No abstract available.
Carbon* ; Knee*

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

PURPOSE: To evaluate the surgical results and efficacy of laser refractive cataract surgery with a femtosecond laser compared with conventional phacoemulsification. METHODS: Thirty-one eyes from 31 patients underwent laser refractive cataract surgery (femtosecond laser group), and conventional cataract surgery with phacoemulsification was performed in 30 eyes from 30 patients (conventional group). Best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, diameter of continuous curvilinear capsulorrhexis (CCC), distance from visual axis to the center of CCC, intraocular lens (IOL) tilt, mean absolute error, effective phaco time, average phaco power and operation time were measured to compare the 2 groups. RESULTS: No significant differences were found between best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, mean absolute error, effective phaco time, average phaco power or operation time. Significant differences were found in the diameter of CCC, distance from visual axis to the center of CCC, and IOL tilt. CONCLUSIONS: Results of laser refractive cataract surgery with a femtosecond laser showed more precise CCC, and more stable IOL position than conventional cataract surgery.
Astigmatism ; Axis, Cervical Vertebra ; Capsulorhexis ; Cataract ; Chlormequat ; Eye ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Visual Acuity

The Congenital Ulnar Drift of the fingers is a relatively uncommon and has symmetrical malformations of hand, face and foot characterized by MP joint flexion contracture and ulnarward deviation of the fingers and microstomia, In tarsal deformity, there are clubfoot and congenital vertical talus with rocker bottom deformity. In treatment, the report of the surgical treatment was rare. We experienced congenital ulnar drift of fingers in 2 patients in one family, which were treated by dome resection corrective osteotomy of the metacarpals. Therefore remarkable symptomatic improvement was obtained.
Clubfoot ; Congenital Abnormalities ; Contracture ; Fingers ; Foot ; Hand ; Humans ; Joints ; Metacarpal Bones ; Microstomia ; Osteotomy ; Talus

The experimental study for peripheral nerve reconstruction was performed using degenerated skeletal muscle and omentum. At the sciatic nerves of 26 rabbits, about 10mm gaps were made under ketamine anesthesia. Degenerated skeletal muscles were made through the procedure of freezing with liquid nitrogen and thawing in distilled water. And omenta were taken through midline abdominal incisions. On 14 rabbits of experimental group, the nerves were connected with the degenerated skeletal muscles and surrounded with the omenta. On 6 rabbits of control group, the nerve gaps were connected with the degenerated skeletal muscles without surrounding with the omenta. And the other 6 rabbits of control group, the gaps were lets without further treatment. After 3, 6, 9 and 12 weeks, the results were compared using light microscope and transmission electron microscope. There were contractions and fragmentations at the skeletal muscles during the freezing and thawing. There were nerve regenerations through the degenerated skeletal muscles. The nerve tissues of the experimental group were more abundant than the control group using the degenerated skeletal muscles only.
Anesthesia ; Freezing ; Ketamine ; Linear Energy Transfer ; Muscle, Skeletal ; Nerve Regeneration ; Nerve Tissue ; Nitrogen ; Omentum ; Peripheral Nerves ; Rabbits ; Sciatic Nerve ; Water

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

PURPOSE: To determine the risk factors of intraoperative complications in femtosecond laser-assisted cataract surgery. METHODS: This study included 598 eyes of 337 patients who underwent femtosecond laser-assisted cataract surgery (FLACS) between July, 2012 and January, 2017. All eyes had corneal incisions, anterior capsulotomy, nuclear fragmentation, and limbal relaxing incisions (if required). Intraoperative complications were analyzed by watching videos, and the related factors of each complication were retrospectively reviewed alongside the medical records. RESULTS: The mean age of the patients was 62.1 ± 11.9 years. Among the study group, 18 eyes required manual creation of corneal incisions; because the corneal incisions could not be made due to corneal central opacity, corneal peripheral degeneration, ptreygium, conjunctival chalasis, or idiopathic. The anterior capsulotomy was incomplete in 43 cases and manual capsulorrhexis was required for completion. These cases were associated with various conditions, including hypermature cataract, anterior polar or subcapsular cataract, corneal central opacity, pupillary abnormality, lens subluxation, poor pupil dilation, and idiopathic. Overall, 22 eyes had difficulties with nuclear fragmentation, with either mature cataract, lens subluxation, corneal central opacity, anterior polar or subcapsular cataract, or pupillary abnormality. Using the Laser SoftFit™ patient interface decreased the incidences of incomplete corneal incision (from 3.56% to 2.24%, p = 0.367), anterior capsulotomy (from 9.31% to 4.03%, p < 0.05), and nuclear fragmentation (from 5.20% to 1.34%, p < 0.05). The incidences of complications in the experienced group was statistically lower compared with the novice group (p < 0.05 for all comparisons). CONCLUSIONS: The femtosecond laser platform was effective and safe for cataract surgery. However, in the presence of related factors, use of this platform might need to be re-assessed and should be considered for intraoperative complications. Additionally, with the Laser SoftFit™ patient interface and improved surgeon experience, better intraoperative results can be expected for FLACS surgery.
Capsulorhexis ; Cataract* ; Corneal Opacity ; Humans ; Incidence ; Intraoperative Complications ; Lens Subluxation ; Medical Records ; Pupil ; Retrospective Studies ; Risk Factors*

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

PURPOSE: We have investigated the long term effect, stability, predictability and complication of ICL implantation to treat high myopia. METHODS: We investigated retrospectively in 176 eyes of 97 patients with spherical equivalent -11.91D (-6D~-23D) that were followed up for at least 6 months after ICL implantation. RESULTS: Mean spherical equivalent was maintained stable as -0.54D at 1 week post-operatively, and at -0.55D for 5years. There was high effect and predictability, with 92.3% of the eyes exhibiting a greater than or equal to best corrected visual acuity (BCVA), 83% of eyes having a post-operative uncorrected visual acuity (UCVA) of 0.5 or better, 91.3% having a post-operative refraction of -1.0D~+1.0D, and 86.4% having a post-operative refraction of -0.5D~+0.5D. The most common complications were glare and halos. With a temporary increase in IOP, significant endothelial cell loss was observed. Repositioning for a dislocated ICL was done in 3 eyes. Post-operative cataracts were found in 7 eyes (3.9%), which was a significant increase in incidence, but not surprising, as the patients were older and had lower Vaulting values. CONCLUSIONS: ICL implantation to treat high myopia was an effective surgery with good predictability and stability, and effective in both short term and long term follow-up periods.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Glare ; Humans ; Incidence ; Myopia* ; Retrospective Studies ; Visual Acuity

The evaluation of stereoacuity provides relatively accurate assessment of binocular function. However, it is difficult to perform and also the reliability rate is low in the 2-to 5-year-old age range. We investigated the over-all success rate, the success rate according to age, and efficacy with the Randot preschool stereoacuity and Lang test in the 2-to 5-year-old children of 96 patients. The overall success rate of the two stereotests were 84. 4%, 47. 4%in the 2-year-old children and more than 87%in children over 3-year-old. When children with normal binocular vision were examined with the Randot preschool stereoacuity test, mean stereoacuity was 333 arc sec in the 2-year-age group, 135 arc sec in the 3-year-age group, 48 arc sec in the 4-year-age group, and 50 arc sec in the 5-year-age group. Sensitivity and specificity of Randot preschool stereoacuity test were 100%, 94. 2%, respectively. Sensitivity and specificity of Lang test were 100%, and 92. 4% respectively. As a result, Randot preschool stereoacuity and Lang stereotests might be considered easy available and valuable test for evaluating binocular function in the 3-to 5-year-old preschool children. Moreover, the Randot preschool stereoacuity provided a relatively accurate measurement of stereoacuity in the 3-to 5-year-old age range.
Child ; Child, Preschool ; Humans ; Sensitivity and Specificity ; Telescopes ; Vision, Binocular