Corneal Tattooing to Mask the Opacification after Amniotic Membrane Grafting for Corneal Ulcer

PURPOSE: To report on the cosmetic efficacy of corneal tattooing using India ink in cases where amniotic membrane grafting was performed to promote corneal wound healing in corneal ulcers. METHODS: Amniotic membrane grafting of corneal ulcers was carried out in three patients with no expectation of visual recovery. After corneal reepithelization, a 30 G needle filled with India ink was placed into the amniotic membrane space between the regenerated corneal epithelium and the stromal bed, and the ink was then carefully injected. RESULTS: The staining of corneas to the appropriate opacity with India ink was successful in all cases. There were no significant complications during the mean follow up period of 17 months. All the patients were well satisfied with the corneal staining. CONCLUSIONS: When corneal opacity occurs subsequent to an amniotic membrane graft for a corneal ulcer, this corneal tattooing with an intrastromal injection of India ink into the amniotic membrane space might be a very useful method to achieve a good cosmetic result.

A Comparative Study for Mesopic Contrast Sensitivity between Keratectomy(PRK) and Laser in Situ Keratomileusis(LASIK)

PURPOSE: To compare the effect on visual performance of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with mesopic contrast sensitivity using CSV-1000S in excimer laser refractive surgery using the broad beam type and manual microkeratome. METHODS: Postoperative visual performance for 40 eyes undergoing PRK and 40 eyes undergoing LASIK was compared with mesopic contrast sensitivity at 1, 3, and 6 months postoperatively using the CSV 1000 (VectorVision, Ohio, USA). Eyes were divided into two groups: less than 6.0 D and over 6.25 D. Mesopic contrast sensitivity was performed with the patient's uncorrected-visual acuity of 20/20 or better under photopic condition. RESULTS: Under mesopic conditions a significant decrease in contrast sensitivity for the postoperative PRK and LASIK group was obtained at all spatial frequencies compared to the preoperative baseline (p0.05). CONCLUSIONS: In the broad beam excimer laser, in cases of myopia with below 6.0 D, PRK seemed to have a more significant effect on mesopic contrast sensitivity than LASIK using manual microkeratome at postoperative 6 months.

The Therapeutic Efficacy of Exposed Orbital Implant (Medpor(R)) Using Tenon's Capsule

PURPOSE: To evaluate the therapeutic efficacy of primary closure of subtenon's capsule contained with normal ocular blood vessels in the case of exposed porous orbital implant. METHODS: The subjects consisted of five patients who had failed dermis-fat grafts or scleral graft previously presented with re-exposed Medpor orbital implant and three patients who showed primary exposure of Medpor without other operations. We completely cured the exposed area of Medpor using subtenon capsule closure. The range of superficial exposed size of Medpor was about 3~8 mm 4~8 mm. Under local infiltration with 2% lidocaine, the contaminated superficial margin of Medpor was partially removed and then the subtenon's capsule was isolated from the conjunctiva and the orbital implant was directly sutured with Prolene 5-0 without any tension of ocular tissue. Finally, conjunctival suture was performed with Vicryl 7-0. RESULTS: Seven patients were healed well but one patients experienced a 1.5-mm sized. The exposure of Medpor was treated after re-operation using closure of the subtenon's capsule. The only complication observed were forniceal shortening and decreased orbital implant volume, but there ware no clinically significant complications in wearing artificial eyes. CONCLUSIONS: We succeed in complete recovery of exposed Medpor using tenon's capsule without tissue graft. When the Medpor exspoure was less than 1 X 1 cm, it should be useful a technique to repair the exposed surface by using primary closure of subtenon's capsule.