The accuracy of intraocular lens power calculation in cataract surgery depends on three factor :accuracy of the biometric data[axial length, corneal power, predicted pseudophakic anterior chamber depth], accuracy of manufacturer of IOL power quality, and accuracy of the IOL power formulas usedto obtain desired lens power. We retrospectively analyzed 27 patients[40 eyes] who had taken 3.2 millimeterscleral tunnel incision and been implanted with Silicone IOL. We evaluated the correlation between pseudophakic anterior chamber depth and preoperative lens thickness. And, we calculated the ratio of anterior and posterior distance from the central point on the presumption that there is the central point remaining constant despite of thickening of lens. The preoperative mean lens thickness was 4.47 +/-0 .4 9 mm. The change of anterior chamber depth was significantly increased according to the lens thickness at postoperaitve 3months[r=0.57, p<0.01]. The mean ratio of anterior and posterior distance from central point was 0.29:0.71. This result suggests that the postoperative anatomical center of IOL will change more posterior as increasing preoperative lens thickness. And we concluded that we would more exactly predict postoperative pseudophakic anterior chamber depth considering the preoperative lens thickness if the ratio of lens thickening was constant.
Anterior Chamber* ; Cataract* ; Lenses, Intraocular ; Retrospective Studies ; Silicones

As a study that the incision size was changed at each step of the surgical procedure but it is different, from the universal assumption that. the incision width initially created by a keratome during cataract extraction remained same size after the end of the surgical procedure, the authors investigated a comparative study between the two studies. We used specially designed instrument for accurate measuring of the incision size in 100 eyes and the incision size was measured after the creation of the initial incision, after the coirlpletion of phacoemulsification, after widening the incision and after the folded IOL insertion. Dividing group A and B in 50 eyes respectively, we designated the incision enlargement with 3.0mm keratome as A and 3.2mm keratome as B. It appeared statistically significant widening of the incision by approximately 0.06mm after the completion of phacoemulsification, 0.19mm after the folded IOL insertion in group A and 0. 05mm, 0.1mm in group B, respectively. Future studies of the surgical techniques and the postoperative healing after small incision cataract surgery must measure the actual incision size to avoid misleading assumption that the keratome size at the beginning of the procedure determines the incision size at. the end of the procedure.
Cataract ; Cataract Extraction ; Lenses, Intraocular* ; Phacoemulsification*

Myotonic dystrophy is a muscular disease that is transmitted in autosomal dominant pattern. Typical features are myotonicity due to defective muscular relaxation after its contraction and muscular dystrophy. Ophthalmologic complications are cataract, retinal degeneration, hypotony, ptosis, extraocular muscle weakness, and saccadic eye movement defect. Cardiomyopathy, abnormal conduction of cardiac muscle, alopecia of frontal head, testicular atrophy, diabetes mellitus, decreased pulmonary function, and mental retardation are complications of other organs in this disease. Authors experienced two cases of cataract in two sisters with myotonic dystrophy.
Alopecia ; Atrophy ; Cardiomyopathies ; Cataract* ; Diabetes Mellitus ; Head ; Humans ; Intellectual Disability ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophies ; Myocardium ; Myotonic Dystrophy* ; Relaxation ; Retinal Degeneration ; Saccades ; Siblings*

Two different scleral tunnel incision widths were studied to determine whether the difference of cornea wound extension existed in each scleral tunnel incision widths(4 mm, 3.2 mm).25 patients in group A undergoing phacoemulsification through approximately 4 mmwidth scleral tunnel and folded silicone IOL implantation were studied with internal incision gauge after initial keratome entry, phacoemulsification, and folded IOL implantation. Same procedure was done in group B patients except 3.2 mmscleral tunnel width was made instead. After completion of phacoemulsification, the incision was further widened by a mean of 0.05 mmin both groups. Forceps insertion of silicone IOL resulted in further incision enlargement by a mean of 0.15 mmin group A, and 0.05 mmin group B. No difference was found between the intraoperative or postoperative wound stabilities between two incisions. Vector analysis calculations of mean postoperative induced astigmatism for 4.0 mmincision versus 3.2 mmincision were -0.33D versus -0.20D at 3 month. Therefore, although 4 mmscleral tunnel incision resulted in larger wound extension and induced astigmatism, it showed same wound stability and easier implantation of IOL relative to 3.2 mmscleral tunnel incision. It is necessary that proper scleral tunnel incision width is selected based on degree of surgical skill and compliance of patients.
Astigmatism ; Compliance ; Cornea ; Humans ; Lenses, Intraocular* ; Phacoemulsification ; Silicones ; Surgical Instruments ; Wounds and Injuries*

Ocular ischemic syndrome is caused by reduction of blood to the eyeball, which can prodece anterior and posterior segment ischemia. Initial symptom include sudden or gradual loss of vision and eyeball pain. Anterir segment findings are conjunctival injection, iris neovascularization(NV), angle NV,peripheralanterior synechiae, and lens opacity. Posterior segmentfindings are pale, cupped of edematous opticdisc, disc NV, retinal NV, retinal hemorrhage, cherry red spot, retinal arterioles attenuation or sclerosis, and centralretinal artery collapse with pressure on globe. We have experienced a patient who had left ophthalmic artery stenosis, right ophthalmic artery narrowing and neovascular glaucoma in both eyes. We report the case of ocular ischemic syndrome that had control of IOP, mild improvement of visual acuity and regression of neovascularization after Ahmed glaucoma valve implantation.
Arteries ; Arterioles ; Cataract ; Constriction, Pathologic ; Glaucoma* ; Glaucoma, Neovascular* ; Humans ; Iris ; Ischemia ; Ophthalmic Artery ; Prunus ; Retinal Hemorrhage ; Retinaldehyde ; Sclerosis ; Visual Acuity

The aim of this study was to evaluate the influence of intraocular 1% lidocaine as an adjunct to topical anesthesia on corneal endothelial cell during phacoemulcification. We evaluated 38 patients(50 eyes). All patients underwent phacoemulsification and PCL implantaion. Twenty five eyes were used intraocular 1% lidocaine and topical anesthesia and others used only topical anesthesia. Endothelial cell density was examind preoperatively, and at 1 day, 1 week, 1 and 2 months postoperatively by specular microscopy. The difference of preoperative endothelial cell density between two groups was not statistically significant. In lidocaine-used group, the average endothelial cell loss was 7. 6%, 9. 2%, 10.4%, 10.6%at 1 day, 1 week, 1 and 2 months. In non used group, the average endothelial cell loss was 7. 4%, 9. 4%, 9. 9%, 11. 7%at 1 day, 1 week, 1 and 2 months. The difference of postoperative endothelial cell density between two groups was not statistically significant(P>0.1). From these results, we conclude that the intraocular lidocaine infusion for anesthesia had little effect on the corneal endothelial cell loss.
Anesthesia ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Lidocaine* ; Microscopy ; Phacoemulsification*

PURPOSE: For patient with extreme myopia outside the suspected limit of single procedure alone, we performed Lasik as a secondary procedure for the correction of residual refractive error following phakic IOL implantation. METHODS: First, we made a corneal flap using ACS(Bauch & Lomb surgical/Chirom vision, Irvine, CA) due to the potential risk of endothelial damage by cornea-IOL contact during the flap dissection. One month later, phakic IOLs, Nuvita MA20 (Bauch & Lomb surgical/Chiron vision, Irvine, CA) implantation were done, and 4 months after IOL implantation, stromal ablation was performed with the eximer laser by using previously formed flap. RESULTS: Preoperative spherical equivalent refraction was -25.0 D of Rt eye, -24.0 D of Lt eye, and preoperative visual acuity was 20/500 (best spectacle corrected visual acuity; BSCVA: 20/50) of Rt eye, 20/200 (BSCVA: 20/40) of Lt eye. Spherical equivalent refraction following phakic IOL implantation was -4.25 D of Rt eye, -3.75 D of Lt eye and refractive cylinder was -1.0 D cyl x90 A, visual acuity was 20/100 (BSCVA: 20/40) of Rt eye, 20/100 (BSCVA: 20/40) of Lt eye. Spherical equivalent refraction at the last examination following LASIK was -0.75 D of Rt eye, -0.5 D of Lt eye and visual acuity was 20/25 (BSCVA: 20/25) of Rt eye, 20/25 (BSCVA: 20/25) of Lt eye. CONCLUSIONS: Bioptics by combined anterior chamber phakic intraocular lens and laser in situ keratomileusis is one of the effective methods for patients with refractive error of extreme myopia outside the suspected limits of single procedure alone. Longer follow-up of large number of cases is needed to fully assess the safety and complications.
Anterior Chamber* ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia* ; Phakic Intraocular Lenses* ; Refractive Errors ; Visual Acuity

PURPOSE: This study was aimed to analyze the incidence and the anatomical distributions of HME (Hereditary Multiple Exostoses) on upper limbs and its related change in alignment of the upper limbs in HME patients. MATERIALS AND METHODS: Thirty eight patients who had been diagnosed HME between 2001 and 2009, were categorized into two groups; (1) group A (1-2 involvements); (2) group B (> or =3 involvements). We checked the carrying angle, VAS (Visual Analogue Scale), limitations in daily activities, cosmetic satisfaction according to the number of exostoses invasion. RESULTS: Among the 38 patients, 23 patients (43 cases) had exostoses in the upper limbs. The locations of exostoses in the upper limbs were proximal humerus in 33 cases (30%), distal ulna in 31 cases (28.2%), and distal radius in 24 cases (21.8%). The carrying angle of group A and B was 10.7degrees, 13.8degrees, VAS was 1.3, 3.5, and the limitations in daily activities was 7.3, 6.6 of 8 points. The cosmetic satisfactory cases were 13 and 10 cases, respectively. CONCLUSION: The deformity in upper limbs was observed in 65% of the HME patients. As the number of invasion increases, carrying angle and VAS were increased but limitations in daily activities and cosmetic satisfaction were decreased.
Congenital Abnormalities ; Cosmetics ; Exostoses ; Exostoses, Multiple Hereditary ; Humans ; Humerus ; Incidence ; Lifting ; Radius ; Ulna ; Upper Extremity

We evaluated clinical results and complications of LASIK using Technolas 217 C-LASIKTM excimer laser. This study included 102 patients(203 eyes) who had LASIK from March 1998 to February 1999 and followed up for at least 6months. Preoperative mean spherical equivalent was -3.99+/-1.198(SD), -7.928+/1.138(SD)and -11.92+/-1.060(SD)in each group I, II, III.The results at postoperative 6months were as following: 1. Mean spherical equivalent was -0 .44+/-0.410(SD), -0.34+/-0.500(SD), -0.37+/-0.430(SD)in each group I, II, III. 2. The 70 eyes(65%), 48 eyes(61%), 10 eyes(60%)in each group I, II, III were within+/-0.5D. 3. Mean uncorrected visual acuitywas 1.00+/-0.130(SD), 0.96+/-0.140(SD), 0.86+/-0.150(SD)in each group I, II, III. 4. Loss of best spectacle corrected visual acuity of two or more lines was 6 eyes(3%). Intraoperative complications was thin flap(5 eyes, 2.5%), flap tear(1 eyes, 0.5%)and postoperative complications was night glare and halo(58 eyes, 28.8%), punctate epithelial keratopathy(35 eyes, 12.3%)and interface foreign body(23 eyes, 11.3%). Above results suggests that myopic keratomileusis using Technolas 217 C-LASIKTM is a safe, effective way to correct myopia.
Glare ; Intraoperative Complications ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Postoperative Complications ; Visual Acuity

No abstract available.
Spine*