The anatomic and physiologic changes of the anopthalmic orbit affect cosmetic appearance of the patient and function of the socket and the prosthesis. During the past three years, the authors studied 13 cases of dermis-fat graft and 27 cases of posterior Tenon's capsule suturing with a plastic implant, and compared the post'operative effects of the two procedures. Dermis-fat graft produced good fornix formation with no remarkable fat atrophy after both primary and secondary proceddure. Posterior Tenon's capsule suture technique showes good effect to keep implant from migration or extrusion. Size of the plastic implant and fixation of the extraocular muscles were important factors also for good cosmesis and implant motility. There revealed no significant difference between the two procedures in EOM motility, enophthalmos, deep superior sulcus deformity, implant migration or prolapse etc.

No abstract available.
Orbit*

Fifty-four marginal rotation procedures for cicatrical entropion and marginal entropion were performed in twenty-eight patients (8 males, 20 females). The age ranged from 4 to 74 years old (meant 51.1 years old). After the follow up periods of 6 to 48 months, excellent correction of the eyelid margin and good cosmetic appearance were noticed in most cases, but nine cases combined with severe trichiasis showed recurred trichiasis requiring reoperation.
Entropion ; Eyelids ; Follow-Up Studies ; Humans ; Male ; Reoperation ; Trichiasis

Experimental parotid duct-conjunctivoplasty was carried out using great saphenous vein graft in six dogs. After the operation, the tear meniscus level in the operated eye was higher than that of the control eye. The parotid secretion was noticed through the conjunctival opening of the vein graft in the lower lateral fornix. Profuse tearing was not detected during the time of having meal, which was supposed due to a good lacrimal drainage. In Schirmer test of the operated eye, the preoperative mean value was similar to the postoperative value. But, the intraprandial mean value of Schirmer test was measured as slightly higher than the preprandial value. In paired t-test, no significant difference could be detected. On scintigraphic study with 99mTc-O4, three cases of the four dogs revealed the parotid flow with good patency of the grafted vein. These results suggest that the parotid duct-conjunctivoplasty will be an effective surgery for dry eye syndrome, if the grafted vein could be kept from an obstruction for a prolonged period.
Animals ; Dogs ; Drainage ; Dry Eye Syndromes ; Meals ; Saphenous Vein* ; Transplants* ; Veins

PURPOSE: The preoperative axial length measured by ultrasonography in the phthisis bulbi and the postoperative surgical outcome was evaluated in order to determine the surgical procedure of an evisceration or enucleation. METHODS: The preoperative axial length was measured by ultrasonography in 30 eyes of 30 patients with phthisis bulbi from January 2000 to October 2002. Enucleation was performed on 20 eyes with a relatively short preoperative axial length. The axial length of the enucleated globe was measured and compared with the preoperative axial length. Evisceration was performed in 10 eyes with a relatively long preoperative axial length. The size of the implant, the thickness of prosthesis, and the complications were evaluated postoperatively. RESULTS: In the 20 eyes that underwent enucleation, the preoperative axial length was 6.8~16.6 mm (mean 12.4 mm) and the axial length of the enucleated globes was 9.0~20.0 mm (mean 15.3 mm). The size of implants was 16.5~20.0 mm (mean 19.5 mm). In the 10 eyes that underwent evisceration, the preoperative axial length was 13.5~22.7 mm (mean 19.1 mm). The size of the implants was 18.5~20.0 mm (mean 19.4 mm). During a follow-up period of 6-30 months (mean 16.0 months), none of the eyes showed any complications such as conjunctival dehiscence or implant exposure or extrusion. CONCLUSIONS: The preoperative axial length measurement was helpful in deciding if enucleation or evisceration of the phthisis bulbi should be performed. Evisceration was performed sufficiently in cases of a preoperative axial length of 16 mm or more.
Follow-Up Studies ; Humans ; Prostheses and Implants ; Ultrasonography*

Sixty-five levator aponeurotic surgeries were carried out to treat acquired and congenital blepharoptosis including those with very poor levator function. Margin reflex distance(MRD) was measured and postoperative drooping of the upperlid was observed carefully during the follow-up period of 6 months to 1 year. Most of these cases had a stationary level of MRD or less than 1 mm change of MRD but three cases resulted in more than 1.5 mm postoperative fall of the upperlid. This procedure also proved the excellent surgical efficacy in severe congenital ptosis with very poor levator function. In our experience, about 1 mm overcorrection at surgery provided a more satisfactory result.
Blepharoptosis ; Follow-Up Studies ; Reflex

BACKGROUND: Tandem duplication of chromosome 17p11.2-p12 including peripheral myelin protein 22 (PMP22) gene is the most frequent cause of Charcot-Marie-Tooth 1A (CMT1A). Patients carrying one extra copy of PMP22 develop CMT1A, whereas the deletion of the 17p11.2-p12 region causes hereditary neuropathy with the liability to pressure palsies (HNPP). In the present study, we established the genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the 17p11.2-p12 regions by the hexaplex PCR for the genetic diagnosis of CMT1A duplication and HNPP deletion. METHODS: We established polymorphic behavior and genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the duplication region. The 6 markers were amplified by hexaplex PCR reaction and analyzed by an automatic sequencing analyzer and genotyper program. RESULTS: The genotype distributions of all markers were not significantly deviated from the Hardy-Weinberg equilibrium (P>or=0.05). When comparing the control group and CMT1A, HNPP patients group by the distribution of allele, there is no significant difference in the 5 locus except in the 1 locus (D17S921) among HNPP patients. The specificity was more than 99.9%. The sensitivity of each CMT1 and HNPP was 56.3% (40/71 pedigrees) and 72.1% (31/43 HNPP pedigrees), respectively. CONCLUSIONS: The error rate for the system may be less than 0.001. According to this study, it is possible to have rapid and exact genetic diagnosis of both CMT1A and HNPP, which may be helpful for the development of personalized therapy according to genetic defects.
Alleles ; Charcot-Marie-Tooth Disease ; Diagnosis* ; Genotype ; Humans ; Microsatellite Repeats* ; Multiplex Polymerase Chain Reaction* ; Myelin Sheath ; Paralysis ; Polymerase Chain Reaction ; Sensitivity and Specificity

PURPOSE: To evaluate the success rate of conventional skin dacryocystorhinostomy(DCR), the success rate and postoperative complications were evaluated after the follow-up period of 6~72 months(average 16.7 months), and compared with those of our previous reports on endonasal DCR, at postoperative 6 months(PO6M) and 12 months(PO12M). METHODS: skin DCR was performed in 76 patients, 89 eyes between July 1993 and June 2000 at the Department of Ophthalmology, Yeungnam University College of Medicine. RESULTS: Primary success rate of skin DCR was 93.3%, and the final success rate after revision of mucosal ostium revealed 96.6%. Postoperative complications included 7 cases of silicone tube protrusion and 4 cases of mucosal ostium obstruction. CONCLUSIONS: Primary success rate of skin DCR was 93.3%, and those of endonasal DCR were 92.3%(PO6M) and 89.8%(PO12M). The final success rate of skin DCR was 96.6%, and those of endonasal DCR were 98.4%(PO6M) and 99.2%(PO12M).
Follow-Up Studies ; Humans ; Ophthalmology ; Postoperative Complications ; Silicones ; Skin

This study was carried out to compare the clinical effect of the endonasal lacrimal surgery done in 75 eyes of the 62 patients with that of the conventional lacrimal surgery done by the same operator in 72 eyes of the 57 patients. The diameter of intranasal ostium was 1.9 +/- 0.4 mm in endonasal approach and 2.6 +/- 1.4 mm in skin approach (p<0.05), respectively. Postoperative hospitalization were 1.7 - 2.5 days shorter in endonasal lacrimal surgery than those of conventional lacrimal surgery (p<0.001). Satisfactory tear drainge was observed in 29 eyes (90.6%) after endonasal dacryocystorhinostomy and in 28 eyes (90.3%) after conventional dacryocystorhinostomy, and 41 eyes (95.3%) revealed astisfactory tear drainge after endonasal conjunctivodacrystorhinostomy and 39 eyes (95.1%) showed good results after conventional conjunctivodacr yocystorhinostomy. In summary, endonasal lacrimal surgery showed no cutaneous scar, less edema and hematoma with short recovery time and similar success rate to the conventional lacrimal surgery. Thus, endonasal lacrimal surgery might be better than conventional lacrimal surgery.
Cicatrix ; Dacryocystorhinostomy ; Edema ; Hematoma ; Hospitalization ; Humans ; Skin ; Tears

PURPOSE: Achieving good eyelid position and symmetric palpebral fissure for asymmetric bialteral congenital ptosis would require skillful technique and a lot of experiences of surgeon. Patients were divided into two groups, A and B, in terms of preoperative MRD and the possible relationship between preoperative MRD difference. The outcome of the surgery was studied. METHODS: External levator resection with apponeurotic approach was performed for 19 patients with asymmetric bilateral congenital ptosis from October 1994 to June 2000. According to differences of MRD between the both eyes, patients were divided into two groups. Group A included 8 patients with 1.0~2.0 mm of MRD differences, and group B included 11 patients with more than 2.0 mm of MRD differences. RESULTS: Age of patients ranged from 3 to 20 years (mean 6.1 years) and follow-up period was 9 to 60 months (mean 20 months). Six patients of group A and seven patients of group B showed almost excellent symmetric palpebral fissure. Only one patient of group B had postoperative MRD difference more than 2.0 mm, and none in group A. CONCLUSIONS: Success rate was 100% in group A and 91% in group B, but no statistical difference was found between group A and group B (p>0.05).
Eyelids ; Follow-Up Studies ; Humans