Conjunctival Mini-flap Technique and Conjunctival Autotransplantation in Pterygium Surgery

PURPOSE: To compare postoperative recurrence rates between conjunctival autotransplant ation and the conjunctival mini-flap technique in pterygium surgery and to identify factors associated with postoperative recurrence. METHODS: In a retrospective survey of patients who underwent pterygium surgery between March, 2001 and February, 2004 at Severance Hospital, 49 eyes with pterygium removed by the conjunctival mini-flap technique and 41 eyes that underwent pterygium removal surgery by the conjunctival autotransplantation technique were studied. RESULTS: During the mean follow-up period of 8.79 3.9 months, recurrence of pterygium was observed in 3 of 49 eyes (7.1%) that received the conjunctival mini-flap technique. There were 9 recurrent cases out of 41 eyes (21.9%) that were treated by the conjunctival autotransplantation technique. There was no statistical significance between recurrence rate and age, sex, or previous operation in either of the respective surgical techniques. CONCLUSIONS: This study showed that the conjunctival mini-flap technique has a lower recurrence rate than the conjunctival autotransplantation technique. We also found that the conjunctival mini-flap technique is an effective and safe technique that does not generally cause serious complications.

Treatment of Failed Macular Hole after Vitrectomy by Outpatient Gas Injection and Laser Photocoagulation

PURPOSE: This study aimed to assess the effect of gas injection and laser photocoagulation for patients with opened macular holes who had previously undergone trans pars plana vitrectomy. METHODS: A retrospective study for 6 patients (6 eyes) who had opened macular holes after vitrectomy were treated by an outpatient method consisting of laser photocoagulation to the foveal pigment epithelium followed by injection of 100% SF6 gas. Visual acuity, anatomic status of the macular hole, and complications were evaluated. RESULTS: The length of period of gas injection and laser photocoagulation was distributed to 1 month to 8months (mean 3.2 months) and follow up period was distributed to 8 months to 25 months (mean 14.3months). Three of six eyes with gas injection and laser photocoagulation achieved anatomic success and two of them achieved visual improvement by more than two lines. Three eyes among four phakic eyes developed nucleosclerosis of the lens and one eye developed transient elevation of intraocular pressure. CONCLUSIONS: The outpatient gas injection and laser photocoagulation appears to be a safe and cost-effective alternative to repeated surgery for opened macular holes after trans pars plana vitrectomy.

The Effect of Suturing on the Corneal Perforation During LASIK

PURPOSE: To evaluate the influence of corneal suturing on corneal perforation during LASIK. METHODS: Three eyes from three patients which were perforated during LASIK received corneal suturing and the effect of the suturing on the integrity of the corneas was analyzed. RESULTS: The development of keratectasia was prevented with sutures even though corneal perforation occurred during LASIK in the normal cornea. CONCLUSIONS: The development of keratectasia was prevented with corneal sutures on the perforated cornea during the LASIK, and it might be the result of suture itself and scars causing the adherence of the flap to the stromal bed.

The Relationship between the Dacryoscintigraphy and the Satisfaction with Punctal Occlusion in Patients with Dry Eye Syndrome

PURPOSE: The purpose of this study was to assess the relationship between the result of dacryoscintigraphy and the effect of punctal occlusion in dry eye syndrome. METHODS: Dacryoscintigraphy was performed in 86 eyes with dry eye syndrome and collagen plugs were inserted into low punctum. We evaluated the relationship between the results of dacryoscintigraphy and the effect of punctal occlusion with collagen plugs. RESULTS: In 36 eyes, tear transit time was normal in dacryoscintigraphy (Group I). In 28 eyes, tear transit time was more than 20 minutes (Group II). In 18 eyes, no tear transit was seen during 60 minutes and after dripping of normal saline, tear transit was seen (Group III). In 4 eyes, there was no tear transit after dripping of normal saline (Group IV). Symptom reduction after punctal occlusion with collagen plugs was observed in 34 eyes (94%) of Group I and 22 eyes (79%) of Group II . There was no significant differences between the two groups. In Group III, symptom reduction was observed in 4 eyes (22%) and it showed significant differences between the other groups. CONCLUSIONS: According to this results, punctal occlusion in dry eye syndrome was not effective in patients who showed tear transit after 60 minutes.

A Case of Valsalva-induced Subhyaloid Hemorrhage Nasal to the Optic Disc

PURPOSE: To report a case of valsalva hemorrhagic retinopathy. METHODS: A 14 year-old healthy man who presented with subhyaloidal and subretinal hemorrhages after blowing his nose over 30 times. RESULTS: Initial visual acuity was 20/20 and right fundal examination revealed peripapillary subhyaloidal and subretinal hemorrhages as well as vitreous hemorrhage. Fluorescein angiography demonstrated blocked fluorescences due to the hemorrhage and no leakage from the retinal vessels. At 4 week follow up, corrected visual acuity remained as 20/20 and subhyaloidal and vitreous hemorrhages were completely absorbed. Subretinal hemorrhage decreased significantly.