Apraclonidine is a potent alpha-adrenergic agonist that, like clonidine, is relatively selective for alpha-2 receptors. Apraclonidine has been shown to lower intraocular pressure by diminishing aqueous humor formation. The purpose of this study is to know the morphological changes in the ciliary epithelium by apraclonidine against aqueous formation. In group I, two drops of 1% apraclonidine hydrochloride were instilled on the right eye of the pigmented rabbits and the eyes were enucleated on 1,2.6 and 24 hours after instillation to find out the duration of action of the drug and the tissue response. In group II, one drop was instilled twice daily for seven days on the right eye and the eyes were enucleated on 1, 2 and 5 days after cessation of the instillation observing the cumulative effect of the drug and the tissue response. These eyes were studied with electron mIcroscopIc examiation. As a result, widening of cell membranes(basal infoldings) of the non-pigmented epithelium(NPE) were observed. This change was recovered with time, and seems to be the principal morphological changes of apraclonidine against aqueous formation in the ciliary body. In group II, the cellular changes were minimal except for well developed rough endoplasmic reticulum representing resumed secretary function of the cell.
Rabbits ; Animals

Iridocorneal endothelial syndrome is a disease characterized by corneal endothelial degeneration, corneal edema, peripheral anterior synechia, iris stromal change, and secondary glaucoma. This syndrome is considered to have three major variations: Chandler's syndrome, progressive (essential) iris atrophy, and Cogan-Reese syndrome. We experienced three cases of iridocorneal endothelial syndrome with transient intraocular pressure elevation.

PURPOSE: The degree of laxity of the medial and lateral canthal tendon in Korean subjects with and without involutional entropion and epiphora was evaluated in the present study. METHODS: The present study included 180 normal subjects (360 eyes), 12 patients (15 eyes) with involutional entropion, and 41 patients (58 eyes) with epiphora. The degree of laxity of the medial and lateral canthal tendon, which grades the position of the inferior punctum, was measured using the lateral and medial distraction test. RESULTS: The mean degree of medial and lateral canthal tendon laxity was 1.83/1.08 in normal subjects. A statistical difference was not observed between sexes, and the mean degree of laxity tended to be higher in older patients. The mean degree of laxity was 2.78/2.18 and 2.28/1.22 in the involutional entropion group and the epiphora group, respectively. The involutional entropion group and the epiphora group underwent endoscopic endonasal dacryocystitis (D), medial spindle procedure (M), and endoscopic endonasal dacryocystitis with the medial spindle procedure and/or the tarsal strip procedure (T). The mean degree of laxity was 1.84/1.04 in group D, 3.00/1.20 in group M, 2.33/2.00 in group D + T, 3.20/1.40 in group D + M and 3.50/2.00 in group D + T + M before surgery. CONCLUSIONS: The results from the present study may aid in the selection of a basic treatment plan for Korean patients with involutional entropion or epiphora.
Dacryocystitis ; Entropion ; Humans ; Lacrimal Apparatus Diseases ; Tendons

PURPOSE: The clinical effectiveness of monocanalicular or bicanalicular intubation with sequential probing was evaluated in patients over the age of 24 months with congenital nasolacrimal duct obstruction. METHODS: Patients over 24 months of age with congenital nasolacrimal duct obstruction who underwent monocanalicular intubation with sequential probing (19 patients, 20 eyes) or bicanalicular intubation with sequential probing (22 patients, 22 eyes) were studied. Success rates and complications were evaluated. Silicone tube was removed 6 months after surgery. Success was defined as no epiphora and no retention on fluorescein dye disappearance test. RESULTS: The success rate was 95.0% (19 eyes / 20 eyes) in the monocanalicular intubation group and complications included 7 cases of early tube dislodgement, which achieved successful outcome. The success rate was 82.6% (19 eyes / 22 eyes) in the bicanalicular intubation group and complications included 4 cases of punctal slitting, and 3 cases of tube extrusion. The success and complication rates were not significantly different between the 2 groups (p = 0.608, p = 1.000, respectively). CONCLUSIONS: In congenital nasolacrimal duct obstruction, the monocanalicular tube intubation group had similar success and complication rates to the bicanalicular tube intubation group. Silicone tube maintenance for 2 months in the monocanalicular group and for 3 months in the bicanalicular group was sufficient.
Fluorescein ; General Surgery ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Silicones

Synovial sarcoma is a rare renal neoplasm that is not easy to diagnose unless SYT-SSX fusion transcripts are identified. We report here on a case of primary renal synovial sarcoma in a 35-year-old woman. A mass was discovered by accident in the lower part of the right kidney when ultrasonography was performed, and it was removed via radical nephrectomy. Grossly, the tumor was a homogeneously tan-brown soft mass that measured 4.5x3.2x3.0 cm, and it was encircled by a well-defined cystic space. The lesion exhibited hypercellularity of the oval or short spindle cells that were arranged in various solid sheets or intersecting fascicles. Immunohistochemically, the tumor showed diffuse positivity for vimentin, bcl-2 and CD99, and it showed focal positivity for epithelial membrane antigen. The SYT-SSX fusion transcripts were detected by reverse transcription-polymerase chain reaction (RT-PCR). Synovial sarcoma should be considered in the differential diagnosis when a spindle cell neoplasm is encountered in the kidney.
Adult ; Diagnosis, Differential ; Female ; Humans ; Kidney ; Kidney Neoplasms ; Mucin-1 ; Nephrectomy ; Oncogene Proteins, Fusion ; Sarcoma, Synovial ; Vimentin

PURPOSE: To evaluate anatomical locations and distributions of supraorbital notch and foramen using facial 3D computed tomography in the Korean adult population. METHODS: The study sample was composed of 87 adult patients with no history of trauma or ocular disease. The horizontal position of the supraorbital foramen or notch was recorded in relation to a vertical line defined by a reproducible hypothetical point, such as the nasion and mid-maxilla and the midpoint of the horizontal supraorbital plane. The distance and angle for each supraorbital foramen and notch were calculated from the defined vertical line. Furthermore, vertical distance from supraorbital plane, which was established using the highest points of both supraorbital rims, was obtained from the supraorbital foramen. RESULTS: The mean age of the 87 patients was 45.44 +/- 8.34 years (range, 30-59 years). There were 66 eyes in the supraorbital notch and 108 eyes in the supraorbital foramen. There were no distributional differences between the 2 sides. The mean horizontal distance of both types was 23.95 +/- 3.93 mm (range, 16.41-38.94 mm). The horizontal distance of male patients was longer than the female patients (25.18 +/- 4.16 mm vs. 22.63 +/- 3.19 mm, p < 0.001, based on independent t-test) and the horizontal distance of supraorbital notch was shorter than the supraorbital foramen (22.59 +/- 3.18 mm vs. 26.18 +/- 4.04 mm, respectively, p < 0.001, based on independent t-test). The mean vertical distance and mean angles of the supraorbital foramen were 3.02 +/- 1.119 mm and 6.81 +/- 2.31 degrees (degrees), respectively. CONCLUSIONS: The present study described the anatomical location of each supraorbital opening type in Korean adults. According to horizontal distance, a surgeon can avoid iatrogenic injury of the supraorbital neurovascular complex, especially during brow surgery. In addition, the anatomy can aid in targeting supraorbital neurovascular complex in cases of nerve block.
Adult ; Female ; Humans ; Male ; Nerve Block

PURPOSE: To investigate the clinical characteristics of ocular injuries for the prevention and predictability of visual prognosis and the treatment of ocular injuries using the ocular trauma score. METHODS: A retrospective survey was performed in 1341 eyes of 1257 patients, who visited Korea University Medical Center from May 2009 to December 2009. The sex, age, causes, diagnosis, primary ocular surgery, injury site, initial and final visual acuities and complications were statistically reviewed. The ocular trauma score was calculated by assigning certain numerical raw points to the following six variables: initial visual acuity, globe rupture, endophthalmitis, perforating injury, retinal detachment, and a relative afferent pupillary defect. The correlation of the ocular traumascore with the final visual acuity was investigated. RESULTS: The incidence of ocular injuries was higher in males (79.0%) than in females and was more common in people in their 40s and 20s respectively. Among the patient the diagnoses, corneal erosion was most common in males, orbital wall fracture was most common in females, and corneal erosion, orbital wall fracture, orbital contusion, and hyphema were most common overall. An ocular trauma score was less than 44 in 6 eyes (0.7%), 9 eyes (1.0%) between a score of 45 and 65, 48 eyes (5.2%) between a score of 66 and 80, 122 eyes (13.2%) between a score of 81 and 90, and 737 eyes (79.9%) between a score of 91 and 100. CONCLUSIONS: The present study determined that the ocular trauma score showed a good visual predictive value and could be used in prevention and treatment of ocular injuries.
Academic Medical Centers ; Contusions ; Endophthalmitis ; Eye ; Female ; Humans ; Hyphema ; Incidence ; Korea ; Male ; Orbit ; Orbital Fractures ; Prognosis ; Pupil Disorders ; Retinal Detachment ; Retrospective Studies ; Rupture ; Visual Acuity

PURPOSE: In this study we evaluated the location and shape of the optic canal using computed tomography (CT) for diagnosis and treatment of posterior orbital diseases. METHODS: Fifty patients, who had received a facial bone CT between November 2012 and June 2013 at Korea University Hospital were included in the present study. The location and shape of the optic canal was evaluated using 9 parameters on CT (P1: nasal bone tip; P2: middle point of tuberculum sellae; P3: root of columella nasi; P4: orbit end of the optic canal; P5: cranium end or the optic canal; P6: P1's projection on L2; L1: line that links P1 and P2; L2: goes through P3 and parallel to L1; L3: bisector of right and left and goes through P1). RESULTS: The distance between P3 and P4 was 81.5 mm and 75.6 mm in males and females, respectively (p = 0.001). The distance between P3 and P5 was 88.5 mm and 82.1 mm in, males and females, respectively (p = 0.001). The width of the orbital end and cranium end of the optic canal, the length of the optic canal was 2.4 mm, 4.1 mm, 10.9 mm in males and 2.3 mm, 3.6 mm, 10.2 mm, in females, respectively. CONCLUSIONS: By determining the location and shape of the optic canal, these results can facilitate endoscopic approaches to diagnose and manage posterior orbital diseases as well as manage and prevent disorders associated with the optic canal.
Diagnosis ; Facial Bones ; Female ; Humans ; Korea ; Male ; Nasal Bone ; Orbit ; Orbital Diseases ; Skull

PURPOSE: To present easily measurable 2D orbit computed tomography (CT) reference data that can be used in a preoperative study for orbital decompression and classification of individual orbital morphologies. METHODS: The study sample was composed of 77 patients with orbital contusion (42 Asian males + 35 Asian females = 154 orbits) who visited the emergency room of the Korea University Guro Hospital from September 2012 to June 2013. Patients with orbital wall fracture, retrobulbar hemorrhage, or eyeball rupture were excluded. Medical records including 2D orbit or facial bone CT were retrospectively reviewed and 4 orbital parameters (orbital length, OL; globe length, GL; GL/OL ratio and 2D cone angle) were measured. RESULTS: The average OL was 42.53 +/- 2.46 mm (35.63-49.09 mm) and average GL was 24.83 +/- 1.09 mm (22.75-28.13 mm). The average GL/OL ratio using these 2 parameters was 0.59 +/- 0.04 (0.50-0.68). The posterior cone angle was on average, 45.96 +/- 5.91degrees (29.35-60.04degrees). CONCLUSIONS: Simple measurement of 4 parameters using 2D orbit CT and classification of Asian individual orbital morphology may help in the choice of the most effective surgical technique for decompression surgery in thyroid eye disease patients.
Asian Continental Ancestry Group ; Classification ; Contusions ; Decompression* ; Emergency Service, Hospital ; Eye Diseases* ; Facial Bones ; Female ; Humans ; Korea ; Male ; Medical Records ; Orbit* ; Retrobulbar Hemorrhage ; Retrospective Studies ; Rupture ; Thyroid Gland*

BACKGROUND: Defects caused by excision of benign lid margin tumors are conventionally repaired by reconstructive surgery. However, second intention healing is another option for managing wounds on the lid margin. OBJECTIVE: To evaluate the effectiveness of second intention healing after a shave excision of benign tumors on the lid margin. METHODS: Lid defects following a shave excision of the lid margin tumor were allowed to heal by second intention in 25 patients (26 lesions). The epithelialzation period was calculated, and cosmetic and functional results and complications were evaluated by photographs and ophthalmological examination. RESULTS: The locations of the defects were as follows: upper lid (n=13), lower lid (n=11), and both upper and lower lids (n=1). The mean tumor size was 3.8x3.6 mm, and the mean epithelialization period by second intention was 6.1+/-1.2 weeks. Pathological examinations revealed intradermal nevus (12 cases), compound nevus (five cases), squamous papilloma (five cases), and epidermal cyst (three cases). No patients had a corneal erosion, trichiasis, or hypertrophic scar, except loss of cilia in two cases. The functional and cosmetic results were satisfactory in all patients. CONCLUSION: Healing by second intention is a safe and effective alternative to surgical reconstruction after a shave excision of benign lid margin tumors.
Cicatrix, Hypertrophic ; Cilia ; Cosmetics ; Epidermal Cyst ; Humans ; Intention ; Nevus ; Nevus, Intradermal ; Papilloma ; Trichiasis