The Clinical Study of Retinal Detachment Associated with B ranch Retinal Vein Occlusion

The branch retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. Complications such as macular edema, retinal neovascularization, vitreous hemorrhage, epiretinal membrane may be associated. But, the retinal detachment may occur rarely in BRVO patients. We studied the clinical features of retinal detachment associated with branch retinal vein occlusion. We reviewed the medical records of 15 retinal detachment patients associated with branch retinal vein occlusion. Mean age was 54.7 years old and 10 patients(66.7%) were female. Hypertension was associated in 13cases(86.7%). The duration between the development of BRVO and the development of retinal detachment was shorter than 4 years in all cases and shorter than 2 years in 9 cases(60.0%). Retinal break was identified in 14 cases(93.3%), among which 13 cases(92.2%) were located inside the lesion of branch vein occlusion. The epiretinal membrane was frequently combined 8 cases(53.3%). The preoperative laser photocoagulation was done in 4 cases(26.7%). The primary surgical procedures included scleral buckling in 8 cases(53.3%), pars plana vitrectomy in 6 cases(40.0%), and scleral buckling with pars plana vitrectomy in 1 case(6.7%). Three cases(20.0%) required reoperations. The postoperative complications included the progression of cataract in 6 cases(40.0%), iatrogenic retinal tear in 3 cases(20.0%), epiretinal membrane in 2 cases(13.3%), and proliferative vitreoretinopathy in 1 case(6.7%). The anatomic retinal reattachment was achieved in 14 cases(93.5%) and the visual recovery in 11 cases(73.3%).

The Surgical Results of Medial Rectus Muscle Resection of Dominant Eye and Lateral Rectus Muscle Recession of Non-dominant Eye in Intermittent Exotropia

Intermittent Exotropia has been treated by various surgical methods such as bilateral medial rectus resection, lateral rectus recession and medial rectus resection of deviating eye, and bilateral lateral rectus recession. However, the outcomes of such operations are unsatisfactory because of high incidence of postoperative undercorrection and overcorrection. Authors have performed a surgical method which is the medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye in 68 patients. Authors considered the outcome successful if patients achieve deviation between 10 PD of exophoria and 5 PD of esophoria, good stereopsis, no suppression and no manifest deviation. The success rate was 83.8% (57/68) and there was no overcorrection over 6 months follow-up. As postoperative complications, 5 cases of temporary turning of face and 3 cases of asymmetric palpebral fissure were seen. Therefore, these results suggest that medial rectus resection of dominant eye and lateral rectus recession of non-dominant eye in intermittent exotropia may be an alternative surgical method for intermittent exotropia. However, further studies are necessary to determine the exact surgical amounts and mechanism of this surgical method.

The Factors Related to Surgical Success Rate of Endonasal Dacryocystorhinostomy

Endonasal DCR has been reported for the advantages of lack of a cutaneous scar and short operating time but that the surgical success rates were lower than conventional method. We have performed endonasal DCR and had follow-up of at least 6 months in 107 patients who had been diagnosed with lacrimal pathway obstruction, and also surveyed the age, sex, sac size and nasal cavity abnormality to evaluate the factors related to success rate. Primary success rates were 82.2%(88eyes) and higher success rates were noted in younger age, man and large sac but not significant. But. the cases associated with nasal cavity abnormality as septal deviation, middle turbinate hypertrophy, ethmoiditis and polyp showed poor surgical results due to membranous ostium closure, formation of granuloma within the ostium, and formation of cicatrix with the middle turbinate.(P<0.05) Improvement of success rate may be owing to appropriate preoperative evaluation, proper management of nasal cavity abnormality preoperatively and intraoperatively, and show consider the conventional method in cases of that lower success rate are predict.