The Characteristics of Infants with Congenital Nasolacrimal Duct Obstruction Iimproved with Lacrimal Sac Digital Massage

PURPOSE: The treatments for congenital nasolacrimal duct obstruction range from minimally invasive to more invasive methods. Initially, clinicians select lacrimal sac massage with topical antibiotics application or early lacrimal sac probing. We studied if the characteristics of infants improved after lacrimal sac massage with topical antibiotic application. METHODS: Two hundred thirty-four eyes of 204 patients diagnosed with congenital nasolacrimal duct obstruction from March 2001 to January 2007 were included. Excluded were infants who had obvious epiblepharon or eyelid abnormalities, tumors of the lacrimal system, or a history of trauma. Neonates less than 1 month were also excluded to rule out neonatal conjunctivitis. At the first visit, we recorded birth profile information such as gestational age, birth weight and height, onset time of symptoms, and post-conceptional age. We compared the results between the successful treatment group and failure group after lacrimal sac massage and topical antibiotic application. RESULTS: One hundred twenty-three eyes showed improvement after conservative treatment (52.6%), and the infants included in the success group visited earlier and had lower PCA (P<0.05). No other factors evaluated in this study contributed toward the improvement in symptoms observed. CONCLUSIONS: When considering treatment for congenital nasolacrimal duct obstruction, an evaluation of factors related to birth should be performed. According to the results, infants with the characteristics of favorable outcome should be treated conservatively, while those patients who do not have the characteristics for favorable outcome should be treated by early probing to achieve an effective and satisfactory outcome.

A Case of Conjunctival Benign Lymphoid Hyperplasia associated with Ptosis of the Eyelid in a Child

PURPOSE: Benign lymphoid hyperplasia of the conjunctiva occurs infrequently in children. We report a case of benign lymphoid hyperplasia, accompanied by ptosis and conjunctival injection. METHODS: A nine-year-old girl showing ptosis and conjunctival injection underwent examination. RESULTS: There was ptosis of the right eye. Ophthalmologic findings included nodules which seemed like salmon's patch in the conjunctiva. The function of the levator muscle and the Neostigmine test were normal. There was no specific finding in fundus and orbital CT. Biopsy of the nodules was done under local anesthesia, and the pathologic result was benign reactive lymphoid hyperplasia. Ofloxacin and fluorometholone eye drops were used for 6 weeks, and oral prednisolone was used for 2 weeks. The ptosis was improved 3 weeks after surgery and follow-up survey was continuing at 10 months after surgery at the time of writing. CONCLUSIONS: We report one case of a child with benign lymphoid hyperplasia of the conjunctiva who showed ptosis and conjunctival injection, and present a literature.

Pigmented Spindle Cell Nevus of the Palpebral Conjunctiva

PURPOSE: Pigmented spindle cell tumor of the palpebral conjunctiva is very rare, and most of the tumors arise at extremities or trunk. To our best knowledge, no case has been repoted in Korea so far. We report one case of pigmented spindle cell nevus with literature review. METHODS: A 21 years-old male patient complaining of mass on the left upper palpebral conjunctiva underwent excisional biopsy with minimal touch technique. RESULTS: On histopathologic examination, the mass consisted of small, regular and spindle cells with pigmentation. And HMB-45 and CD-34 stains were negative, while S-100 stain was weakly positive. CONCLUSIONS: We report one case of pigmented spindle cell nevus as the first case in Korea.

Surgical Results of Deep Lamellar Keratoplasty

We performed the deep lamellar keratoplasties in which stroma about 90% in thickness were removed on 15 patients(12 males and 3 females). The patients included in this study showed deep corneal opacity preserving endothelium intact. During the operation, we experienced microperforation in 3 cases, but no complications were found with immediate closure. After the operation, all patients acquired the corneal clarity except one whose cornea was opaque as the Grade II by the slit lamp examination. The patients had visual improvement of two lines or more in Snellen chart. Three patients had no change of visual acuity and one patient bad astigmatism more than 3D. Only one patient suffered the stromal rejection raction, but improved with the use of oral steroid and topical steroid eye drops.

The Effect of Anterior Capsulotomy Size and Lens Epithelial cells Removal on the Posterior Capsular Opacification

The most common complication of cataract surgery, posterior capsular opacification is known to arise from the lentivular epithelial proliferation. The simple mechanical elimination of the lenticular epithelial cells by irrigation and asiration is most widely used now. Recently, the defenite size of continous curvilinear capsulorhexis(C.C.C.) and the effect of partial mechanical removal of lens epi thelial cells is under the discussion. We used 15 Neuzealand white rabbits(30 eyes) to examine the appropriate capsulotomy size and the effect of simple irrigation and aspiration on the posterior capsular opacification for 3 months after operation. The results from by using the slit lamp and the ophthalmoscope examination showed that the posterior capsular opacificaiton grade score was lower in the small(3~4mm) capsulotomy with irrigation and aspiration group(1.7) than in the small capsulotomy(3~4mm) group without irrigation and aspiration group(2.3) or the large capsulotomy (6~7mm) group without irrigation and aspiration(2.4). The optical power meter and posterior eye evaluation technique also presented the same results of posterior capsular opacification grade as those of slit lamp and ophthalmoscope examination which was done on the eneuc1eated eyes at postoperative 3 months.