PURPOSE: To analyze the preoperative clinical characteristics, surgical methods, outcomes and visual prognosis of retinal detachment following congenital cataract surgery. METHODS: We retrospectively analyzed the medical records of 16 patients (16 eyes) who had undergone an operation for retinal detachment following congenital cataract surgery. Anatomical success was considered to have occurred if the retina was well attached in fundus exam at postoperative 6 months. RESULTS: There were more male (81.3%) patients than female patients. The average age of cataract surgery was 19.3 years, and the mean interval between cataract surgery and retinal detachment was 7.7 years. The most common type of the retinal break was a round hole and the most common location of retinal break was the inferotemporal quadrant. Total retinal detachment was 56.2% and the macula was detached in 87.5% of patients. The anatomical success rate of the primary operation was 43.8% and the final success rate was 87.5%. Postoperative visual acuity increased in 43.8% of patients. CONCLUSIONS: Retinal detachment following congenital cataract surgery had a poor success rate compared to that of other retinal detachments due to difficulties in finding the retinal break (37.5%) and frequent total retinal detachment. Early diagnosis, prompt surgery, vitrectomy and intraocular tamponade for primary operation would increase the success rate and improve postoperative visual prognosis.
Cataract* ; Early Diagnosis ; Female ; Humans ; Male ; Medical Records ; Prognosis ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity ; Vitrectomy

We retrospectively investigated long-term visual prognosis following successful retinal reattachment in eyes with rhegmatogenous retinal detach-ment involving the macula. We operated 852 eyes using scleral buckling technique between May 1983 and May 1995. Among them 20 patients with macular detachment had been followed for more than three years postoperatively. The age range of patients was between 13 and 37 years[mean 23.6 +/-8.0]. Among 10 eyes, the best-corrected visual acuity at 3 years after surgery improved by one line than best-corrected visual acuity at 3 months postoperatively[improved group]. Among the other 10 eyes, no interval change was found during the period[unimproved group]. Improvement of long-term postoperative visual acuity was found to be statistically correlated with shorter duration of macular detachment[< or =30 days]and the location of detachment[inferior][p<0.05]. According to this study, surgeon should be aware that the visual function of reattached retina may improve during the long postoperative peroid, especially in eyes with above features.
Humans ; Prognosis ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Visual Acuity*

Medical records of 27 patients(34 eyes)with upper and lower eyelid retraction were reviewed to evaluate the surgical efficacy from September 1987 through September 1999 at the Department of Ophthalmology, Yeungnam University College of Medicine. The causes of 23 patients(28 eyes)with the upper eyelid retraction revealed ptosis overcorrection(12 eyes), thyroid ophthalmopathy(7 eyes), trauma(6 eyes)and congenital deformity(3 eyes). Recession of upper eyelid retractors was performed in all cases and combined M u llerectomy was carried out in 4 eyes of thyroid ophthalmopathy. Preserved sclera was used as a spacer in 2 eyes. For the 4 patients(6 eyes)with lower eyelid retraction, recession of lower eyelid retractors was performed and preserved sclera was used in 4 eyes. After the follow-up periods of 6 to 60 months(mean 27 months), 25 eyes(89%)of the upper eyelid retractions and all of the 6 lower eyelid retractions showed good cosmetic appearance. Postoperative problems included asymmetry of upper eyelid contour(1 eye), overcorrection(4 eyes), and undercorrection(2 eyes). Advancement of levator aponeurosis was performed in 2 overcorrected cases with good result. Recession of the upper or lower eyelid retractors with or without M u llerectomy allowed satisfactory appearance for the patients with upper and lower eyelid retraction. Spacer material of the preserved sclera was used for the patients with severe eyelid retraction.
Eyelids* ; Follow-Up Studies ; Humans ; Medical Records ; Ophthalmology ; Sclera ; Thyroid Gland

The Valsalva maneuver is described as an expiratory effort against a closed glottis or airway. It leads to elevation of retinal venous pressure and may result in retinal hemorrhage. A fifty two-year-old man presented with an acute reduction of central visual acuity in his right eye which occurred after considerable straining at stool. Detailed past medical history revealed that he suffered from chronic constipation and hypertension. There were one disc sized subhyaloid hemorrhage and three small intraretinal hemorrhages around the fovea at the dilated fundus examination. After three months of follow-up without any treatment, the retinal hemorrhages resolved without any sequelae. Here we report a patient with sudden visual loss and retinal hemorrhage.
Constipation ; Follow-Up Studies ; Glottis ; Hemorrhage ; Humans ; Hypertension ; Retinal Hemorrhage ; Retinaldehyde ; Valsalva Maneuver ; Venous Pressure ; Visual Acuity

Exfoliation syndrome(XFS)has rarely been reported in Korea even though its worldwide distribution. The purpose of this study is to report clinical manifestations of XFS in Korea and to determine its relationship to the development of glaucoma in patients with XFS. We retrospectively reviewed the medical records of 31 patients with XFS presenting over a 6-year period at Yeungnam university hospital. Patients were considered to have XFS if characteristic fibrillar exfoliative materials were visualized on the anterior lens capsule. We investigated clinical features such as gender, age, combined systemic disease, laterality, presence of cataract or glaucoma, methods of treatment and complications. We could identify 24 males and 7 females with XFS. All the cases were aged 60 years or more except one case, with the peak in the eighth decade(mean 71.5, range from 37 to 92 years). In 11 patients(35%), XFS was bilateral. Cataract was associated in 28 eyes(67%)out of the total 42 eyes and cataract extractions were performed in 8 eyes. Glaucoma developed in 17(55%)out of the total 31 patients, with the predilection toward the case with bilateral involvement(73%)of XFS, and 44%of glaucomatous eyes required trabeculectomy. The clinical features of XFS in Korea were similar to previous reports from other parts of the world, but interestingly male predominance was a unique finding in this study. Our study suggests that XFS occurs not uncommonly among the Korean population.
Cataract ; Cataract Extraction ; Exfoliation Syndrome* ; Female ; Glaucoma ; Humans ; Korea* ; Male ; Medical Records ; Retrospective Studies ; Trabeculectomy

PURPOSE: To investigate the efficacy of anterior chamber paracentesis in intravitreal triamcinolone acetonide injection (IVTA). METHODS: A prospective, randomized clinical trial was conducted on 30 eyes of 30 patients undergoing IVTA. Eyes were randomly divided into two groups, those which had undergone anterior chamber paracentesis (Group 1, 15 eyes) and those which had not (Group 2, 15 eyes). We analyzed postoperative changes in intraocular pressure (IOP) in each group. RESULTS: In group 1, the mean preoperative IOP was 15.33+/-1.72 mmHg; postoperative IOP at 2 and 15 minutes was 7.80+/-1.47 and 11.73+/-1.67 mmHg, respectively. In group 2, there was significant elevation of IOP (46.73+/-8.26 mmHg) 2 minutes after the injection, although this was reduced to the normal range (16.13+/-2.61 mmHg) within 15 minutes. CONCLUSIONS: Routine anterior chamber paracentesis seems to be inappropriate considering the brief elevation in IOP that immediately follows IVTA.
Anterior Chamber* ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Paracentesis* ; Prospective Studies ; Reference Values ; Triamcinolone Acetonide ; Triamcinolone*

PURPOSE: To report the clinical finding of 3 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). CASE SUMMARY: Five eyes of 3 patients with focal choroidal excavation detected by SD-OCT were enrolled in the present study. All patients had myopia (average refractive power -5.60 diopter). Two of the 3 patients had focal choroidal excavation in both eyes. All 5 eyes revealed foveal pigmentary changes on fundus examination. The excavation area in the autofluorescence image was hypofluorescent. Fluorescein angiographic finding was normal to various degrees of hyperfluoresence. Indocyanine green angiography revealed hypofluoresence at the excavation area. The excavation involoved from the retinal pigment epithelium layer to the external limiting membrane or outer nuclear layer and average choroidal thickness at excavation were statistically thinner than the uninvolved area based on SD-OCT (p = 0.002). Retinoschisis, serous pigment epithelial detachment and choroidal neovascularziation (CNV) were detected individually in 3 eyes. The other 2 eyes had no specific abnormalities. CONCLUSIONS: During the follow-up period, the choroidal excavation remained relatively stable in 4 of 5 eyes, but CNV developed in 1 eye. Therefore, intravitreal bevacizumab injection was performed. Longer follow-up periods are necessary to determine the etiology, clinical course and visual prognosis of eyes with focal choroidal excavation.
Angiography ; Choroid* ; Fluorescein ; Follow-Up Studies ; Humans ; Indocyanine Green ; Membranes ; Myopia ; Prognosis ; Retinal Pigment Epithelium ; Retinoschisis ; Tomography, Optical Coherence* ; Bevacizumab

PURPOSE: The authors report a case of a giant subretinal nodular mass following surgical vitreous opacity removal. CASE SUMMARY: A 72-year-old man complained of visual loss and vitreous floaters in the left eye for 3 months (best corrected visual acuity: 0.1). The fundus was not clearly visualized due to vitreous opacity. Vitrectomy, phacoemulsification, and posterior chamber intraocular lens implantation were performed in the left eye. After removing the vitreous opacity, fundus examination revealed a creamy yellowish-white subretinal nodular mass (4 disc in size) infero-temporal to the fovea with adjoining chorioretinal folds and exudative retinal detachment. Fluorescein angiography (FA) of the left eye showed hypofluorescence of the nodule surrounded by a well-demarcated hyperfluorescent margin. B-scan ultrasonography revealed a prominent dome-shaped large echogenic nodule bordered by hypoechoic signal at the sclerochoroidal level. Giant nodular posterior scleritis was suspected and the patient was treated with oral corticosteroids. The large nodular lesion resolved completely within 3 months after initiation of the treatment and the best corrected visual acuity improved to 0.5. CONCLUSIONS: The authors of the present case study recommend a thorough evaluation of large posterior segment nodular lesions in order to detect this under-recognized but eminently treatable condition.
Adrenal Cortex Hormones ; Aged ; Eye ; Fluorescein Angiography ; Humans ; Lens Implantation, Intraocular ; Phacoemulsification ; Retinal Detachment ; Scleritis ; Visual Acuity ; Vitrectomy

PURPOSE: Vasoproliferative tumor of the retina (VPTR) is a histologically benign lesion that can lead to visual loss due to associated complications. Herein, the authors report the clinical presentation, treatment, and prognosis of 3 VPTR cases. CASE SUMMARY: Three eyes of 3 patients with VPTR were enrolled in the present study. The patients' fundoscopic feature showed characteristic elevated lesions of the peripheral retina without previous history of ocular disease. The patients included 2 males and 1 female, with an average age of 44.7 years. Fluorescein angiography (FAG) and indocyanine green angiography (ICGA) were helpful in establishing the diagnosis of VPTR. Additionally, 1 patient underwent ultrasonography and 2 patients underwent magnetic resonance imaging (MRI). During the follow-up period, subtenon triamcinolone acetonide injection was performed for 1 patient with macular edema, and cryotherapy was performed for 1 patient with increased peripheral exudation. CONCLUSIONS: For an adequate diagnosis of VPTR, careful examination of the peripheral retina is important. In addition, FAG/ICGA and ultrasonography can be helpful in VPTR diagnosis. Furthermore, proper treatment according to each subset of complication during the follow-up period is recommended.
Angiography ; Cryotherapy ; Diagnosis ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Edema ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retina* ; Triamcinolone Acetonide ; Ultrasonography

PURPOSE: To compare the anatomical and functional results of vitrectomy for macular hole with and without prone posture. METHODS: We retrospectively reviewed the medical records of 71 eyes of 71 patients who received macular hole repair and were followed up for at least 6 months. The anatomical success, complications, and best corrected visual acuity at postoperative 6 months and last follow-up between patients who were advised to take a prone posture for 1 week (group 1) and patients who were advised to simply avoid the supine position right from the surgery (group 2) were analyzed. Subgroup division analysis according to macular hole size and concurrent phacoemulsification was performed. RESULTS: Macular hole closure rate was 91.7% (33 of 36 eyes) in group 1 and 88.6% (31 of 35 eyes) in group 2 (p=0.710). The mean visual acuity at final follow-up increased in both groups by 4.75 +/- 3.83 and 4.76 +/- 2.96 lines, respectively and revealed no statistically significant difference (p = 0.988). Twenty-seven of 36 eyes (75%) in group 1 and 30 of 35 eyes (85.7%) in group 2 underwent concurrent phacoemulsification, and no difference in macular hole closure rate and visual acuity improvement between the two postures was observed. CONCLUSIONS: Favorable anatomical and functional outcomes were achieved without postoperative face-down posturing in the case of phacovitrectomy with wide internal limiting membrane peeling and gas tamponade.
Follow-Up Studies ; General Surgery* ; Humans ; Medical Records ; Membranes ; Phacoemulsification ; Posture ; Retinal Perforations* ; Retrospective Studies ; Supine Position ; Visual Acuity ; Vitrectomy*