Trabeculectomy, as a surgical intervention in the treatment of glaucoma, has become most popular. The most common cause of filtration failure is obstruction of aqueous outflow due to bleb fibrosis. Adjunctive intraoperative mitomycin-C has been reported to improve the success of filtration surgery in eyes of high risk for failure. But its use increases the rate of complications after filtering surgery: especially postoperative hypotony, wound leakage, and scleral necrosis. We have experienced two patients whose scleral flaps were necrotized after trabeculectomy with mitomycin-C in uncomplicated glaucoma. We report successful results in revision of filtering bleb by using Gore-Tex as a patch graft.
Blister* ; Fibrosis ; Filtering Surgery ; Filtration ; Glaucoma ; Humans ; Mitomycin* ; Necrosis ; Polytetrafluoroethylene* ; Trabeculectomy* ; Transplants ; Wounds and Injuries

No abstract available.

We compared the result of 6 patients[group A]treated with high dose steroid only with the result of 14 patients[group B]treated with optic canal decompression after at least 24 hours of high dose steroid therapy without improvement. 4 of 6 patients[66%]in group A and 7 of 14 patients[50%]in group B improved in visual acuity.But 1 of 6 patients[17%] in group A and 6 of 14 patients[43%]in group B had marked improvement in visual function[above 0.02].Of 5 patients with optic canal fracture in orbit CT in group B, all had improved visual function and 4 had marked improvement in visual function. If CT demonstrates bony fragments impinging on intracanalicular optic nerve, or if vision deteriorates or fails to improve during the first 24 hours of high dose steroid and initial visual acuity is no light perception, optic canal decompression is considered effective and valid treatment modality in TON.
Decompression* ; Humans ; Optic Nerve ; Optic Nerve Injuries* ; Orbit ; Visual Acuity

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Multiple fixation techniques for arthrodesis of the ankle and hindfoot have been introduced. The cannulated screw fixation provides excellent internal compression for arthrodesis. We used 5.0 and 6.5mm cannulated screws for seven ankle, seven subtalar, four tibiotalocalcaneal, three pantalar and two triple arthrodesis between January 1994 and September 1995. No iliac bone graft was utilized. The follow-up period was from 12 to 25 months. Ages of the patients ranged from 25 to 58 years. All fused except one who was preoperatively diagnosed as pyogenic arthritis of the ankle and hindfoot. One patient with diagnosis of Streeter's disease was complicated with partial necrosis of the forefoot. We think this procedure has several advantages; 1. The leg or foot length is largely preserved because minimal subchondral bone is removed. So, the leg and foot is aesthetically pleasing and the musculature around the ankle and foot can be maintained in the normal balanced position. 2. The rate of fusion is high, because the soft tissues are minimally stripped and cannulated screw compresses the subchondral bone surface. 3. The cannulated screws rarely requires removal. So, we believe that the cannulated screw fixation for the ankle and hindfoot arthrodesis is an excellent treatment method.
Ankle* ; Arthritis ; Arthrodesis* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Leg ; Necrosis ; Transplants

Behcet's disease (BD) involves multisystem vasculitis of unknown origin. Ocular manifestations of BD mostly include bilateral panuveitis and retinal vasculitis, which are very challenging to treat. Interferon alfa-2a (IFN) has been recently introduced for treating refractory Behcet uveitis, mainly in Germany and Turkey. Nonetheless, there is so far no consensus about the ideal treatment regimen of IFN for Behcet uveitis. We report our experience of IFN treatment in five Korean BD patients with refractory uveitis. All patients complained of oral ulcers; one patient had a positive pathergy test and 2 showed the presence of HLA-B51. Immunosuppressive agents used prior to IFN treatment included cyclosporine and methotrexate. The IFN treatment was commenced with a dose of 6-9 MIU/day for 7 days, adjusted according to individual ocular manifestations, tapered down to 3 MIU three times in a week, and then discontinued. All patients showed positive response to IFN treatment; 50% of them showed complete response without additional major ocular inflammation during the follow-up period. Other BD symptoms also improved after IFN treatment in most cases. After treatment, the relapse rate and the required dose of oral corticosteroid were decreased in most cases, showing a significant steroid-sparing effect. However, the visual acuity was not improved in most cases due to irreversible macular sequelae. Despite the small sample size of this study, we suggest that, in Korean patients, IFN is an effective treatment modality for BD uveitis as was observed in German and Turkish patients.
Adult ; Behcet Syndrome/complications/diagnosis/*drug therapy ; Chronic Disease ; Cyclosporine/therapeutic use ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Interferon-alpha/*therapeutic use ; Male ; Recombinant Proteins/therapeutic use ; Recurrence ; Remission Induction ; Treatment Outcome ; Turkey ; Uveitis/diagnosis/*drug therapy/etiology ; Visual Acuity

No abstract available.

PURPOSE: To compare the two transscleral fixation (TSF) techniques of intrascleral pocket and conventional scleral flap with conjunctival division techniques in terms of short-term clinical effects. METHODS: This retrospective cohort study included all consecutive patients with aphakia in Gyeongsang National University Hospital in Jinju, Korea, who underwent TSF between January 2012 and December 2014. The medical records of all patients were retrospectively reviewed, and the endothelial cell count (ECC), refraction, best-corrected visual acuity (BCVA), intraocular pressure, slit lamp, and fundus examination results before and 1 day and 6 months after surgery were recorded. The postoperative complications and visual outcomes were also recorded. RESULTS: The intrascleral pocket and conventional-flap groups did not differ significantly in terms of demographics, presurgical BCVA, or ECC. However, the intrascleral pocket group had a significantly lower BCVA at 1 day and 6 months after surgery compared to the conventional-flap group. The two groups did not differ in terms of ECC 6 months after surgery. The intrascleral pocket group had no postoperative complications, but five patients in the conventional-flap group complained of irritation. In both groups, the intraocular lens was well positioned without tilting or subluxation, and astigmatism was significantly reduced at 1 day and 6 months after surgery. CONCLUSIONS: The intrascleral pocket technique of TSF does not involve conjunctival dissection and is a successful method of sulcus fixation. It stably corrects the intraocular lens and is easy to perform, which helps to reduce operation time. It also reliably yields rapid visual acuity recovery without complications.
Aphakia ; Astigmatism ; Cohort Studies* ; Demography ; Endothelial Cells ; Gyeongsangnam-do ; Humans ; Intraocular Pressure ; Korea ; Lenses, Intraocular ; Medical Records ; Postoperative Complications ; Retrospective Studies* ; Visual Acuity

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A