Success Rate of Silicone Tube Intubation

It has been Known that silicone intubation may be an effective procedure for total or partial obstruction in infants of age one year or less, and the older the patient, the lower the success rate. We had performed silicone intubation on 40 eyes of 39 patients from january 1995 to May 1996, and they were divided into 3 groups according to age: group 1, 6 months to 6 years: group 2,6 to 16.: group 3, one 16 years. The success rate was 92.4% in groups 1 and 2, respectively: 83.3% ingroup 3. The success rate in patients with partial obstruction in group 3 was 100% In view of the results of the present study, silicone intubation may be in primary procedure for partial obstruction of lacrimal drainage system.

Autologous Simple Conjunctival Graft and Conjunctiva/Tenon Graft on Focal Scleromalacia

A retrospective review was done on 15 eyes of consecutive patients who presented to the Asan Medical Center with scleronecrosis between January 1993 and June 1996 was studies. Ten eyes were managed by autologous conjunctival graft(group 1) and others by autologous conjunctiva/tenon graft(group 2), followed over 9 months, and the outcome evaluated included symptoms and complications. All patients had scleronecrois size less than 3mm in diameter with foreign body sensation, tearing, and pain etc. In both group, the symptoms were improved after surgery. The complications were that first group was slippage of donor tissue in graft site in two eyes and focal hyperemia in all cases. Management of slippage was sucessfully performed by reoperation; focal hyperemia was gradually improved no other specific management. These results indicate that autologus conjunctiva and autologous conjunctiva/tenon graft may be effective for the treatment of small scleronecrosis.

Use of Viscoelastic Substance in Longstanding Recurrent Hyphema Patient

Rebleeding in traumatic hyphema may cause several complications in the affected eye, and specific treatment of recurrent hyphema is still not estabilished and only conservative medical treatments are used except for surgical evacuation of the clot in case of persistent high intraocular pressure. We treated longstanding recurrent hyphema patient unresponsive to conventional medical treatment, with viscoeleastic substance which was injucted into anterior chamber. A large dose(0.2CC) of viscoelastic substance sufficient to directly compress the anterior structures(Iris, ciliary body) was injected and subsequently it increased the intraocular pressur gradually. We assume that these tamponade effect by the viscoelastic substance and later intraocular pressure rise was responsible for the therapeutic effect. Thus, viscoelastic injection into anterior chamber in longstanding recu.rrent hyphema patient may be a useful treatment.

Three Cases of the Posterior Lenticonus

Posterior lenticonus is a circumscribed round or oval bulge of posterior lens capsule and cortex. About 100 cases have been reported since the first clinical description given in 1888 by Meyer. Most cases in the literature were unilateral and were not usually associated with other congenital anomaly. The authors have recently experienced a case of bilateral posterior lenticonus with left keratoconus in a 21 year-old male patient and two cases of characteristic posterior lenticonus not associated with other ocular anomalies in 22 year-old male patients.

The Direct Medial Canthal Approach in the Repair of Blowout Fracture of the Medial Orbital Wall

Fracture of the medial orbital wall with entrapment of the medial rectus muscle is a rarely reported occurence. Fractures of the medial orbital wall can occur alone. but they are frequently associated with fractures of the orbital floor. As the result of blowout fracture of the medial orbital wall, epistaxis, limitation of abduction, restriction of abduction, globe retraction upon attempted abduction, and enophthalmos are developed. Serious complications of medial orbital wall trauma are rare. Significant enophthalmos, definite limitation to the forced ductions, or marked incarceration of orbital tissue are usually indications for the need for exploration. Surgical approaches to blowout fracture of the medial orbital wall are made through a skin incision in the lower eyelid placed just below the eyelashes, a conjunctival incision, and direct medial canthal incision. Recently, the authors have repaired two blowout fractures of the medial orbital wall by use of Direct Medial Canthal approach, and follow-up for six months has been done.

A Case of Peripheral Corneal Ulcer Treated with Partial Lamellar Keratoplasty

Corneal ulcerations are divided into two morphologic types: central and marginal. Marginal corneal ulcerations are characterized by focal, muItifocal, multifocal or diffuse ulcerative, infiltrative, or vascular involvement of the peripheral cornea, and the exact pathogenesis of these ulcerations is not clearly understood but infectious, toxic or autoimmune factors may be involved. The authors treated one peripheral corneal ulcer patient, no respond to steroid and antibiotic therapy, with lamellar keratoplasty and had a good result.