No abstract available.
Nylons* ; Ocular Hypotension* ; Stents*

PURPOSE: To determine the risk factors for transient hypotony after silicone oil removal in rhegmatogenous retinal detachment and to analyze changes in intraocular pressure and visual acuity after silicone oil removal. METHODS: The medical records of 54 eyes of 52 patients who underwent pars plana vitrectomy, silicone oil tamponade followed by silicone oil removal due to rhegmatogenous retinal detachment, were reviewed. RESULTS: The incidence of transient hypotony after silicone oil removal was 18.5%. Young age (p = 0.011) and axial length (p = 0.002) were risk factors for transient hypotony based on univariate analysis. In multivariate analysis, axial length longer than 26 mm was the only risk factor for transient hypotony (p = 0.005). Seven hypotony patients recovered to normal intraocular pressure spontaneously within 2 weeks. In 2 patients, intraocular pressure was normalized after intravitreal injection of C3F8 gas and 1 patient recovered after a balanced salt solution injection into the anterior chamber. Two weeks after silicone oil removal, there was no significant difference in intraocular pressure between the hypotony group and normal intraocular pressure group. Additionally, there was no statistically significant difference in best corrected visual acuity between the 2 groups after 2 weeks. CONCLUSIONS: Although transient hypotony after silicone oil removal in rhegmatogenous retinal detachment was frequently observed in the present study, the final best corrected visual acuity and intraocular pressure was not always affected. Ocular hypotony should be examined thoroughly in the early postoperative period.
Anterior Chamber ; Humans ; Incidence ; Intraocular Pressure ; Intravitreal Injections ; Medical Records ; Multivariate Analysis ; Ocular Hypotension ; Postoperative Period ; Retinal Detachment* ; Risk Factors ; Silicone Oils* ; Visual Acuity ; Vitrectomy

PURPOSE: To report a case of chronic hypotony maculopathy caused by traumatic cyclodialysis cleft and treated with 20% sulfur hexafluoride (SF6) gas tamponade with cyclocryotherapy. CASE SUMMARY: A 39-year-old woman with a history of blunt trauma developed a unilateral chronic ocular hypotony in her left eye. She was treated with topical atropine sulphate 1% for 2 months. Three years later, she was referred to our clinic for evaluation and treatment of persistent hypotony. The intraocular pressure (IOP) was 4 mm Hg and the best corrected visual acuity was 0.4. B-scan echography revealed a choroidal effusion and fundus examination showed choroidal detachment and macular folds. Gonioscopy examination revealed cyclodialysis cleft from the direction of 7 o'clock to 11 o'clock. A single bubble of SF6 20% (0.4 cc) was injected into the vitreous cavity and transconjunctival cyclocryotherapy was performed under retrobulbar anesthesia. Six months later, the IOP was 12 mm Hg and the best corrected visual acuity was 1.0. B-scan echograpy and fundus examination showed the disappearance of the choroidal effusion. CONCLUSIONS: Gas tamponade with cyclocryotherapy may be useful in cases of cyclodialysis cleft that failed to respond to medical therapy.
Adult ; Anesthesia ; Atropine ; Choroid ; Eye ; Female ; Gonioscopy ; Humans ; Intraocular Pressure ; Ocular Hypotension ; Sulfur Hexafluoride ; Visual Acuity

Honey is produced by bees from nectar collected from nearby flowers. Sometimes, honey produced from the Rhododendron species is contaminated by Grayanotoxin (GTX) in Nepal and other countries. There have been reports of GTX intoxication, also known as 'mad honey disease', from honey produced in countries other than Korea. The importation of wild honey has been prohibited by the Korean Food and Drug Administration since 2005, yet it is still distributed within Korea by the occasional tourist. We report a case of GTX intoxication from contaminated honey which included the symptoms of nausea, vomiting, general weakness, dizziness, blurred vision, hypotension and sinus bradycardia. By means of infusion with normal saline and atropine sulfate, the patient's condition fully recovered within 8 hours of hospital admission, and she was discharged without any complications.
Atropine ; Bees ; Bradycardia ; Dizziness ; Flowers ; Honey ; Hypotension ; Korea ; Nausea ; Nepal ; Plant Nectar ; Rhododendron ; United States Food and Drug Administration ; Vision, Ocular ; Vomiting

PURPOSE: To report a case of a recurrent macular hemorrhage that developed after surgical removal of the internal limiting membrane (ILM) for subintimal hemorrhage due to retinal macroaneurysm. CASE SUMMARY: A 75-year-old female was admitted to the hospital complaining of decreased vision in the left eye which had started 3 weeks previously. The best corrected visual acuity (BCVA) of the right and left eye was 0.7 and 0.03, respectively. The intraocular pressure (IOP) of the right and left eye was 10 mm Hg and 12 mm Hg, respectively. On the fundus examination, macular preretinal and subretinal hemorrhage was observed and a diagnosis of retinal arterial macroaneurym of the inferonasal major artery was made. Vitrectomy was performed. After indocyanine green dye staining, the sub-ILM hemorrhage was treated with removal of the ILM. At postoperative day 3, the annular chorioretinal folds were observed due to the hypotony (4 mm Hg). However, the absence of leakage was confirmed through the sclerotomy site. At postoperative day 8, recurrent submacular hemorrhage occurred and the hemorrhage was observed to have spread after intravitreal C3F8 gas injection and when the patient was placed in the prone position. At postoperative 4 months, the hemorrhage that had invaded the macular area was completely resolved. The BCVA was 0.3, respectively. CONCLUSIONS: When removing a sub-ILM hemorrhage due to retinal macroaneurysm, recurrent hemorrhage can occur especially in a patient with ocular hypotony, as in the present case report. Physicians should be aware of this possibility and the proper treatment the condition requires.
Aged ; Arteries ; Eye ; Female ; Hemorrhage ; Humans ; Indocyanine Green ; Intraocular Pressure ; Membranes ; Ocular Hypotension ; Prone Position ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Vitrectomy

PURPOSE: To examine the influence of irradiation methods on the long-term results of contact transscleral Nd:YAG laser cyclophotocoagulation and to evaluate the factors that affect changes in intraocular pressure (IOP) and occurrence of ocular hypotony after cyclophotocoagulation. METHODS: In this retrospective study, 36 refractory glaucomatous eyes of 36 patients were observed for at least one year after a cyclophotocoagulation procedure. Contact transscleral Nd:YAG laser cyclophotocoagulation was performed with 7 to 10 Watts of power, a duration of 0.7 seconds, with one or two rows, and ranges of either greater or less than 180 degrees. The change in IOP, the success rate of the procedure, and the occurrence rate of hypotony were analyzed with regard to the methods of cyclophotocoagulation. RESULTS: In this series of patients with refractory glaucoma, the final IOP and success rate were not significantly influenced by the laser application method or by the total energy used. The eyes with ocular hypotony showed significantly decreased IOP one year after cyclophotocoagulation when compared with eyes without ocular hypotony. The IOP percent reduction in the patients with ocular hypotony tended to decrease more rapidly than did that of the patients without hypotony, beginning three months after the operation. CONCLUSIONS: The application methods of cyclophotocoagulation appear to have no significant influence on success rate, IOP or ocular hypotony rate. The percent reduction in IOP was higher in the hypotony group, including during the early postoperative periods.
Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Ocular Hypotension ; Postoperative Period ; Retrospective Studies

PURPOSE: To evaluate the efficacy of excision of avascular bleb and advancement of adjacent conjunctiva (EBAC) for treatment of hypotony after trabeculectomy with mitomycin C (MMC). METHODS: Fifteen patients (17 eyes) who received EBAC for correction of hypotony between September 1996 and October 2008 were reviewed retrospectively. The main outcomes were intraocular pressure (IOP) and postoperative complications. RESULTS: Hypotony (IOP <6 mmHg) of eight eyes (47.1%, seven patients) was caused by bleb perforation. Of these, two eyes (two patients) had a history of trauma. Hypotony appeared at 33.9+/-30.8 months, and EBAC was performed at 48.2+/-35.3 months after trabeculectomy with MMC. The mean follow-up period was 38.3+/-29.8 months. The qualified success rate of EBAC was 100% at 51 months after EBAC, and the complete success rate of EBAC was 76.5% at six months and 70.6% at 51 months, as determined by Kaplan-Meier analysis. Post-EBAC complications included blepharoptosis in four eyes (23.5%) and bleb perforation in one (5.9%). The blepharoptosis resolved within one month after EBAC in two patients. However, in the other patients, mild blepharoptosis remained at 17 and 22 months postoperatively. CONCLUSIONS: EBAC was found to be an effective method for treatment of hypotony after trabeculectomy with MMC, and postoperative blepharoptosis was a major complication.
Adolescent ; Adult ; Aged ; Blister/etiology/*surgery ; Conjunctiva/*surgery ; Female ; Follow-Up Studies ; Glaucoma/surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Ocular Hypotension/etiology/physiopathology/*surgery ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Trabeculectomy/adverse effects ; Treatment Outcome ; Young Adult

PURPOSE: To report a case of retinal detachment with a giant retinal tear, which was treated with perfluorocarbon liquid as an intraocular substitute. CASE SUMMARY: A 37-year-old woman with a dislocated lens and a giant retinal tear underwent vitrectomy and lensectomy and was instructed to maintain a supine position after the operation. Perfluorocarbon liquid (Perfluoro-N-octane, C8F18) was used as a substitute in the vitreous cavity for 17 days. After 17 days, the perfluorocarbon liquid was removed and intraocular lens scleral fixation was performed. After removal of the perfluorocarbon liquid, the corneal endothelium was stable without other complications (including corneal edema, elevated intraocular pressure, ocular hypotony, macular pucker), and the best corrected visual acuity after intraocular lens scleral fixation was 0.4. CONCLUSIONS: Perfluorocarbon liquid is a useful surgical material in patients with a dislocated lens and retinal detachment with a giant retinal tear who have difficulty maintaining a prone position.
Adult ; Corneal Edema ; Endothelium, Corneal ; Female ; Fluorocarbons ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lenses, Intraocular ; Ocular Hypotension ; Prone Position ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Supine Position ; Visual Acuity ; Vitrectomy

Anterior ischemic optic neuropathy (AION) is rarely reported in end stage renal disease. In particular, AION combined with sudden sensorineural hearing loss (SNHL) has not been reported in domestic and international journals. Here we report the first case of this combined condition. A 58-year-old male patient in end-stage renal disease presented on painless bilateral visual and hearing deterioration. Clinical findings and imaging studies were compatible with a diagnosis of AION and SNHL. Despite of high-dose steroid therapy, vision and hearing were not significantly recovered. Uremic patients often have coexisting pathology such as hypotension during dialysis, atherosclerosis and anemia, predisposing to AION and SNHL. We describe a patient of dialysis for 10 years who presented with bilateral visual and hearing loss due to complications of long-term dialysis. Our case suggests that nephrologists have to know and treat more carefully this rare but emergent complications of dialysis.
Anemia ; Atherosclerosis ; Dialysis ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Hypotension ; Kidney Failure, Chronic ; Male ; Middle Aged ; Optic Neuropathy, Ischemic ; Renal Dialysis ; Vision, Ocular

PURPOSE: Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD. METHODS: The medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed. RESULTS: The incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean+/-SD; 2.5+/-1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4+/-4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD. CONCLUSIONS: The retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Choroid Diseases/*etiology ; Female ; Humans ; Incidence ; Intraocular Pressure ; Male ; Middle Aged ; Ocular Hypotension/etiology ; Retinal Detachment/*complications ; Retinal Perforations/*complications ; Risk Factors ; Rupture, Spontaneous