Clinical Outcomes of ATOS-mediated SmartSight Lenticule Extraction

Purpose@#To evaluate the clinical outcomes of a new refractive corneal lenticule extraction method (SmartSight) using a Schwind ATOS femtosecond laser (Schwind Eye-Tech-Solutions, Kleinostheim, Germany). @*Methods@#The medical records of 338 eyes of 170 patients who underwent SmartSight treatment from April to September 2022 and were followed-up for at least 3 months were retrospectively analyzed. The patients were followed-up at 1 day, 1 week, and 1 and 3 months after operation. Refraction, visual acuity, and intraocular pressure were measured at each visit. @*Results@#Preoperatively, the uncorrected distant visual acuity was 1.26 ± 0.33 logarithm of minimum angle or resolution (logMAR) and the spherical equivalent was -4.52 ± 1.77 diopters. The 3-month, postoperative, uncorrected distant visual acuity was 0.01 ± 0.03 logMAR and the spherical equivalent was -0.12 ± 0.22 diopters. The 3-month data were as follows: efficacy of refractive surgery, 0.99 ± 0.11; safety, 1.00 ± 0.05; predictabilities at ±0.5 and ± 1.0 diopters, 97% and 100%, respectively. @*Conclusions@#Myopic astigmatism correction using the SmartSight method was effective, safe, and predictable in terms of visual outcomes.

The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection

PURPOSE: To evaluate microvascular change (microaneurysm) in diabetic retinopathy patients who undergo intravitreal bevacizumab injection using fluorescein angiography (FAG). METHODS: Thirty one eyes of 31 diabetic retinopathy patients undergoing intravitreal bevacizumab injection (1.25 mg/0.05 mL) in only 1 eye were included in this study. The control group (31 eyes) consisted of the fellow eyes. We excluded cased with intravitreal bevacizumab injection in both eyes and medial opacity obscuring three fundus image due to vitreous hemorrhage. The microaneurysmal change was analyzed at the same site the circle with optic disc radius and macula using FAG 2 to 4 months after injection. RESULTS: The average number of microaneurysms was 42.58 +/- 33.93 and significantly decreased to 28.74 +/- 28.06 after intravitreal bevacizumab injection (p < 0.05). The decrease of 35.70 +/- 24.79% in the treatment group was statistically higher than 13.95 +/- 38.21% in the control group with the fellow eyes (p < 0.05). CONCLUSIONS: In the present study, intravitreal bevacizumab injection reduced neovascularization, cystoid macular edema. Therefore this data can be used for future research on microvascular changes in the retina.

The Clinical Evaluation of Congenital Lacrimal Fistula

PURPOSE: To evaluate the surgical results and clinical characteristics of congenital lacrimal fistula. METHODS: Fourteen patients were diagnosed with congenital lacrimal fistula and received simple fistulectomy. Three patients received anterior lamella reposition operation simultaneously due to epiblepharon. We retrospectively reviewed the medical records and conducted telephone interviews. RESULTS: In 15 eyes of the 14 patients, epiphora through lacrimal fistula disappeared. Two eyes of 2 patients showed a little epiphora only outdoors but there was no need of further treatment. All patients accepted the surgical results cosmetically. Histologically, stratified squamous epithelial change with keratinization was remarkable by aging. In adults, hair follicles with increased keratinization were contained and the result with skin was similar. CONCLUSIONS: Simple fistulectomy was a useful technique for congenital lacrimal fistula.

A Case of Squamous Cell Carcinoma Originating from the Lacrimal Sac

PURPOSE: The tumor of lacrimal sac is very rare. We report an experience of a 63-year-old female who had a squamous cell carcinoma of the lacrimal sac and discuss its diagnosis and overall management. METHODS: A 63-year-old woman came to our clinic with a 2-month history of a growing mass in the region of the left medial canthus, left eye tearing. Examination revealed left epiphora and swelling on the left medial canthus and the left lacrimal sac, which was firm. Lacrimal irrigation indicated an obstruction. A computed tomographic scan demonstrated a well enhancing soft tissue mass in medial aspect of left orbit and no evidence of invasion of rectus muscles and adjacent bony destruction. The mass was excised by dacryocystectomy and subsequently, required 200 cGy a day, 5 times a week, 6000 cGy of radiotherapy for 6 weeks. RESULTS: The patient was finally diagnosed with keratinizing, squamous cell carcinoma that was proven by histopathologic finding. There was no evidence of recurrence of the tumor in lacrimal sac throughout 24 months of follow-up period.

A Study on the Location of Corneal Thinnest Point and Corneal Thickness in Midperiphery

PURPOSE: To evaluate the association with corneal thickness and corneal thinnest point using Orbscan topography. METHODS: One hundred and four eyes of the 52 normal subjects who were investigated using an Orbscan topography, were devided into following two groups ; one was inferonasal group which has the thinnest point in inferonasal quadrant(23 eyes, 22.1%), and the other was inferotemporal group which has the thinnest point in inferotemporal quadrant. (79 eyes, 76%) Among them, age-matched 30 eyes were randomly selected. The corneal thickness of two groups were measured at eight meridian of each point distant 1.0, 1.5, 2.0, 2.5, 3.0mm from corneal center. The thickest point and the thinnest point of cornea in two groups were compared and analysed. RESULTS: The thickest point of cornea in two groups was located in the superior portion. The thinnest quadrant was located in the inferonasal portion for inferonasal group and in the inferotemporal portion for inferotemporal group. CONCLUSIONS: The quadrant where the thinnest quadrant existed had the thinnest corneal thickness in comparing with any other quadrant.

The Effect of Upper and Lower Lid Blepharoplasty for Patients with Corneal Problems due to Medial Upper and Lower Eyelash

PURPOSE: Epicanthal folds and epiblepharon which often develop in oriental children are congenital anomalies of eyelids. These may need surgical correction because corneal irritation may develop by medial upper and lower eyelash besides cosmetic problems. V-Y plasty and Mustarde's method are standards for correction of epicanthal folds, but not usually performed because of cosmetic scar formation. METHODS: This study included 26 patients, 52 eyes (19 females, 38 eyes; 7 males, 14 eyes) with corneal irritation due to medial upper and lower eyelash. We performed upper and lower lid blepharoplasty simultaneously and analyzed their results and complications through medical records. RESULTS: Epiblepharon associated with epicanthus tarsalis was found in 22 patients, 22 eyes, epicanthus palpebralis in 4 patients, 8 eyes. At the time of surgery mean age was 7 years old (3.7~10.3 years old). During the follow-up more than 6 months, double fold asymmetry was found in 1 patient, double fold loosening in 1 patient, 2 eyes, lower eyelid undercorrection in 2 patients, 3 eyes. CONCLUSIONS: These findings suggest that simultaneous upper and lower lid blepharoplasty for patients with corneal problems due to medial upper and lower eyelash is more unsatisfactory in the cosmetic result than standard method, but has advantage of less scarring, and thought to be a good method to relieve corneal irritation.