1.Clinical Manifestation and Result of Vitrectomy of Vitreomacular Traction Syndrome.
Won Il RHIM ; Hyung Soo KIM ; Eun Koo LEE
Journal of the Korean Ophthalmological Society 2008;49(9):1468-1474
PURPOSE: To investigate the clinical manifestation and the result of vitrectomy in patients with vitreomacular traction syndrome. METHODS: Optical coherent tomography (OCT) was used to evaluate the clinical manifestation and the results of vitrectomy for 26 eyes with vitreomacular traction syndrome. RESULTS: Spontaneous relief of vitreomacular traction was achieved in 3 of 8 eyes after a mean follow-up duration of 9 months. One eye recovered visual acuity, but the other 2 eyes could not attain better visual acuity because of persistent sponge-like macular edemas. Six of 13 eyes (46%) improved by two or more lines of visual acuity after vitrectomy. The presence of simple macular cysts without sponge-like macular edemas or tractional retinal detachment seemed to be related to good results after vitrectomy. CONCLUSIONS: Vitrectomy is a preferable way to treat vitreomacular traction syndrome. Preoperative OCT could predict the surgical prognosis.
Eye
;
Follow-Up Studies
;
Humans
;
Macular Edema
;
Prognosis
;
Retinal Detachment
;
Traction
;
Visual Acuity
;
Vitrectomy
2.Two Cases of Ocular Ischemia following Scleral Encircling.
Hyung Su KIM ; Kyeong Bok KANG ; Won IL RHIM ; Eun Koo LEE
Journal of the Korean Ophthalmological Society 2007;48(8):1158-1162
PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged
;
Anesthesia
;
Anterior Chamber
;
Conjunctiva
;
Cryotherapy
;
Female
;
Glaucoma
;
Humans
;
Ischemia*
;
Mannitol
;
Muscles
;
Ophthalmic Artery
;
Paracentesis
;
Retinal Artery Occlusion
;
Retinal Detachment
;
Retinal Perforations
;
Young Adult
3.Correlation between the Thyroid Associated Ophthalmopathy and Thyroid Function State.
Won Il RHIM ; Seung Sik CHOI ; Helen LEW ; Young Soo YUN
Journal of the Korean Ophthalmological Society 2002;43(3):431-436
PURPOSE: To determine the prevalence of thyroid-associated ophthalmopathy (TAO) and the correlation between TAO and the thyroid function state. METHODS: 40 patients with TAO were selected among 2,000 patients of thyroid disease between September 1, 1995 and December 31, 2000, and classified by the Van Dyk's ''NOSPECS and RELIEF'' classification. T3, T4, TSH and Thyroid stimulating antibody (TSAb) levels were examined before and after treatment of TAO and thyroid disease. Relationship between TAO and thyroid function state was evaluated by using paired t-test and logistic regression test. RESULTS: The prevalence of TAO was about 2% in thyroid disease patients. Clinical manifestations of TAO were eyelid retraction (75%), exophthalmos (62.5%), soft tissue periorbital swelling (42.5%), diplopia and extraocular muscle restriction (20%), keratopathy (2.5%) and optic neuropathy (2.5%). Thyroid function state decided by T3, T4 and TSH level had no correlation with the improvement of TAO (p<0.05). But, TSAb level in improved TAO group (n=8) significantly decreased after treatment of TAO and thyroid disease (p<0.05). CONCLUSIONS: Thyroid function restoration may not help to improve the course of TAO. But, low TSAb level can be thought as a significant marker in improvement of TAO.
Classification
;
Diplopia
;
Exophthalmos
;
Eyelids
;
Graves Ophthalmopathy*
;
Humans
;
Immunoglobulins, Thyroid-Stimulating
;
Logistic Models
;
Optic Nerve Diseases
;
Prevalence
;
Thyroid Diseases
;
Thyroid Gland*
;
Troleandomycin
4.Analysis of Tear Composition in Chronic Blepharitis.
Won Il RHIM ; Ho Sun LEE ; Young Soo YUN ; Hyun Jung CHOI
Journal of the Korean Ophthalmological Society 2003;44(4):931-936
PURPOSE: To analyze the changes of tear composition in chronic blepharitis patients. METHODS: Tear samples were collected from 30 eyes of 29 patients diagnosed as chronic blepharitis by slit-lamp examination, and from 30 eyes of 30 normal volunteers. Chronic blepharitis group was subdivided into untreated group (10 eyes; tear sampling before the initiation of treatment) and treated group (20 eyes; tear sampling after the initiation of treatment). Tear pH, concentration of ions (Na+, K+, Cl-, Ca2+), total protein concentration and tear protein fraction (TPF) were measured. Statistical analysis was done by using Mann-Whitney U test and Kruscal-Wallis test, and p-value
5.Papanicolaou smear in cervical intraepithelial neoplasm and invasive cancer.
Keun Ho LEE ; Yong Il KWON ; Won Chul LEE ; Hyun Woo RHIM ; Jin Woong SHIN ; Tae Chul PARK ; Jong Sup PARK ; Sung Eun NAMKOONG
Korean Journal of Obstetrics and Gynecology 1999;42(10):2328-2333
OBJECTIVES: To investigate whether the aspects of Pap smear affect cervical abnormality in our country. METHODS: We compared the sensitivity of Pap smear of 241 cases of pathologic proven CIN & invasive cancer, compared to that of 655 cases with normal cervical biopsy, and reviewed the history of the test of 138 cases, retrospectively. RESULTS: The sensitivity of the test was 89.6%, 92.7% in CIN & invasive cancer group, respectively, with 96.9% specificity. Among 241 cases, 138 cases were examined for the frequency of test during the 3 years with the result of 2.42, 2.17/3yr in CIN and invasive cancer. And distribution of the test was not different between the two groups. The mean intervals of last two Pap smear before diagnosing final pathology in CIN and cancer were 12.1, 13.7 months, respectively, with no statistical significance (p>0.05). CONCLUSION: We concluded that in our country the aspects of Pap smear such as frequency and interval do not influence the result of cervical abnormality, so recommend the annual Pap test as a screening.
Biopsy
;
Cervical Intraepithelial Neoplasia*
;
Mass Screening
;
Papanicolaou Test*
;
Pathology
;
Retrospective Studies
;
Sensitivity and Specificity
6.A Case of Acquired Brown Syndrome after Surgical Repair of a Medial Orbital Wall Fracture.
Il Hun SEO ; Jay Won RHIM ; Young Woo SUH ; Yoonae A CHO
Korean Journal of Ophthalmology 2010;24(1):53-56
A case of acquired Brown syndrome caused by surgical repair of medial orbital wall fracture is reported in the present paper. A 23-year-old man presented at the hospital with right periorbital trauma. Although the patient did not complain of any diplopia, the imaging study revealed a blow-out fracture of the medial orbital wall. Surgical repair with a calvarial bone autograft was performed at the department of plastic surgery. The patient was referred to the ophthalmologic department due to diplopia that newly developed after surgery. The prism cover test at distant fixation showed hypotropia of the right eye, which was 4 prism diopters (PD) in primary gaze, 20 PD in left gaze, while orthophoric in right gaze. Eye movement of the right eye was markedly limited on elevation in adduction with normal elevation in abduction with intorsion in the right eye present. Forced duction test of the right eye showed restricted elevation in adduction. Computerized tomography scan of the orbits showed the right superior oblique muscle was entrapped between the autografted bone fragment and posterior margin of the fracture. When repairing medial orbital wall fracture that causes Brown syndrome, surgeons should always be careful of entrapment of the superior oblique muscle if the implant is inserted without identifying the superior and posterior margin of the orbital fracture site.
Bone Transplantation/*adverse effects
;
Diplopia/etiology
;
Humans
;
Male
;
Ocular Motility Disorders/*etiology/radiography
;
Ophthalmologic Surgical Procedures/*adverse effects
;
Orbital Fractures/*surgery
;
Tomography, X-Ray Computed
;
Transplantation, Autologous
;
Young Adult
7.A Case of Morphological and Chemical Analysis of Recurrent Dacryoliths after Dacryocystorhinostomy.
Won Il RHIM ; Helen LEW ; Young Soo YUN ; Hee Jung AHN
Journal of the Korean Ophthalmological Society 2002;43(7):1128-1132
PURPOSE: To present the morphological and chemical analysis of dacryoliths and review factors contributing to form dacryoliths with previous studies. METHODS: From a 58-year-old female patient operated with dacryocystorhinostomy, dacryoliths were obtained during the procedure and postoperative follow-up period. Morphological and microbial analysis of the dacryoliths was performed by culture and light microscopic examination. Various electrolytes in the dacryoliths were analyzed by flame atomic absorbable spectrometry(FAAS) for Na+ and K+ and by inductively coupled plasma atomic emission spectrometry(ICPAES) for Ca2+ and Mg2+. RESULTS: No bacterial and fungal organisms were cultured, but multiple bacterial colonies were found by H&E stain. Chemical analysis revealed mainly organic composition 97.91% and inorganic composition 2.09%. Inorganic composition was consisted with Ca2+ 0.82%, Na+ 0.76%, Mg2+ 0.27%, and K+ 0.24% in order. CONCLUSIONS: To prevent the recurrence of the nasolacrimal duct obstruction by the dacryoliths after dacryocystorhinostomy, pathogenesis of the dacryoliths formation may be studied with morphological and chemical analysis of the Dacryoliths.
Dacryocystorhinostomy*
;
Electrolytes
;
Female
;
Follow-Up Studies
;
Humans
;
Middle Aged
;
Nasolacrimal Duct
;
Plasma
;
Recurrence
8.Morphological Study of Removed Silicone Tube from Nasolacrimal Duct Obstruction Patients.
Won Il RHIM ; Hyung Soo KIM ; Helen LEW ; Young Soo YUN
Journal of the Korean Ophthalmological Society 2002;43(11):2106-2111
PURPOSE: To search the histopathologic change of the nasolacrimal duct after silicone tube intubation by the microscopic examination of removed silicone tube. METHOD: Sixty nasolacrimal duct obstruction (NLDO) patients (11 congenital and 49 acquired NLDO) operated by silicone tube intubation and conventional dacryocystorhinostomy were participated. Duration of silicone tube intubation and the length of the removed silicone tube were measured. Removed silicone tubes were stained with H and E to inspect cellular components and Alcian-blue to evaluate mucin contents. By the microscopic findings, all patients were classified to inflammatory and non-inflammatory group. Various factors contributing to occur inflammation were statistically evaluated by t-test and Fisher's exact test. RESULTS: Frequencies of inflammatory group were 27.3% (3 cases) in congenital NLDO and 34.7% (17 cases) in acquired NLDO. Five cases of acquired NLDO group showed much inflammatory cells and bacterial colony and 32 cases (65.3%) showed squamous and columnar epithelial cells and mucin in three cases. Inflammatory response of the nasolacrimal duct was not related with duration, degree, location of NLDO, duration of silicone tube intubation and length of silicone tube. CONCLUSION: Re-epithelization and mucin formation of the nasolacrimal duct may be predicted after silicone tube intubation in NLDO patients without severe inflammation.
Dacryocystorhinostomy
;
Epithelial Cells
;
Humans
;
Inflammation
;
Intubation
;
Mucins
;
Nasolacrimal Duct*
;
Silicones*
9.Clinical Features of Risk factors and Regression of Retinopathy of Prematurity.
Won Il RHIM ; Helen LEW ; Young Soo YUN
Journal of the Korean Ophthalmological Society 2002;43(7):1199-1205
PURPOSE: To determine the recent incidence and spontaneous regression rate of retinopathy of prematurity(ROP) and risk factors associated with ROP. METHODS: Medical records of 510 eyes of 255 premature infants under 36 weeks of gestational age(GA) who had taken retinal examination between January 1, 2000 and Febrary 28, 2001 were retrospectively reviewed. Incidence, various associated medical conditions and spontaneous regression rates of ROP were investigated. The statistical analysis methods in the study were t-test and multiple logistic regression for risk factors, ANOVA for the duration to spontaneous regression of ROP. RESULTS: Total incidence rate of ROP was 12.2%. The significant risk factors related to ROP were low birth weight, low GA, mechanical ventilation and surfactant(p<0.05). Spontaneous regression rate of ROP was 74.2%. Mean duration to spontaneous regression was 14.1 weeks. CONCLUSIONS: This report about the risk factors and the clinical features of ROP may help to establish the therapeutic plan of ROP.
Humans
;
Incidence
;
Infant, Low Birth Weight
;
Infant, Newborn
;
Infant, Premature
;
Logistic Models
;
Medical Records
;
Respiration, Artificial
;
Retinaldehyde
;
Retinopathy of Prematurity*
;
Retrospective Studies
;
Risk Factors*
10.Management of Acute Laryngeal Trauma Patients.
Jeong Pyo BONG ; Ki Won YU ; Ki Soo HONG ; Gu Il RHIM ; Jun Kyu LEE ; Won HEO
Korean Journal of Otolaryngology - Head and Neck Surgery 1998;41(11):1459-1463
BACKGROUND AND OBJECTIVES: Laryngeal trauma is an uncommon but potentially catastrophic injury. The purpose of this study was to analyze the association between injury mechanism and the degree of injury, and to assess the outcome after the treatment. MATERIALS AND METHOD: A 10-year retrospective study of 21 patients with acute laryngeal trauma seen from 1988 to 1997 at Wonju Christian Hospital is presented. All patients are classified by injury mechanism (penetrating vs blunt) and degree of injury (Group I through V). These patients have been studied with attention to clinical manifestation, injury mechanism, degree of injury and outcome after the treatment. RESULTS: The main presenting symptoms and signs were dyspnea, hoarseness, tenderness and subcutaneous emphysema. Eleven cases were categorized as penetrating injury and the other ten cases as blunt injury. Sites of laryngeal injury included thyroid cartilage fracture, soft tissue laceration, cricoid cartilage fracture, pyriform sinus perforation and vocal folds injury. All patients were decannulated. Sixteen patients made a full return to normal voice, four were assessed fair but one was graded as poor. CONCLUSION: Conservative treatment of group II injuries was effective. In this cases, the greater the actual trauma, the poorer the results. Also, blunt trauma proved more serious than penetrating trauma and early surgical intervention was associated with better outcome. Authors suggest esophagoscopy to be performed at the time of operation.
Cricoid Cartilage
;
Dyspnea
;
Esophagoscopy
;
Gangwon-do
;
Hoarseness
;
Humans
;
Lacerations
;
Pyriform Sinus
;
Retrospective Studies
;
Subcutaneous Emphysema
;
Thyroid Cartilage
;
Vocal Cords
;
Voice
;
Wounds, Nonpenetrating