No abstract available.
Orbit*

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.

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

The authors have studied 132 biopsy specimens of the levator muscle by light microscopy and electron microscopy, after the external levator resetion for congen ital and acquired ptosis in 98 patients. Severe atrophy and complete absence of the levator muscle fiber were observed frequently in the all types of congenital and acquired ptosis, Fibrosis and fatty infiltration of the levator muscle and Miiller's muscle were examined in the specimens with severe atrophy of muscle fibers, There was no histopathological difference between congenital and acquired ptosis. On histochemical detection of muscle fibers using ATPase stain, lightly stained type I fibers of the levator muscle were larger in amount than darkly stained type II fibers and atrophy of the two fiber was similar in degree. Muller's muscle fiber was preserved well in normal structure.
Adenosine Triphosphatases ; Atrophy ; Biopsy ; Fibrosis ; Humans ; Microscopy ; Microscopy, Electron

Sixteen canaliculoplasties using Mini-Monoka(R) were performed for repair of monocanalicalar lacerations. Mini-Monoka(R) was introduced into the dilated punctum and the proximal canaliculus, and passed through the distal end of the canaliculus. End-to-end anastomosis was done with 9-0 Ethylone(spatula needle) or 6-0 Vicryl(round needle). Fixation suture was placed with 6-0 black silk to secure the head portion of Mini-Monoka(R). Removal of the tube was performed 4 months after surgery. After the follow-up period of 6-14 months(mean 9.3 months), fifteen eyes were successful. One eye had intermittent epiphora with canalicular obstruction due to early loss of the tube. Postoperative complications were one case each of punctal slit, punctal granuloma and corneal erosion. The authors suggest that canaliculoplasty using Mini-Monoka(R) is an ideal procedure for repair of monocanalicular laceration. The advantages of this procedure include 1) no damage of the another intact canaliculus, 2) no passage through the nasal cavity, 3) easy technique, 4) short operation time, 5) less discomf ort and 6) cosmetically well acceptable.
Follow-Up Studies ; Granuloma ; Head ; Lacerations ; Lacrimal Apparatus Diseases ; Nasal Cavity ; Postoperative Complications ; Silk ; Sutures

The degree and completion of the fibrovascular ingrowth into the implant were evaluated by magnetic resonance imaging on twenty-one cases of intraorbital hydroxyapatite implant insertion following evisceration (16 cases), enucleation (3 cases), and secondary implantation (2 cases) operated at the Department of Ophthalmology, Yeungnam University Hospital during the period from April 1993 through June 1995. Six to seven microholes were made into the hydroxyapatite sphere. It was inserted into the orbital cavity without wrapping with the preserved sclera during the enucleation procedure and posterior scleral incision was performed for insertion of the implant in the evisceration procedure. The magnetic resonance imaging was first taken 2 months postoperatively and then a month interval by the time of complete fibrovascularization. The range of complete fibrovascularization time varied from 86 to 203 postoperative days. The mean time was 4.48 months which was significantly faster than that of the other authors reported in the literatures. The complete fibrovascularization time of the implant had no significant relation to the preoperative conditions, the age, the surgical procedures and the sizes of the implant.
Durapatite* ; Magnetic Resonance Imaging* ; Ophthalmology ; Orbit* ; Sclera