Three year Follow up of Laser Trabeculoplasty using Q-switched frequency doubled Nd: YAG laser

PURPOSE: To assess the efficacy and safety of selective laser trabeculoplasty treatment (SLT) using Q-switched frequency doubled Nd: YAG laser at three year follow-up. METHODS: Fifteen eyes of 12 primary open angle glaucoma patients treated between July and August 1997 with Q switched frequency doubled Nd: YAG laser were evaluated. With clinical examinations including slit-lamp examination, applanation tonometry and funduscopy, we evaluated preoperative and postoperative intraocular pressure (IOP) of treated eyes, IOP response between treated and untreated eyes, and complications at 3 year follow-up retrospectively. RESULTS: IOP before treatment was 25.2 2.3 mmHg. At one year after treatment, IOP was 20.3 4.1 mmHg (19.6% reduction). At 2 and 3 years follow-up, IOP's were 21.1 3.5 mmHg (16.4%) and 19.7 4.9 mmHg (23.2%) respectively. In the comparison between treated eyes and untreated fellow eyes, the mean IOP reduction in the untreated eyes showed 12.1%, the treated eyes showed significant reductions in IOP at all follow-ups (P=0.0003). Complication included anterior uveitis in one eye at intermediate follow-up and transient increased IOP in seven eyes. CONCLUSIONS: SLT showed stable IOP compared with preoperative intraocular pressure during 3 years follow-up period without severe complication.

Outcome of Vitreoretinal Surgery and Penetrating Keratoplasty using Temporary Keratoprosthesis

PURPOSE: Using a temporary keratoprosthesis(TKP), earlier surgical treatment became amenable in eyes with coexisting vitreoretinal and corneal disease. We analysed our experience with this type of surgery. METHOD: Medical records of patients who had undergone pars plana vitrectomy(PPV) using Eckardt TKP from 1994 to 2000 were reviewed. Analysis was focused on preoperative conditions, surgical outcome and complications. RESULT: Of 34 eyes of consecutive 34 patients, 25(73.5%) showed trauma-related indications and 4 had IOFB. Retinal detachments were present in 24(70.6%) eyes, proliferative vitreoretinopathy in 8(23.5%) and vitreous hemorrhage in 10(29.4%) eyes. Penetrating keratoplasty(PKP) with donor corneas were performed in only 3 patients at the time of surgery and patient's excised corneas were sutured to 31 patients, 9 of whom underwent PKP later. After mean follow up period of 14 months, retinas remained attached in 27(79.4%) eyes and 3 eyes were phthisical. Visual acuity improved in 18(53%) eyes and worsened in 5 eyes. CONCLUSIONS: In cases with coexisting corneal and vitreoretinal pathology, PPV using TKP was effective for preserving vision and globe. Timing of grafting clear cornea might be delayed when donor cornea was not available.

Retinopathy and Keratopathy Associated with Chronic Tamoxifen Medication

PURPOSE: Tamoxifen retinopathy is one of the uncommon side effects together with keratopathy, crystalline retinopathy and cystoid macula edema when tamoxifen is administered with high dose to breast cancer patients. We report here a case of retinopathy patient with five years of tamoxifen application. METHOD: A 46 year old female breast cancer patient complained about decreased visual acuity in both eyes after taking total amount of 37.28 g tamoxifen (20 mg/day) for 5 years. Whorl-like superficial corneal opacity was detected and yellowish white macular crystalline deposits were seen in both eyes. Moreover, decreased b wave amplitude of ERG was detected in electroretinography and RPE atrophy was found in FAG. RESULT: The patient stopped taking tamoxifen immediately after diagnosed with tamoxifen retinopathy. Two months later, it showed decreased corneal opacity and improved visual acuity in the left eye but also showed increased macular crystalline deposits in the left eye.