Corneal Melting and Descemetocele Resulting From Noninfectious Keratitis Related to the Cosmetic Contact Lenses

PURPOSE:To report 2 cases of corneal melting and corneal melting with descemetocele that occurred in users of cosmetic contact lenses. CASE SUMMARY: A-12-year-old and a 13-year-old female who used cosmetic contact lenses were referred to our clinic under the preliminary diagnosis of keratitis and corneal melting. The patients had purchased the lenses from an optician and had worn the lenses for approximately 1 month without being educated on their proper use. The signs and symptoms improved after 2 weeks of treatment with oral steroid and 1% topical prednisolone acetate. However, descemetocele occurred in the 12-year-old patient. Reepithelization of the cornea had been completed within the treatment period. However, corneal thinning with mild opacity remained in the lesions, and the best corrected visual acuities on the Snellen chart were 20/30 in both patients.

Comparison of Contrast Sensitivity with ACV (Visual Capacity Analyzer) in Different Types of Posterior Capsular Opacification

PURPOSE: To compare contrast sensitivity (CS) in type and degree of posterior capsule opacification (PCO) in pseudophakic eyes before and after neodymium: YAG capsulotomy. METHODS: Nine eyes with fibrosis-type PCO and 26 with Elschnig-pearl type PCO were examined for best corrected visual acuity (BCVA) and CS before and 1 week after capsulotomy. CS was tested with visual capacity analyzer (ACV) which uses a Landolt ring of 5 different spatial frequencies (SF) under two different conditions of day (100cd/m2) and night (30cd/m2). The patients were divided into two groups based on the BCVA before capsulotomy: Group A, 4 eyes and 18 eyes with below 0.63 in fibrosis-type and pearls-type PCO, respectively; Group B, 5 eyes and 8 eyes with above 0.63 in fibrosis-type and pearls-type PCO, respectively. RESULTS: The patients with PCO had worse BCVA and CS, but these were improved by Nd: YAG capsulotomy. This was not affected by the types and degrees of PCO. In the daytime condition, CS of B group was worse at all SF in patients with pearl-type PCO than in those with fibrosis-type PCO before capsulotomy, except 19 cpd (p0.05). CONCLUSIONS: In the daytime condition, the patients with pearls-type PCO of relatively poor BCVA had lower CS than those with fibrosis-type PCO.

The Effects of Healon(R), Amvisc(R) and Methylcellulose as Viscoelastic Materials on Rabbit Corneal Endothelium and Intraocular Pressure

To compare the corneal reaction of the widely used viscoelastic substance such as Healon(R), Amvisc(R) and newly developed and less expensive viscoelastic substance(2% methylcellulose), 0.2ml each of various viscous solutions were injected into the anterior chamber of rabbit eyes and their reactions were observed. BSS(Balanced salt solution) was used as a control. 1. Intraocular pressure was elevated to the peak in 3 hours after injection of Healon(R)(44.0 +/- 14.4mmHg), methylcellulose(32.0 +/- 4.0mmHg), Amvisc(R)(33.7 +/- 14.5mmHg) and control BSS(25.8 +/- 4.6mmHg). Intraocular pressure returned to normal at 9 hours after injection of methlycellulose group, while Healon(R) and Amvisc(R) group returned to normal at 24 hours. 2. Central corneal thickness was increased to the peak 12 hours after injection in all groups; Healon(R) 475 +/- 71.9 micrometer, methylcellulose 454 +/- 55.0 micrometer, Amvisc(R) 489 +/- 90.9 micrometer and control BSS 403 +/- 14.0 micrometer. Corneal thickness returned to normal after 2 days in Healon(R) and control groups but it took 6 days for methyclellulose and Amvisc(R) groups. 3. The endothelial cell density 2 weeks after injection were Healon(R) 2,280 +/- 125.0 cells/mm2, methylcellulose 2,187 +/- 120.0 cells/mm2, amvisc(R) and BSS 2,338 +/- 74.0 cells/mm2. The endothelial cell reduction rate was Healon(R) 7%, methylcellulose 6%, Amvisc(R) 14.5% and BSS 3.0%, respectively. 4. In all groups except control ESS group, the endothelial cells under the scanning electron microscope showed decreased microvilli and enlargement of intercellular space. Scanning electron micrograph 2 weeks after injection of Amvisc(R) showed the findings of more edematous endothelial cells compared with those of other groups.

Two Cases of Duane's Retraction Syndrome

At the turn of the centry. European and American ophthalmologists began describing the curious set of physical findings that has become known as Duane's retraction syndrome. In 1905 Alexander Duane defined six characteristics in the affected eye: 1) decreased abduction. 2) decreased adduction. 3) retraction into the orbit on adduction. 4) oblique elevation or depression on adduction. 5) partial closure of the eyelids on adduction, and 6) deficient convergence. We experienced two cases of Duane's retraction syndrome from the Kang Nam St. Mary's Hospital in Apr, 1982. Tile first case, 3 yrs old boy was not operated due to orthotropic appearance at primary position, and the case. 21 yrs old female was operated due to severe esotropia.