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Intraocular Lens Power Calculation after Refractive Surgery: A Comparative Analysis of Accuracy and Predictability.

Byeong Soo KANG ; Jeong Mo HAN ; Joo Youn OH ; Mee Kum KIM ; Won Ryang WEE

Korean Journal of Ophthalmology.2017;31(6):479-488. doi:10.3341/kjo.2016.0078

PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculation using conventional regression formulae or the American Society of Cataract and Refractive Surgery (ASCRS) IOL power calculator for previous corneal refractive surgery. METHODS: We retrospectively reviewed 96 eyes from 68 patients that had undergone cataract surgery after keratorefractive surgeries. We calculated the formula with two approaches: IOL powers using the ASCRS IOL power calculator and IOL powers using conventional formulae with previous refractive data (Camellin, Jarade, Savini, and clinical history method) or without prior data (0, 2 and, 4 mm total mean power in topography, Wang-Koch-Maloney, Shammas, Seitz, and Maloney). Two conventional IOL formulae (the SRK/T and the Hoffer Q) were calculated with the single K and double K methods. Mean arithmetic refractive error and mean absolute error were calculated at the first postoperative month. RESULTS: In conventional formulae, the Jarade method or the Seitz method, applied in the Hoffer Q formula with the single K or double K method, have the lowest prediction errors. The least prediction error was found in the Shammas-PL method in the ASCRS group. There was no statistically significant difference between the 10 lowest mean absolute error conventional methods, the Shammas-PL method and the Barrett True-K method calculated with using the ASCRS calculator, without using preoperative data. CONCLUSIONS: The Shammas-PL formula and the Barrett True-K formula, calculated with the ASCRS calculator, without using history, were methods comparable to the 10 most accurate conventional formulae. Other methods using the ASCRS calculator show a myopic tendency.
Cataract ; Humans ; Lenses, Intraocular* ; Methods ; Refractive Errors ; Refractive Surgical Procedures* ; Retrospective Studies

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Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium.

Jun Seok LEE ; Sang Won HA ; Sung YU ; Gwang Ja LEE ; Young Jeung PARK

Korean Journal of Ophthalmology.2017;31(6):469-478. doi:10.3341/kjo.2016.0135

PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
Astigmatism ; Autografts* ; Bevacizumab ; Cicatrix ; Edema ; Follow-Up Studies ; Granuloma, Pyogenic ; Humans ; Male ; Medical Records ; Postoperative Complications ; Pterygium* ; Recurrence ; Tissue Donors ; Transplants ; Visual Acuity

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A Case of Congenital Simple Hamartoma of the Retinal Pigment Epithelium and Coats' Disease in the Same Eye.

Won Jae HEO ; Dong Ho PARK ; Jae Pil SHIN

Korean Journal of Ophthalmology.2015;29(4):282-283. doi:10.3341/kjo.2015.29.4.282

No abstract available.
Diagnosis, Differential ; Fluorescein Angiography ; Fundus Oculi ; Hamartoma/*congenital/diagnosis ; Humans ; Male ; Retinal Diseases/*congenital/diagnosis ; Retinal Pigment Epithelium/*pathology ; Retinal Telangiectasis/*diagnosis ; Tomography, Optical Coherence ; Young Adult

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Complete Visual Recovery after Mycotic Aneurysm Embolization Complicated by Cavernous Sinus Thrombophlebitis.

Ungsoo Samuel KIM ; Ji Soo KIM ; O Ki KWON ; Jeong Min HWANG

Korean Journal of Ophthalmology.2010;24(5):322-324. doi:10.3341/kjo.2010.24.5.322

A 62-year-old woman has been suffered from cavernous sinus thrombophlebitis which was confirmed by four-vessel angiography, orbit magnetic resonance imaging, and blood culture. Three weeks after recovery of cavernous sinus thrombophlebitis, right eye proptosis and complete third, fourth, and sixth cranial nerve palsies developed. Best-corrected visual acuity decreased to 20/70 in the right eye. Repeat magnetic resonance imaging demonstrated a 1.5-cm-sized mass in the right cavernous sinus, suspicious for mycotic aneurysm. Amphotericin B supplementation was begun and was followed by successful transarterial Guglielmi detachable coil embolization. Four months later, extraocular movement was normalized, and visual acuity improved to 20/25 in the right eye.
Amphotericin B/therapeutic use ; Aneurysm, Infected/*etiology/*therapy ; Angiography ; Antifungal Agents/therapeutic use ; Cavernous Sinus Thrombosis/*complications ; Embolization, Therapeutic/*methods ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Visual Acuity

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A Case of Pantoea Endophthalmitis.

Na Eun LEE ; In Young CHUNG ; Jong Moon PARK

Korean Journal of Ophthalmology.2010;24(5):318-321. doi:10.3341/kjo.2010.24.5.318

A previously healthy 50-year-old man was transferred to our hospital for evaluation of acute inflammation in his right eye after ocular trauma while using a grass mower. Slit lamp examination showed 1 mm-length full thickness corneal laceration without leakage, 4+ cells and inflammatory membrane in the anterior chamber, 10% hypopyon, posterior synechiae formation, and cataract change. Upon orbital computerized tomography, a metallic intraocular foreign body in the lens was indentified. Vitrectomy, phacoemulsification, foreign body removal, anterior chamber irrigation, and intravitreal antibiotics injections of vancomycin and ceftazidime were performed. In a culture of humor from the anterior chamber grew Pantoea species. More procedures were performed, including intravitreal antibiotics injection of ceftazidime. Upon administering a course of intravenous ceftazidime, fortified ceftazidime and moxifloxacin eye drops, and oral prednisolone, the patient improved.
Anti-Infective Agents/administration & dosage ; Diagnosis, Differential ; Endophthalmitis/diagnosis/*microbiology/therapy ; Enterobacteriaceae Infections/diagnosis/*microbiology/therapy ; Humans ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Pantoea/*isolation & purification ; Republic of Korea

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Two Cases of Mirror-Image Eye Anomalies in Monozygotic Twins.

Wook Kyum KIM ; Seung Ah CHUNG ; Jong Bok LEE

Korean Journal of Ophthalmology.2010;24(5):314-317. doi:10.3341/kjo.2010.24.5.314

We report two cases of mirror image anomalies in two different pairs of monozygotic twins. In case 1, the twins exhibited mirroring of strabismus and refractive errors. Twin 1 had 35 prism diopters (PD) right intermittent exotropia at distant fixation and myopic anisometropia that was spherical 2.00 diopters more myopic in the right eye. Twin 2 had 35 PD left intermittent exotropia at distant fixation and her left eye was more myopic by - spherical 1.00 diopters. In case 2, the twins were diagnosed with infantile nystagmus with upbeat jerk. Twin 1 exhibited a habitual head turn of 30degrees to the left with dampening of her nystagmus in dextroversion. Twin 2 also exhibited abnormal head position, but in his case the habitual turn was 30degrees to the right. We believe that this is the first report describing mirror imaged intermittent exotropia with anisometropia and infantile nystagmus with opposite abnormal head positions in pairs of monozygotic twins.
Child ; Eye Abnormalities/*diagnosis/genetics/surgery ; Eyeglasses ; Female ; Humans ; Male ; Twins, Monozygotic ; Visual Acuity

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Macular Infarction Associated with Reactive Arthritis.

Ju Young KIM ; Jong Hyuck LEE ; Ie Na YOON

Korean Journal of Ophthalmology.2010;24(5):310-313. doi:10.3341/kjo.2010.24.5.310

A 53-year-old woman visited the Department of Rheumatology with a chief complaint of a 3-day history of fever and chills and also presented with pain occuring in both knees at the time of outpatient visit. Based on rheumatologic and hematological lab studies, ultrasonography, and a needle aspiration biopsy of the articular cavity, the patient was diagnosed with reactive arthritis. On hospitalization day 3, consultation with the Department of Ophthalmology was requested regarding decreased visual acuity lasting for 3 days. Upon ophthalmologic examination, the corrected visual acuity was 0.1 in the right eye and 0.05 in the left eye. Upon slit lamp microscopy, there were no abnormal findings in the anterior segment. Upon fundus examination, however, there were yellow-white lesions in the macular area of both eyes. Fluorescein angiographywas performed to assess the macular lesions, and the findings were suggestive of macular infarction in both eyes. Due to a lack of other underlying disease, a past surgical history, and a past history of drug administration, the patient was diagnosed with macular infarction in both eyes associated with reactive arthritis. To date, there have been no other such cases reported. In a patient with reactive arthritis, we experienced a case of macular infarction in both eyes, which occurred without association with a past history of specific drug use or underlying disease. Herein, we report our case, with a review of the literature.
Angiography ; Arthritis, Reactive/*complications/diagnosis ; Diagnosis, Differential ; Female ; Humans ; Infarction/diagnosis/*etiology ; Macula Lutea/*blood supply ; Middle Aged ; Tomography, Optical Coherence

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Dacryocystitis associated with nasolacrimal duct cyst.

Mi Young CHOI ; Se Oh OH ; Moo Jin CHOO

Korean Journal of Ophthalmology.1995;9(2):122-124. doi:10.3341/kjo.1995.9.2.122

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.
Cysts/*complications/surgery ; Dacryocystitis/*complications/surgery ; Endoscopy ; Female ; Humans ; Infant ; Lacrimal Apparatus Diseases/*complications/surgery ; *Nasolacrimal Duct ; Recurrence

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Cyst of accessory lacrimal gland.

Kyung In WOO ; Yoon Duck KIM

Korean Journal of Ophthalmology.1995;9(2):117-121. doi:10.3341/kjo.1995.9.2.117

When a patient is presented with a subconjunctival cyst, it is not only hard to reveal its true nature clinically but also easy to rupture during excision. We experienced cases with cysts of the accessory lacrimal gland in two patients with subconjunctival cysts. They had lid swelling at initial presentation and underwent surgical excision of subconjunctival cysts located in superior portion of the upper tarsal plate. The lining of these cysts composed of ductal epithelia. Biochemical analyses for serum and cystic fluid were performed in one case, in which was found high Ig A titer in the cystic fluid. These cysts seemed to originate from the duct of Wolfring's accessory lacrimal gland, considering their anatomic locations and pathologic findings. Complete removal of the cyst is important, because recurrences have been reported in cases of incomplete removal or simple aspiration.
Adult ; Conjunctival Diseases/pathology/surgery ; Cysts/*pathology/surgery ; Female ; Humans ; Lacrimal Apparatus Diseases/*pathology/surgery ; Orbit/radiography ; Tomography, X-Ray Computed

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Change of refraction in premature infants after cryotherapy for retinopathy of prematurity between the age of six months and three years.

Sang In KHWARG ; Hyeong Gon YU ; Young Suk YU

Korean Journal of Ophthalmology.1995;9(2):111-116. doi:10.3341/kjo.1995.9.2.111

To investigate the chronological change of refraction in premature infants after cryotherapy for retinopathy of prematurity (ROP), cycloplegic refractions had been performed at 6 months and 3 years after term in premature infants who underwent cryotherapy for ROP. The changes of refractions between the two study ages were evaluated not only in the total cryo-treated eyes, but also in the subdivided groups according to the posterior pole appearances. In the total 61 eyes of 32 premature infants, mean spherical equivalents were -4.05D vs. -5.94D (6 months vs. 3 years) (p = 0.0001). In the normal posterior pole group (48 eyes), mean spherical equivalents were -3.45D vs. -5.68D (6 months vs. 3 years) (p = 0.0000), and in the abnormal posterior pole group (13 eyes), -6.28D vs. -6.86D (6 months vs. 3 years) (p = 0.6496). These results mean that there is a myopic progressive change between 6 months and 3 years after term in the cryo-treated eyes for acute ROP and it is more evident in the eyes with normal posterior pole.
Acute Disease ; Child, Preschool ; Cryosurgery/*adverse effects ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; *Infant, Premature ; Myopia/*etiology/physiopathology ; *Refraction, Ocular ; Retinopathy of Prematurity/physiopathology/*surgery

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