Ultrastructural Study on the Development of Ciliary Body in Human Fetuses

Morphological development of the ciliary body was studied by electron microscope in human fetuses from 50 to 260 mm crown-rump length(11-30 weeks of gestational age). At a 50 mm(11 weeks) fetus, the anlage of ciliary body was not appeared. At a 70 mm(13 weeks) fetus, the anlage of ciliary epithelium was appeared as the folds were formed by invaginating vessels in the basal surface of pigmented epithelium at the rim of optic cup. At the time, the anlage of ciliary muscle was formed as the mesenchymal cells, which located between the rim of optic cup and the scleral condensation, different-iate into the myoblasts, and the unmyelinated nerve fibers and the axon terminals were found in the interstitial tissue of mesenchyme. At 100-260 mm(15-30 weeks) fetuses, the myoblasts of ciliary body continued to develop into typical smooth muscle cells. At 200-260 mm(20-30 weeks) fetuses, the well-developed infoldings in the basal lamina and the well-developed interdigitations in the lateral sur-face were observed at both pigmented and nonpigmented epithelia. At the time, ganglion cells, Schwan cells and axon terminals were observed in the interstitial tissue of ciliary muscle.

Reconstruction of the skin and soft tissue defects of the lower leg with anteromedial fasciocutaneous leg flaps

No abstract available.

An experimental study on the epidermal differentiation of artificial hybrid skin by different culture methods

No abstract available.

The effect of epinephrine on full thickness skin grafts

No abstract available.

Clinical experience of opponensplasty (4-case report)

No abstract available.

Reconstruction of the foot by first web space island flap

No abstract available.

Reconstruction of lower extremity by fibular free flaps

No abstract available.

Optic Nerve Glioma: A Case of Surgical Treatment to the Optic Chiasm Tumor

A twenty nine-year-old woman has suffered for ten years from progressive proptosis and loss of vision in the right eye. Her right eye had deviated out-and-upwards, and its visual acuity was tested by hand motions. With the help of a brain and orbit CT, the tumor was found around the optic nerve and in the parasellar area. This tumor was surgically removed twice by Kroenlein operation and craniotomy, and was treated with irradiation(total dose: 5400 RAD). It was histopathologically diagnosed as astracytoma grade I. In the consecutive study, no evidence of recurrence of the tumor in either the orbit or brain was found.

A Clinical Study on Strabismus in Children

Retrospective studies were performed in 338 cases among 633 cases under the age of 12 who visited the ophthalmologic department of Chonnam National University hospital from Jan. 1982 to Dec 1989. With this sample group, we have assessed information such as detected time of strabismus, type of deviation, sex distribution, refractory power, visual acuity test, angle of strabismus as well as operative result. After through study and analytical review of our data, we report these results of our study. 1. Sex distribution was 161 male(47.6%) and 177 female(52.4%), too redundant. Average age(year) at time of detection of esotropia, exotropia and hypertropia was 2.4, 3.8, 2.4 respectively. 2. Distribution according to type of strabismus was 103 cases(30.5%) of esotropia, 230 cases(68.0%) of exotropia, 5 cases(1.5%) of hypertropia. Again, too redundant. In esotropia, nonaccommodative esotropia included 65 cases(63.1%) and in exotropia, intermittent exotropia included 145 cases(63.0%). 3. Preoperative angle deviation of 25-40 delta in esotropia was observed in 58 cases(56.3%), but was observed 79.6% in 183 cases of exotropia. In those involving hypertropia 32 cases(60.0%) have had preoperative angle deviation below 20 delta, the largest number. 4. Type of refractory abnormality in esotropia was mostly hyperopic. Range of +2.0D - +4.0D was measured in 32 cases(32.3%) and showed variable distribution in exotropia, but the range of -1.0D - +1.0D in 119 cases(55.9%) was the greatest in number. 5. The number of patients who underwent surgery was 234(69.2%) and 104(30.8%) had no operation. Average age(year) at the time of the operation was 3.4 for esotropia, 5.4 for exotropia and 5.5 for hypertropia. Again, too redundant/obvious. 6. In esotropia medial rectus recession(65.3%) was performed, most frequently. In exotropia lateral rectus recession(86.2%) was performed, most often. As a result of primary operative repair of esotropia, normal position was achieved in 12 cases(24.5%). In 34 cases(69.4%), there was undercorrection, one hundred- five and overcorrection was observed in 3 cases(6.1%). 105 cases of exotropia attained normal position, 54 cases had undercorrection, and 22 cases had overcorrection. In vertical strabismus, 3(75%) attained normal position, and one(25%) undercorrection was observed. 7. Amblyopia occurred in 64 cases(18.9%), its distribution was 37 cases of esotropia, 26 cases of exotropia, and 1 case of hypertropia. After performing occlusion, at least a two-level vision test chart improvement was attained in 84.4% of cases.

A Case of Metastatic Squamous Cell Carcinoma of the Choroid

In adults, it is known that the choroid is the most eyeball common site of metastasis. However, only a few cases have been reported. The authors have experienced a case of pulmonary squamous cell carcinoma metastasis in the Lt. choroid in a 57 year old Korean male patient. We report this case and a review of the literature.

A Clinical Study of 3M Multifocal Intraocular Lens Implant

Recently, it has been widely recognized that the newly developed multi focal intraocular lens provides good near and far vision. Therefore, among 70 eyes who underwent 3M multifocal intraocular lens insertion procedure at our hospital from July 1989 to may 1990, 50 eyes that could be closely followed up for at least 3 months postoperatively were chosen as our study subjects. After careful analytical review of data such as postoperative near and far vision, refractory power, spherical equivalent of diopter of spectacles needed for correction of vision, change of vision according to size of pupil as well as relationship between central location of intraocular lens(IOL) and vision, and multifocusing ability of IOL, we have attained the following results. 1. 36(72.0%) males and 14 females(28.0%) have received multifocal IOL. According to age, 16 eyes(32.0%) were in their 40's, comprising the greatest number, followed by those in the 50's(24.0%) and 60's(24.0%). 2. Postoperatively, 23 eyes(46.0%) have attained emmetropia. 12 eyes(24.0%) were hyperopic, and 15 eyes(30.0%) were myopic. Spherical equivalent of corrected spectacles was -0.35D. The number of eyes attaining corrected vision over 1.0 was 36(72.0%),44 eyes over 0.5(88.0%), and 6 eyes less than 0.4(12.0%). 3. The number of near vision J1 with corrected vision over 1.0 were 33 eyes(66.0%), greater than J2 were 36(72.0%), and in the case of vision of 0.9-0.8 J1 and J2 were 2 eyes(4.0%) and 3 eyes(6.0%), respectively; vision of 0.7-0.5 J2 was 1 eye(2.0%), J3 were 2 eyes(4.0%). In vision less than 0.4, J3 and less than J3 were 3 eyes(6.0%) in each cases. 4. Corrected near vision attained by additional diopter in 15 eyes that have a near vision of less than J2 are as follow: 7 eyes of J1(14.0%), 4 eyes of J2(8.0%) 2 eyes of J3(4.0%) and 2 eyes of less than J3(4.0%). Average additional diopter required to obtain J1 was +0.64D. 5. In the group that has corrected vision over 1.0, the number of eyes that had matched center of IOL and center of pupil was 17(34.0%), number of eyes that has a deviation of 0.5 mm was 6(12.0%), 8 eyes with a deviation of 1.0 mm(16.0%), 5 eyes with a deviation of 1.5 mm(10.0%); but, none have affected vision. 6. Change of vision according to the size of pupil was measured. In the case of corrected vision over 1.0, pupil size of 2.0-4.0 mm and dilated pupil size over 5.0 mm occurred in 36 eyes in each case, and a constricted pupil size less than 2.0 mm occurred 35 eyes with no vision change observed. 7. In the case of corrected vision over 1.0, additional use of lens from +1.0D to -3.0D has not affected vision when maintained at a level of over 0.8 but use of any lens out of this range has dramatically decreased vision. 8. After inserting vultifocal IOL, complaints of diplopia, glare, dizziness and seeing rings were observed in 10 eyes(20.0%); but, 5 months later symptoms had disappeared in all cases.

A Clinical Study of 3M Multifocal Intraocular Lens Implant

Recently, it has been widely recognized that the newly developed multi focal intraocular lens provides good near and far vision. Therefore, among 70 eyes who underwent 3M multifocal intraocular lens insertion procedure at our hospital from July 1989 to may 1990, 50 eyes that could be closely followed up for at least 3 months postoperatively were chosen as our study subjects. After careful analytical review of data such as postoperative near and far vision, refractory power, spherical equivalent of diopter of spectacles needed for correction of vision, change of vision according to size of pupil as well as relationship between central location of intraocular lens(IOL) and vision, and multifocusing ability of IOL, we have attained the following results. 1. 36(72.0%) males and 14 females(28.0%) have received multifocal IOL. According to age, 16 eyes(32.0%) were in their 40's, comprising the greatest number, followed by those in the 50's(24.0%) and 60's(24.0%). 2. Postoperatively, 23 eyes(46.0%) have attained emmetropia. 12 eyes(24.0%) were hyperopic, and 15 eyes(30.0%) were myopic. Spherical equivalent of corrected spectacles was -0.35D. The number of eyes attaining corrected vision over 1.0 was 36(72.0%),44 eyes over 0.5(88.0%), and 6 eyes less than 0.4(12.0%). 3. The number of near vision J1 with corrected vision over 1.0 were 33 eyes(66.0%), greater than J2 were 36(72.0%), and in the case of vision of 0.9-0.8 J1 and J2 were 2 eyes(4.0%) and 3 eyes(6.0%), respectively; vision of 0.7-0.5 J2 was 1 eye(2.0%), J3 were 2 eyes(4.0%). In vision less than 0.4, J3 and less than J3 were 3 eyes(6.0%) in each cases. 4. Corrected near vision attained by additional diopter in 15 eyes that have a near vision of less than J2 are as follow: 7 eyes of J1(14.0%), 4 eyes of J2(8.0%) 2 eyes of J3(4.0%) and 2 eyes of less than J3(4.0%). Average additional diopter required to obtain J1 was +0.64D. 5. In the group that has corrected vision over 1.0, the number of eyes that had matched center of IOL and center of pupil was 17(34.0%), number of eyes that has a deviation of 0.5 mm was 6(12.0%), 8 eyes with a deviation of 1.0 mm(16.0%), 5 eyes with a deviation of 1.5 mm(10.0%); but, none have affected vision. 6. Change of vision according to the size of pupil was measured. In the case of corrected vision over 1.0, pupil size of 2.0-4.0 mm and dilated pupil size over 5.0 mm occurred in 36 eyes in each case, and a constricted pupil size less than 2.0 mm occurred 35 eyes with no vision change observed. 7. In the case of corrected vision over 1.0, additional use of lens from +1.0D to -3.0D has not affected vision when maintained at a level of over 0.8 but use of any lens out of this range has dramatically decreased vision. 8. After inserting vultifocal IOL, complaints of diplopia, glare, dizziness and seeing rings were observed in 10 eyes(20.0%); but, 5 months later symptoms had disappeared in all cases.

A Clinical Study on Blindness

The causes of blindness may be related to a person's life style, social status, age, sex, place of residence and era. To investigate the general aspects of the causes of blindness, authors reviewed clinical records of 16,671 patients who visited the Ophthal mology Department of Chonnam University Hospital in the years 1977, 1980, 1985, and 1989. After reviewing records of patients who had corrected vision below 0.1, we have obtained following results. 1. In the studied sample, 1,696 patients were identified as blind. The blind males(11.0%) were more prevalent than the blind females(9.3%) with a significant difference(p<0.05) and the blininess occurred most frequently in the sixtieth age group. 2. The leading etiologic factors of the blindness were cataract(43.0%) followed by trauma(19.4%), general eyeball dise~ses etc. In 1977 the main cause of blindness was general eyeball diseases. Thereafter, cataract was the leading cause of the blindness. 3. Visual acuities of studied samples were in the order of hand motions, 0.02-0.06, counting fingers, and light perception. The most common causes of absolute blindness were trauma and general eyeball diseases. In the case of visual acuity of better than hand motions, cataract was the leading cause. Cataracts were more prevalent in the age group above fiftieth, while trauma was the chief cause in those under thirtieth. 4. Suggested etiology of disease which directly cause blindness included unknown etiology(54.8%), trauma, undetermined and systemic diseases. In the unknown etiology group, cataract and glaucoma were distributed in high proportion while in the trauma group corneal diseases were the chief cause.

Clinical Study of Posterior Chamber Lens Implant in 1000 Eyes

The authors compared and analysed planned extracapsular cataract extraction(ECCE) and Kelman phacoemulsification(KPE) on the 1000 cases out of 1546 cases which had undergone cataract operation during the period of September, 1983 through June, 1989. The results were as follows; 1. Postoperative visual acuity of 0.5 or better was achieved in 96%(960 eyes) and 1.0 or better in 67.6%(676 eyes). Average of visual acuity was similar each other: 0.92 +/- 0.24 in planned ECCE and 1.00 +/- 0.21 in KPE. 2. The mean spherical equivalent of required spectacle lens power was similar too: -1.07D +/- 1.51 in total, -1.08D +/- 1.57 in planned ECCE and -1.05D +/- 1.42 in KPE. 3. The mean postoperative astigmatism was -0.81D +/- 1.05 in total, -0.98D +/- 1.15 in planned ECCE and -0.54D +/- 0.79 in KPE. There was significant correlation between two groups(P<0.01). 4. The difference between predicted and postoperative refraction in terms of spherical equivalent was -0.36D +/- 1.12 in total, -0.36D +/- 1.12 in planned ECCE and -0.37D +/- 1.11 in KPE with no significant different value. The difference by Binkhorst formula was -0.50D +/- 1.10, and -0.06D +/- 1.09, the significant correlative value by regression SRK formula(P<0.05). 5. Mean changes of corneal refractive power was 0.43D +/- 0.99 in horizontal meridian and -0.21D +/-1.14 in vertical meridian in planned ECCE and 0.23D +/- 0.72 in horizontal meridian and 0.01D +/- 0.90 in vertical meridian in KPE. There was significant correlation between two groups(P<0.01). 6. The correlation between postoperative corneal astigmetism and actual astigmatism by skiascopy was very close: regression coefficient was 0.64087 in total, 0.62698 in planned ECCE and 0.62026 in KPE respectively(P<0.01).

A Clinical Study of Ocular Injury Cases

The authors clinically analysed 2,856 ocular injury patients among 36,922 patients who visited department of ophthalmology of Chonnam National University Hospital during the 9 years form January 1, 1981 to August 31, 1989. The results were as follows: 1. The incidence of ocular injury was 15.6% of all outpatient in first group(1981-83) and 29.7% in third group(1987-89.8). There was tendency to increase group by group and the average incidence was 7.7% of all patient. Among them, 2180 cases(76.3%) were male and 676 cases(23.7%) female. Males were nearly three times as many as females. 2. In comparison with age groups, the largest group in eye injury cases was in the age group of 20-29 years(27.2%). And the incidence was more common in the age of 3rd to 4th decades(47.2%), consisting about 1/2 of the total patient. 3. According to affected side, there was no significant difference between the right eye(43.2%) and the left eye(45.6%). Both eye involvement was 320cases(11.2%) and ones ide involvement was 1301 cases(45.6%). 4. According to seasonal distribution, visits were more common in spring(27.5%) and least in autumn(22.4%). 5. In regard to days, the most patients visited on sunday(20.0%), while the least patients on monday(10.4%). 6. The most common cause of ocular injuries was violence(26.4%), followed by injuries from traffic accident(19.1%), metal particles(11.3%) and explosive material(9.6%). In the cases of ocular perforation, metal particles(26.5%) is most common cause, followed by traffic accident(24.0%), flying particle(11.3%). 7. The most common ocular injury was corneal injury(37.8%), followed by eye lid injury(20.0%), traumatic hyphema(13.5%) and conjunctival injury(12.9%). 8. The incidence of IOF for ocular perforation patients was 43 cases(7.8%), and more common in male(6.6%) than female(1.2%). 9. Before treatment, visual acuity showed 0.08 or less in 627 cases(72.6 %) and 0.6 or more in 95 cases(11.0%), however after treatment, the number of the patients with visual acuity under 0.08 decreased to 325 cases(37.6%) and over 0.6 increased to 288 cases(33.3%).

Mycotic Flora in Normal Conjunctival Sac

In recent years, numerous cases of intraocular fungal infections have been reported. Mycotic infections of eyes have occurred after surgery, trauma, and topical antibiotics or cortisone therapy, which are considered the infections produced by exogenous origin. To know ocular mycotic infection, the normal fungal flora of the eyes becomes extremely important, because these organisms may be the source of the infection. We cultured, fungi from normal conjunctival sac by Sabouraud glucose agar media at Chonnam National University Hospital and the results obtained as follows. The results were as follows: 1. The mycotic flora of the conjunctival sac was investigated in following five groups: group I: neonates to less than 2months of eyes(44 cases), group II: 2 months to 19 years(34 cases), group III: 20 to 39 years(84 cases), group IV: 40 years and over(95 cases), group V: controls(257 cases). 2. Positive cultures were observed in 13.2% of total cases. Cultures from the group I were positive in 2 cases(4.5%), the group II were positive in 8 cases (3.5%), the group III were positive in 9 cases(10.7%), and the group IV were positive in 15 cases(15.8%). The lowest positivity(4.5%) was observed in the group I, and the highst(23.5%) in the group II. 3. There was no significant differences in positive culture rate between male and female group, as 11.4% in male and 15.4% in female group. 4. Fungi cultured were identified as the following species: Penicillium SP.(8 cases), Aspergillus SP.(6 cases), Candida SP.(6 cases), Mucor SP.(6 cases), Trichophyton(5 cases) and Cephalosporium SP.(3 cases).

Mycotic Flora in Normal Conjunctival Sac

In recent years, numerous cases of intraocular fungal infections have been reported. Mycotic infections of eyes have occurred after surgery, trauma, and topical antibiotics or cortisone therapy, which are considered the infections produced by exogenous origin. To know ocular mycotic infection, the normal fungal flora of the eyes becomes extremely important, because these organisms may be the source of the infection. We cultured, fungi from normal conjunctival sac by Sabouraud glucose agar media at Chonnam National University Hospital and the results obtained as follows. The results were as follows: 1. The mycotic flora of the conjunctival sac was investigated in following five groups: group I: neonates to less than 2months of eyes(44 cases), group II: 2 months to 19 years(34 cases), group III: 20 to 39 years(84 cases), group IV: 40 years and over(95 cases), group V: controls(257 cases). 2. Positive cultures were observed in 13.2% of total cases. Cultures from the group I were positive in 2 cases(4.5%), the group II were positive in 8 cases (3.5%), the group III were positive in 9 cases(10.7%), and the group IV were positive in 15 cases(15.8%). The lowest positivity(4.5%) was observed in the group I, and the highst(23.5%) in the group II. 3. There was no significant differences in positive culture rate between male and female group, as 11.4% in male and 15.4% in female group. 4. Fungi cultured were identified as the following species: Penicillium SP.(8 cases), Aspergillus SP.(6 cases), Candida SP.(6 cases), Mucor SP.(6 cases), Trichophyton(5 cases) and Cephalosporium SP.(3 cases).

Effect of A Constant in SRK(TM) Formula on the Determination of Intraocular Lens Power

There are a number of formulas to calculate the implant power in cataract surgery, but SRK(TM) regression formula has been used to calculate the power of over 90% of all IOLs implanted in U.S.A.. The same may be said of our country. A constant in the SRK(TM) formula exerts an influence on the accuracy of any implant power calculation by various factors. Furthermore, it is suspicious that A constant designated in West shall apply to the Koreans, because anatomical structure of the eye between the two is more or less different. Therefore, in order to achieve the desired postoperative refractive state, it is desirable to individualize the SRK(TM) regression formula by calculating a revised A constant using a given style of lens implant from the same manufacturer. This study included 418 posterior chamber lenses of 5 different styles undergoing cataract surgery with IOL implantion in the Department of Ophthalmology, Chonnam University Hospital. Revised A constants were calculated retrospectively by evaluating the results. Predicted postoperative refractive state after IOL implantation of the power given by using Binkhorst formula, SRK(TM) formula with designated A constant and SRK(TM) formula with revised A constant, respectively, and actual postoperative refractive state were compared and analyzed to evaluate the accuracy among those three groups. The results were as follows: 1. The revised A constants obtained from retrospective analysis were as follows: IOLAB, 116.1; 3M, 115.1; Cilco with angulated haptics, 116.4: Copeland, 116.1; Cilco with uniplanar haptics, 115.2. The revised A constants in all the styles of implants were more or less reduced than the designated A constants. 2. There were no difference in the revised A constants between phacoemulification group and planned extracapsular cataract extraction group. 3. In all the styles of IOLs, the SRK(TM) formulas with revised A constants weremore accurate than the Binkhorst formulas and the SRK(TM) formulas with designated A constants in deternining IOL power. 4. In accuracy according to variable axial lengths and corneal refractive powers among those three groups, better result was obtained in the SRK with revised A constant.

A Case of Choroidal Malignant Melanoma

The patient, 54-year-old female, visited our department of ophthalmology because of decreased visual acuity of left eye. The light brown to gray colored mass was visible through clear ocular media, and extensive serous detaclunent of adjacent retina was noticed. Ultrasonograpy showed large smooth smooth ecogenic density extending into vitreous cavity and occupying most of vitreous cavity. Enucleation was performed. The histopatholgical examination revealed malignant choroidal melanoma composed of spindle B type cells and epithelioid cells. Extrascleral invasion was not found.

A Case of Orbital Cavernous Hemangioma

A 40 year-old female was admitted to our hospital because of proptosis for 4 years. Detecting a 2 cm-sized retrobulber mass on computerized tomography, we extracted well capsulated reddish brown mass, which confirmed as a cavernous hemangioma by histologic examination. One year postoperatively, her proptosis was gone, visual acuity was normal, and ocular motility was good.