Multiple tooth loss can cause disharmonious occlusial plane, loss of vertical dimension and deflection of mandibular movement. Therefore, restoring proper vertical dimension and occlusion in the centric relation is an important treatment goal. Implant-assisted removable partial denture is a recently used clinical technique, because it increases patient satisfaction by improving retention, support, and stability of conventional denture. The objective of this article is to present a case report describing the fabrication of treatment denture and implant assisted removable partial denture using previously placed implants for a patient with partial loss of posterior support and anterior stop.

Purpose: To analyze the intraocular pressure (IOP) lowering effect, prognostic factors, and complications that occurred after iStent inject® or XEN® implantation in South Korea. Methods: We retrospectively analyzed 83 eyes with glaucoma who were followed-up for more than 6 months after iStent inject® or XEN® implantation alone or combination with cataract surgery. The success of surgery was defined as an IOP ≤21 mmHg and IOP reduction ≥20% from preoperative IOP. Results: The average IOP drop rate for 6 months after surgery was 33.80% for iStent inject® (group A, 24 eyes), 24.91% for XEN® (group B, 15 eyes), 20.47% for combined iStent inject® and cataract surgery (group A-1, 32 eyes), and 30.39% for combined XEN® and cataract surgery. The cumulative success rate of 6 months after surgery was 45.5% ± 11.2% for group A, 52.8% ± 15.4% for group B, 51.9% ± 9.0% for group A-1, and 83.3% ± 10.8% for group B-1. The difference in success rates between groups A and B was not statistically significant (p = 0.574), and also between groups A-1 and B-1 (p = 0.079). Conclusions iStent inject® and XEN® both have a significant effect on lowering IOP, regardless of combining cataract surgery. XEN® implantation led to a statistically significant reduction in IOP lowering medications.

Purpose: We report the postoperative results of a two stage surgical procedure for bilateral sixth nerve palsy with large-angle esotropia due to a traumatic event. Case summary: A 66-year-old female had a traffic accident and sustained a subdural hemorrhage. After the accident, the patient complained of diplopia. Using the Krimsky test, large-angle esotropia of about 90 prism diopters at the primary position, and -6 limitation of lateral gaze eye movement were observed in both eye. At 14 months after the accident, we performed medial rectus recession and augmentation of the superior rectus, and inferior rectus transposition at the lateral rectus insertion along the spiral of Tillaux in a two stage surgical correction. Two months after the second operation, the patient’s eye alignments showed slight exophoria of about 2 prism diopters at the primary position on the far and near alternate prism cover test. Abduction and adduction limitations of -1 were found in both eyes and her diplopia had disappeared. Conclusions We report a case of bilateral sixth nerve palsy with large-angle esotropia due to trauma. Although it was difficult to predict the surgical outcome, two stage surgery provided a stable surgical result, and additional sutures between the transposed muscle and the lateral rectus muscle, resulted in improvement of the abduction disorder.

Purpose: We report the postoperative results of a two stage surgical procedure for bilateral sixth nerve palsy with large-angle esotropia due to a traumatic event. Case summary: A 66-year-old female had a traffic accident and sustained a subdural hemorrhage. After the accident, the patient complained of diplopia. Using the Krimsky test, large-angle esotropia of about 90 prism diopters at the primary position, and -6 limitation of lateral gaze eye movement were observed in both eye. At 14 months after the accident, we performed medial rectus recession and augmentation of the superior rectus, and inferior rectus transposition at the lateral rectus insertion along the spiral of Tillaux in a two stage surgical correction. Two months after the second operation, the patient’s eye alignments showed slight exophoria of about 2 prism diopters at the primary position on the far and near alternate prism cover test. Abduction and adduction limitations of -1 were found in both eyes and her diplopia had disappeared. Conclusions We report a case of bilateral sixth nerve palsy with large-angle esotropia due to trauma. Although it was difficult to predict the surgical outcome, two stage surgery provided a stable surgical result, and additional sutures between the transposed muscle and the lateral rectus muscle, resulted in improvement of the abduction disorder.

PURPOSE: Febrile seizure (FS) is the most common type of seizure in children between 6 months to 5 years of age. A family history of febrile seizures can increase the risk a child will have a FS. Yet, prevalence of FS regarding external environment has not been clearly proved. This study attempts to determine the association between prevalence of FS and weather. METHODS: This study included medical records from the Korea National Health Insurance Review and Assessment Service. Data were collected from 29,240 children, born after 2004, diagnosed with FS who were admitted to one of the hospitals in Seoul, Korea, between January 2009 and December 2013. During the corresponding time period, data from the Korea Meteorological Administration on daily monitoring of four meteorological factors (sea-level pressure, amount of precipitation, humidity and temperature) were collected. The relationships of FS prevalence and each meteorological factor will be designed using Poisson generalized additive model (GAM). Also, the contributory effect of viral infections on FS prevalence and weather will be discussed. RESULTS: The amount of precipitation was divided into two groups for comparison: one with less than 5 mm and the other with equal to or more than 5 mm. As a result of Poisson GAM, higher prevalence of FS showed a correlation with smaller amount of precipitation. Smoothing function was used to classify the relationships between three variables (sea-level pressure, humidity, and temperature) and prevalence of FS. FS prevalence was correlated with lower sea-level pressure and lower humidity. FS prevalence was high in two temperature ranges (-7 to -1℃ and 18–21℃). CONCLUSION: Low sea-level pressure, small amount of precipitation, and low relative air humidity may increase FS prevalence risk.
Child* ; Fever ; Humans ; Humidity ; Korea ; Medical Records ; Meteorological Concepts ; National Health Programs ; Prevalence* ; Seizures ; Seizures, Febrile* ; Seoul ; Weather*

PURPOSE: In this study, we evaluated the associations between intraocular pressure (IOP) and systemic and socioeconomic factors. METHODS: A population-based cross-sectional study using a nation-wide, stratified, multistage, clustered sampling method included 15,421 subjects aged ≥20 years with no history of ocular surgery or glaucoma who participated in the Korean National Health and Nutritional Examination Survey 2008-2011. RESULTS: Univariate regression analyses showed statistically significant linear relationships between IOP and body mass index (BMI), smoking status, heavy drinking, systolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), metabolic syndrome (p < 0.001, respectively), low density lipoprotein cholesterol (p = 0.003), refractive error (p < 0.001), and office work (p = 0.029). In addition, analysis of variance (ANOVA) showed statistically significant differences in IOP and refraction according to occupation (p < 0.001, all). CONCLUSIONS: We concluded that increased IOP was associated with age, BMI, heavy drinking, systolic blood pressure, total cholesterol, and refraction. There were statistically significant differences in IOP and refraction according to occupation.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Cross-Sectional Studies ; Drinking ; Fasting ; Glaucoma ; Homeostasis ; Insulin ; Insulin Resistance ; Intraocular Pressure* ; Methods ; Occupations ; Refractive Errors ; Smoke ; Smoking ; Socioeconomic Factors ; Triglycerides

PURPOSE: To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters. METHODS: In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer's test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman's correlation coefficients. RESULTS: The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer's test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013). CONCLUSIONS: Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool.
Cross-Sectional Studies ; Diagnosis* ; Dry Eye Syndromes ; Humans ; Osmolar Concentration* ; Tears*

PURPOSE: To compare the response of dry eye treatment in patients divided by the degree of lower lid laxity. METHODS: Thirty patients were classified into three groups - normal, moderate and severe, according to the degree of lower lid laxity. Tear break-up time (TBUT), Schirmer test (ST), ocular surface disease index (OSDI) scores and changes in OSDI score in each group were compared before and at 3 months after the treatment. RESULTS: TBUT, ST and OSDI scores were not different among the three groups at baseline. TBUT improved to 6.60 +/- 1.43, 6.0 +/- 2.54 and 6.0 +/- 1.45 sec in normal, moderate and severe lower lid laxity group, respectively at 3 months after the treatment and no difference among the groups was found. ST scores did not increase after the treatment, while OSDI scores improved to 12.20 +/- 1.40, 16.10 +/- 4.63 and 20.80 +/- 4.52 in each group, respectively and they were significantly different (p = 0.029, 0.029, <0.001, respectively). The response to the dry eye treatment as assessed by changes in OSDI scores was poorer in patients in the severe lower lid laxity group (p = 0.019 vs. moderate laxity group, <0.01 vs. normal group). CONCLUSIONS: As the degree of lower lid laxity increases, the response to dry eye treatment becomes poorer even when TBUT increases.
Humans

PURPOSE: Sildenafil citrate was developed to treat angina, but was found to also inhibit PDE in the corpus callosum and is now widely used to treat impotence. We report a case of enlargement of the inferior rectus muscle after sildenafil citrate ingestion. CASE SUMMARY: A 58-year-old male presented with binocular diplopia which started 2 weeks prior. He had no underlying disease. The patient had taken sildenafil citrate on 3 different occasions 2 weeks prior, and 2 days after his first ingestion, his right conjunctiva was injected and binocular diplopia started. On the first visit, he showed 16 PD hypotropia of the right eye with limitation of motion at upgaze. The MRI scan showed enlargement and enhancement of the inferior rectus muscle, and 50 mg of prednisone was prescribed. The amount of hypotropia decreased to 8 PD 2 weeks later. CONCLUSIONS: Enlargement of extraocular muscle caused by sildenafil citrate ingestion has not been reported in Korea, and related mechanisms are yet to be researched. Additional case reports and research are necessary in the future.
Citric Acid ; Conjunctiva ; Corpus Callosum ; Diplopia ; Eating ; Erectile Dysfunction ; Eye ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Muscles ; Myositis ; Piperazines ; Prednisone ; Purines ; Strabismus ; Sulfones ; Telescopes ; Sildenafil Citrate

PURPOSE: To report a case of iatrogenic exotropia caused by accidental excision of medial rectus muscle during functional endoscopic sinus surgery (FESS), which was successfully corrected by sequential surgical intervention (superior and inferior rectus muscle transposition followed by lateral rectus muscle recession). CASE SUMMARY: Forty one year old male patient visited our clinic with large exotropia of the right eye developed after functional endoscopic sinus surgery (FESS) which was performed one year ago. At the initial visit in our clinic, there was a large exotropia (95 PD) of the right eye and transection of the medial rectus muscle was observed at the orbital MRI. In order to correct this large iatrogenic exotropia, sequential surgery was planned. Initially, full-tendon transposition of the right superior and inferior rectus muscle was performed which reduced the deviation to 35 PD. Six weeks after the initial surgery, 7 mm right lateral rectus muscle recession was additionally performed, which resulted in exotropia of 10 PD. Diplopia was also improved and the patient was esthetically satisfied with the result. CONCLUSIONS: Even in a case of iatrogenic exotropia following one year after an accidental excision of medial rectus muscle during intranasal sinus surgery, sequential surgery such as transposition of superior and inferior rectus muscle followed by lateral rectus muscle recession can result in satisfying cosmetic and functional improvement.
Cosmetics ; Diplopia ; Exotropia ; Eye ; Humans ; Male ; Muscles ; Orbit