On supine position the patient fixed at a point on the celling with the intact eye. Under the fluoroscope the tip of lacrimal probe was brought on the sclera, where the foreign body cast its shadow. Two exposures were taken at right angle. one frontally and the other laterally. The location of the foreign body was calculated with reference to the lacrimal probe. If a fluoroscope was not availabe, a lacrimal probe was brought to the estimated point on the sclera and two exposures were taken as above. If there was an error more than 3 mm between the indicator and the foreign body, the second localization was almost indispensable for the successful surgery. Bone free technique of Vogt was applied for very small foreign body in the anterior vitreous cavity. This accurate and convenient technique may be applied in every clinics for preparing the foreign body extraction, because it requires no special apparatus other than a standard X-ray machine and a lacrimal probe.
Foreign Bodies* ; Humans ; Sclera ; Supine Position

Normal pattern VEP was measured to applicate its value in the comparison with abnormal pattern VEP findings of various ocular disease. Mean P1 latency time in 74 healthy subjects of 20 to 60 years old with uncorrected or corrected visual acuity better than 0.9 was 92.51 +/- 4.35 msec and mean amplitude was 11.58 +/- 3.45 micro V. There was no statistically significant difference between male and female iri latency time and amplitude. The latency time was delayed in the 6 th decades. The amplitude was largest in VEP stimulated with 13.1 X 10.6 min checksize, but the changes of latency in 60 min to 10 min check-size was not statistically signifiant. In the emetropic state, the amplitude was largest and visual acuity was correlated with the amplitude. In miotic eyes, the latency time was delayed and the amplitude was largest in physiologic pupil. The amplitude and latency was similar in the location of recording electorde at 2~4 cm above inion.
Female ; Humans ; Male ; Middle Aged ; Pupil ; Visual Acuity

While retinal detachment is not rarely associated with posterior staphyloma and macular hole, very few cases of retinal detachment with equatorial scleral staphyloma are reported until recentily. In the course of retinal detachment surgery, an equatorial staphyloma is found unexpectedly and makes surgical treatment difficult. We experienced a 70 year old woman who had retinal detachment due to a hole at the 1 o'clock equator. During the retinal detachment surgery, a large equatorial staphyloma was noted right over the retinal hole. Scleral surface buckling procedure and graft using the preserved human sclera were performed. After the follow up period of 6 months, retina was still reattached.
Aged ; Female ; Follow-Up Studies ; Humans ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Transplants

PURPOSE: To evaluate the effectiveness of a dexamethasone intravitreal implant (Ozurdex(R)) in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone. METHODS: We reviewed 9 eyes of 9 patients with diabetic macular edema treated with dexamethasone intravitreal implant. The patients were included in the study if presenting with refractory diabetic macular edema of more than 3 months despite combined treatment of intravitreal bevacizumab injection with posterior subtenon triamcinolone injection or intravitreal triamcinolone injection. We assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography at initial visit and 1, 3 and 4 months. RESULTS: The mean follow-up was 6.7 +/- 2.2 months. The baseline mean BCVA was 0.81 +/- 0.47 logarithm of the minimum angle of resolution (log MAR), which improved to 0.61 +/- 0.37 log MAR (p = 0.017), 0.57 +/- 0.38 log MAR (p = 0.011) and 0.62 +/- 0.36 log MAR (p = 0.027) at 1 month, 3 months and 4 months, respectively. The baseline mean CMT was 558.0 +/- 110.32 microm and decreased to 325 +/- 64.21 microm (p = 0.008) and 300.22 +/- 59.46 microm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 +/- 150.85 microm (p = 0.058) at 4 months after injection. CONCLUSIONS: Dexamethasone intravitreal implant showed short-term efficacy in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone and produced significant improvements in BCVA and CMT until 3 months after injection. The CMT then increased, but BCVA was sustained until the fourth month.
Dexamethasone* ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema* ; Tomography, Optical Coherence ; Triamcinolone ; Visual Acuity ; Bevacizumab

VEP is an objective method for the evaluation of macular function and optic nerve disease, but its large inter and intraindividual variation prevented clinical and experimental application. We recorded a relatively stable VEP A wave in pigmented rabbits with cortical electrode and following results were obtained. The amplitude of VEP A wave was 97.8 +/- 29.8 micro V and latent time was 52.2 +/- 6.9 msec. Inter- and intraindividual variation of VEP latent time was much smaller than that of VEP amplitude. So latent time of VEP A wave may be a good indicator in evaluation of pharmacologic and toxicologic experiment of systemically administered drug.
Electrodes ; Evoked Potentials, Visual* ; Optic Nerve Diseases ; Rabbits*

Systemic lupus erythematosus(SLE) is a multisystem disorder in which the various organs are damaged by deposition of autoantibodies and immune complex. Ocular man-ifestations of SLE are involvement of the eyelids, conjunctiva, cornea, episclera, retina and optic nerve. Retinal vascular manifestations are the most common form of ocular manifestation. Most frequently these consist of cotton wool spots, retinal hemorrhage, but occasionally more severe retinal vaso'occlusive disease has been noted. The authors experienced 22 year'old woman who had SLE and severe retinal vaso'occlusive disease. Her left eye was treated with focal photocoagulation and vitrectomy but the visual acuity was F.C. 60 cm due to ischemic state of parafoveal capillary network. Right eye maintain visual acuity of 0.9 by photocoagulation and vitrectomy for vitreous hemorrhage and tractional retinal detachment. As shown in this case, the SLE patients who developed vitreous hemorrhage due to extensive retinal vaso-occlusive disease may have very poor visual prognosis. So periodic ocular examinations and appropriate treatment for vascular occlusion can prevent serious visual loss in SLE.
Antigen-Antibody Complex ; Autoantibodies ; Capillaries ; Conjunctiva ; Cornea ; Eyelids ; Female ; Humans ; Light Coagulation ; Lupus Erythematosus, Systemic* ; Optic Nerve ; Prognosis ; Retina ; Retinal Detachment ; Retinal Hemorrhage ; Retinaldehyde* ; Traction ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Wool

A retrospective study is reported on 96 eyes treated by pars plana vitrectomy and intravitreal silicone oil tamponade for treatment of complicated retinal detachment to evaluate ocular complications secondary to intravitreal silicone oil complete retinal reattachment occurred in 59(61.5%) of 96 eyes at initial surgery. Recurrent retinal detachment and recurrent proliferative vitreoretinopathy occurred in 19(32.3%) and 15(25.4%) of 59 eyes respectively. The major complications associated with intravitreal silicone oil were cataract(96.6% of phakic eyes) and keratopathy(29.2%) and their peak onset was around 3 months after intravitreal silicone oil injection. Other complications were intraocular pressme elevation, hypotony, hyphema, fibrin reaction in anterior chamber, etc. These findings suggest that even though intravitreal silicone oil injection is a valid procedure for treatment of complicated retinal detachment, its removal is recommended after about 3 months before development of vision-threatening complicatoins such as cataract and keratopathy.
Anterior Chamber ; Cataract ; Fibrin ; Hyphema ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Silicone Oils* ; Vitrectomy ; Vitreoretinopathy, Proliferative

PURPOSE: In order to evaluate the prognostic factors of vitrectomy for the teatment of retinal detachment due to macular hole. METHODS: The medical records of 19 patients who had undergone pars plana vitrectomy were analyzed. RESULTS: After the first operation, the retinal reattachment was achieved in 12 patients out of 19 patients(63.2%). Among 7 patients who had persistent retinal detachment after the first operation, 6 patients underwent reoperation and 4 out of whom were successfully reattached. The final success rate was 88.9%(16 out of 18 patients). Between 12 patients with successful first operation and the remaining 7 patients, there were statistically significant differences in the incidence of posterior staphyloma, myopic chorioretinal atrophy, proliferative vitreoretinopathy, retinal detachment in two quadrant or more, and complete removal of epiretinal membrane(p<0.05). CONCLUSION: These results suggest that surgical success of post-operation of retinal detachment due to macular hole seems to be related to complete epiretinal membrane removal, proliferative vitreoretinopathy, posterior staphyloma, myopic chorioretinal atrophy and extension of retinal detachment.
Atrophy ; Epiretinal Membrane ; Humans ; Incidence ; Medical Records ; Prognosis* ; Reoperation ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Vitrectomy ; Vitreoretinopathy, Proliferative

Perfluorocarbon liquids have been shown to be a useful intraoperative adjunct in managing complicated retinal detachment. To prove the effectiveness of intraoperative use of perfluorocarbon liquid and the improvement of surgical and functional outcomes, we retrospcetively evaluated the clinical results of the patients[13 eyes]who had retinal detachment complicated with proliferative vitreoretinopathy [over PVR Grade C4, C4 :7 eyes, C5 :6 eyes]. We performed standard 3-port pars plana vitrectomy in all eyes included in this study.Perfluorodecalin[DK-line]was used as a shortterm vitreous substitute intraoperatively and removed before the end of the surgery. The mean follow-up period was 15 months.Anatomical success rate was 86%[6 eyes]in Grade C4, 67%[4 eyes]in Grade C5, Visual acuity was over 5/200 in one eye[8%]and there was improvement in 5 eyes[40%] although it was below 5/200. Consequently, we could easily manage the retinal detachment with PVR with help of intraoperative perfluorocarbon liquid and could improve the postoperative surgical and visual outcomes.
Follow-Up Studies ; Retinal Detachment ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative*

As the number of diabetic patient increases, it is important to manage diabetic retinopathy. Clinically sufficient pupillary dilatation should be obtained for fundoscopic examination and laser photocoagulation theraphy of diabetic patient but we experienced insufficient and delayed pupillary dilatation after instillation of mydriatics. In order to examine abnormality of pupillary dilatation and its relationship to the stage of diabetic retiniopathy, the course of pupillary diameter was measured with Haab's pupillometer after instillation of one drop of 1% Mydriacyl(R) and 2.5% Mydfrin(R) in 72 patients with diabetes mellitus (40-69 years old) and 11 normal controls (40-69 years old). The following results were obtained. After instillation of 1% Mydracy(R), the maximum pupillary diameter was smaller in diabetic retinopathy group than in controls. As the severity of diabetic retinopathy was increased, maximum pupillary diameter was decreased. After instillation of 2.5% Mydfrin(R), the delay of the average time to reach maximal mydriasis in diabetic group was larger than that in controls. This delay was proportional to the severity of diabetic retinopathy. Therefore it was considered that the abservation of the course of pupillary diameter after instillation of mydriatics would be useful for diagnosis of the severity of diabetic retinopathy.
Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Dilatation* ; Humans ; Light Coagulation ; Mydriasis ; Mydriatics*