The Frequency and Aspects of Ptosis in Korean Old Age

PURPOSE: To study the frequency and aspects of ptosis in Koreans aged 50 years or older. METHODS: In this study, 377 elderly people visiting retirement center were included. Margin-reflex distance 1 (MRD1) and palpebral fissure (PF) were evaluated with an attempt to eliminate eyebrow elevation. Levator function (LF) was measured with Berke's method. If the measured MRD1 was less than 2 mm, ptosis was diagnosed and its frequency, relation to sex, age, levator function and superior deep sulcus were investigated. RESULTS: There was a correlation between decreasing MRD1, PF and LF with increasing age. Ptosis was observed in 207 subjects (54.9%), and its frequency was augmented as age increased. Although it was not statistically significant, the levator function of those with ptosis (10.0+/-1.9 mm) was lower than those without ptosis (11.3+/-1.9 mm). Questionnaires were administered and 196 respondents (51%) said that their eyelid droop had become more pronounced over time. Among these respondents, 33 (16.1%) indicated that their droopy eyelid causes discomfort by blocking their vision. Their MRD1 was 1.2+/-1.0 mm, which was significantly lower than that of the other 163 respondents (1.8+/-1.1 mm, P<0.05). CONCLUSIONS: Koreans aged 50 years or older showed a very high frequency (54.9%) of ptosis and as age increased, the frequency of ptosis also increased. Surgical correction is recommended when the ptosis causes patient discomfort due to impaired vision.

The Frequency and Aspects of Ptosis in Korean Old Age

PURPOSE: To study the frequency and aspects of ptosis in Koreans aged 50 years or older. METHODS: In this study, 377 elderly people visiting retirement center were included. Margin-reflex distance 1 (MRD1) and palpebral fissure (PF) were evaluated with an attempt to eliminate eyebrow elevation. Levator function (LF) was measured with Berke's method. If the measured MRD1 was less than 2 mm, ptosis was diagnosed and its frequency, relation to sex, age, levator function and superior deep sulcus were investigated. RESULTS: There was a correlation between decreasing MRD1, PF and LF with increasing age. Ptosis was observed in 207 subjects (54.9%), and its frequency was augmented as age increased. Although it was not statistically significant, the levator function of those with ptosis (10.0+/-1.9 mm) was lower than those without ptosis (11.3+/-1.9 mm). Questionnaires were administered and 196 respondents (51%) said that their eyelid droop had become more pronounced over time. Among these respondents, 33 (16.1%) indicated that their droopy eyelid causes discomfort by blocking their vision. Their MRD1 was 1.2+/-1.0 mm, which was significantly lower than that of the other 163 respondents (1.8+/-1.1 mm, P<0.05). CONCLUSIONS: Koreans aged 50 years or older showed a very high frequency (54.9%) of ptosis and as age increased, the frequency of ptosis also increased. Surgical correction is recommended when the ptosis causes patient discomfort due to impaired vision.

The Change of the Corneal Endothelial Cell after Acute Angle Closure Glaucoma

PURPOSE: To evaluate the change of corneal endothelial cell following acute angle closure glaucoma attack, the central endothelial cell between the affected and the fellow eye was compared. METHODS: Twelve patients with uniocular acute angle closure glaucoma were enrolled. After acute attacks were resolved with medical treatment, 12 affected and 12 fellow eyes received laser peripheral iridotomy. The central endothelial cell counts of the affected and the fellow eyes were measured with specular microscope. RESULTS: While the mean central endothelial cell count of the affected eye was 1758.67+/-794.33 cells/mm2, that of the fellow eye was 2727.17+/-355.20 cells/mm2. The average difference of endothelial cell count between the affected and the fellow eye was 968.5 cells/mm2. It showed a mean decrease in cell density of 35.51% (p=0.000). There was a clear correlation between the duration of elevated pressure and the number of central corneal endothelial cells lost (p=0.014). CONCLUSIONS: Even if the intraocular pressure was well controlled after acute angle closure glaucoma attack, the endothelial cell count of cornea can be decreased. Therefore, if acute angle closure glaucoma attack occurs, intraocular pressure should be reduced immediately. If the eye attacked by acute angle closure glaucoma is to have intraocular surgery, there clearly needs to be care not to injure the endothelium and measure the endothelial cell count preoperatively.

The Effect of Amniotic Membrane Transplantation on Corneal Epithelial Cell Proliferation

PURPOSE: to investigate the effect of amniotic membrane transplantation (AMT) on corneal epithelial healing. METHODS: A 4-mm epithelial debridement was made in central rabbit cornea. Then, human amniotic membrane was transplanted (AMT group) or a contact lens was applied (contact lens group). The contralateral eyes were unwounded as controls. After surgery 5-bromo-2'-deoxyuridine (BrdU) was injected via ear vein. Each corneal tissue including the limbus was obtained on postoperative 12, 24 and 48 hours. Proliferating cell nuclear antigen (PCNA) in limbal and peripheral corneal epithelium and keratinocyte growth factor (KGF) in limbal stroma were immunolocalized by immunohistochemical method. Incorporation of BrdU in limbal and peripheral corneal epithelium was visualized by indirect immunofluorescent method. RESULTS: AMT group significantly accelerated the expression of PCNA and BrdU at limbal and peripheral corneal epithelial cells. The expression of PCNA and BrdU showed a peak at 24hr in both groups and increased in limbal epithelial cells more than peripheral corneal epithelial cell in AMT group. The expression of KGF on limbal keratocyte increased in AMT group more than contact lens group and coincided wiht the expression pattern of PCNA and BrdU. The number of keratocyte in significantly decreased in contanct lens group compared wiht AMT group. CONCLUSION: AMT enhanced corneal epithelial wound healing in vivo by stimulating limbal epithelial proliferation which is indirectly mediated in part by upregulating the expression of KGF, which is a potent epithelial mitogen secreted by limbal keratocytes.

Brimonidine 0.2% versus Apraclonidine 0.5% for Controlling Intraocular Pressure Elevation after Q-switched Nd:YAG Laser Posterior Capsulotomy

PURPOSE: To compare the effectiveness of 0.2% brimonidine tartrate and that of 0.5% apraclonidine hydrochloride for controlling IOP elevation after Nd:YAG laser capsulotomy. METHODS: Thirty eyes were given with 0.2% brimonidine (group 1) and fourteen eyes with 0.5% apraclonidine (group 2) before and after the procedure. Fifteen eyes served as untreated controls (group 3). Intraocular pressure and visual acuity were measured preoperatively and 1 hour, 3 hours, 24 hours, and 1 week postoperatively in all cases. RESULTS: The postoperative mean intraocular pressures of group 3 (14.97+/-3.58, 16.47+/-3.93 mmHg) at 1 hour and 3 hours were statistically significant higher than those of group 1 (11.23+/-3.43, 11.50+/-3.01mmHg), and those of group 2 (10.79+/-3.51, 11.57+/-3.03 mmHg)(p< 0.05), but, there were no statistically significant differences in mean IOP at 1 hour and 3 hours between group 1 and group 2 (P=0.569, P=0.610). At 1 hour and 3 hours, there was no case of IOP elevation of 5 mmHg above baseline in group1 and group 2. but, there were 5 cases (33.3%) at 1 hour and 6 cases (40%) at 3 hours in group 3. CONCLUSIONS: This result suggests that 0.2% brimonidine and 0.5% apraclonidine are equally effective for preventing acute IOP elevation after Nd:YAG laser capsulotomy, that is, 0.2% brimonidine is an effective and well-tolerated agent for preventing acute IOP rises after Nd:YAG laser posterior capsulotomy.