Objective To observe the role of ultrasound biomicroscopy(UBM)in two-year post-operative follow-up for primary open-angle glaucoma patients with modified CO
Carbon Dioxide ; Follow-Up Studies ; Glaucoma, Open-Angle/surgery* ; Humans ; Microscopy, Acoustic ; Sclera/diagnostic imaging* ; Treatment Outcome

Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma following pterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who do not respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologous perichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performed on four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at Gyeongsang National University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified in cultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctival flap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcome was stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchal cartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatment is ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.
Anti-Bacterial Agents/therapeutic use ; Autografts ; Cartilage/surgery ; Communicable Diseases ; Debridement ; Eye Infections, Bacterial/etiology/*therapy ; Female ; Humans ; Ophthalmologic Surgical Procedures ; Postoperative Complications ; Pseudomonas Infections/microbiology/*therapy ; Pseudomonas aeruginosa/*isolation & purification ; Pterygium/surgery ; Republic of Korea ; Sclera/*surgery/transplantation ; Scleritis/microbiology/*therapy ; Surgical Wound Infection/microbiology/*therapy ; Transplantation, Autologous ; Treatment Outcome

No abstract available.
Aphakia/*surgery ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Male ; Sclera/*surgery ; *Vitrectomy

In this case series, we assessed a new technique, the intrascleral pocket procedure of transscleral fixation (TF) of the intraocular lens (IOL) in post-vitrectomized eyes. We performed the transscleral fixation of IOL in four aphakic patients who underwent pars plana vitrectomy. Two points 180degrees apart were marked at the limbus. A 2-mm-sized intrascleral pocket was created by lamellar dissection using a crescent blade without conjunctival dissection. A 2.8-mm clear corneal incision (CCI) was made using a keratome. Prolene sutures were exteriorized through the CCI pocket and a three-piece foldable acrylic IOL was injected via CCI and the ends of the haptics were exteriorized through the CCI. The prolene sutures for each haptic in the intrascleral pocket bed were then tied and knots were buried under scleral flaps. No patient had complaints such as conjunctival irritation, and visual acuity was almost identical to preoperative best-corrected visual acuity at day 1 postoperatively. IOLs were well placed without tilting or subluxation. They had no wound dehiscence or endophthalmitis postoperatively. The intrascleral pocket procedure of TF without the need for conjunctival dissection is a successful method for sulcus fixation in post-vitrectomized eyes predisposed to developing glaucoma.
Aged ; Aged, 80 and over ; Aphakia/*surgery ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Male ; Middle Aged ; Sclera/*surgery ; Sutures ; Treatment Outcome ; *Vitrectomy

PURPOSE: The 2.2-mm microincision cataract surgery and small-gauge vitrectomy system is known to result in less surgically-induced astigmatism (SIA) in comparison to conventional surgical methods. We compared the amounts of SIA after combined phacoemulsification and 23-gauge transconjunctival sutureless vitrectomy (23G-TSV) using the 2.2-mm microincision and 2.75-mm standard incision methods. METHODS: We studied 59 patients (61 eyes) who underwent combined phacoemulsification and 23G-TSV from November 2008 to September 2012. Twenty-eight patients (28 eyes) underwent 2.2-mm microincision coaxial phacoemulsification, and 31 patients (33 eyes) underwent 2.75-mm standard incision phacoemulsification. SIA was evaluated using Naeser's polar method with the simulated keratometric values obtained from corneal topography. Preoperative and 1-week and 1-month postoperative KP (Naeser's polar value along the specific axis) and DeltaKP values were compared between the 2.2-mm microincision and 2.75-mm standard incision groups. RESULTS: One week after surgery, both groups exhibited similar amounts of SIA (-DeltaKP[120], 0.40 +/- 0.41 vs. 0.51 +/- 0.56 diopters [D]; p = 0.390). One month after surgery, however, the amount of SIA was significantly smaller in the 2.2-mm microincision group as compared to the 2.75-mm standard incision group (-DeltaKP[120], 0.31 +/- 0.54 vs. 0.56 +/- 0.42 D; p = 0.045). CONCLUSIONS: In combined phacoemulsification with 23G-TSV, 2.2-mm microincision coaxial phacoemulsification induces less SIA than does 2.75-mm standard coaxial phacoemulsification.
Aged ; Astigmatism/diagnosis/*etiology ; *Cataract ; Cornea/surgery ; Corneal Topography/methods ; Female ; Humans ; Lens Implantation, Intraocular/*adverse effects/methods ; Male ; Middle Aged ; Phacoemulsification/*adverse effects/methods ; Postoperative Complications/diagnosis/etiology ; Sclera/surgery ; Vitrectomy/*adverse effects/instrumentation/methods

BACKGROUND: The reconstruction of eyelid defects is extremely complex because both functional and aesthetic aspects should be considered. Numerous techniques for reconstruction are available for repairing eyelid defects, depending on the size, location, and extent of the defect. OBJECTIVE: This study was aimed at assessing the effectiveness and cosmetic consequences of various reconstruction techniques for eyelid defects after Mohs micrographic surgery. METHODS: Twenty patients who received a diagnosis of skin cancer of the eyelids from November 2005 to August 2009 were analyzed. Among them, 15 patients were treated with a local flap to reconstruct the defective eyelids, and the remaining patients were treated with primary closure. The medical records and photographs were reviewed by two independent physicians, and postoperative results were evaluated. RESULTS: Eyelid defects were reconstructed with various surgical techniques, such as primary closure, transposition flap, subcutaneous island pedicle flap, advancement flap, rotation flap, Tenzel flap, and hard palate mucous membrane graft. The cosmetic results were satisfactory, and 16 of 20 (80%) patients showed good to excellent results. However, one patient developed a sclera show and another patient showed tumor recurrence. CONCLUSION: Many reconstruction techniques can be used for eyelid defects. An optimal choice would be one that is based on the extent, depth, and location of the defect; skin condition and wishes of the patient; and the surgeon's experience. Furthermore, it is important to have an understanding of the anatomy of the eyelid, the basic principles of the reconstruction techniques, and the merits and drawbacks of each technique.
Diagnosis ; Eyelids* ; Humans ; Medical Records ; Mohs Surgery* ; Mucous Membrane ; Palate, Hard ; Recurrence ; Sclera ; Skin ; Skin Neoplasms* ; Transplants

OBJECTIVE: To evaluate the oblique angle, diplopia and stereoacuity before and after rectus recession-suspension on posterior sclera surgery in patients with restrictive strabismus caused by thyroid associated ophthalmopathy (TAO). METHODS: Data from 18 patients (19 eyes) with restrictive strabismus caused by TAO, who underwent rectus recession-suspension on posterior sclera surgery from July 2010 to June 2013 in Xiangya Hospital, Central South University, were analyzed retrospectively. Eight patients (8 eyes) or 5 patients (5 eyes) with hypotropia were operated with inferior rectus recession or superior rectus recession. Two patients (2 eyes) with esohypertropia or 3 patients (4 eyes) with esotropia were operated with inferior rectus recession plus medial rectus recession or medial rectus recession. Two patients (1 hypotropia, 1 esotropia) underwent orbital decompression surgery before strabismus surgery. All patients were performed rectus recession-suspension on posterior sclera surgery, and the oblique angle, diplopia view and stereopsis test were examined before and after the operation. RESULTS: All patients were followed up for more than 6 months. The preoperative prism were 20(Δ)- 80(Δ) and postoperative prism were 2(Δ)-10(Δ). There was diplopia on the primary position before surgery in 16 patients. After surgery, the diplopia in 14 patients disappeared on the primary and 15° down gaze, and 2 patients had not diplopia on the primary position but residual diplopia on inferior field. Two patients had stereopsis before surgery, and the numbers of patients raised to 14 after surgery. Compared with pre-operation, changes of the above measured indexs in post-operation were significant difference (all P<0.05). CONCLUSION The rectus recession-suspension on posterior sclera surgery is effective to improve oblique angle and diplopia in restrictive strabismus caused by TAO, which can improve patient's living quality.
Decompression, Surgical ; Diplopia ; Graves Ophthalmopathy ; complications ; Humans ; Oculomotor Muscles ; surgery ; Ophthalmologic Surgical Procedures ; methods ; Retrospective Studies ; Sclera ; surgery ; Strabismus ; surgery ; Treatment Outcome ; Visual Acuity

PURPOSE: To describe the long-term results of deep sclerectomy with collagen implant (DSCI) with or without adjuvant mitomycin C in Korean patients with primary or secondary open-angle glaucoma (OAG). METHODS: This retrospective review was comprised of 65 Korean patients who received DSCI with or without adjuvant mitomycin C due to primary or secondary OAG. Patients were followed for 72 months after surgery. Complete success was defined as intraocular pressure (IOP) <21 mmHg without medication and qualified success was defined as IOP <21 mmHg with or without medication. RESULTS: Mean postoperative follow-up period was 53.0 +/- 16.2 months. Mean IOP was 30.5 +/- 11.7 mmHg preoperatively, 8.4 +/- 4.3 mmHg at postoperative day one and 13.4 +/- 3.8 mmHg 60 months after surgery. The mean number of glaucoma medications was decreased from 3.6 +/- 1.1 to 1.6 +/- 1.3 at 60 months after the operation. Complete and qualified success rates were 36.7% and 79.6% at postoperative 60 months, respectively (Kaplan-Meier survival curve). No shallow or flat anterior chamber, endophthalmitis, or surgery-induced significant cataract was observed. CONCLUSIONS: The results of DSCI in Korean patients presented here seem reasonably excellent with qualified success rates of over 70% at six years with negligible complications.
Adult ; Anterior Chamber/*surgery ; Collagen/*administration & dosage ; Drug Implants/*administration & dosage ; Female ; Follow-Up Studies ; Glaucoma, Open-Angle/physiopathology/*surgery ; Humans ; Incidence ; Intraocular Pressure ; Male ; Postoperative Complications/epidemiology ; Postoperative Period ; Republic of Korea/epidemiology ; Retrospective Studies ; Sclera/*surgery ; Sclerostomy/*methods ; Time Factors ; Treatment Outcome ; Visual Acuity

To report the surgical outcome of full-thickness sclerotomy in five cases of uveal effusion syndrome (UES). Full-thickness sclerotomy without sclerectomy was performed on five eyes of four patients with UES with or without nanophthalmos. In four of the eyes, exudative retinal detachment associated with UES resolved after the sclerotomy. The subretinal fluid in one eye, which had a normal axial length, was relieved after undergoing three sclerotomy procedures. Full-thickness sclerotomy without vortex vein decompression or sclerectomy is an effective surgical option for the management of significant UES.
Adult ; Aged ; Drainage/methods ; Exudates and Transudates/*metabolism ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*methods ; Retinal Detachment/metabolism/surgery ; Sclera/*surgery ; Uveal Diseases/*metabolism/*surgery

PURPOSE: To compare the surgical outcomes of the two different methods used for Ahmed Glaucoma Valve (AGV) implantation between the donor scleral graft method and the partial-thickness scleral flap method. METHODS: We retrospectively reviewed medical records of 28 eyes of 26 patients diagnosed as neovascular glaucoma followed by AGV implantation. Based on the surgical method, the included eyes were divided into two groups. In the graft group (n = 18), the drainage tube was inserted into the anterior chamber, and then covered with preserved donor sclera. In the flap group (n = 10), the drainage tube was inserted under the partial-thickness scleral flap, and then covered with the flap. We compared the postoperative intraocular pressure (IOP), surgical success rates, and postoperative complications between the two groups. RESULTS: Postoperative IOP was not significantly different between the two groups (p = 0.967, 0.495 at 12 months, 24 months, respectively, by the Mann-Whitney U-test). The mean success periods were 53.1 +/- 10.1 months in the graft group versus 50.9 +/- 9.4 months in the flap group (p = 0.882 by log rank test), and cumulative success rates were 77.8% and 80.0% at one year, respectively. However, tube migration occurred more frequently in the flap group than in the graft group (p = 0.037 by Fisher's exact test). CONCLUSIONS: In AGV surgery for neovascular glaucoma, the scleral graft method may be associated with relatively less complication about tube migration than the scleral flap method. The surgical results, however, were not statistically different.
Adult ; Aged ; Aged, 80 and over ; Filtering Surgery/*methods ; Follow-Up Studies ; *Glaucoma Drainage Implants ; Glaucoma, Neovascular/physiopathology/*surgery ; Humans ; Intraocular Pressure ; Middle Aged ; Retrospective Studies ; Sclera/*transplantation ; *Surgical Flaps ; Treatment Outcome ; Young Adult