To evaluate the possibility of Dacron patch for artificial sclera. Dacron(polyethylene terephthalate) which is readily available, biocompatable, safe, and inert synthetic material was implanted in the area of full-thickness scleral defect in rabbits. The histopathologic examinations showed that fibrovascular tissue invested into all interstices of Dacron filaments and fibroconnective tissue encapsulation around Dacron patch had strong connection with collagen fibers of recipient sclera at 4 weeks after graft There were no adverse reactions such as retinal detachment and fibrous proliferation into the vitreous cavity except mild inflammatory response of surrounding tissue at the early postoperative stage. As a result, Dacron graft showed successful firm adhesion to the recipient sclera without serious complications. Thus, We think that Dacron could possibly be used, instead of donor sclera, as artificial scleral graft material for the surgical treatment of perforating scleral diseases.
Collagen ; Humans ; Polyethylene Terephthalates* ; Rabbits* ; Retinal Detachment ; Sclera ; Scleral Diseases ; Tissue Donors ; Transplants*

A case of a juvenile xanthogranuloma of the corneoscleral limbus was encountered in a 5-year-old oriental boy, who presented with a 5-month history of a lump in the right eye. The lesion extended from the inferior limbus. This yellow-orange mass was vascular and firmly fixed to the underlying tissue. The lesion was diagnosed preoperatively as an atypical dermolipoma and an uneventful excisional biopsy was performed. The pathologic diagnosis showed the characteristic picture of a juvenile xanthogranuloma with numerous Touton giant cells. Dermoid and lipodermoid tumors, as a corneoscleral limbal mass, are the most frequently encountered in childhood. A juvenile xanthogranuloma is a rare and usually benign skin disease with an unknown cause, which occurs in infants and young children. However, it can occur also as a corneoscleral limbal mass in young children.
Child, Preschool ; Corneal Diseases/*pathology/*surgery ; Human ; *Limbus Corneae ; Male ; Scleral Diseases/*pathology/*surgery ; Xanthogranuloma, Juvenile/*pathology/*surgery

PURPOSE: To report the results of vision screening in the elderly and operations for the blind in 2003. METHODS: A nation-wide, indigent aged group of over 65-year-old of low-income population was surveyed. Visual acuity was tested, refractive error was measured, and ocular examination was performed to determine the group needed for operation. RESULTS: Among the indigent subjects who live in urban or rural community, 7, 750 subjects aged over 65 years old were examined by the ophthalmologists. For those screened, the most common ocular disease was cataract (4, 383 subjects, 45.4%), followed by conjunctival and scleral disease (1, 741 eyes, 18%), retinal disease (434 eyes, 4.5%), refractive errors (374 eyes, 3.9%). Surgery was performed on 1, 813 eyes of 1, 109 subjects, and these were classified by the disease category. Surgery for cataract was performed on 1, 762 eyes (97.2%), and for retinal disease on 51 eyes (2.8%). The visual acuity change after cataract surgery was 0.23 +/- 0.15 preoperatively and 0.64 +/- 0.25 postoperatively. CONCLUSIONS: Among the geriatric public health problem in eye care services, the most prevalent cause of visual impairment was senile cataract, for which the vision can be improved by surgery. Therefore, continuous vision screening and surgery for the blind among this group are important and should be performed more extensively.
Aged* ; Cataract ; Humans ; Poverty ; Public Health ; Refractive Errors ; Retinal Diseases ; Rural Population ; Scleral Diseases ; Vision Disorders ; Vision Screening* ; Visual Acuity

In order to assess the prevalence of ocular disorders of the aged patients, retrospective survey was carried out in 5,659 patients over the age of 60, who visited outpatient clinics of three hospitals (St. Mary's Hospital, Cheonnam University Hospital and Inha University Hospital) between 1989 and 1990. An analysis of data was resulted in as follow: 1. Proportion of the aged patients to total out-patients was 15%. 2. The age distributions of patients were sixties (59%), seventies (34%), over eighty (7%). 3. In the patient 60 years old and older, 36.9% of the cases had best corrected visual acuities of 0.7 or better. 4. The most prevalent ocular disorder was senile cataract (44.0%), and others included conjunctival and scleral diseases (14.9%), retinal diseases (14.4%), refractive error (9.1%), glaucoma (4.4%), and corneal diseases (3.2%). 5. The proportion of causes of blindness indicates; senile cataract (58.8%), retinal diseases (15.4%), glaucoma (6.8%), and corneal diseases (5.0%), etc. 6. The systemic disorders associated with ocular diseases were hypertension 7.0%, diabetes 5.0%, respiratory diseases 4.2%, and heart diseases 2.0%. 7. Visual acuities better than 0.4 were obtained in 87.4% of postoperative cataract surgeries in aged patients.
Age Distribution ; Ambulatory Care Facilities ; Blindness ; Cataract ; Corneal Diseases ; Glaucoma ; Heart Diseases ; Humans ; Hypertension ; Middle Aged ; Outpatients ; Prevalence* ; Refractive Errors ; Retinal Diseases ; Retrospective Studies ; Scleral Diseases ; Visual Acuity

A 40-year-old woman presented with ocular discomfort in both eyes that had persisted for several months. Six months ago, she had undergone a bilateral nasal and temporal conjunctivectomy using a bare scleral technique followed by a postoperative application of 0.02% mitomycin C (MMC) to treat her chronic hyperemic conjunctiva for cosmesis. Slit-lamp examination revealed that the patient had bilateral nasal and temporal scleral thinning, and a calcified plaque on her nasal conjunctiva. There was no episcleral tissue present around the wound area, and it was difficult to detect any normal conjunctival tissue in the adjacent area for covering the lesion. We believe that performing an aggressive conjunctival excision procedure followed with MMC application for cosmetic enhancement may be disastrous in certain cases.
Adult ; Antibiotics, Antineoplastic/adverse effects ; Conjunctival Diseases/*drug therapy/pathology/*surgery ; Female ; Humans ; Mitomycin/*adverse effects ; Postoperative Complications/*chemically induced/pathology ; Scleral Diseases/*chemically induced/pathology

To describe the first case of the treatment of a corneoscleral cyst by distilled water injection into a corneal cyst. The anterior wall of a cyst of the limbal communication was punctured with a surgical blade. Aspiration and irrigation of the contents of the cyst with a 27-gauge anterior chamber cannula were performed repeatedly, three times. Distilled water, instead of balanced salt solution, was injected into the collapsed cyst, and was then aspirated completely after 5 minutes. The injection and aspiration of distilled water was repeated once more. The scleral cyst was surgically excised. Twelve months after surgery, several small white granular opacities, presumably epithelial cell nests, were observed on the interface of the collapsed cyst cavity, but there was no recurrence of the cyst. The best spectacle-corrected visual acuity (BSCVA) was 1.0 with a correction of +1.25-2.00 X 45. No significant change in central corneal endothelial cell density was noted. We suggest that this simple technique may represent an alternative method for the management of corneal cysts, and may have less risk of developing a corneal opacity or causing other serious damage to surrounding tissues.
Adolescent ; Cornea/*pathology ; Corneal Diseases/pathology/*therapy ; Corneal Topography ; Cysts/pathology/*therapy ; Human ; Injections ; Irrigation ; Male ; Scleral Diseases/pathology/*therapy ; Visual Acuity ; Water/*administration&dosage

One patient with bilateral acute retinal necrosis underwent encircling scleral buckle, vitrectomy, and intravitreal acyclovir on both eyes. This procedure was performed on the right eye while the retina was attached. The retina of the right eye was reattached by performing fluid-gas exchange and modified panretinal photocoagulation when the retina subsequently detached. Soon after the development of retinal detachment in the left eye, the above surgical procedures were performed on the left eye, and the retina was successfully reattached.Bilateral acute retinal necrosis with significant vitreous opacification, which is a devastating ocular disease causing possible blindness in both eyes, requires more aggressive, early surgical management.
Acute Disease ; Acyclovir/therapeutic use ; Adult ; Fundus Oculi ; Humans ; Light Coagulation ; Male ; Necrosis/surgery ; Retinal Detachment/surgery ; Retinal Diseases/drug therapy/pathology/*surgery ; Scleral Buckling ; Syndrome ; Vitrectomy

Congenital coloboma which is characterized by an absence of a part of normal ocular tissues involving iris, lens, ciliary body, choroid, and optic nerve. And choroidal coloboma is a rare disease in which there are defects of a part or all parts of choroid and retinal pigment epithelium. Retinal detachment has been reported in 23-42% of the patients with choroidal coloboma, and when retinal breaks are within the area of coloboma, conventional scleral buckling technique has resulted in low rates of anatomic success. We report a case of choroidal coloboma combined by retinal detachment which was treated by pars, plana vitrectomy, fluid-gas exchange, and laser photocoagulation.
Choroid* ; Ciliary Body ; Coloboma* ; Humans ; Iris ; Light Coagulation ; Optic Nerve ; Rare Diseases ; Retinal Detachment* ; Retinal Perforations ; Retinal Pigment Epithelium ; Retinaldehyde* ; Scleral Buckling ; Vitrectomy

We report four cases in which a pericardium (Tutoplast(R)) plug was used to repair a corneoscleral fistula after Ahmed Glaucoma Valve (AGV) explantation. In four cases in which the AGV tube had been exposed, AGV explantation was performed using a pericardium (Tutoplast(R)) plug to seal the defect previously occupied by the tube. After debridement of the fistula, a piece of processed pericardium (Tutoplast(R)), measured 1 mm in width, was plugged into the fistula and secured with two interrupted 10-0 nylon sutures. To control intraocular pressure, a new AGV was implanted elsewhere in case 1, phaco-trabeculectomy was performed concurrently in case 2, cyclophotocoagulation was performed postoperatively in case 3 and anti-glaucomatous medication was added in case 4. No complication related to the fistula developed at the latest follow-up (range: 12~26 months). The pericardium (Tutoplast(R)) plug seems to be an effective method in the repair of corneoscleral fistulas resulting from explantation of glaucoma drainage implants.
Adolescent ; Corneal Diseases/etiology/*surgery ; Device Removal/adverse effects ; Fistula/etiology/*surgery ; *Glaucoma Drainage Implants ; Glaucoma, Neovascular/*surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Pericardium/*transplantation ; *Postoperative Complications ; Reoperation ; Scleral Diseases/etiology/*surgery ; Suture Techniques

The branch retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. Complications such as macular edema, retinal neovascularization, vitreous hemorrhage, epiretinal membrane may be associated. But, the retinal detachment may occur rarely in BRVO patients. We studied the clinical features of retinal detachment associated with branch retinal vein occlusion. We reviewed the medical records of 15 retinal detachment patients associated with branch retinal vein occlusion. Mean age was 54.7 years old and 10 patients(66.7%) were female. Hypertension was associated in 13cases(86.7%). The duration between the development of BRVO and the development of retinal detachment was shorter than 4 years in all cases and shorter than 2 years in 9 cases(60.0%). Retinal break was identified in 14 cases(93.3%), among which 13 cases(92.2%) were located inside the lesion of branch vein occlusion. The epiretinal membrane was frequently combined 8 cases(53.3%). The preoperative laser photocoagulation was done in 4 cases(26.7%). The primary surgical procedures included scleral buckling in 8 cases(53.3%), pars plana vitrectomy in 6 cases(40.0%), and scleral buckling with pars plana vitrectomy in 1 case(6.7%). Three cases(20.0%) required reoperations. The postoperative complications included the progression of cataract in 6 cases(40.0%), iatrogenic retinal tear in 3 cases(20.0%), epiretinal membrane in 2 cases(13.3%), and proliferative vitreoretinopathy in 1 case(6.7%). The anatomic retinal reattachment was achieved in 14 cases(93.5%) and the visual recovery in 11 cases(73.3%).
Cataract ; Diabetic Retinopathy ; Epiretinal Membrane ; Female ; Humans ; Hypertension ; Light Coagulation ; Macular Edema ; Medical Records ; Postoperative Complications ; Retinal Detachment* ; Retinal Neovascularization ; Retinal Perforations ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Scleral Buckling ; Vascular Diseases ; Veins ; Vitrectomy ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage