Scleral Fixation of Foldable Intraocular Lenses Using Injector

PURPOSE: To introduce the method of scleral fixation, using Mport(TM) (Bausch & Lomb) injector and silicone three-piece foldable IOL (Silens 6, Bausch & Lomb). METHODS: The study was conducted for five cases of aphakia requiring secondary implantation of IOL. The partial-thickness scleral flaps were made on 2 and 8 o' clock site. A double-armed 10-0 polypropylene suture and 26G needle were inserted through each sclera. Surgical and 26G needle were conjoined and passed out through 2 o' clock site sclera. The clear corneal incision was made on 10 o' clock site through which a suture was pulled out and cut. The end of suture which originated from 8 o' clock site was passed through the injector and tied to the leading haptic of IOL, then inserted. The other end of suture was tied to the following haptic and complete the insertion of IOL with forceps. RESULTS: Time taken for the above procedure was within 20 minutes and postoperatively induced astigmatism was less than 1.5 diopters. No specific complication was noticed. CONCLUSIONS: This technique may be an effective and substitute procedure for that have been used for reasons of less astigmatism, and stable chamber maintenance during procedure.

Two Cases of Tsutsugamushi Disease with Ocular Disease and Eschars on the Lower Eyelid

PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.

Early Reversible Changes on ERG in Pharmaceutically Induced Retinal Degeneration in Rats

PURPOSE: To evaluate the early ERG (electroretinogram) changes in N-methyl-N-nitrosourea (MNU)-induced retinal degeneration in rats. METHODS: Thirty-six 6-week-old male rats were injected intraperitoneally with 60mg/kg MNU and divided into 6 groups. Histology and ERG were recorded for the rats of each group before treatment and at 3, 6, 12, 18, and 24 hours after MNU injection. Promptly after the ERG recording, rats were sacrificed and the eyeballs prepared for histologic sectioning. The Tdt-mediated dUTP-digoxigenin nick end labeling (TUNEL) method was used to detect photoreceptor cell death. RESULTS: The first decreases of ERG responses were noticed maximally at 3 hours after the treatment. Thereafter, the amplitude of the responses was partially recovered at 12 hours post-treatment. The second decrease of ERG amplitudes was observed in the 18-hour recordings, and those changes progressed to 24 hours after the treatment. In the histologic findings, TUNEL (+) cells in the Outer Nuclear Layer (ONL) were not detected at 3 hours after MNU injection, but were initially noticed at 6 hours post-injection. CONCLUSIONS: The first decreases of ERG amplitudes proceeded the appearance of TUNEL (+) cells in ONL, and these electrophysiological changes seemed to not be related to photoreceptor cell death. We propose that electrophysiological changes observed might be related to the MNU-induced activity enhancement of guanylate cyclase in the phototransduction pathway. We also show that photoreceptor cell death in the MNU-induced retinal degeneration model occurs at 6 hours after the treatment, which is earlier than the results of previous reports.