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Surgical Results and Complications of Implanted Primary Intraocular Lenses in Pediatric Cataract.

Journal of the Korean Ophthalmological Society.2007;48(9):1220-1226. doi:10.3341/jkos.2007.48.9.1220

PURPOSE: To evaluate surgical results and complications of different intraocular lenses (IOL) implantation in pediatric cataract surgery. METHODS: We retrospectively reviewed 139 eyes of 80 patients who had undergone irrigation and aspiration of cataracts and primary posterior chamber intraocular lens implantation with posterior continuous curvilinear capsulorhexis and optic capture from July 1998 to December 2005. All the eyes were divided into three groups into the intraocular lenses implanated: group 1 (n=40), PMMA lens was implantated; group 2 (n=42), hydrophobic acrylic lens was implantated; group 3 (n=57), hydrophilic acrylic lens was implanated. The surgical results and complications was evaluated. RESULTS: Wound leakage, iris prolapse, shallow anterior chamber during operation were the most common in group 1. Peripheral anterior synechiae, conjuntival cyst, pigment deposition of IOL, exudative membrane, elevated intraocular pressure were also the most common in group 1 (P<0.05). There was no statistically significant defference in the prevalence of intraoperative and postoperative complications between group 2 and 3. Postoperative final visual acuity and astigmatism were not significantly different between the three groups. CONCLUSIONS: Implantation of hydrophilic acrylic IOLs, as well as hydrophobic acrylic IOLs decrease complications and have good surgical results compared to PMMA IOLs in pediatric cataract surgery.
Anterior Chamber ; Astigmatism ; Capsulorhexis ; Cataract* ; Humans ; Intraocular Pressure ; Iris ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Membranes ; Polymethyl Methacrylate ; Postoperative Complications ; Prevalence ; Prolapse ; Retrospective Studies ; Visual Acuity ; Wounds and Injuries

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Clinical Analysis of Herpetic Keratitis in Korea.

Joon Seo HWANG ; Won Ryang WEE ; Jin Hak LEE ; Mee Kum KIM

Journal of the Korean Ophthalmological Society.2007;48(9):1212-1219. doi:10.3341/jkos.2007.48.9.1212

PURPOSE: To investigate the clinical characteristics of herpetic keratitis in Korea. METHODS: A retrospective analysis was performed on 90 eyes of 84 patients who were clinically diagnosed with herpetic keratitis and were followed for at least 4 months or more. Information on prior herpetic keratitis, type of keratitis, time to remission, recurrence rate, administration of oral acyclovir, final visual acuity was reviewed. Remission time and recurrence rate were compared according to types of herpetic keratitis and the application of oral acyclovir in epithelial, stromal or endothelial keratitis; and the relation of history of previous herpetic keratitis, recurrence and final vision, was analyzed. RESULTS: Sex ratio (M:F) was 1.31 and the mean age was 54.6 years. Of 90 eyes, the proportion of infectious epithelial keratitis, stromal keratitis, endothelitis and neurotrophic ulcer was 51.1, 17.8, 25.6 and 5.6%, respectively. The mean remission time was 1.92+/-1.01, 4.13+/-5.05, 5.52+/-5.08, 4.00+/-1.00, respectively (p=0.001, one-way Anova). Recurrence occurred in 21 (42.9%) eyes of 49, which were followed up for more than 12 months, in a year after the previous attack. The rates of recurrence of infectious epithelial keratitis, stromal keratitis and endothelitis were 25.0%, 63.6% and 53.8%, respectively. Oral acyclovir neither shortens the remission nor prevents the recurrence. The percentage of final vision over 20/40 in infectious epithelial keratitis, stromal keratitis and endothelitis was 81.1, 57.1 and 60.0%, respectively. The final vision was worse in the group with a history of herpetic keratitis. CONCLUSIONS: Stromal keratitis and endothelitis showed a higher recurrence rate and longer remission time than infectious epithelial keratitis. Because recurrent and severe keratitis may result in corneal opacity and vision loss, aggressive and proper treatment is needed. However, these cases are often resistant to therapy.
Acyclovir ; Corneal Opacity ; Humans ; Keratitis ; Keratitis, Herpetic* ; Korea* ; Recurrence ; Retrospective Studies ; Sex Ratio ; Ulcer ; Visual Acuity

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Risk Factors Affecting Efficacy of Intracameral Amphotericin Injection in Deep Keratomycosis.

Je Hyun SEO ; Won Ryang WEE ; Jin Hak LEE ; Mee Kum KIM

Journal of the Korean Ophthalmological Society.2007;48(9):1202-1211. doi:10.3341/jkos.2007.48.9.1202

PURPOSE: To investigate the clinical efficacy of intracameral amphotericin injection and to evaluate risk factors affecting primary treatment success in fungal infection invading the anterior segment of the eye. METHODS: Twenty-six eyes of 26 patients diagnosed with fungal infection in the anterior segment were studied. The initial treatment regimen was a topical 0.15% amphotericin application and itraconazole oral administration after culture. Amphotericin (5 ug/0.1 ml, 0.1 cc) was repeatedly injected intracamerally when the infection intensified. Penetrating keratoplasty was conducted for eyes unresponsive to intracameral amphotericin injection. The relative risk ratios of ulcer size, infiltration depth, culture positivity, and hypopyon were compared in each treatment group to evaluate the treatment response. RESULTS: Of patients with fungal infection, 30.7% were cured with intracameral amphotericin injection, while 30.7% needed penetrating keratoplasty. Intracameral amphotericin injection was needed in the presence of large corneal ulcers (>14 mm2), hypopyon, positive fungal culture, use of steroid eye drops, and deep infiltration at initial examination. Large ulcer size (>14 mm2) was the main risk factor for needing penetrating keratoplasty. Of the eyes Candida infection, 66.5% needed evisceration. CONCLUSIONS: Large ulcer size and the isolation of Candida were poor prognostic factors related to the efficacy of intracameral amphotericin injection.
Administration, Oral ; Amphotericin B* ; Candida ; Humans ; Itraconazole ; Keratoplasty, Penetrating ; Odds Ratio ; Ophthalmic Solutions ; Risk Factors* ; Ulcer

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Comparison of Laser Epithelial Keratomileusis Versus Epipolis-Laser in Situ Keratomileusis for Moderate to High Myopia.

Suk Kyue CHOI ; Hae Young PARK ; Yoon Hee KIM ; Sung Kun CHUNG

Journal of the Korean Ophthalmological Society.2007;48(9):1196-1201. doi:10.3341/jkos.2007.48.9.1196

PURPOSE: To compare the clinical visual results and complications of laser-assisted subepithelial keratectomy (LASEK) and epipolis laser in situ keratomileusis (Epi-LASIK). METHODS: A retrospective analysis of a case series of eyes treated with LASEK or Epi-LASIK with a follow-up of six months was performed. Twenty-two eyes were treated with LASEK, and 20 eyes were treated using Epi-LASIK. The main outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction at one week, one month, three months, and six months after refractive surgery, and the presence of any complications. RESULTS: There was no significant difference of UCVA and mean postoperative spherical equivalent (SE) between the eyes treated with LASEK or Epi-LASIK at one week, three months, and six months. However at one month there was significant difference of UCVA. Additionally, in a comparison between moderate and serve myopia, there was no significant difference of UCVA and mean postoperative spherical equivalent (SE) between groups treated with LASEK or Epi-LASIK at one week, one month, three months, and six months. Seven eyes treated with LASEK and two eyes treated with Epi-LASIK showed persistent epithelial erosion less than one week. Two eyes treated with LASEK exhibited newly-developed corneal opacity, which persisted-through the last visit. CONCLUSIONS: Epi-LASIK showed clinical visual results and complications comparable to LASEK and showed better epithelial healing.
Corneal Opacity ; Follow-Up Studies ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Myopia* ; Outcome Assessment (Health Care) ; Refractive Surgical Procedures ; Retrospective Studies ; Visual Acuity

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Comparison of Graft Rejection of First Eyes and Second Eyes after Bilateral Penetrating Keratoplasty.

Ho Sik HWANG ; Su Young KIM ; Man Soo KIM

Journal of the Korean Ophthalmological Society.2007;48(9):1189-1195. doi:10.3341/jkos.2007.48.8.1189

PURPOSE: To compare graft rejection of the first and second eyes after bilateral penetrating keratoplasty. METHODS: We performed a retrospective review of the cases of 16 patients who underwent bilateral penetrating keratoplasty. Nonparametric Kaplan-Meier survival analysis was used to account for variable follow-up among patients. RESULTS: The mean age of the 16 patients (12 M, 4 F) was 39.1 years. Mean follow-up was 89.8 months after surgery in the first eye and 42.8 months after surgery in the second eye. The average time interval between surgery on the first and second eyes was 47.0 months. The indications for surgery were keratoconus (37.5%), corneal dystrophy (25.0%), pseudophakic bullous keratopathy (12.5%), band keratopathy (12.5%), and inflammatory corneal opacity (12.5%). Endothelial rejection occurred in five of the first eyes but was treated successfully, remaining clear until the last follow-up. Endothelial rejections were seen in five of the second eyes, two of which failed. Survival analysis of endothelial rejection showed no significant difference between the first and second eyes; however, survival analysis of the graft failure showed a decreased survival rate of the second eyes compared with that of the first eyes. The best corrected visual acuity at the last follow-up of the second eyes seemed to be worse than that of the first eyes. CONCLUSIONS: Survival analysis of the endothelial rejections showed no significant difference between the first and second eyes. Survival analysis of the graft failure showed decreased survival rate of the second eyes. At the last follow-up the best corrected visual acuity of the second eyes appeared to be worse than that of the first eyes.
Corneal Opacity ; Follow-Up Studies ; Graft Rejection* ; Humans ; Keratoconus ; Keratoplasty, Penetrating* ; Retrospective Studies ; Survival Rate ; Transplants* ; Visual Acuity

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Accuracy of Surgeon-Selected Ablation Center in Active Eye-Tracker-Assisted Advanced Surface Ablation-Photorefractive Keratectomy (ASA-PRK).

Sang Bumm LEE ; Myung Jin CHO

Journal of the Korean Ophthalmological Society.2007;48(9):1177-1188. doi:10.3341/jkos.2007.48.9.1177

PURPOSE: To evaluate the accuracy of the surgeon-selected ablation center in active eye-tracker-assisted ASA-PRK and to identify factors influencing the ablation center. METHODS: This retrospective study included 109 eyes of 62 patients who underwent active eye-tracker-assisted ASA-PRK (VISX STARTM S4 with ActiveTrakTM System). The location the surgeon-selected ablation center and its distance from the center of the entrance pupil were analyzed by corneal topography (EyeSys Corneal Analysis SystemTM with pupil finding software). The factors influencing centration were investigated. RESULTS: The mean decentration was 0.24+/-0.13 mm (range 0.04 to 0.83 mm). One-hundred and five eyes (96%) were within 0.5 mm of the pupillary center. Supero-nasal displacement of the ablation center occurred most frequently in 44 eyes (40%) after ASA-PRK. The decentration amount was not dependant on factors related to the patient, the surgeon, or the surgery. There was no significant correlation between the amount of decentration and the vertical scale bar of the ActiveTrakTM icon on the screen representing the distance from the pupil center determined by the tracking system, to the surgeon-selected ablation center. CONCLUSIONS: This method of tracking the ablation center, which was selected by the surgeon according to each patient's specific pupil decentration with the active eye tracking system, was highly accurate and effective in avoiding severe decentration in ASA-PRK.
Corneal Topography ; Humans ; Photorefractive Keratectomy ; Pupil ; Retrospective Studies

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The Surgical Results of Endonasal DCR with Two Silicone Tubes in Common Canalicular Obstruction.

Se Jong KIM ; Sang Duck KIM

Journal of the Korean Ophthalmological Society.2007;48(9):1170-1176. doi:10.3341/jkos.2007.48.9.1170

PURPOSE: To evaluate the surgical results of endonasal dacrocystorhinostomy with two silicone intubation in common canalicular obstruction. METHODS: Forty patients (57 eyes) who complained of tearing due to common canalicular obstruction underwent endonasal dacryocystorhinostomy. In this study, We randomly divided patients into two groups. One group underwent one-silicone tube intubation (29 eyes, group A) and the other group underwent two-silicone tube intubation (28 eyes, group B). After surgery, we compared the success rates and the causes of surgical failure between the two groups. RESULTS: There were no significant differences between the two groups with regard to age, sex, duration of silicone intubation, or follow-up time. The primary success rates of the group A and the group B were 65.5% (19/29) and 85.7% (24/28) [(P=0.078)], respectively. the final success rates after the revisional surgery were 76.4% (21/29) and 92.8% (26/28) [(P=0.043)] respectively. Primary causes of surgical failure in the group A were: membranous obstruction of the internal ostium (6), common canalicular re-obstruction (2), sump syndrome (1), and functional obstruction (1). The main causes of surgical failure in the group B were: membranous obstruction of the internal ostium (2), and granuloma formation (2). CONCLUSIONS: We believe that endonasal dacryocystorhinostomy with two-silicone tube intubation might be an excellent alternative treatment modality in order to improve success rates in common canalicular obstruction.
Dacryocystorhinostomy ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Postcholecystectomy Syndrome ; Silicones*

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The Results of Periocular Injections of Triamcinolone for Thyroid Orbitopathy.

Bo Young JUNG ; Yoon Duck KIM

Journal of the Korean Ophthalmological Society.2007;48(9):1163-1169. doi:10.3341/jkos.2007.48.9.1163

PURPOSE: The aim of this study is to evaluate the effects and complications of periocular injections of triamcinolone acetonide in patients with thyroid orbitopathy who could not tolerate systemic corticosteroid therapy. METHODS: Six patients with a mean age of 48.7 years showed symptoms of severe acute thyroid orbitopathy. They received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The response to treatment and the presence of adverse effects were evaluated retrospectively. RESULTS: Three of six patients (50%) showed significant improvement in soft tissue swelling in both eyes. Only one patient (17%) showed improvement of proptosis. No patients showed improvement in diplopia and ocular motility. The mean thickness of the extraocular muscles measured by CT scan remained unchanged. Compressive optic neuropathy developed in one patient and resolved after intravenous high-dose steroid treatment. Two patients received radiation therapy for resistant inflammatory symptoms. One patient underwent extraocular muscle surgery. In one patient, there was no adverse effect at the injection site, except for a foreign body granuloma. CONCLUSIONS: Periocular triamcinolone injection could be effective for patients with thyroid orbitopathy in the acute inflammatory phase in reducing soft tissue swelling. The procedure showed no significant effect on exophthalmos or ocular motility.
Diplopia ; Exophthalmos ; Granuloma, Foreign-Body ; Humans ; Injections, Intraocular* ; Muscles ; Optic Nerve Diseases ; Orbit ; Retrospective Studies ; Thyroid Gland* ; Tomography, X-Ray Computed ; Triamcinolone Acetonide ; Triamcinolone*

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Eight Cases of Microbial Growth in Soft Contact Lenses.

Meeg Yeoung PARK ; Hung Won TCHAH

Journal of the Korean Ophthalmological Society.1991;32(11):1024-1030.

Microbial growth(including fungal growth in 6 cases) was detected in 8 soft contact lenses Among the contact lens wearers who visited the Department of Ophthalmology, Asan Medical Center, between May, 1990 and Nov, 1990, contact lens deposits were easily recognized with naked eye and it was not removed by conventional cleaning methods, such as chemical cleaners and enzymatic agents. We examined these deposits under the microscope and found them microbial colonies. Isolation of microorganisms from the contact lenses and storage solutions was attempted in order to identify them. Direct microscopic observation of colonies grown in the contact lenses made it possible to identify 5 out of 10 cases. Growths of four cases were identified as Actinomyces sp., Trichothecium sp., Dermatophilus congolensis, Alternaria sp., and one case was found mixed growth of Humicolor sp. and Fusarium sp. Other 3 cases were highly suspected as fungus. Culure of the eight storage solutions were all revealed Serratia marcescens Our patients showed foreign body sense and redness in all 8 cases, superficial punctate keratitis in 1 case, and corneal erosion in 1 case.
Actinomyces ; Alternaria ; Chungcheongnam-do ; Contact Lenses ; Contact Lenses, Hydrophilic* ; Foreign Bodies ; Fungi ; Fusarium ; Humans ; Keratitis ; Ophthalmology ; Serratia marcescens

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A Case of Posterior Polymorphous Dystrophy.

In Chul PARK ; Sung Kun CHUNG ; Yoon Won MYONG ; Sang Wook RHEE

Journal of the Korean Ophthalmological Society.1991;32(11):1020-1023.

Posterior polymorphous dystrophy is a bilateral, dominantly inherited (rarely recessively inherited) disorder of corneal endothelium, characterized by a spectrum of changes in posterior cornea and less commonly in the iris and angle structures. We have experienced a 39-year-old male patient complaining of visual disturbance in the right eye. On examination, we found characteristics of postenor polymorphous dystrophy which were Descemet's membrane thickening. peripheral anterior synechiae, iridocorneal adhesion. abnormal corneal endothelial cells in both eyes, and corneal epithelial and stromal edema in the right eye and after penetrating keratoplasty, the result was good. Therefore, we report a case of posterior polymorphous dystrophy with review of literatures.
Adult ; Cornea ; Descemet Membrane ; Edema ; Endothelial Cells ; Endothelium, Corneal ; Humans ; Iris ; Keratoplasty, Penetrating ; Male

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