ABSTRACT
We report a 36-year-old male with the bilateral visual field defect following LASIK was observed. Preoperatively, patient had high myopia(right. -7.25 0.75x18, left. -7.5-0.5x12), normal intraocular pressure(IOP)(right/left: 16/14 mmHg), normal visual field(Humphrey 30-2 visual field)and revealed the tilted discs with symetric optic nerve head cupping(cup-to-disc ratio, 0.70), parapapillary atrophy. Bilateral LASIK keratorefractive surgery was on the same day and intraoperative complication was not noted. After the first operative visit day, examination revealed uncorreted visual acuity right 0.8 and left 0.6 but scotoma was reported. Three months later, Humphrey 30-2 visual field revealed a near-superior altitudinal defect in the right eye and nasal side visual field defect in the left eye. Best corrected visual acuity was 1.0 in the right eye, 0.8 in the left eye. Repeated visual fields over a 11-month period postoperatively showed stability of the defect, with IOP of 12 mmHg to 15 mmHg in each eye. We considered LASIK uses a microkeratome vaccum ring to make a corneal flap, transient elevation of IOP alters the microcirculation of optic nerve head and may have precipitated visual field defect.
Subject(s)
Adult , Humans , Male , Atrophy , Intraoperative Complications , Keratomileusis, Laser In Situ , Microcirculation , Optic Disk , Scotoma , Visual Acuity , Visual FieldsABSTRACT
Anatomical examinations on Bruch's membrane have almost been by light microscopy or transmission electron microscopy. Scanning electron microscopy allowed us to evaluate surface features topographically. Each layer of Bruch's membrane was exposed sequentially to mechanical or enzymatic treatment of the retinal pigment epithelium choroid complex from human cadavar eye. The authors examined the surface features of the membrane by dry-cracking scanning electron microscopy. The basement membrane of retinal pigment epithelium appeared like a smooth thin plastic membrane which was framed by collagen fibers. The inner collagenous layer was composed of many collagen fiber bundles which were placed in order and the ground substance between them was not visible. Elastic layer of Burch's membrane appeared to be coarse and fine fibers matted together by some amorphous substance. This layer had many openings on its solid sheet and the outer collagenous zone was visible though these openings.
Subject(s)
Humans , Basement Membrane , Bruch Membrane , Choroid , Collagen , Membranes , Microscopy , Microscopy, Electron, Scanning , Microscopy, Electron, Transmission , Plastics , Retinal Pigment EpitheliumABSTRACT
The surgical methods for the obstruction of nasolacrimal duct include conventional dacryocystorhinostomy and nasal endoscopic dacryocystorhinostomy.The authors followed 52 eyes of 54 patients who had undergone conventional or endoscopic dacryocystorhinostomy to compare the surgical success rate, between the group whose nasolacrimal duct was washed with normal saline and the control group without irrigation. Nasal cavity of all patients were examined for the abnormalities such asnasal septal deviation, hypertropy of middle concha, ethmoid sinusitis and nasal polyp.The patients with those abnormalities were excluded. There was significant difference between the two groups, showing better outcome in the group with nasal irrigation. These results suggest that washing NLD after the dacryocystorhinostomy may be effective as an additional therapy to enhance the success rate of operation.
Subject(s)
Humans , Dacryocystorhinostomy , Ethmoid Sinus , Ethmoid Sinusitis , Nasal Cavity , Nasal Lavage , Nasolacrimal DuctABSTRACT
Meconium peritonitis is a non-bacterial foreign body and chemical peritonitis caused by meconium contamination resulting from bowel perforation during late intrauterine or early neonatal periods. Prenatal ultrasonographic diagnosis of the meconium peritonitis provides the preparation for proper management and decreasing motality and morbidity of the neonate. We have experienced a case of meconium peritonitis diagnosed by ultrasonography at 34+4 gestational weeks and presented this case with a brief review of the literatures.