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

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

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*

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

Surgical effects were evaluated in 37 cases of mono-canalicular laceration following canaliculoplasty using Mini-Monoka from April, 1993 through SEptember, 1997 in the Department of Ophthalomology, Yeungnam University, College of Medicine. Lower canalicular laceration was included in 33 cases and upper canalicular laceration was found in 4 cases. Distance from the punctum to the lacerated canaliculus was noted to be 1 to 9mm(mean 4.6mm) and age ranged from 3 to 57 years(mean29.3 years). Thirty-four patients were men and three were women. Punctal portion of Mini-Monoka was fixated at the punctum with 6-0 black silk suture. End to end anastomosis was performed with 9-0 Ethylone(spatula needle) or 6-0 Vicryl(round needle). Steroid and antibiotics eye drops were used for 6 months after surgery. Mini-Monoka was removed 4 months postoperatively. After the follow-up period of 6-49 months(mean 11.3 months), 36 cases became recanalized well but 1 case showed obstruction because the laceration site was distant, 9mm from the punctum. Postoperative complications included loss of tube(3 cases), granuloma of the punctum(3 cases) and corneal abrasion(2 cases). Canaliculoplasty using Mini-Monoka is a procedure of choice for repair of mono-canalicular laceration with prevention of loss of the tube by punctal fixation suture without damage of the intact another canaliculi and the inferior meatus.
Anti-Bacterial Agents ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Lacerations ; Male ; Ophthalmic Solutions ; Postoperative Complications ; Silk ; Sutures

The authors reviewed 73 cases of the eyelid tumors diagnosed histopathologically at Department of Ophthalmology, Yeungnam University Medical Center from March, 1984 to December, 1995. Twenty-three persons were men and fifty persons were women. The benign tumors were distributed evenly in all decades, but the malignant tumors were noted frequently in seventh and eighth decades. Histologically, benign tumors were 58 cases and malignant tumors were 15 cases. The frequency of benign eyelid tumors was noted in this order : nevus, cyst, squamous papilloma, hemangioma, seborrheic keratosis. Malignant eyelid tumors included 10 cases of basal cell carcinoma, 5 cases of meibomian gland carcinoma. The location of the benign tumors of the lids was noted in this order : the upper eyelid(30 cases), the lower eyelid(23 cases), the medial canthus(3 cases) and both eyelids(2 cases). In malignant tumors, the locations of basal cell carcinoma were the lower eyelid(6 cases), the medial canthus(3 cases) and the upper eyelid(1 case). Meibomian gland carcinoma was found in the upper eyelid(3 cases) and in the lower eyelid(2 cases). Excisional biopsy was performed in all of benign tumors(58 cases, 100%). For the treatment of the malignant tumors, simple excision(5 cases, 33%), excision and reconstruction(6 cases, 40%), excision and skin graf(3 cases, 20%) were performed. Exenteration and several courses of radiation therapy were carried out for a recurred meibomian gland carcinoma(1 case, 7%).
Academic Medical Centers ; Biopsy ; Carcinoma, Basal Cell ; Classification* ; Eyelids* ; Female ; Hemangioma ; Humans ; Keratosis, Seborrheic ; Male ; Meibomian Glands ; Nevus ; Ophthalmology ; Papilloma ; Skin

The relationship between intraorbital hydroxyapatite implantation and drilling was studied in 85 cases of 85 patients from September 1991 through December 1996 in the Separtment of Ophthalmology, Yeungnam University College of Medicine. The incidence of drilling after intraorbital implantation and the causes of not being able to drill were evaluated. Postoperative extraocular muscle and prosthetic motility of the cases with and without drilling were reviewed. Drilling was performed in 39 cases(45.9%). Forty-six cases were not received drilling due to mildly contracted, tight socket(17 cases), satisfactory prosthetic motility without drilling (13 cases), limitation of extraocular muscle motility(9 cases), thin prosthesis(4 cases) and exposure of implant(3 cases). A fter the follow-up period of 6-56 months(mean 18 months), postoperative prosthetic motility was satisfactory in 30 cases(76.9%) in drilling cases and 12 cases(26.1%) in non-drilling cases.
Durapatite ; Follow-Up Studies ; Humans ; Incidence ; Ophthalmology ; Orbit* ; Orbital Implants*