(PCIOL) implantation(group 1) and 14 eyes of 12 patients without glaucoma undergoing ECCE/PCIOL(group 2) were studied to assess the effect on anterior chamber depth, anterior chamber angle, and intraocular pressure (IOP). We measured the anterior chamber depth and angle using the EAS-1000 Scheimpflug camera. Following ECCE/PCIOL in group 1, the anterior chamber depth increased 1.00 +/- 0.25mm(p=0.0001), the anterior chamber angle widened 15.36 +/- 5.61 degrees(p=0.0001), and the postoperative IOP drop of 4.7mmHg(23.9%) showed statistical significance. Group 2 showed the increase of anterior chamber depth 0.22 +/- 0.44mm(p=0.0964), the widening of anterior chamber angle 2.51 +/- 2.65 degrees(p=0.0047), and the decrease of IOP 0.9mmHg(6.2%, p=0.0933). The effects on anterior chamber depth, anterior chamber angle, and rap were statistically significant between the two groups. Based on these results, we recommend that eyes with cataract and CACG may be considered for ECCE/PCIOL implantation as a first procedure rather than combined cataract and filtering surgery.
Anterior Chamber ; Cataract Extraction* ; Cataract* ; Filtering Surgery ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure

Postoperative endophthalmitis has been greatly improved over the past decade by the use of improved medical therapy and the use of vitrectomy. However, the appropriate use of the different treatment modalities and the appropriate time of vitrectomy in the treatment of postoperative endophthalmitis remains controversial. We have experienced consecutive endophthalmitis following 2 cases of cataract surgery, 1 case of glaucoma filtering surgery with cataract operation and 1 case of secondary posterior chamber intraocular lens(PCL) implantation. We report the presumed cause of endophthalmitis and its therapeutic results. 1. Four of five patients who underwent cataract and combined glaucoma surgery were detected Pseudomonas aeruginosa and its infective cause presumed to be the I and A Kit of phacoemulsifier(Cavltron Kelman 8000). 2. More severe 3 of 4 patients who developed postoperative endohthalmitis were treated with vitrectomy and mild 1 patient was treated medically. 3. At the time of follow-up(mean, 11 months), the final corrected average visual acuity of 20/30 was achieved.
Cataract ; Endophthalmitis* ; Filtering Surgery ; Glaucoma ; Humans ; Pseudomonas aeruginosa ; Visual Acuity ; Vitrectomy

Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.
Antibodies, Antinuclear ; Autoantibodies ; Female ; Follow-Up Studies ; Heart Block ; Humans ; Infant ; Lupus Erythematosus, Cutaneous

Aphakic or pseudophakic glau-oma is known to be at high risk for failure after filtration surgery. The authors retrospectively investigated the results of trabeculectomy in 14 eyes of 14 patients with glaucoma, seven aphakic and seven pseudophakic eyes, which were followed from six months to three years with an average ot 16.5 months. A conventional trabeculectomy without using antifibrotic agents was performed in all the eyes. The site of conjunctival incision was prepared on the virgin area of the conjunctiva; 8 superonasal, 4 inferonasal and 2 inferotemporal approaches. An average postoperative intraocular pressure reduction was 13.4 mmHg. The number of medications decreased in 11 eyes. A spontaneously developed functioning bleb was found in seven eyes. In other four eyes, the filtering bleb was formed with an aid of massage or needling. The remallllllg three eyes did not show a functioning bleb. Postoperative complications included hyphema in 3 eyes, overfiltration in 2 eyes, choroidal detachment in 1 eye, corneal edema in 1 eye and endophthalmitis in 1 eye.
Aphakia* ; Blister ; Choroid ; Conjunctiva ; Corneal Edema ; Endophthalmitis ; Filtering Surgery* ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Massage ; Postoperative Complications ; Pseudophakia* ; Retrospective Studies ; Trabeculectomy

In order to research the clinical utility of Pilogel(R), we administered Pilogel(R) to 13 POAG(primary open angle glaucoma) patients once daily for four weeks and measured the degree of intraocular pressure reduction and accompanying side effects three days after; one week after; two weeks after; three weeks after and four weeks administration. 1. Administration of Pilogel(R) single dose at bed time produced the same effect of intraocular pressure reduction as that of 4% Pilocarpine eye drop four times a day. 2. Up to four weeks of daily administration of Pilogel(R) did not produced tachyphylaxis. 3. Degree of intraocular pressure reduction after administration of Pilogel(R) was maintained at the almost same level from days 3 up to 4 weeks. 4. The intraocular pressure reduction effect with pilogel(R) was maintained at the constant level for 18 hours following administration of it. 5. Once a day regimen of Pilogel(R) was proven to be more comfortable than the 4 times a day regimen of pilocarpine eye drop. And the side effect of Pilogel(R) was no greater than that of pilocarpine eye drop.
Glaucoma* ; Humans ; Intraocular Pressure ; Pilocarpine* ; Tachyphylaxis

In order to compare the corneal sensation after phacoemulsification and the planned extracapsular cataract extraction(p-ECCE), we studied 40 eyes of 31 patients prospetively. A Cochet-Bonnet esthesiometer was used to measure corneal sensitivity preoperatively and at one day, three day, one week, one month, and two months postoperatively, by the same surgeon using the same technique. There was no difference in corneal sensation between phacoemulsification and p-ECCE group preoperatively. The mean corneal sensitivity at 10:00(2:00) o`clock in phacoemulsificantion/p-ECCE was 17.3+/-7.0(18.2+/-6.7)/9.9+/-1.5(10.3+1.9), 22.1+/-6.9 (23.2+/-6.3)/14.1+/-2.3(14.3+/-2.3), 29.4+/-7.7(30.6+/-7.2)/17.7+2.2(18.7+/-2.2), 37.7+/-9.3(37.8+/-9.4)/26.3+/-7.9(27.7+/-8.4), 56.3+/-7.6(56.3+7.9)/59.2+/-3.8(59.4+/-2.7)mm after 1, 3, 7, 30, 60 days, respectively. Corneal sensation at the center and the 3, 6, and 9 o`clock positions was not changed in all eyes. Corenal sensitivity was significantly more recovered in phacoemulsification group than the p-ECCE group at postoperative onemonth(p<0.05). However, there were no statistically significant difference in recovery of corneal sensation between phacoemulsification group and p-ECCE group at postoperative two months. Conclusively corneal sensation returned to peroperative level at two months postoperatively in both groups.
Cataract Extraction* ; Cataract* ; Humans ; Phacoemulsification* ; Sensation*

Failure of a glaucoma filtering operation mainly results from scarring at the filtering wound, and postoperative proliferation and migration of fibroblasts play an important role histologically in the formation of scar tissue. As an inhibitory agent for fibroblast proliferation, gamma-interferon has been introduced, and the application of gamma-interferon following filtering surgery is now being made on a trial basis. We studied the effect of gamma-interferon histologically on the fibroblast proliferation and collagen synthesis occurring at the filtering site by comparing the effect of gamma-interferon on the experimental group with that of 5-fluorouracil on the control group, using 10 rabbits (20 eyes) after posterior lip sclerectomy. Both groups showed similar flat and diffused bleb grossly and also showed a similar inhibitory effect on fibroblast proliferation and collagen fiber synthesis histologically. Our findings seem to justify the clinical use of gamma-interferon. Further studies on adequate dosage, method of administration, and local and systemic complications would be desired.
Animals ; Anterior Chamber/drug effects ; Cell Division/drug effects ; Collagen/*biosynthesis ; Fibroblasts/drug effects ; Fluorouracil/pharmacology ; Glaucoma/pathology/*surgery ; Interferon-gamma/*pharmacology ; Rabbits ; Sclera/pathology ; *Sclerostomy

Generally, the postoperative failure of glaucoma filtrationsurgery(GFS) is caused by scarring of filtering site. Mitomycin C(MMC) has been commonly used for preventing the scarring of filtering site. Though the antifibroblastic effect of this drug is approved clinically, its cytotoxic side effect cannot be overlooked,. alpha-tocopherol is known to inhibit proliferation of fibroblast without cytotoxic complications. In this study, we used alpha-tocopherol in GFS of rabbits and investigated the maintenance of bleb formation, complications and inhibition of fibroblast proliferation compared with MMC. Thirty six rabbits were divided into 6 groups Negative control groups were the balanced salt solution soaked group and the 19% ethanol soaked group and positive control group was soaked with 0.2mg/ml MMC during GFS. As experimental groups, group I, II, III were soaked with 100micrometer, 1mM and 10mM alpha-tocopherol. The results were as follows: For the maintenance of bleb formation, at postoperative 2 weeks, all extinguished in negative control groups and each experimental groups from I to III showed 16.7%, 33.3%, 50%, with highest rate of 66.7% in MMC soaked group, but at 2 months, group III and MMC soaked group showed 33.3% equally. Various complications were present in MMC soaked group but rare in alpha-tocopherol soaked groups. On histologic examinations, proliferation of fibroblast and infiltration of lymphocyte in group II, III and MMC soaked group except group I were much less than those of negative control groups and the degree of inhibition was proportional to concentration of tocopherol. There was no statistic difference(P>0.05) in area of reticulin fibers between group III and MMC soaked group and antifibroblastic effects were also similar between these two groups. These result suggest when directlyconcentration(1mM<) as much as MMC. Moreover, it is expected to be used more safely during GFS withous serious cytotoxic complications. However, application method, dosageand possible long term complications.
alpha-Tocopherol* ; Blister ; Cicatrix ; Ethanol ; Fibroblasts* ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Lymphocytes ; Mitomycin ; Rabbits* ; Reticulin ; Tocopherols

We reviewed 39 consecutive cases of extracapsular cataract extraction and with or without posterior chamber intraocular lens implantation combined with trabeculectomy in 35 glucoma patients. In 26 (66.7%) of the 39 cases, intraocular lens was implanted. The mean preoperative intraocular pressure was 26.3mmHg on glaucoma medications Postoperatively, the average intraocular pressure was 15.5mmHg which was 1O.8mmHg(41.5%) lower than the preoperative level. Visual acuity improved in 37 eyes (94.9%) with an average improvement of 4.3 lines at postopertive 6 months. The postoperative complications are hyphema (5 yeyes. 12.8%), shallow anterior chamber (3 eyes, 7.7%), fibroexudative membrane (3 eyes, 7.7%) and endophthalmitis(1 eye, 2.6%).
Anterior Chamber ; Cataract Extraction ; Cataract* ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Membranes ; Postoperative Complications ; Trabeculectomy ; Visual Acuity