PURPOSE: To identify the long term clinical course of amblyopia and strabismus that developed secondary to a monocular corneal opacity following suspected epidemic keratoconjunctivitis (EKC) in infancy. METHODS: This was a retrospective study analyzing the medical records of seven patients, treated in our clinic, who were followed for more than five years. RESULTS: Four patients in our clinic underwent a corneal ulcer treatment following suspected EKC. Each developed a monocular corneal opacity. Three patients with a chief complaint of corneal opacity were transferred to our clinic from other clinics. These patients had documented histories of treatment for EKC in infancy. All patients were treated with early occlusion therapy, but amblyopia persisted in four patients. Furthermore, all patients had strabismus and showed a significant reduction of stereoscopic vision. CONCLUSIONS: Although infants with EKC are not always cooperative, slit lamp examination should be performed as early as possible, and appropriate medical treatment should be performed, thus reducing the development of corneal opacity. Careful follow up should be regularly performed, and the occurrence of amblyopia or strabismus should be verified at an early stage using visual acuity or ocular alignment examination. Ophthalmologic treatments, including active occlusion therapy, should also be pursued.
Adenoviridae Infections/*complications/diagnosis/epidemiology ; Amblyopia/*etiology/pathology/physiopathology ; Child ; Child, Preschool ; Corneal Opacity/*complications/pathology ; Disease Progression ; *Epidemics ; Eye Infections, Viral/*complications/diagnosis/epidemiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Keratoconjunctivitis/*complications/diagnosis/epidemiology ; Male ; Prognosis ; Refraction, Ocular ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Strabismus/*etiology/pathology/physiopathology ; Vision, Binocular ; Visual Acuity

PURPOSE: To evaluate and compare the efficacy and tolerance of fibrin glue and sutures for closing conjunctival wounds in strabismus surgery. METHODS: In a prospective trial, we performed strabismus surgery using limbal incisions. Conjunctival wounds were closed with fibrin glue in 20 eyes of 20 patients (fibrin group) and 8-0 polyglactin suture in 20 eyes of 20 patients (suture group). Postoperative pain, tearing, and inflammation were compared at 1 day, 1 week, 3 weeks, and 6 weeks after surgery. Conjunctival incision healing was also investigated. RESULTS: One day and one week post-operatively, pain and tearing scores were lower in the fibrin group (p = 0.000, respectively). Mean surgery time was significantly shorter in the fibrin (48 +/- 5 minutes) than the suture group (63 +/- 7 minutes) (p = 0.000). Inflammation was significantly more severe in the suture group until 3 weeks postoperative (p = 0.000, respectively), but conjunctival healing did not differ between the groups. Hyperemia appeared more prominent in the fibrin group 3 and 6 weeks after surgery (p = 0.087 and 0.000, respectively). Two eyes in the fibrin group showed conjunctival gaps of more than 2 mm, which closed spontaneously by three weeks after surgery. No allergic reactions or infections developed. CONCLUSIONS: Fibrin glue proved to be as effective as sutures in closing conjunctival wounds. It provides more comfortable early postoperative courses and might be considered as an alternative to sutures in strabismus surgery.
Adolescent ; Adult ; Child ; Child, Preschool ; Conjunctiva/*surgery ; Fibrin Tissue Adhesive/*therapeutic use ; Humans ; Inflammation/etiology/pathology ; Male ; Middle Aged ; Pain, Postoperative/etiology/physiopathology ; Polyglactin 910 ; Postoperative Period ; Severity of Illness Index ; Strabismus/*surgery ; *Sutures/adverse effects ; Tears/secretion ; Tissue Adhesives/*therapeutic use ; *Wound Closure Techniques/adverse effects ; Young Adult