PURPOSE: To evaluate the efficacy of the KR-1W aberrometer in assessing the astigmatism and the achieved axis after AcrySof Toric intraocular lens (IOL) implantation. METHODS: Thirty-nine patients (48 eyes) that had undergone phacoemulsification and AcrySof Toric IOL implantation were included in the present study. At postoperative 1 month, ocular aberrations of all the eyes were measured using the KR-1W aberrometer before mydriasis and the achieved axis of AcrySof Toric IOL was measured by slit lamp examination after mydriasis. The achieved axis measured by slit lamp examination and the astigmatism of the implanted AcrySof Toric IOL were compared with the KR-1W. RESULTS: The mean achieved lens axis after mydriasis measured by slit lamp examination and KR-1W was 86.43 +/- 47.49 degrees and 88.93 +/- 41.22 degrees, respectively. The correlation coefficient of the 2 methods was 0.992 (p < 0.001). The measured astigmatism according to the AcrySof Toric IOL model was 1.11 +/- 0.47D in SN60T3, 1.71 +/- 0.51D in SN60T4, and 3.32 +/- 0.78D in SN60T5. CONCLUSIONS: Without the need to directly evaluate the axis of implanted Toric IOL after mydriasis, the achieved lens axis can be measured by the KR-1W without mydriasis. The AcrySof Toric IOL model could be assessed by the KR-1W without information about the AcrySof Toric IOL model.
Astigmatism ; Axis, Cervical Vertebra ; Eye ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Mydriasis ; Phacoemulsification

After direct superior rectus muscle injection of BtA in rabbit eyes, we examined the ultrasructural changes of the muscles from 1 day to 8 weeks after injection. The most profound changes seen at electron microxcopic levels after BtA injedtion were early vacuolization of the sarcoplasmic structure, extensive damage of myofibril, degeneration of the postjunctional fold and widening of the synaptic cleft. Myofiber changes were reversible with no apparent long-term consequence. However, most of the degenerations of myoneuronal junction were still present in 8 weeks post-injedtion. Comparing myotoxic effects according to rabbit age, the botulinum toxin seems to make more severe histologic damage in the fibers of the two-month old than six-month old or older. AchE activity of injection group is mildly decrease in number of positive fibers rather than control group, which was not statistically significant in the quantitative analysis. In conclusion the early vacuolization and degeneration of the sarcoplasmic structure, and degeneration of the postjunctional folds after toxin injection in the muscles are most likely due to a direct myotoxic effect of BtA.
Botulinum Toxins* ; Botulinum Toxins, Type A ; Muscles ; Myofibrils

After retrobulbar, peribulbar and direct muscle injection of 2% lidocaine in rabbit eyes, we examined the ultrastructural changes of superior and inferior rectus muscles from 30 minutes to 30 days after injections. Physiologic saline was injected in control group as the same method. The purpose of this study is as followings : (1) to determine the myotoxic effect of the anesthetic and subsequent regeneration of muscle fibers; (2) to compare the myotoxic effects among retrobulbar, peribulbar and direct muscle injection; and (3) to evaluate toxic effect to optic nerve. The lesions of retrobulbar and peribulbar injection resulted in the degeneration of the muscle fibers on the surface of extraocular muscles. In contrast, large internal lesion were frequently observed in the muscles that received direct injections of 2% lidocaine. No ultrastructural damages of optic nerve were observed. With these anesthetic methods, initial damages were restored by regeneration up to 30 days. The myotoxic effects of retrobulbar and peribulbar injection seem to be less harmful than that of direct muscle injection of 2% lidocaine in rabbits. This results suggest that the intentional or accidental direct muscle injection of local anesthetics during surgery may cause strabismus especially in elderly patients who have poor muscle regeneration capacity.
Aged ; Anesthesia, Local* ; Anesthetics, Local ; Humans ; Lidocaine ; Muscles ; Optic Nerve ; Rabbits ; Regeneration ; Strabismus

Gottron's acrogeria syndrome is a rare genetic disease of unknown etiology with some features suggestive of accelerated aging. The typical clinical presentation consists of premature aging of the skin with atrophy of the cutis and the subcutis. After a brief review of the literature available on this syndrome, we report a case of Gottron s acrogeria syndrome in a 19 year-old man whose right rectus femoris muscle had a fibrotic contracture.
Aging ; Aging, Premature ; Atrophy ; Contracture ; Humans ; Quadriceps Muscle ; Skin ; Young Adult

The macula may be displaced by retinal scarring or fibrous strands, often as a result of retrolental fibroplasia. The displacement is usually temporal and may occur bilaterally but may also be superior or inferior and unilateral after severe retinitis(Toxocara canis). Ectopic macula causes a displacement of the visual line and thus occasionally produces a large positive angle kappa that simulates exotropia. Displacement of the macula also may be congenital. Ocular toxocariasis is recognized to be an important cause of childhood blindness. It usually results as a sequela of systemic infestation with the second or third stage larva of T. canis(visceral larval migrans). The roundworm Toxocara canis is an intestinal parasite of dogs. Humans are infected accidentally by ingesting infective ova from contaminated soil. Only on rare occasions has ocular involvement been reported in visceral larva migrans. Ocular toxocariasis can assume a variety of clinical forms. The authors experienced a case of ectopic macula in presumed ocular toxocariasis which was diagnosed on the basis of the clinical appearance and a history of exposure to puppy. A review of this subject is provided, with emphasis upon pathogenesis, clinical features, diagnostic approaches and therapeutic techniques.
Animals ; Blindness ; Cicatrix ; Dogs ; Exotropia ; Humans ; Larva ; Larva Migrans, Visceral ; Ovum ; Parasites ; Retinaldehyde ; Retinopathy of Prematurity ; Soil ; Toxocara canis ; Toxocariasis*

Lymphangiomas are congenital, benign, slowly progressive tumors of the lymphovascular system. Those located in the ocular adnexa are uncommon and may appear clinically as isolated orbital, eyelid, or conjunctival lesions, or some combination of these. The authors have experienced a case of lymphangiomas of the eyelid and conjunctiva in 8 years old male. This patient was seen with a history of a lump on the superonasal aspect of the left upper eyelid present since birth and intermittent hemorrhagic edematous swelling of the left bulbar conjunctiva beginning at the age of 4 year. The lid mass was partially excised and a biopsy of the conjunctival lesion was also undertaken. Microscopic examination of the excised tissues revealed cavernous lymphangiomas with a moderate lymphocytic infiltration. So, the authors report this case with a brief review of the literature.
Biopsy ; Child ; Conjunctiva* ; Eyelids* ; Humans ; Lymphangioma* ; Male ; Orbit ; Parturition

We analyzed preoperative clinical characteristics, incidence of amblyopia, surgical results according to the type, resolution of preoperative symptoms and postoperative complications in 62 patients with intermittent exotropia, who were more than 15 years of age. The most frequent preoperative annoying symptom was eye strain from fatigue(40%), and the next one was cosmesis(23%). But, diplopia(14%) was relatively infrequent presenting complaint. Among 62 patients, 45 (72%) patients had equal vision, and 11 patients (18%) had amblyopia with two line difference between two eyes. The overall surgical success rate were seventy-seven percent. The 3 patients with postoperative esodeviation more than 5 prism diopters(PD) showed persistent uncrossed diplopia. The 4 patients with undercorrection more than 15 PD did not improve symptomatically. All patients with` postoperative exodeviation less than 15 PD had improvement or resolution of the symptoms. Our results suggest that overcorrection often resulted in unexpected diplopia in adults with intermittent exotropia. Therefore, it may be desirable to make undercorrection within 15 PD or orthotropic state in the patients more than 15 years of age.
Adult ; Amblyopia ; Diplopia ; Esotropia ; Exotropia* ; Humans ; Incidence ; Postoperative Complications

Implantation of a gestational sac within a previous cesarean scar is the rarest form of ectopic pregnancy. A delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, and significant maternal morbidity due to severe hemorrhage. As developing of transvaginal ultrasound and MRI, early diagnosis could be made and conservative treatment could be possible. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, and enabled the successful treatment to preserve the patient's reproductive capability.
Cesarean Section ; Cicatrix* ; Diagnosis ; Early Diagnosis ; Female ; Gestational Sac ; Hemorrhage ; Hysterectomy ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography ; Uterine Rupture

Agenesis of trachea is a rare congenital anomaly. The main signs are respiratory distress, cyanosis, inability to vocalise and impossible tracheal intubation. There is no long-term surgical solution at present, therefore the condition is ultimately fatal. We report a case of tracheal agenesis. We anesthetized a 2.25 kg neonate for endoscopic examination, who was intubated successfully. Beyond 2.5 cm from the vocal cord, there was no trachea and we can only see esophageal lumen with fistula opening. After the endoscopic examination, exploratory thoracotomy was done, but surgical correction was impossible. After the surgery, she died from progressive ventilatory failure. Autopsy revealed a Floyd's type II tracheal agenesis with tracheo-esophageal fistula.
Autopsy ; Cyanosis ; Fistula ; Humans ; Infant, Newborn ; Intubation ; Thoracotomy ; Trachea ; Vocal Cords

After Neodynium(Nd)-YAG laser photodisruption for vitreous floaters which were annoying the central visual field in 28 patients(28 eyes), we evaluated the efficacy of the procedure and the satisfaction degree of patients. Vitreous floaters were not recognized in 46 percents(13 eyes) of the patients, stayed away from the central visual field in 32 percents of the patients(9 eyes). Broken opacities were moved to retina in 22 percents(6 eyes) after treatment. In satisfaction degree of patients, 64 percents of the patients(18 eyes) were completely satisfied, 25 percents of them(7 eyes) were fairly satisfied, and 11 percents of them(3 eyes) were not satisfied at all. Complaints of unsatisfied patients were persisting floaters in 5 eyes, increased number of the floaters in 3 eyes and central visual field disturbance in 2 eyes. The responsible factors for failure in treatment were the size of the floaters larger than 2/3 disc diameter(DD), their locations closer than 2DD from retinal surface and their peripheral locations. Complications included the fragment shifting to posterior central zone in 2 eyes and the chorioretinal damage in 2 eyes. Our results suggest that Nd-YAG laser photodisruption seems to be useful on the discrete vitreous floaters less than 1/3DD in size and apart from retinal surface more than 2DD.
Humans ; Lasers, Solid-State ; Retina ; Retinaldehyde ; Visual Fields