Efficacy of ciprofloxacin and dexamethasone in experimental pseudomonas endophthalmitis

To determine injection time and effective dose of ciprofloxacin in endophthalmitis and to evaluate the effectiveness of dexamethasone. In rabbits, Pseudomonas aeruginosa (2 x 10(4) CFU/0.1 ml) was inoculated intravitreally. At 6, 12, 18, 24 hours postinoculation, single intravitreal doses of ciprofloxacin (300 microgram/0.15 ml or 100 microgram/0.05 ml) alone or with dexamethasone (400 microgram) were given. Electrophysiological and histologic measures were utilized to rate drug effectiveness. 300 micrograms ciprofloxacin was effective in killing P. aeruginosa at 6 and 12 hours postinoculation, but one hundred ug ciprofloxacin was not effective. 300 ug ciprofloxacin had no significant effect in killing P. alphaeruginosa at 18 hrs and 24 hrs postinoculation. Eyes treated with dexamethasone (400 microgram) and ciprofloxacin (300 microgram) at 6 hours postinoculation did not differ from eyes treated with ciprofloxacin alone. Cultures from eyes treated with dexamethasone and ciprofloxacin at 12 hours postinoculation were positive. Cultures from eyes treated with ciprofloxacin alone were negative. The failure of treatment at 18 hrs and 24 hrs postinoculation may be due to either an increased rate of clearance of drugs from the eyes or a reduced bactericidal effect of ciprofloxacin which could be altered by acidic pH, degree of hypoxia or bacterial counts. Dexamethasone had no beneficial effect in the treatment of P. aeruginosa endophthalmitis in the early phase.

A Case of Capsule Contraction Syndrome following Continuous Curvilinear Capsulorhexis

Capsule contraction syndrome is severe constriction of the anterior capsular opening and equatorial capsular bag diameter after extracapsular cataract surgery. It is relatively common in patients with continuous curvilinear capsulorhexis, but rarely in can-opener capsulotomy or anterior radial capsular tears. It is due to capsular bag contraction from fibrous dysplasia of residual lens epithelial cells with weakened zonular resistance. We experienced a case of capsule contraction syndrome in a 72-year old woman with retinitis pigmentosa, who had phacoemulsification following an intact 5.0mm-continuous curvilinear capsulorhexis 4 months before. After successful YAG laser radial anterior relaxing capsulotomy, her visual acuity restored to 0.3, limited by cystoid macular edema.

Comparison of Corneal Astigmatism According to Varing Incision Location and Suture Method in Phacoemulsification

In order to evaluate the effects of incision location and suture method on induced astigmatism in cataract surgery, three different procedures were applied to 150 eyes which had phacoemulsification through 6 mm incision with 6 mm optic IOLs. The group 1(50 eyes) had posterior limbal incision followed by interrupted radial sutures. The group 2(50 eyes) had posterior limbal incision followed by continuous shoelace sutures. The group 3(50 eys) had scleral pocket incision at 2 - 2.5 mm apart from the surgical limbus followed by sutureless technique. The corneal astigmatism was ana lysed by algebraic and vector methods. Keratometric astigmatic changes with vector analysis on postoperative 1 day were 2.34 diopter(D), 1.41D, 0.74D in the group 1, group 2, gruop 3 respectively. There were statistically significant differences among the three groups(p<0.01). At postoperative 1 week. the keratometric astigmatic change of the group 3 was less than that of the group 1(p<0.01) and the visual acuity of the group 3 was better than that of the group 1(p<0.05). During postoperative 1 to 6 months, there was no statistically significant differences among the three groups in astigmatic changes or visual acuity. It could be concluded that scleral pocket incision with suture less technique showed significantly less astigmatism than other techniques initially, and continuous shoelace suture technique could have more stable and less astigmatism than interrupted radial suture technique.

Preoperative Maximal Mydriasis Test in Cataract Patients

To predict the mydriatic status of the cataract patients preoperatively, we performed maximal mydriasis test with stepwise instillations of 1% tropicamide and 2.5% phenylephrine or 10% phenylephrine to the out-patients who was scheduled to have cataract operation. Among 210 eyes of 113 patients, the pupillary size of 167 eyes was dilated to 8mm or more and the other 43 eyes were insufficiently dilated to less than 8mm diameter. In the insufficiently dilated group, we have observed the presumable causes of insufficient mydriasis as follows: posterior synechiae, diabetic autonomic pupillopathy, age-related miosis and unknown. By this test, we could predict the mydriatic status of the cataract patient preoperatively and could prepare the appropriate operative method and equipment effectively.

Incidence and Risk Factors in Retinopathy of Prematurity

The incidence of retinopathy of prematurity(ROP) was observed in 194 infants admitted in our nursery room, who had birthweighs less than 2000 gm, or who had gestational ages less than 37 weeks and received supplemental oxygen therapy. To minimize the multiple correlation of birthweights and gestational ages with other possible risk factors of ROP, we selected a control group of normal infants whose birthweights or gestational ages were similar to ROP group, and then other risk factors were analyzed statisticully through a case-control study. Among 194 infants, 41 infants(21%) were diagnosed as ROP. The incidence of ROP was 48%(24/50) in infants with birthweights less than 1500 gm , 41%(28/68) in infants with gestational ages less than 32 weeks(por=5 days) ahd high concentration(>or=40%) were highly associated with ROP(p<0.01). Other statistically significant risk factors included mechanical ventilation duration, 5 minutes Apgar score, apnea of prematurity, blood transfusion, anemia, asphyxia neonatorum, respiratory distress syndrome, xanthine administration, and parity, cesarean section, pregnancy induced hypertension in mother's factors(p<0.05).

Clinical Study of Traumatic Hyphema

Clinical study has been carried out on the 108 cases (108 eyes) of nonperforating traumatic hyphema who had been admitted to Kyungpook National University Hospital during the past five years. Male patients were 95(87.9%) of 108 and the third decade occupied about 40% of all cases. Grade I hyphema(less than one third of the height of the anterior chamber) was 66 cases(61.1%). Various projectiles accounted for nearly one third of the injuries. The most commonly associated ocular injuries included angle re cession, retinal edema, and eyelids laceration. Secondary hemorrhage occurred in 7.4% of all cases, and it seems that rebleeding increased the risk of secondary glaucoma. Although the final visual acuities were worse in eyes with larger hyphema and secondary hemorrhage, the associated ocular injuries such as vitreoretinal disorder, cataract, etc. accounted for the decreased visual acuity.

A Case of Cavernous Hemangioma of the Bulbar Conjunctiva

A 15 year-old male patient visited our department with a progressively enlarged conjunctival mass on Nov. 28, 1988. Excisional biopsy and histopathologic examination revealed cavernous hemangioma, an uncommon tumor of the conjunctiva. Authors report a case of cavernous hemangioma of the bulbar conjunctiva. A review of literature of recent years related to cavernous hemangioma was added.

A Case of Cavernous Hemangioma of the Bulbar Conjunctiva

A 15 year-old male patient visited our department with a progressively enlarged conjunctival mass on Nov. 28, 1988. Excisional biopsy and histopathologic examination revealed cavernous hemangioma, an uncommon tumor of the conjunctiva. Authors report a case of cavernous hemangioma of the bulbar conjunctiva. A review of literature of recent years related to cavernous hemangioma was added.