PURPOSE: To evaluate the clinical efficacy and the histopathologic tolerance of 2-octylcyanoacrylate versus 8-0 polyglactin sutures for conjunctival wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Conjunctival peritomy of 8 mm was done in the superior limbus followed by extensive subconjunctival dissection in both eyes. The eyes of the rabbits were divided into two groups. The conjunctiva was then attached to the limbus again by the proposed 2-octylcyanoacrylate adhesive (left eye, Group A) or 8-0 polyglactin suture (right eye, Group B). The clinical efficacy of the closure of the conjunctival wound, either with sutures or adhesives, and the clinical and histopathologic tolerances such as hyperemia, discharge, residual adhesive or suture, inflammatory change and fibrosis were observed at 1 day and at 1, 2, 4 and 6 weeks after surgery. Two rabbits were sacrificed at each of 1, 2, 4 and 6 weeks, and specimens of their conjunctiva were examined histologically. RESULTS: Both conjunctival surgical closure methods were found to be equally efficacious in fixing the conjunctiva to the limbus. There were no significant clinical or histopathologic tolerance differences between the two groups. The conjunctiva at 6 weeks of Group A showed nearly normalized morphology with disappeared inflammatory cells and fibroblasts, whereas those of Group B showed foreign body inflammatory reaction around the absorbing suture materials. CONCLUSIONS: 2-Octylcyanoacrylate adhesive was an efficient conjunctival closure method and was very well tolerated by the ocular surface. 2-Octylcyanoacrylate may be a possible tissue adhesive for conjunctival wound closure.
Adhesives ; Conjunctiva ; Fibroblasts ; Fibrosis ; Foreign Bodies ; Hyperemia ; New Zealand ; Polyglactin 910* ; Rabbits* ; Sutures* ; Tissue Adhesives ; Wounds and Injuries*

PURPOSE: To evaluate the safety, stability and effectiveness of the LADARVision active tracking narrow beam excimer laser system using laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for the correction of spherical myopia and astigmatism. METHODS: We reviewed 233 eyes that underwent LASIK (Group A: -6D) and PRK (Group C) from August 2002 to March 2003. We investigated uncorrected visual acuity (UCVA), manifest refraction, spherical equivalent, cyclotorsion, and astigmatic change before undergoing refractive surgery. The evaluation was repeated at 1 week, 1 month, 3 months, and 6 months after surgery. RESULTS: AT one week following surgery, the mean UCVA was 1.39+/-0.30 in Group A, 1.25+/-0.34 in Group B, and 1.06+/-0.25 in Group C. At postoperative 6 months, the mean UCVA was 1.32+/-0.30, 1.09+/-0.16, and 1.32+/-0.24 in Groups A, B, and C, respectively. In all 215 eyes, cyclotorsion was 74.4%: counterclockwise, 48.4% (4.01+/-3.01); and clockwise, 26.0% (-4.42+/-3.18). The astigmatism correction rate was 79.16% in Groups A and B (LASIK groups), and 70.10% in Group C. CONCLUSIONS: The LADARVision 4000 laser yielded excellent results in myopia, with or without astigmatism and showed early refractive stability, good UCVA outcomes, and effective correction of astigmatism at 6 months postoperatively. Further studies are needed to compare custom LASIK and conventional LASIK using LADARVision.
Astigmatism ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Photorefractive Keratectomy* ; Refractive Surgical Procedures ; Visual Acuity

PURPOSE: To compare the effects of the lateral tarsal strip procedure alone and the lateral tarsal strip procedure combined with silicone tube intubation in the treatment of functional lacrimal duct obstruction. METHODS: The present study investigated 27 eyes of 20 patients underwent lateral tarsal strip procedure (LTS) alone and 29 eyes of 18 patients underwent combined lateral tarsal strip procedure and silicone tube intubation and who were diagnosed with functional lacrimal duct obstruction. The authors retrospectively reviewed patients' medical records for information including age, gender, history, follow-up period, tear meniscus height (TMH), and symptoms. RESULTS: The average age of the LTS alone group was 60.3 years, and that of the combined groups was 65.9 years. The TMHs in the LTS only and combined operation groups were 0.62 +/- 0.23 mm and 0.62 +/- 0.19 mm before the operation and 0.43 +/- 0.20 mm and 0.26 +/- 0.09 mm after the operation, respectively. The postoperative improvement in epiphora was 74.1% after the LTS alone and 86.2% after combined LTS with silicone tube intubation. The postoperative improvement in epiphora and the operative technique of the lateral tarsal strip-canthus sparing or cantholysis were not relevant. CONCLUSIONS: Lateral tarsal strip combined with silicone tube intubation appeared useful in the treatment of epiphora patients without anatomic lacrimal duct obstruction. Determining which operative technique of lateral tarsal strip procedure should be chosen is difficult, and the preoperative syringing and snap back test may be helpful.
Eye ; Follow-Up Studies ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction ; Medical Records ; Nasolacrimal Duct ; Retrospective Studies ; Silicones

PURPOSE: To investigate the effect of nocturnal dip influence on the progression of glaucomatous visual field defect. METHODS: We performed 24hr ABPM and V/F tests on patients diagnosed with NTG (140 patients, 280 eyes) and POAG (84 patients, 168 eyes). Nocturnal dips below 10% were classified as non-dippers, and those above 10% were noted as dippers. The correlations among nocturnal dip, progression of glaucomatous visual field defect, and hypertension treatment were examined. RESULTS: In NTG, dippers in both systolic and diastolic blood pressure furthered glaucomatous visual field defects, with a relative risk of approximately three times that of non-dippers. Hypertension treatment was not influenced by the progression of glaucomatous visual field defect but was influenced by dips in the systolic and diastolic pressures in NTG and in diastolic pressure in POAG. Nocturnal dips were more frequent in the group with progression of the visual field compared to those in the group with non-progression of the visual field in NTG. CONCLUSIONS: Dipper caused a progression of glaucomatous visual field defects in NTG and was influenced by hypertension treatment in NTG and POAG. Performing 24hr ABPM should be helpful for glaucoma patients with progression of a glaucomatous visual field defect even when the IOP is less than the target pressure. In addition, hypertension treatment should be considered an important factor in the treatment of glaucoma.
Blood Pressure ; Glaucoma ; Humans ; Hypertension ; Salicylates ; Visual Fields

PURPOSE: To report the change of pupil sizes according to age and illuminance in the normal Korean population. METHODS: Normal Koreans outpatients who never had a history of ophthalmic disease were examined. The patients consisted of 320 eyes of 160 patients, which were classified into 8 age decades (teenage to 80's) with 40 eyes in each age group. The vertical and horizontal pupil size and area under 4 different illuminances (3,500, 1,200, 500, 5 lux) were measured using the Colvard pupillometer(R) (OASIS Medical, Glendora, CA, USA). RESULTS: The pupil size was significantly decreased as the age increased under each illuminance. The pupil area measured after dark adaptation was 47.30 mm2 in the teenage group, 43.32 mm2 in the 20's group, 41.94 mm2 in the 30's group, 40.98 mm2 in the 40's group, 40.61 mm2 in the 50's group, 38.60 mm2 in the 60's group, 37.78 mm2 in the 70's group and 35.45 mm2 in the 80's group. The decrease in pupil area was statistically significant. CONCLUSIONS: In the normal Korean population, a significant decrease in pupil size and area was observed with aging. The present study results provide good basic data for cataract and presbyopia refractive surgery.
Aging ; Cataract ; Dark Adaptation ; Eye ; Humans ; Outpatients ; Presbyopia ; Pupil ; Refractive Surgical Procedures

PURPOSE: We report a case of a scleral perforation during inferior rectus recession in congenital fibrosis of extraocular muscles and the management of this perforation with a scleral patch graft. CASE SUMMARY: A 20-month-old female with bilateral ptosis, absence of elevation and a chin-up position was diagnosed with congenital fibrosis of extraocular muscles. Because severe esotropia in the downward gaze was observed, we first performed esotropia surgery. After 1 year, she underwent a bilateral ptosis correction. We decided to perform bilateral inferior rectus recession due to an abnormal head posture and the absence of elevation. Because the inferior rectus muscles were extremely tight and adhered to the sclera, hooking and isolating these muscles during surgery was difficult. After muscle suture placement, a portion of the sclera that contacted the left inferior rectus was chipped off as this muscle was disinserted with blunt Westcott scissors. A scleral perforation was observed, thus, we placed a scleral patch graft using the donor sclera and finished the bilateral inferior rectus recession. No abnormal findings for the vitreous or retina were detected. At 8 months after surgery, the patient exhibited exotropia of 12 prism diopters in her primary gaze. Her abnormal head posture nearly disappeared. CONCLUSIONS: Careful isolation and disinsertion of the muscle from the globe is necessary in the treatment of patients who are expected to exhibit severe adhesions between the muscle and sclera, such as patients with congenital fibrosis of extraocular muscles.
Esotropia ; Exotropia ; Female ; Fibrosis* ; Head ; Humans ; Infant ; Muscles* ; Posture ; Retina ; Sclera ; Sutures ; Tissue Donors ; Transplants

PURPOSE: To investigate the effects of additional prednisolone treatments in orbital cellulitis after bougination. METHODS: The medical records of five patients treated for orbital cellulitis after bougination were reviewed. The number of times bouginated, clinical symptoms, biopsy findings, treatment course, recurrence, and prognosis were reviewed. RESULTS: A diffuse, erythematous mass on the lower lid around the medial canthal area was found in all patients. Bougination was performed more than twice in three patients. Chronic inflammation was checked via pathologic tissue biopsy examination in four patients. No patients receiving antibiotic treatments improved, thus additional prednisolone was used and showed satisfactory results, although recurrence was observed in two patients. The recurred two patients improved with repetitive prednisolone treatments. CONCLUSIONS: Although antibiotics are administered for the treatment of orbital cellulitis after bougination, the use of additional corticosteroids may be beneficial when inflammation is sustained.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Biopsy ; Humans ; Inflammation ; Medical Records ; Orbit ; Orbital Cellulitis ; Prednisolone ; Prognosis ; Recurrence

PURPOSE: To report a case of pituitary apoplexy presenting as isolated bilateral oculomotor nerve palsy. CASE SUMMARY: A 46-year-old male presented with bilateral ptosis and acute severe headaches for 6 days. He underwent head surgery and bilateral vitrectomy 12 years prior to his visit because of ocular and head trauma. He mentioned that previous visual acuities in both eyes were not good. The initial corrected visual acuity was finger counting in the right eye and 20/500 in the left eye. Ocular motility testing revealed the limitation of adduction, supraduction, and infraduction with complete bilateral ptosis in both eyes, and his left pupil was dilated. He was diagnosed with an isolated bilateral oculomotor nerve palsy. Magnetic resonance imaging indicated pituitary gland hemorrhage with a tumor, which was suspicious of pituitary apoplexy. The patient was treated intravenous with 1.0 g methylprednisolone to prevent the corticotropic deficiency. In addition, he underwent surgical decompression using a navigation-guided transsphenoidal approach and aspiration biopsy. He was confirmed with pituitary adenoma using a pathological examination. The patient's ocular movements began to dramatically improve by the third day postoperatively. At 4 months postoperative follow-up, his ocular movement and double vision were completely recovered. CONCLUSIONS: This was a rare case of pituitary apoplexy with bilateral isolated oculomotor nerve palsy, which was the first report in the Republic of Korea. A full recovery was achieved after early surgical treatment.
Biopsy, Needle ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Decompression, Surgical ; Diplopia ; Fingers ; Follow-Up Studies ; Head ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone ; Middle Aged ; Oculomotor Nerve Diseases ; Oculomotor Nerve ; Pituitary Apoplexy ; Pituitary Gland ; Pituitary Neoplasms ; Pupil ; Republic of Korea ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

PURPOSE: To generate a Korean specific brain template, especially in patients with Alzheimer's disease (AD) by optimizing the voxel-based analysis. MATERIALS AND METHODS: Three-dimensional T1-weighted images were obtained from 123 subjects who were 43 cognitively normal subjects and patients with 44 mild cognitive impairment (MCI) and 36 AD. The template and the corresponding aprior maps were created by using the matched pairs approach with considering differences of age, gender and differential diagnosis (DDX). We measured several characteristics in both our and the MNI templates, including in the ventricle size. Also, the fractions of gray matter and white matter voxels normalized by the total intracranial were evaluated. RESULTS: The high resolution template and the corresponding aprior maps of gray matter, white matter (WM) and CSF were created with the voxel-size of 1 x 1 x 1 mm. Mean distance measures and the ventricle sizes differed between two templates. Our brain template had less gray matter and white matter areas than the MNI template. There were volume differences more in gray matter than in white matter. CONCLUSION: Gray matter and/or white matter integrity studies in populations of Korean elderly and patients with AD are needed to investigate with this template.
Aged ; Alzheimer Disease ; Brain ; Diagnosis, Differential ; Humans ; Mild Cognitive Impairment