Effects of Interleukin-6 on Corneal Epithelial Wound Closure after Excimer Laser Surface Ablation in Rabbits

To evaluate the effects of interleukin-6(IL-6) on epithelial migration in corneal epithelial wound healing process after excimer laser surface ablation, the morphologic changes as well as the healing rate of the defect area were observed on 30 rabbits(60 eyes). The animals were divided into three groups of twenty each: the control group and the two IL-6 treated groups(eye dropping with 0.1mg/L and 1.0mg/L of IL-6). On light microscopic examination, after 9 hours, centripetal migration of epithelial cells and covering of bare stroma with monolayered epithelial cells were more remarkable in the 1.0mg/L group than in the control group, reaching the peak at 18 hours. On transmission electron microscopic examination after 18 hour, the 1.0mg/L group showed the loss of hemidesmosome beneath the leading edge of sliding epithelial cell, other intracellular structures were well preserved. On scanning electron microscopic examination, epithelial migration started at 9 hour in all three groups and the epithelial migration was more rapid in the 1.0mg/L group than in the control group. Fifteen hours and afterwards, the healing rate was significantly accelerated in the 1.0mg/L group than in the control group. In view of the above findings, it was speculated that IL-6 could be used effectively in the early treatment of excimer laser keratectomy and other corneal epithelial injury.

Decentration and Tilt of Posterior Chamber Lens According to Anterior Capsulotomy

To evaluate the abnormal positions of intraocular lens after cataract extraction and intraocular lens implantation, the study used the image analysis technique. Tilting and decent ration of posterior chamber intraocular lens(PCL) were studied according to the anterior capsulotomy. 103 patients(120 eyes) were randomized into 6 groups(20 eyes each) according to posterior chamber lens style and anterior capsulotomy type, and measured the degrees of tilting and decent ration of PCL by Scheimpflug camera. Three piece PCL implantation group showed significant less tilting than one piece PCL implantation group at postoperative 1 week. In one radial tear of anterior capsulotomy group, three piece PCL showed less tilting than one piece PCL. At postoperative 2 months, continuous curvilinear capsulorhexis without radial tear group showed significant less decent ration and tilting than one radial tear group. At postoperative 1 week and 2 months tilting of the continuous curvilinear capsulorhexis group was less than two or more radial tears group. As time passes from 1 week to 2 months tilting decreased significantly, but decentration did not showed significant decrease.

The Effect of 5-Fluorouracil or Mitomycin-C in Glaucoma Filtration Surgery on the Rabbit Cornea and Sclera

The authors investigated the toxicity of two antimetabolites. 5-fluorouracil(5-FU) and mitomycin-C(MMC) on the rabbit cornea and sclera following glaucoma filtration surgery(GFS). Forty rabbits were divided into four groups; the first control group(I) was the balanced salt solution soaked group(BSS) during GFS, the second(II) was the 5-FU subconjunctival injected group(5-FU SC) after GFS, the third(III) was the 5-FU soaked group(5-FU) during GFS, and the fourth(IV) was the MMC soaked group(MMC) during GFS. At the fifth day after GFS, scanning electron microscopic findings showed that corneal epithelial cells were most seriously damaged in 5-FU SC group, slightly damaged in 5-FU group, and no change in MMC and BSS group. At six months after GFS, transmission electron microscopic observation on sclera revealed the most profound degenerative changes in 5-FU group, and followed by an order of MMC, 5-FU SC, and BSS group. These results suggest that the dosage and application method of antimetabolites should be selected with great caution to prevent ocular toxicity.

Superior oblique lengthening procedure with silicone expander in rabbits

Using a rabbit model, we assessed the postoperative status and histopathologic findings of superior oblique tenotomy with silicone expander procedure. In the control group we marked and cut the superior oblique, and in the experimental group we inserted a silicone 240 retinal band 4 mm in length along the edges of incision. At the postoperative weeks 1,3,5 and 7, we randomly chose five rabbits and made a histopathologic examination after hematoxylin-eosin and Masson's trichrome stain. The distance between the incised edges was various in the control group, but constant in the experimental group. With time inflammation decreased and fibrosis of the superior oblique increased. Foreign body reaction occurred around the suture material in both groups., but not around the silicone expander. At 5 weeks atrophy of the superior oblique was observed in both groups.From the above results, we concluded that the superior oblique lengthening procedure using silicone expander is a useful surgical method for weakening the superior oblique muscle.

The Effect of Indomethacin Pretreatment Before Nd:YAG Laser Anterior Capsulotomy on Intraoular Pressure of Rabbits

To evaluate the cause of intraocular pressure elevation and the effect of indomethacin after Nd:YAG laser anterior capsulotomy in rabbit authors measured the intraocular pressure, prostaglandin E2 and thromboxane B2 concentrations of aquous humor, and observed the morphological change of trabecular meshwork using scanning electron microscope in indomethacin pretreatment (group I) and non-treatment (group II) group. The intraocular pressure and the concentrations of prostaglanding E2 and thromboxane B2 in group II were higher than in group I. And the scanning electron microscopy showed inflammatory reaction in group II. These results support that the causes of intraocular pressure elevation are elevation of prostaglandin E2. thromboxane B2 concentrations in aqueous humor and intraocular inflammation secondary to it.

The Effect of Indomethacin Pretreatment Before Nd:YAG Laser Anterior Capsulotomy on Intraoular Pressure of Rabbits

To evaluate the cause of intraocular pressure elevation and the effect of indomethacin after Nd:YAG laser anterior capsulotomy in rabbit authors measured the intraocular pressure, prostaglandin E2 and thromboxane B2 concentrations of aquous humor, and observed the morphological change of trabecular meshwork using scanning electron microscope in indomethacin pretreatment (group I) and non-treatment (group II) group. The intraocular pressure and the concentrations of prostaglanding E2 and thromboxane B2 in group II were higher than in group I. And the scanning electron microscopy showed inflammatory reaction in group II. These results support that the causes of intraocular pressure elevation are elevation of prostaglandin E2. thromboxane B2 concentrations in aqueous humor and intraocular inflammation secondary to it.

The Clinical Survey of the Prevalence of Ocular Disorders in Aged Patients

In order to assess the prevalence of ocular disorders of the aged patients, retrospective survey was carried out in 5,659 patients over the age of 60, who visited outpatient clinics of three hospitals (St. Mary's Hospital, Cheonnam University Hospital and Inha University Hospital) between 1989 and 1990. An analysis of data was resulted in as follow: 1. Proportion of the aged patients to total out-patients was 15%. 2. The age distributions of patients were sixties (59%), seventies (34%), over eighty (7%). 3. In the patient 60 years old and older, 36.9% of the cases had best corrected visual acuities of 0.7 or better. 4. The most prevalent ocular disorder was senile cataract (44.0%), and others included conjunctival and scleral diseases (14.9%), retinal diseases (14.4%), refractive error (9.1%), glaucoma (4.4%), and corneal diseases (3.2%). 5. The proportion of causes of blindness indicates; senile cataract (58.8%), retinal diseases (15.4%), glaucoma (6.8%), and corneal diseases (5.0%), etc. 6. The systemic disorders associated with ocular diseases were hypertension 7.0%, diabetes 5.0%, respiratory diseases 4.2%, and heart diseases 2.0%. 7. Visual acuities better than 0.4 were obtained in 87.4% of postoperative cataract surgeries in aged patients.

Clinical Results of Penetrating Keratoplasty in Corneal Perforation

Therapeutic keratoplasties for 7 patients (7 eyes) with the corneal perforation were performed at St. Mary's Hospital, Catholic University Medical College, from November 1988 to December 1991 for about 3 years. The causative diseases of corneal perforation were herpes simplex keratitis in 2 eyes (28.6%), corneal ulcers after trauma in 2 eyes (28.6%), and keratitis of unknown etiology in 3 eyes (42.9%). Postoperative complications were cataract (2 eyes; 28.6%), synechiaes(2 eyes; 28.6%), glaucoma (1 eye; 14.3%)' endophthalmitis (1 eye; 14.3%) and graft failure (1 eye; 14.3%). Among the 7 grafted corneas, clear corneas were noted in 2 eyes (28.6%), but opaque corneas developed in 4 eyes (57.1 %), and eVIsceration was performed in 1 eye (14.3%) due to endophthalmitis. After keratoplasty, the visual acuity was over 0.1 in lout of the 6 eyes. In the corneal perforation, it was good to delay keratoplasty until the intraocular inflammation was subsided, but we preferred to do the keratoplasty immediately for large perforation or removal of the causative disease.

The Clinical Results of Penetrating Keratoplasty after Corneal Alkali Burn

A retrospective study was made for 12 penetrating keratoplasties (9 patients) for corneal opacity due to severe corneal alkali burn from January 1987 to December 1991 at St. Mary's Hospital, Catholic University Medical College. 5 eyes which received penetrating keratoplasty within a year after alkali burn have never improved in visual acuity, but 3 out of 7 eyes which received penetrating keratoplasty after a year obtained improved visual acuity during the follow up period of 6 months After keratoplasty, the corrected visual acuity of 11 out of the 12 transplants (91.7%) were temporary improved in comparision with the preoperative levels. But 3 eyes (27.2%) have kept improved visual acuity during the follow up period of 6 months. The relationship between preoperative corneal scarring type according to Kinoshita and Manabe's classification and postoperative corneal transparency was reviewed; 3 among 6 eyes with scarring type A have kept clear cornea, but all of 6 eyes with scarring type B were noted to have .opaque cornea during the follow up period of 6 months.

Clinical Results of Penetrating Keratoplasty in Keratoconus

We conducted a retrospective study of 45 penetrating keratoplasties (39 patients) for keratoconus from March 1986 to February 1991 at St. Mary's Hospital, Catholic University Medical College. The follow-up period was at least over 1 year. The penetrating keratoplasties were performed most commonly in the interval between 1 and 5 years after the diagnosis of keratoconus (25 patients; 64.1%). The hard contact lenses were the most commonly used for visual correction before penetrating keratoplasty. Corneal scar was the most common indication for keratoplasty (35 eyes: 77.8%). The most common postoperative complication was loose suture (14 eyes; 31.1%). Overall, 43 out of the 45 corneal transplants (95.6%) remained clear and these eyes attained best-corrected visual acuity of 0.5 or better.

The Effect of 1 % Apraclnidine on Intraocular Pressure Following Argon Laser Iridotomy and Laser Trabeculoplasty

We studied the effect of 1% apraclonidine (Iopidine(R)) on the ocular hypotensive action and its ocular side effects following laser surgery for glaucoma. One hundred twenty patients with primary angle closure glaucoma underwent argon laser peripheral iridotomy and 40 patients with primary open angle glaucoma were treated with laser trabeculoplasty. Mean lOP of eyes instilled with 1% apraclonidine fell by 16% 3 hours after instillation in laser iridotomy cases and by 28% 3 hours after instillation in trabeculoplasty cases. lOP elevation greater than lO mmHg was found in 18 eyes (30%) of the control group in iridotomy cases and 4 eyes (40%) in trabeculoplasty cases, but none in the apraclonidine group in both treated cases for the first three hours. Apraclonidine reduced the incidence and magnitude of potentially harmful lOP elevations after laser irdotomy and trabeculoplasty.

Clinical Results of Graft Rejection after Unilateral and Bilateral Keratoplasty in Keratoconus

Penetrating keratoplasty was performed on 72 eyes with keratoconus (60 patients) including 12 bilateral cases. We analyzed the difference of unilateral and bilateral grafts about incidence of graft rejection, age and sex dlstribution, and visual acuity change after keratoplasty. In 48 unilatferal grafts, graft rejection was developed in ll eyes (22.9%). in 12 bilateral grafts, there was graft rejection in 3 eyes (25%) of first eyes and 4 eyes (33.3%) of second eyes. The statlstical analysis showed no signifiant difference between the groups (P>0.05). The rejectlOn tlme of 16 eyes (88.8%) was within the first postoperative year. The mean interval between grafts performed on the first and second eyes was 8.8 months. When the interval was Within 1 year, 7 cases of graft rejectlon was developed. In 65 out of 72 grafts (90.3%), the best corrected visual acuity was 0.4 or better. In 18 eyes with graft rejection episode. 15 (83.3%) achieved 0.4 or better.

Clinical Evaluations of Penetrating Keratoplasty in Aphakic Bullous Keratopathy

We analysed a retrospective study of 22 aphakic bullous keratopathy patients (22 eyes) with penetrating keratoplasty for 5 years from January 1987 to December 1991 in the Department of Ophthalmology at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Of the 22 eyes with aphakic bullous keratopathy 16 eyes (72.7%) had previously undergone intracapsular cataract extraction, 6 eyes (27.3%) had extracapsular cataract extraction. 2. The mean time from cataract extraction to aphakic bullous keratopathy to penetrating keratoplasty was 13.8 months. 3. After keratoplasty, the visual acuity of 20 among the 22 transplants (90.9%) were significantly improved compared to the preoperative levels, however that of 2 among the 22 transplants were worse than the preoperative levels. The factors limiting postoperative visual acuity were senile macular degeneration and graft failure. 4. Postoperative complications were glaucoma (2 eyes, 9.1%), cystoid macular edema (1 eye, 4.6%) and graft failure (1 eye, 4.6%).

Clinical Results of UNI(R) Intraocular Lens Implantation

We evaluated the clinical results of 43 patients (47 eyes) who underwent cataract extraction and implantation of domestic posterior chamber intraocular lens manufactured by Universal Optics Co. (UNI(R) IOL) and could be followed up over 6 months. The mean follow-up period was 10.2 months with a range of 6 to 15 months. The results were as follows: 1. The final corrected visual acuity of 0.5 or better was noted in 41 eyes (87.2%). 2. The difference between the calculated postoperative refraction and the actual postoperative refraction was less than +/-1.00 D in 33 eyes (70.2%). 3. The corneal thickness increased 8.2% at postoperative period of 3 days and returned to preoperative level at postoperative period of 4 weeks. 4. The corneal endothelial cell density decreased 11.2% at postoperative period of 4 weeks and 12.8% at postoperative period of 6 months. 5. The early postoperative inflammatory reaction in anterior chamber and deposits on the surface of intraocular lens decreased gradually in the course of postoperative period. 6. The postoperative complications included posterior capsular opacification (7 eyes), fibrinous membrane (3 eyes), and hyphema (2 eyes). The above results showed that the visual outcome and the safety of UNI(R) IOL were favorable.

Clinical Evaluations of Penetrating Keratoplasty in Aphakic Bullous Keratopathy

We analysed a retrospective study of 22 aphakic bullous keratopathy patients (22 eyes) with penetrating keratoplasty for 5 years from January 1987 to December 1991 in the Department of Ophthalmology at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Of the 22 eyes with aphakic bullous keratopathy 16 eyes (72.7%) had previously undergone intracapsular cataract extraction, 6 eyes (27.3%) had extracapsular cataract extraction. 2. The mean time from cataract extraction to aphakic bullous keratopathy to penetrating keratoplasty was 13.8 months. 3. After keratoplasty, the visual acuity of 20 among the 22 transplants (90.9%) were significantly improved compared to the preoperative levels, however that of 2 among the 22 transplants were worse than the preoperative levels. The factors limiting postoperative visual acuity were senile macular degeneration and graft failure. 4. Postoperative complications were glaucoma (2 eyes, 9.1%), cystoid macular edema (1 eye, 4.6%) and graft failure (1 eye, 4.6%).

The Effects of Tissue Plasminogen Activator in Experimental Hyphema of White Rabbits

The purpose of this study is to observe the resorption effect of the anterior chamber blood by introducing tissue plasminogen activator (tPA). The results were as follows: 1. Hyphema of the tPA injection group was cleared completely within six days under the slit lamp examination, while no injection group and saline injection group showed no complete erythrocyte resorption even up to 21 days (p<0.01). 2. In the tPA injection group, intraocular pressure (lOP) returned to normal level in short period of time. However, in the other two groups lOPs were maintained higher than in the tPA injection group (p

Analysis of Donor Eye Contamination

We evaluated sex and age distribution, cause of death, death to enucleation time and contamination and viral (HBs Ag) infection of 211 donor eyes which were obtained from Central Eye Bank at St. Mary's Hospital from April 1, 1990 to September 30, 1991. 1. In sex and age distribution, 112 (53.1 %) donors were male, and 121 (57.3%) donors were above 61 years of age. The age group from 71 to 80 years was the most common (47 donors; 22.3%). 2. The most common cause of death was respiratory disease (75 donors; 35.6%), and then circulatory disease (53 donors; 25.1 %), tumor (35 donors; 16.6%) and infectious disease ( 29 donors; 13.7%). 3. 197 (93.4%) donor eyes were required within 6 hours from death to enucleation. 4. The conjunctival and limbal cultures of 211 donor eyes which were irrigated by 0.3% gentamicin eyedrop solution after extraction were positive in 56 eyes (26.5%). 5. The most prevailing cultured organism was Staphylococcus aureus (14 eyes; 25.0%). 6. Hepatitis B surface antigen in aqueous humor of all donor eyes was negative.

Analysis of Donor Eye Contamination

We evaluated sex and age distribution, cause of death, death to enucleation time and contamination and viral (HBs Ag) infection of 211 donor eyes which were obtained from Central Eye Bank at St. Mary's Hospital from April 1, 1990 to September 30, 1991. 1. In sex and age distribution, 112 (53.1 %) donors were male, and 121 (57.3%) donors were above 61 years of age. The age group from 71 to 80 years was the most common (47 donors; 22.3%). 2. The most common cause of death was respiratory disease (75 donors; 35.6%), and then circulatory disease (53 donors; 25.1 %), tumor (35 donors; 16.6%) and infectious disease ( 29 donors; 13.7%). 3. 197 (93.4%) donor eyes were required within 6 hours from death to enucleation. 4. The conjunctival and limbal cultures of 211 donor eyes which were irrigated by 0.3% gentamicin eyedrop solution after extraction were positive in 56 eyes (26.5%). 5. The most prevailing cultured organism was Staphylococcus aureus (14 eyes; 25.0%). 6. Hepatitis B surface antigen in aqueous humor of all donor eyes was negative.

Clinical Evaluations of Recurrence after Keratoplasty in Herpes Simplex Keratitis

We conducted a retrospective study of 30 penetrating keratoplasties (30 patients) for corneal opacity due to herpes simplex keratitis from Jan. 1980 to Dec. 1989 at St. Mary's Hospital. The follow-up periods ranged from 1.3 years to 11 years (mean; 4.8 years). Overall, 23 out of the 30 transplants (76.7%) remained clear grafted cornea and 18 eyes (60%) achieved good to excellent visual acuities (0.3 or better). Herpes simplex keratitis was inactive at the time of corneal transplantation in 27 eyes (90%) and the recurrent rate after surgery was 18.5%. Patients with active ulceration or perforation, had particularly poor success rates. The overall rate of recurrent herpetic keratitis after transplantation for herpes was 26.6% Preoperative corneal neovascularization was not a statistically significant prognostic factor with regard to final visual outcome, graft clarity, graft rejection or recurrent herpetic keratitis.

Clinical Evaluations of Recurrence after Keratoplasty in Herpes Simplex Keratitis

We conducted a retrospective study of 30 penetrating keratoplasties (30 patients) for corneal opacity due to herpes simplex keratitis from Jan. 1980 to Dec. 1989 at St. Mary's Hospital. The follow-up periods ranged from 1.3 years to 11 years (mean; 4.8 years). Overall, 23 out of the 30 transplants (76.7%) remained clear grafted cornea and 18 eyes (60%) achieved good to excellent visual acuities (0.3 or better). Herpes simplex keratitis was inactive at the time of corneal transplantation in 27 eyes (90%) and the recurrent rate after surgery was 18.5%. Patients with active ulceration or perforation, had particularly poor success rates. The overall rate of recurrent herpetic keratitis after transplantation for herpes was 26.6% Preoperative corneal neovascularization was not a statistically significant prognostic factor with regard to final visual outcome, graft clarity, graft rejection or recurrent herpetic keratitis.