PURPOSE: To compare the clinical outcomes of glistening-free intraocular lens (IOL) and conventional 1-piece aspheric IOL in implanted in-the-bag. METHODS: After phacoemulsification performed by a single surgeon, 2 different IOLs were implanted: enVista MX60 (glistening-free 1-piece aspheric IOL) in 38 eyes (group A) and AcrySof IQ (conventional 1-piece aspheric IOL) in 46 eyes (group B). Glare symptom score (0-5) obtained by questionnaires, best corrected visual acuity (BCVA), Functional Acuity Contrast Test (FACT), posterior capsular opacity (PCO), glistening formation and spherical equivalent error were compared and analyzed preoperatively and 6 months and 12 months postoperatively. RESULTS: A statistically significant improvement of BCVA and contrast sensitivity postoperatively was observed in all groups. There was statistically significant increase of glistening in group B compared with group A. However, there was no significant difference of FACT scores of spatial frequency in A, B, C, D and E columns and glare symptom score (0-10) obtained by questionnaires 12 months after surgery. Spherical equivalent errors were -0.38 +/- 0.27 D and -0.36 +/- 0.28 D for groups A and B, respectively. PCO occurred in 2 eyes in group A and 4 eyes in group B. CONCLUSIONS: EnVista MX60 IOL showed less glistening formation than AcrySof IQ IOL, however, there was no significant difference in terms of vision quality such as BCVA, FACT and glare symptom score at 12 months postoperatively.
Cataract* ; Contrast Sensitivity ; Glare ; Lenses, Intraocular* ; Phacoemulsification ; Visual Acuity

PURPOSE: To report a case of chronic osteomyelitis of the orbit. CASE SUMMARY: A 61-year-old woman visited the ophthalmology clinic with a 3-month history of right periorbital swelling and pain. She had a history of ondontitis treated with oral antibiotics three months previously. A hard, tender, swollen mass was palpated near the right lower eyelid extending to the floor of the right orbit. Otherwise, there were no other clinically-specific ocular signs. Orbital computed tomography and bone scan findings suggested right periorbital soft tissue inflammation with underlying osteomyelitis of maxillar and zygomatic bones involving the inferior and lateral orbital walls. The patient was admitted and treated with broad spectrum systemic antibiotics. After 7 days, periorbital soft tissue swelling and pain were improved, but the size of the hard mass was unchanged. Seven days after admission, incision and drainage of the periorbital hard mass near the lower eyelid and debridement of the necrotic and pyogenic tissue were performed. Histologic examination showed chronic granulomatous inflammation and bony necrosis of the mass. The patient was discharged after receiving systemic antibiotics for 7 more days. At the 6-month follow-up, no recurrence or abnormal findings in the right periorbital region were observed. CONCLUSIONS: Chronic orbital osteomyelitis should be treated with combined systemic antibiotics and surgical intervention.
Anti-Bacterial Agents ; Debridement ; Drainage ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Middle Aged ; Necrosis ; Ophthalmology ; Orbit* ; Osteomyelitis* ; Recurrence

PURPOSE: We aimed to analyze the clinical features of herpetic endotheliitis and to investigate the risk factors for recurrence of herpetic endotheliitis and corneal decompensation. METHODS: The medical records of 58 patients (58 eyes) who were diagnosed with herpetic endotheliitis were retrospectively reviewed. Patients with a follow-up period of less than 6 months and a previous history of ocular inflammation were excluded from this study. We recorded visual acuity, intraocular pressure, central corneal thickness, and endothelial cell density on both initial and final visit, and recorded clinical findings of the anterior and posterior segments of the eye only on initial visit. Factors affecting the recurrence of herpetic endotheliitis and corneal decompensation were also analyzed. RESULTS: Among the 58 patients, 45 patients had disciform type endotheliitis, 11 patients had diffuse type, and 2 patients had linear type. There were no significant differences between final clinical manifestations according to subtype. 14 patients exhibited recurrence of herpetic endotheliitis. High intraocular pressure and high-grade anterior chamber cells were associated with the recurrence of herpetic endotheliitis. On multivariate analysis, the only risk factor for the recurrence of herpetic endotheliitis was high intraocular pressure. We found that 8 patients exhibited corneal decompensation, and high intraocular pressure, high anterior chamber cell grade, and a history of cataract surgery were associated with corneal decompensation. On multivariate analysis, the risk factors for corneal decompensation were high anterior chamber cell grade and cataract surgery history. CONCLUSIONS: For herpetic endotheliitis, the subtype did not affect the final records of clinical manifestation, and the only risk factor for the recurrence of herpetic endotheliitis was high intraocular pressure. Additionally, the risk factors of corneal decompensation were found to be high-grade anterior chamber cells and a history of cataract surgery. Initial examinations of clinical manifestation are important for the successful treatment of herpetic endotheliitis.
Anterior Chamber ; Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Inflammation ; Intraocular Pressure ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Risk Factors ; Visual Acuity

PURPOSE: To investigate the risk factors related to the location of visual field defects in normal tension glaucoma. METHODS: Eighty-one eyes diagnosed as normal tension glaucoma in patients with early glaucomatous visual field defects were divided into central visual field defects and peripheral visual field defects. The difference between the 2 groups based on the intra-individual comparison were assessed with several ocular risk factors such as sex, age, hypertension, diabetes mellitus, smoking, laterality, intraocular pressure, central corneal thickness, cup-disc ratio, peripapillary atrophy, mean deviation, pattern standard deviation, best corrected visual acuity, and refractive errors. RESULTS: The incidence of hypertension in the central visual field defects group (60.6%) was higher than in the peripheral visual field defects group (22.9%, p = 0.001). The central corneal thickness in the central group (533.1 +/- 18.2 microm) was thinner than in the peripheral group (545.0 +/- 30.0 microm, p = 0.003). Hypertension was the only risk factors for central visual field defects (p = 0.001). In both the central group and peripheral group, upper visual field defects were more common than lower defects. CONCLUSIONS: Hypertension in patients with normal tension glaucoma was a factor involved in central visual field defects. Additionally, numerous visual field defects were mainly found the superior portion.
Atrophy ; Diabetes Mellitus ; Eye ; Humans ; Hypertension ; Incidence ; Intraocular Pressure ; Low Tension Glaucoma ; Risk Factors ; Smoke ; Smoking ; Visual Acuity ; Visual Fields

PURPOSE: To investigate changes in the clinical manifestations of ocular injuries induced by power lawn mowers. METHODS: In a retrospective study of 172 patients with ocular injuries induced by power lawn mowers in 2006, 2010, and 2014. Best corrected visual acuity (BCVA) at the time of presentation and 6 months after trauma, age, sex and seasonal distribution were analyzed. We assessed the degree of injury using slit lamp biomicroscopy, fundus examination, and computed tomography and analyzed the prognoses according to open/closed injury and, anterior/posterior segment injury. All patients underwent medical or surgical treatment, and the factors affecting final BCVA were analyzed. RESULTS: The ratio of closed injuries increased significantly (p = 0.027), as did the ratio of corneal erosion (p = 0.020), and, the ratio of corneal laceration decreased significantly (p = 0.014) over time. In the multivariate analysis, initial BCVA was the only risk factor of poor visual outcome in both open and closed injuries. CONCLUSIONS: The proportion of open globe injury has decreased over time. In contrast, the proportion of simple injuries such as corneal erosion has increased in ocular injuries induced by power lawn mowers. Lower initial visual acuity was the only risk factor of poor visual outcome in both open and closed injuries.
Humans ; Lacerations ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors ; Seasons ; Visual Acuity

Purpose: To report a case of acute bilateral corneal edema after inhalation of spray paint.Case summary: A 47-year-old male presented with blurred vision in both eyes 12 hours after inhalation of spray paint. He had no history of ocular surgery or chronic ocular disease. The corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. An ocular examination revealed diffuse bullous changes in the epithelium and mild stromal edema in the cornea of both eyes. At one week after treatment with topical hypertonic solutions and corticosteroids, the visual acuity had improved to 20/20 and slit-lamp examination showed clear corneas without edema. Conclusions Inhalation of a chemical substance can lead to acute bilateral corneal edema, even without direct contact, but the lesion may resolve rapidly.

Purpose: To compare the clinical characteristics of Vogt-Koyanagi-Harada (VKH) disease between patients with and without prodromal manifestations. Methods: We retrospectively reviewed the medical records of patients with VKH disease who were treated with systemic steroids. We grouped the patients into the incomplete type (36 eyes of 18 patients) and probable type (32 eyes of 16 patients) according to the presence of prodromal manifestations. We compared the following outcomes between groups: best-corrected visual acuity (BCVA), anterior chamber (A/C) cell, central foveal thickness (CFT), maximal subretinal fluid (SRF) height, choroidal thickness at baseline and 12 months after treatment, and recurrence rate. Results: BCVA logarithm of the minimum angle of resolution (logMAR) significantly improved from 0.37 ± 0.26 at baseline to 0.09 ± 0.17 at 12 months in the incomplete type group (p < 0.05) and from 0.35 ± 0.24 at baseline to 0.10 ± 0.18 at 12 months in the probable type group (p < 0.05); BCVA did not significantly differ between groups. Choroidal thickness significantly decreased at 12 months after treatment, compared with one week after treatment, in both groups (p < 0.05); choroidal thickness did not significantly differ between groups. There were no significant differences in clinical factors between groups, including baseline A/C cell, CFT, maximal SRF height, and recurrence rate. Conclusions No associations were found between disease type and clinical outcomes (BCVA, OCT findings, and recurrence). These data suggested that categorization of disease according to prodromal manifestations has limited usefulness in terms of clinical outcomes of VKH disease.

Purpose: To evaluate the accuracy of intraocular pressure (IOP) measurements obtained by a rebound and non-contact tonometer in eyes with a therapeutic contact lens (CL) after vitrectomy. Methods: In 60 eyes of 60 patients who underwent vitrectomy for vitreoretinal disease, IOP was measured using a rebound tonometer (iCare ic200®; IOPRT) and non-contact computerized air puff tonometer (CT-80, IOPNCT), before and after wearing a CL (Purevision2®, +0.0 diopter). The mean IOP of three consecutive measurements were analyzed, and a comparative analysis with IOP measured by a Goldman applanation tonometer (IOPGAT) was performed. Results: The mean IOPRT without and with the CL was 12.55 ± 5.43 and 13.12 ± 5.13 mmHg, respectively, showing a statistically significant difference (p = 0.02) and strong positive correlation (r = 0.90, p < 0.001). The mean IOPNCT with and without the CL was 12.18 ± 3.24 and 12.17 ± 3.14 mmHg, showing no statistically significant difference (p = 0.17). The consistency with IOPGAT (12.57 ± 5.22 mmHg) was highest in IOPRT without the CL, followed by IOPRT with the CL, IOPNCT without the CL, and IOPNCT with the CL (intraclass correlation coefficients = 0.955, 0.945, 0.856, and 0.850, respectively). In addition, the rebound tonometer successfully measured IOP, regardless of whether the CL was worn; however, the non-contact tonometer failed to measure IOP in seven eyes without the CL and nine with the CL. No difference was observed according to intraocular tamponade type. Conclusions A rebound tonometer can be used as an alternative IOL measuring method in eyes for which it is difficult to use a Goldman applanation tonometer due to the postoperative presence of a therapeutic CL.

PURPOSE: We report a case of infectious keratitis caused by Shewanella putrefaciens in a patient after fishing. CASE SUMMARY: A 75-year-old male with no underlying disease other than hypertension was admitted to our hospital because of decreased visual acuity and congestion in his left eye for 2 weeks. At the first ophthalmic examination, the best-corrected visual acuity (BCVA) of the left eye was counting fingers. Slit lamp examination showed stromal infiltrates with 2.0 × 2.0 mm corneal epithelial defects, endothelial inflammatory plaques and 1 mm height hypopyon with severe inflammation in the anterior chamber. Bacterial culture tests were performed by corneal scraping, which were positive for Shewanella putrefaciens, followed by treatment with moxifloxacin and ceftazidime topical antibiotics. After 2 months of treatment, the BCVA of the left eye improved to 0.4 and the corneal lesion clinically improved with residual mild stromal opacity. CONCLUSIONS: Shewanella putrefaciens should be considered as a causal pathogen of infectious keratitis in patients after fishing. We report a case of infectious keratitis caused by Shewanella putrefaciens, which has never previously been reported in the Republic of Korea.
Aged ; Anterior Chamber ; Anti-Bacterial Agents ; Ceftazidime ; Corneal Ulcer ; Estrogens, Conjugated (USP) ; Fingers ; Humans ; Hypertension ; Inflammation ; Keratitis ; Male ; Republic of Korea ; Shewanella putrefaciens ; Shewanella ; Slit Lamp ; Visual Acuity

Purpose: To report two instances of retinal arterial occlusive vasculitis following intravitreal injection of brolucizumab.Case summary: Two patients noted decreased visual acuity approximately one month after receiving intravitreal brolucizumab injections to treat wet age-related macular degeneration. In case 1, an 85-year-old male reported a reduction in visual acuity in his left eye, declining from a Snellen measurement of 0.2 to hand motion. In case 2, a 70-year-old female experienced a decline in visual acuity in her right eye from 0.4 to finger count at 50 cm. Both patients presented with anterior chamber reactions, and fluorescein angiography demonstrated delayed retinal artery filling time, leading to the diagnosis of retinal occlusive vasculitis. They were treated with both topical and systemic corticosteroids. For case 1, a subsequent vitrectomy was performed to remove the inflammatory membrane located behind the intraocular lens. However, despite aggressive interventions, neither patient showed visual improvement. Conclusions Retinal occlusive vasculitis, which can result from intraocular inflammation, may occur after intravitreal brolucizumab injection. This condition can lead to significant visual impairment even with aggressive treatment.