Objective: This small case series demonstrated pars plana vitrectomy and silicone tamponade without internal limiting membrane (ILM) peeling to be a simple, safe, and effective surgical technique for the treatment of myopic traction maculopathy (MTM). Methods: This is a small case series consisting of 3 eyes with MTM. In all eyes, pars plana vitrectomy with silicone oil tamponade was performed by a single vitreoretinal surgeon. Functional and anatomic outcomes are reported. Results: All 3 eyes had improved visual acuity with no noted short-term complications such as iatrogenic macular hole and retinal detachment. Although foveoschisis was only partly anatomically resolved in 2 out of the 3 cases, functional outcome, in terms of visual acuity at last visit, was satisfactory. Conclusion Vitrectomy with silicone oil tamponade without ILM peeling is a simple, effective, and safe optional surgical technique to treat MTM.
pathologic myopia

Laser Assisted In Situ Keratomileusis(LASIK) has been regarded as an effective treatment for the correction of high myopia. However, excimer laser refractive procedure, itself modifies the refracting power of the cornea by altering the anterior corneal curvature using photoablation. Therefore, The cornea treated by refractive surgery has a potentiality to be in pathologic condition. To impove effectiveness of LASIK, it is required to examine corneal state before operation using slit-lamp biomicroscopy, keratometry, photokeratoscopy, and topography. Also, a careful and conservative approach that ideally preserves 250 of posterior stromal bed after Lasik should be used until further research or experience indicates that corneal intergrity is pressved with less posterior tissue. In this study, we report two cases of corneal ectasia which cannot be anticipated before LASIK and appeared as a typical cornneal ectasia after LASIK. We reviewed useful methods to detec subclinial pathologic conditions of cormea prior to LASIK with literature and also recommed proper operative procedure to prevent cormeal ectasi after LASIK.
Cornea ; Dilatation, Pathologic* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Refractive Surgical Procedures ; Surgical Procedures, Operative

PURPOSE: To evaluate the causes of low uncorrected visual acuity below 20/40 after LASIK (laser in situ keratomileusis). METHODS: 289 eyes (more -6.0 D myopia) that had LASIK between July 1997 and December 1999 by one surgeon were observed for at least 6 months. We evaluated their uncorrected visual acuity and ocular state. RESULTS: 51 eyes (17.64%) of 289 eyes have lower uncorrected visual acuity than 20/40 after LASIK. The causes were myopic regression (22/51), decentering (10/51), undercorrection of myopia (5/51), corneal ectasia (5/51), undercorrection of astigmatism (4/51), central island (2/51), free flap (1/51), postoperative flap displacement (1/51) and incomplete keratome pass (1/51). CONCLUSION: Although LASIK is a safe and effective procedure, many patients had lower uncorrected visual acuity less than 20/40 after LASIK. We must be able to manage correctable factors among the causes above.
Astigmatism ; Dilatation, Pathologic ; Free Tissue Flaps ; Humans ; Keratomileusis, Laser In Situ* ; Myopia ; Visual Acuity*

Spondyloepiphyseal dysplasia congenita (SEDC) is a kind of skeletal dysplasia, inheritable condition. The clinical features of SEDC are dwarfism, myopia with or without retinal detachment, coxa vara, thoracic dysplasia with respiratory failure and laryngotracheal stenosis. A point of particular concern to anesthetists is odontoid hypoplasia which, combined with ligamentous laxity, leads to atlantoaxial instability. We report successful general anesthesia for cervical spine fusion of a patient with SEDC.
Anesthesia, General ; Constriction, Pathologic ; Coxa Vara ; Dwarfism ; Humans ; Ligaments ; Myopia ; Osteochondrodysplasias ; Respiratory Insufficiency ; Retinal Detachment ; Spine

We compared the clinical results of lens extraction with or without intraocular lens (IOL) for 41 eyes of 24 high myopic patients (axial length: >26mm, diopter: <-10) to those of laser in situ keratomileusis (LASIK) for 54 eyes of 29 patients. After operation,uncorrected visual acuity and best corrected visual acuity were improved in both patient groups. They gained visual improvement of 2 or more lines in 73% and 11%, respectively. Predictability was significantly higher in lens extraction group than LASIK group, while postoperative near vision was vise versa. The postoperative intraocular pressure was measured significantly low in LASIK group, while the number of corneal endothelium was significantly decreased in lens extraction group. In the point of postoperative complications, the incidence of posterior capsular opacity was 9.8% in lens extraction group and that of corneal ectasia was 5.3%in LASIK group. Conclusively, for precision and quality of vision, lens extraction with or without IOL implantation would be superior to LASIK for correction of high myopia. However, corneal endothelial cell loss, near vision impair-ment, and developememt of after-cataract might be problems in the procedure of lens extraction.
Corneal Endothelial Cell Loss ; Dilatation, Pathologic ; Endothelium, Corneal ; Humans ; Incidence ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Lenses, Intraocular ; Myopia* ; Postoperative Complications ; Visual Acuity