PURPOSE: To evaluate 20% ethanol toxicity on the rabbit corneal epithelium, ethanol-treated rabbit corneas were examined with electron microscopy. METHODS: Rabbit corneas(24 eyes) were treated with 20% ethanol for 30 seconds, 1 minute, and 2 minutes by using LASEK(Laser Assisted Subepithelial Keratomileusis) instruments, and washed with sterile water. Zero time, 1, 3, 5 days after ethanol treatment, corneas were excised and examined with scanning and transmission electron microscopy. RESULTS: Widespread damage or disappearance of microvilli and local breaks of intercellular junction were observed. The changes were more severe in corneas with longer ethanol treament. In corneas with over 1 minute ethanol treatment, slough of superficial corneal epithelium was shown and increased with time. It was difficult to recognize microvilli or distinctive intercellular junction in corneas with 2 minute-treament. These pathologic changes persisted 5 days after ethanol-treatment. CONCLUSIONS: From these results, 30 seconds to 1 minute-ethanol treatment is recommended in corneal surgery to avoid severe, persisting damage of superficial corneal epithelium.
Cornea ; Epithelial Cells* ; Epithelium, Corneal ; Ethanol ; Intercellular Junctions ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Microvilli ; Water

Cataract extraction is one of the most successful surgical operations currently being performed. In particular, extracapsular cataract extraction with intraocular lens insertion is widely regarded as the treatment best leading to post-surgical improvement in the patient's vision. However, with the increasing use of the 'Nd-YAG laser post capsulotomy' to treat a possible after-cataract following extracapsular cataract extraction, protection of the intraocular lens in the process of that treatment becomes a point at issue. Central to this problem is the degree of separation of the 'laser space' the amount of which was found to be dependent on the inserted lens. Out of total of 122 operations, the absence of a laser ridge on the inserted lens, resulted in the formation of a laser space in only 68.75% of the cases with the average separation being only 0.068mm. Insertion of a lens with a laser ridge, on the other hand, produced a laser space in 100% of the cases with an average separation of some 0.189mm.
Cataract Extraction* ; Cataract* ; Hand ; Lenses, Intraocular

Epidermal growth factor (EGF) has been believed to promote the corneal epithelial wound healing by stimulating the proliferation of the epithelial cells located at the wound base and limbus. Thus we made transepithelial photokeratectomy by excimer laser to cornpare the rate of corneal wound healing and the histological findings between a group received only photokeratectomy (control) and a group with photokeratectorny and topical EGF treatment. The results showed that the corneal epithelial wounds treated with EGF after excimer laser photokeratectomy was closed significantly faster than those without. EGF, PCNA immunoreactive cells appeared at. the basal cell layer of limbus and wound area in EGF-treated groups but, not, in control group These resuite suggest that EGF accelerates the corneal epithelial wound healing after excimer laser photokeratectomy by stimulating the proliferation of the basal cells of limbus and wound area and results in 8 faster wound healing time.
Corneal Surgery, Laser* ; Epidermal Growth Factor* ; Epithelial Cells ; Lasers, Excimer* ; Proliferating Cell Nuclear Antigen ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

PURPOSE: We evaluated ocular penetration and drug level in tear after topical ofloxacin instillation in rabbit eye with amniotic membrane transplantation(AMT). METHODS: In the first set of experiment, 24 rabbits(24 eyes) were divided into 4 groups according to the epithelial removal or AMT. Topical ofloxacin was instilled 4 times every 15 minutes and then, 1 hour after the last eyedrop, the samples of amniotic membrane(AM), cornea and aqueous humor were collected. In the second set of experiment, 24 rabbits(24 eyes) were divided into 6 groups according to the freshness of AM or its attached time. Topical ofloxacin was applied to eyes and then, tear samples were collected at 30 minutes, 1, 2, 4, and 6 hours. Ofloxacin concentration in the samples of two experiments were evaluated using high performance liquid chromatography. RESULTS: Mean ofloxacin concentrations in cornea and aqueous humor were statistically higher in deepithelized corneas regardless of AMT(P<0.05). And mean tear levels of ofloxacin in AMT groups were statistically higher than those in non-AMT groups(P<0.05). CONCLUSIONS: AMT seems to interfere with the ocular penetration of topical ofloxacin in normal rabbit cornea, but rather enhances ofloxacin penetration in the cornea with epithelial defect. And also the ofloxacin level in tear was higher in eyes with AMT up to 1 hour after topical ofloxacin use. Therefore it seems that AM has potential to act as an effective drug delivery system.
Amnion* ; Aqueous Humor ; Chromatography, Liquid ; Cornea ; Drug Delivery Systems ; Ofloxacin*

We evaluated the efficacy of polymerase chain reaction(PCR)in early diagnosis of herpes simplex keratitis(HSK)in rabbit model and compared the sensitivity and specificity of PCR in two kinds of primers. Only one eye of 8 rabbits was inoculated with HSV Type 1(F strain, ATCC VR-73)to induce HSK, and the other eye was used as control. Rabbit cornea was examined under slit lamp examination and PCR test of tear and corneal scraping specimens were performed at 1, 3, 5, 7, and 10th post-inoculation day. The sensitivity of PCR with POL primer was 100%in tear and corneal scraping specimens. The sensitivity of PCR with POL primer and LAT primer were 80%and 100%respectively. PCR test is very useful diagnotic tool for the early diagnosis of HSK in rabbit model. In addition, PCR test with corneal scraping specimens provided better yield compared with tears.
Cornea ; Early Diagnosis* ; Herpes Simplex* ; Keratitis, Herpetic* ; Polymerase Chain Reaction* ; Rabbits ; Sensitivity and Specificity

We retrospectively evaluated postoperative refraction of four patients(five eyes)who received intraocular lens implantation after excimer laser photorefractive keratectomy (PRK).The mean age of the patients was 44.8 years and 3 patients were female and 1 patient was male.The mean interval between PRK and cataract operation was 20.2 months (1 to 45 months)and the mean follow-up time after cataract operation was 16.2 months(2~43months).Phacoemulsification and PMMA-PCL(6.0~6.5 mm)implantation were made in all cases.SRK-II formula,the most popular empirical formula was used in first 3 cases(group I),but Idem-lens formula,a primitive theoretical formula was used in another 2 cases (group II)after occurrence postoperative refraction errors in group I .In group I and II,the mean postoperative refraction error was +3.00 diopters and +0.50 diopters and uncorrected visual acuity at postoperative 2 months was 20/60 and 20/24 respectively.The mean of calculated IOL-power was -3.75 diopter in group I and -0.625 diopter in group II.From these results,the empirical formula is definitely unsuitable for the calculation of IOL power in the cataract operation following excimer laser PRK. Moreover,although a primitive one,Idem-lens theory could be temporally useful for the IOL-power calculation in such cases.In conclusion,new formula is required for the cataract operation following excimer laser PRK.
Cataract* ; Female ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Photorefractive Keratectomy ; Retrospective Studies ; Visual Acuity

PURPOSE: Topical anesthetic abuse resulting in sight-threatening keratitis may be seen as a masquerade syndrome in many cases because of ring infiltration of the cornea. The authors report two cases of keratopathy from topical anesthetic abuse that were originally suspected as infectious keratitis because of ring infiltration of the cornea METHODS: The medical records of two patients were retrospectively reviewed. The pathogenesis, diagnosis, and treatment of ring infiltrates were evaluated. RESULTS: The two patients presented a nonhealing epithelial defect, marked stromal edema, folds in Descemet's membrane, and typical stromal ring infiltrates of unknown etiology. The patients initially were treated empirically with antibacterial and antifungal agents in suspicion of infectious keratitis. These patients had sustained severe ocular pain, and chronically used topical anesthetics (0.5% proparacaine hydrochloride in one patient and 0.4% benoxinate hydrochloride in the other) for several weeks. All microbiology work-ups for the identification of infectious organisms including acanthamoeba were negative. After topical anesthetic was discontinued in two patients, amniotic membrane transplantation was performed on one patient. Corneas in two patients were re-epithelialized with mild scarring with topical antibiotic and steroid treatment.
Acanthamoeba ; Amnion ; Anesthetics ; Antifungal Agents ; Cicatrix ; Cornea ; Descemet Membrane ; Diagnosis ; Edema ; Humans ; Keratitis ; Medical Records ; Retrospective Studies

There are relatively rare cases concerning about concurrent papillary thyroid cancer and thyroid tuberculosis with cervical tuberculous lymphadenitis in English literature so far. Cervical lymphadenitis (scrofula) is a common manifestation of extra-pulmonary invasion of the tuberculosis. A cervical tuberculous lymphadenitis could be confused with metastatic lymph node from the thyroid cancer. A 49-year-old woman with multiple right thyroid nodules of Bethesda category VI referred our department for surgery. We performed the right thyroid lobectomy with anterior compartment neck dissection. The histopathology revealed concurrent papillary thyroid carcinoma and thyroid tuberculosis with cervical tuberculous lymphadenitis. We report a unique case of concurrent papillary thyroid cancer and tuberculosis involving the thyroid gland and ipsilateral paratracheal lymph node with literature review. To our best knowledge, such case has not been reported earlier.
Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Lymph Nodes* ; Lymphadenitis ; Middle Aged ; Neck Dissection ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Tuberculosis* ; Tuberculosis, Lymph Node

Multinodular goiter (MNG) is one of the benign thyroid neoplasm and nodular hyperplasia is the most common pathologic type. MNG could be misdiagnosed as a malignancy because of its characteristic, which is its growing tendency. A-70-year-old female was referred to our clinic from endocrinology, with the huge and recently rapid growing thyroid mass. We performed the neck sonography, its guided fine needle aspiration cytology (FNAC), neck CT and MRI. She was presumed as the malignant thyroid neoplasm except papillary carcinoma. The right completion thyroidectomy and anterior compartment neck dissection had been done and the nodular hyperplasia was diagnosed finally. We learned a valuable lesson from this case in the following. Even if the malignancy is strongly suggested in the radiology and clinically, more careful consideration in determining the surgical method and its extent is mandatory.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Goiter ; Humans ; Hyperplasia ; Neck ; Neck Dissection ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Multinodular goiter (MNG) is one of the benign thyroid neoplasm and nodular hyperplasia is the most common pathologic type. MNG could be misdiagnosed as a malignancy because of its characteristic, which is its growing tendency. A-70-year-old female was referred to our clinic from endocrinology, with the huge and recently rapid growing thyroid mass. We performed the neck sonography, its guided fine needle aspiration cytology (FNAC), neck CT and MRI. She was presumed as the malignant thyroid neoplasm except papillary carcinoma. The right completion thyroidectomy and anterior compartment neck dissection had been done and the nodular hyperplasia was diagnosed finally. We learned a valuable lesson from this case in the following. Even if the malignancy is strongly suggested in the radiology and clinically, more careful consideration in determining the surgical method and its extent is mandatory.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Goiter ; Humans ; Hyperplasia ; Neck ; Neck Dissection ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy