PURPOSE: To compare the pupil sizes measured using the automatic pupillometer and pupil card. METHODS: We measured pupil sizes using a pupil card (Rosenbaum Card, J.G. Rosenbaum, Cleveland, OH, USA) and automated pupillometer (VIP(TM)-200, Neuroptics Inc., San Clemente, CA, USA) under different luminous intensities in 60 eyes of 60 patients who visited the ophthalmology clinic during August 2013. RESULTS: Under the photopic condition, pupil sizes measured using automated pupillometer were larger than those measured using the pupil card with statistical significance. The 2 techniques were not different under mesopic and scotopic conditions. Under all light conditions, automated pupillometer showed higher inter-rater reliability. Under the scotopic condition, pupil sizes measured using the pupil card were smaller than pupil sizes measured using the pupillometer according to increased pupil size. CONCLUSIONS: When compared with pupil card, automated pupillometer provided accurate and reliable measurement with small inter-rater variation and was easy and simple to use. However, based on comparable measurements of both techniques under mesopic and scotopic conditions, the pupil card can be used as preoperative evaluation when considering the cost of purchase and maintenance.
Humans ; Ophthalmology ; Pupil*

PURPOSE: To evaluate the efficacy and safety of surface ablation with mitomycin C (MMC) for the retreatment of refractive errors following laser-assisted in-situ keratomileusis (LASIK) and laser-assisted sub-epithelial keratectomy (LASEK). METHODS: In this retrospective clinical study conducted at a single center, we evaluated 23 eyes that received surface ablation with MMC (0.02%, 20 seconds) between 2009 and 2013 for the treatment of residual refractive errors following myopic LASIK and LASEK. All eyes were evaluated for corneal thickness, initial refractive error, time interval to retreatment, amount of retreatment, duration of postoperative topical steroids use as well as uncorrected vision, spherical equivalent and corneal haziness preoperatively and 1, 3, 6 and 12 months postoperatively. RESULTS: Initially corrected myopia in the LASIK group was -6.47 +/- 2.17 D and -5.68 +/- 2.51 D in the LASEK group. Mean time between initial and retreatment by surface ablation was 11.88 +/- 5.59 months for LASIK and 14.07 +/- 10.10 for LASEK. Retreat amount was 1.49 +/- 0.36 D after LASIK and -1.65 +/- 0.41 D after LASEK. At postoperative 12 months, uncorrected visions were -0.061 +/- 0.886 (log MAR) in the LASIK group and -0.004 +/- 0.745 (log MAR) in the LASEK group and spherical equivalents were -0.55 +/- 0.56 D in the LASIK group and 0.36 +/- 0.33 D in the LASEK group. Postoperative hazes developed in 1 of 8 LASIK eyes and 3 of 15 LASEK eyes which resolved with application of topical steroid for 2-3 months postoperatively. CONCLUSIONS: Surface ablation with 0.02% MMC is safe and highly effective for treating myopic regression following LASIK or LASEK. Application of 0.02% MMC for 20 seconds was effective in preventing postoperative haze formation and maintaining stable vision and spherical equivalent at 12 months after retreatment.
Keratectomy, Subepithelial, Laser-Assisted* ; Keratomileusis, Laser In Situ* ; Mitomycin* ; Myopia ; Refractive Errors ; Retreatment* ; Retrospective Studies ; Steroids

PURPOSE: To evaluate the efficacy and safety of surface ablation with mitomycin C (MMC) for the retreatment of refractive errors following laser-assisted in-situ keratomileusis (LASIK) and laser-assisted sub-epithelial keratectomy (LASEK). METHODS: In this retrospective clinical study conducted at a single center, we evaluated 23 eyes that received surface ablation with MMC (0.02%, 20 seconds) between 2009 and 2013 for the treatment of residual refractive errors following myopic LASIK and LASEK. All eyes were evaluated for corneal thickness, initial refractive error, time interval to retreatment, amount of retreatment, duration of postoperative topical steroids use as well as uncorrected vision, spherical equivalent and corneal haziness preoperatively and 1, 3, 6 and 12 months postoperatively. RESULTS: Initially corrected myopia in the LASIK group was -6.47 +/- 2.17 D and -5.68 +/- 2.51 D in the LASEK group. Mean time between initial and retreatment by surface ablation was 11.88 +/- 5.59 months for LASIK and 14.07 +/- 10.10 for LASEK. Retreat amount was 1.49 +/- 0.36 D after LASIK and -1.65 +/- 0.41 D after LASEK. At postoperative 12 months, uncorrected visions were -0.061 +/- 0.886 (log MAR) in the LASIK group and -0.004 +/- 0.745 (log MAR) in the LASEK group and spherical equivalents were -0.55 +/- 0.56 D in the LASIK group and 0.36 +/- 0.33 D in the LASEK group. Postoperative hazes developed in 1 of 8 LASIK eyes and 3 of 15 LASEK eyes which resolved with application of topical steroid for 2-3 months postoperatively. CONCLUSIONS: Surface ablation with 0.02% MMC is safe and highly effective for treating myopic regression following LASIK or LASEK. Application of 0.02% MMC for 20 seconds was effective in preventing postoperative haze formation and maintaining stable vision and spherical equivalent at 12 months after retreatment.
Keratectomy, Subepithelial, Laser-Assisted* ; Keratomileusis, Laser In Situ* ; Mitomycin* ; Myopia ; Refractive Errors ; Retreatment* ; Retrospective Studies ; Steroids

PURPOSE: To evaluate the efficacy of 0.05% cyclosporine A on tear film parameters and corneal aberration after cataract surgery. METHODS: Patients who underwent cataract surgery were divided into 2 groups. Patients in Group I (23 eyes) were treated with cyclosporine A from 1 week before surgery to 3 months after surgery. Patients in Group II (24 eyes) underwent surgery without cyclosporine treatment. Tear film break-up time (BUT), Schirmer's test I, Oxford scheme, Ocular surface disease index (OSDI), and corneal aberrations were evaluated before surgery and at 1 and 3 months after surgery. RESULTS: In Group I, BUT was significantly improved at 3 months (p = 0.026) after surgery compared with the preoperative value. OSDI decreased significantly at 1 (p = 0.033) and 3 months (p = 0.003) after surgery compared with the preoperative value. However, there were no significant differences between preoperative and postoperative values of BUT and OSDI in Group II. Schirmer's test results and the Oxford scheme were not significantly changed in either group. Preoperative root mean square (RMS) total values were not different between the 2 groups, but was different at postoperative 3 months (p = 0.015). Group I had a significantly lower value for total RMS than Group II. In Group I, Coma 7 (Z3(-1)) (p = 0.018) and spherical aberration (Z4(0)) (p = 0.031) were significantly decreased after surgery. In Group II, Trefoil 6 (Z3(-3)) (p = 0.033) was significantly increased after surgery. CONCLUSIONS: 0.05% cyclosporine A may be effective for improving dry eye syndrome and corneal aberration after cataract surgery.
Cataract* ; Coma ; Cyclosporine* ; Dry Eye Syndromes ; Humans ; Lotus ; Tears*

No abstract available.
Humans ; Thrombocytosis

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult

PURPOSE: The corneal change induced by refractive procedures influence both the postoperative refractive status and the ocular spherical aberration (SA). We evaluated changes in corneal SA after three types of surface ablation: phototherapeutic keratectomy (PTK), myopic photorefractive keratectomy (PRK), and myopic wavefront-guided laser epithelial keratomileusis (LASEK). METHODS: Twenty-six eyes (25 patients) were subjected to PTK 26 eyes (14 patients) to PRK, and 34 eyes (17 patients) to wavefront-guided LASEK. Corneal SA was measured with the iTrace in all patients both preoperatively and 6 months postoperatively. RESULTS: Six months after surgery, mean corneal SA was -0.173 +/- 0.171 micrometer in the PTK group, 0.672 +/- 0.200 micrometer in the PRK group, and 0.143 +/- 0.136 micrometer in the wavefront-guided LASEK group. The mean difference between the preoperative and postoperative corneal SA (DeltaSA) was -0.475 micrometer in the PTK group, 0.402 micrometer in the PRK group, and -0.143 micrometer in the wavefront-guided LASEK group. CONCLUSIONS: Surgically induced changes in corneal SA vary with procedure. The prediction of the pattern of SA change induced by various surface ablation procedures may be helpful for developing future surgical procedures.
Adult ; Aged ; Corneal Dystrophies, Hereditary/*surgery ; Corneal Wavefront Aberration/*surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Male ; Middle Aged ; Myopia/*surgery ; Photorefractive Keratectomy/*methods ; Prospective Studies ; Treatment Outcome

PURPOSE: The corneal change induced by refractive procedures influence both the postoperative refractive status and the ocular spherical aberration (SA). We evaluated changes in corneal SA after three types of surface ablation: phototherapeutic keratectomy (PTK), myopic photorefractive keratectomy (PRK), and myopic wavefront-guided laser epithelial keratomileusis (LASEK). METHODS: Twenty-six eyes (25 patients) were subjected to PTK 26 eyes (14 patients) to PRK, and 34 eyes (17 patients) to wavefront-guided LASEK. Corneal SA was measured with the iTrace in all patients both preoperatively and 6 months postoperatively. RESULTS: Six months after surgery, mean corneal SA was -0.173 +/- 0.171 micrometer in the PTK group, 0.672 +/- 0.200 micrometer in the PRK group, and 0.143 +/- 0.136 micrometer in the wavefront-guided LASEK group. The mean difference between the preoperative and postoperative corneal SA (DeltaSA) was -0.475 micrometer in the PTK group, 0.402 micrometer in the PRK group, and -0.143 micrometer in the wavefront-guided LASEK group. CONCLUSIONS: Surgically induced changes in corneal SA vary with procedure. The prediction of the pattern of SA change induced by various surface ablation procedures may be helpful for developing future surgical procedures.
Adult ; Aged ; Corneal Dystrophies, Hereditary/*surgery ; Corneal Wavefront Aberration/*surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Male ; Middle Aged ; Myopia/*surgery ; Photorefractive Keratectomy/*methods ; Prospective Studies ; Treatment Outcome

BACKGROUND: Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia. We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering. METHODS: Forty five patients undergoing elective cesarean section were randomly assigned to three groups. Group F received warmed intravenous fluid (40degrees C). Group A patients were actively warmed by forced air-warming. Group C was the control group. Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia. Core temperature (tympanic membrane) and the skin temperature of arm and thigh were measured and shivering was graded simultaneously. RESULTS: The core temperature at 45 min decreased less in Groups F and A than Group C (-0.5degrees C +/- 0.3degrees C vs -0.6degrees C +/- 0.4degrees C vs -0.9degrees C +/- 0.4degrees C, respectively; P = 0.004). The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C (P = 0.001 and P = 0.012, respectively). Leg temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group A and Group F than Group C (20%, 13.3%, and 53.3%, respectively; P = 0.035). CONCLUSIONS: Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia.
Anesthesia, Spinal ; Arm ; Cesarean Section ; Female ; Humans ; Hypothermia ; Incidence ; Leg ; Pregnancy ; Shivering ; Skin Temperature ; Thigh

PURPOSE: To predict the accuracy of preoperative refractive error measurement methods in wavefront-guided laser-assisted subepithelial keratectomy (LASEK) surgery and to formulate a nomogram for satisfactory surgical results. METHODS: The medical records of 30 patients (57 eyes) who had undergone wavefront-guided LASEK were reviewed. The ideal surgical ablation amount was defined as the sum of the real surgical ablation amount and the remaining refractive errors. Comparison between the ideal surgical ablation amount and preoperative refractive errors was made using autorefraction, manifest refraction, cycloplegic refraction, postcycloplegic refraction, wavescan, and iTrace aberrometer measurements. RESULTS: The refractive errors measured by the postcycloplegic refraction showed the closest relation with the ideal surgical amount, and the nomogram based on this refraction correlated statistically significantly with the ideal surgical ablation amount. The refractive error using the wavescan also showed more accurate refractive measurements than the autorefractor and iTrace aberrometer. CONCLUSIONS: Accurate manifest refraction immediately before surgery is the most important in determining the ablation amount. Additionally, the refractive errors measured with the wavescan, which is an aberrometer used for wavefront-guided LASEK, showed a minimal amount of errors. After reviewing the results, the nomogram based on these 2 methods can be concluded to possibly contribute to an increase in the accuracy of surgery.
Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Medical Records ; Nomograms ; Refractive Errors