One Family of Aniridia

Aniridia is a congenital lack of iris and rudimentary iris tissue, almost always bilateral, occuring as a dominant characteristic by an autosomal gene with high penetrance and variable expression. The syndrome of congenital aniridia may be composed of four phenotypes. The authors have experienced one an iridic family: mother, one daughter and four sons. The most family members have ectopia lentis. cataract. corneal pannus and glaucoma as well as aniridia, so they were expected the first phenotype of aniridia due to a failure in development of retinal ectoderm. Two sons of them were operated in Chungnam National University Hospital for control of glaucoma and visual impairment due to cataractous ectopic lens. In one case the intraocular pressure was not controlled after trabeculectomy and in another case lens extraction resulted in visual improvement. The review was made of relating literatures for the case of aniridia family, breifly.

One Operated Case of Diabetic Cataract Induced by RH-787 Intoxication

A new rodenticide, RH-787, made in Rhom and Hass co. was introduced in this country because it was known relatively harmless to human and beasts. But many internists found that RH-787 induces diabetes in human after accidental ingestions. The effects of RH-787 on various organ are still controversial but the associaton of RH-787 with diabetes is now recognized through the clinical and experimental studies. The cataract is not infrequently seen in juvenile diabetics of several years' duration. In the case to be reported, the cataract was appeared more rapidly within about 2 years after known diabetes due to RH-787 intoxication than usual diabetic cataracts, and the visual results were good after bilateral extracapsular lens extractions with peripheral iridectomy, without any complication.

A Clinical Study of The Retinal Detachment Surgery Utilizing Silicone Rubber

A clinical analysis was done for 51 eyes of 50 retinal detachment patients, who operated in the Depart of Ophthalmology, Chungnam National University Hospital during last 3 years. The results were as follows: 1) The maximum incidence of detachment in this study occurred between the ages of 51 and 60 years (30 %), and the next over the age of 61 years (22 %), that was somewhat different comparing with other reports in Korea. Men were more common than women. 2) Of all retinal breaks, the round holes were most common (47.1 %), followed by dialyses (27.5 %) and horse-shoe tears(19.6 %) before the ages of 30 years, cases with disinsertions were frequently observed with trauma 3) The over aU success rate of retinal detachment surgery was 74.5 %. There was no effect on the success rate by the shapes and numbers of the retinal breaks. The shorter the duration. the better the preoperative vision, and the samller the extents of detached area showed the better success rate. 4) The most frequent and main causes of failure were massive vitreous retraction and giant tears. 5) No complications of silicon rubber was observed in the operated eyes, such as foreign body reaction or invasion into the globe after surgery.

Two Cases of Duane's Retraction Syndrome

Duane's retraction syndrome is a deficiency in abduction and a defect in abduction movements, with retraction and narrowing of the palpebral fissure of the affected eye. In addition, there are often an upshoot or downshoot of the affected eye on attempted abduction, widening of the palpebral fissure with abduction and mild to marked defect in convergence. But, the clinical picture in Duane's retraction syndrome is extremely variable. Two cases of Duane's retraction syndrome are presented, each of them is Duane's type I and type III, which are affected on left eye. The literatures relating to this syndrome are briefly reviewed.

Two Operated cases in Juvenile Diabetic Cataract

Of the complictions of cataract extraction, it is well known that hemorrhage, infection and delayed wound healing are more frequent in diabetics than in nondiabetics. But if the extraction was performed after diabetes has adequately controlled for several weeks prior to operation, the visual results are almost as good in diabetics as in non-diabetics. However, with precautions for these complications, the aut hers carefully performed cataract extraction in two juvenile diabetics, whose blood sugar level had been poorly controlled in spited of diabetic diet and subcutaneous injection of the insulin before and after operation. The visual results were very good in spite of high blood sugar level before operation.

Experimental Studies on the Transfer of the Lens-induced Uveitis

This experiment was performed in an attempt to reproduce lens-induced uveitis in the guinea pigs after the passive transfer of the lymphocytes and the serum from animals sensitized to the souble lens protein. Hyperimmune serum and the regional lymph nodes were collected from ten guinea pigs previously immunized with the soluble protein of the beef lenses in complete Freund's adjuvant in four sequences at intervals of one week. The lymph nodes were excised and filtered through a fine mesh and sedimented by centrifugation. Cell concentrations were measured and adjusted so that the final transfer population contained approximately 2 ~ 3 X 10(5) cells in 0.1ml saline. The fresh lymphocytes and the serum were transferred to normal healthy guinea pigs by subconjunctival injection in five sequences at intervals of one week. Then the lenses were perforated by Ziegler's knife, and the eyes were examined clinically and enucleated for histological study at various intervals. The characteristic pictures of the reactions found in the series were summerized as follows; 1) Lymphocytes transferred group(18 eyes). Seven of the 18 eyes(38 9%) developed clinical signs of uveitis on the 5th day and reached peak on the 10th day following needling, and then subsided slowly. The inflammation was characterized by the presence of limbal hyperemia, congestion of the iris, cells and flare in the anterior chamber, and small clusters of fibrin around the lens. Twelve of the 18 eyes (66.7%) showed histological evidence of uveitis. The reactions showed that the polymorphonuclear leucocytes were predominant initially, and in later lymphoidal stage, many small and large lymphocytes predominate with the infiltration of the plasma cells. eosinophils, occasionally the epitheloid cells and fibroblasts in the iris stroma, ciliary body. anterior choroid and around the lens. 2) Serum transferred group(8 eyes). 0.1ml of hyperimmune serum were in jected in 8 eyes in the same manner. Two of the 8 eyes showed clinical signs of uveitis but histologically one revealed mild mononuclear cell infiltration in the anterior part of the uvea and around the lens. 3) Control group (8 eyes) The lymphocytes and the serum taken from the animals immunized only with complete Freund's adjuvant in saline were prepared in the same manner and transferred to 8 eyes. All of the 8 eyes revealed no definite reaction in clinical and histolological studies except the transient traumatic inflammatory reaction. Thus it can be considered that the experimental lens-induced uveitis in the guinea pigs can be transferred to normal healthy animals via hyperimmune lymphocytes and the histologic findings a re similar to endophthalmitis phacoanaphy lactica in human.

A Case of Hallermann-Streiff Syndrome

Twenty years old Korean male patient with Hallermann-Streiff syndrome who developed glaucoma is reported. The clinical features are dyscephalia with mandibulo-oculo-facial malformation, bilateral congenital cataract, dental anomalies, hypotrichosis, microphthalmia, nanism and the secondary complications. A brief review of literature is described.

Failure in Retinal Detachment Surgery

An anaysis has been made of 86 eyes of retinal detachment treated surgically in our hospital during the last 3yrs. The final complete failure rate was 16.6% (14 eyes), and the failure rate in the first operation was 25.5% (24 eyes). The preoperative factors that were found to be significant in leading to failure were young age, delay of surgery over 6 months, large extent of detachment, giant tear and fibrosis of vitreous or retina. The failure rate in the first operation due to inadequate surgical techniques was 32%, and subretinal fluid drainage was not contributory to the failure rate. It was noteworthy that 64% of failed cases were due to M.V.R. Adnavces in knowledge of pathophysiology of vitreous in complicated retinal detachment and in technique of vitreous surgery may reduce the failure rate.

Diagnostic Value of Orbitography in the Space-occupying Orbital Lesions: The report of 11 cases

A techque of positive contrast orbitography with 20% Hypaque was described. A retrobulbar injection of 4.0 to 6.0cc. of 20% Hypaque (50% Hypaque 4.0cc., 2% Lidocain 1.0cc., saline solution 5.0cc.) was performed. Simple skull Cantero-posterior and lateral), Water's, Caldowell and Optic foramen views were obtained in 15 minutes after injection. Space-occupying lesions of the orbit produced radiolucencies within the muscle cone of contrast material or indentation and deformities of the contours of the muscle cone. 11 patients with clinical signs of space-occupying orbital lesions were examined. Tumors were accurately outlined in 8 patients, in one case the investigtiaon was not technically satisfactory and another 2 cases we couldn't confirm by surgical removal. No complications were observed in orbitography. The technique is thought to be superior to negative contrast orbitography and angiography.

Clinical Studies on the Normal Retinal Circulation Times

After injection of See of 10% fluorescein sodium into the antecubital vein, the arm-to-retinal times of 22 normal adults were measured by watching through KOWA fundus camera (exciter filter: Fuji 18, barrier filter: Kodak Wratten 15G), and the retinal circulation times of 13 normal adults were measured with pictures of the serial fluorescein angiography by ZEISS fundus camera (exciter filter: Kodak Wratten 47A, barrier filter: Schott GG14). The normal ranges and the mean values of arm-to-retinal time and retinal circulation time are: 1. Arm-to-retina time; 9.0 sec. - 21.5 sec. (mean; 14.1 sec.). 2. Retinal circulation time; a. Early venous phase; 1.0 sec. - 5.0 sec. (mean; 2.6 sec.). b. Late venous phase; 4.5 sec. - 11.0 sec. (mean: 8.1 sec.).

Positive Contrast Orbitography with the aid of Fluoroscopy

Positive contrast orbitography was performed on 5 cases with hypaque under the fluoroscopy using the General Electric television angio-unit. Tumors were outlined in all cases and their size and extent were verified by operation in four of them. All of patients complained of retro-ocular tension and edema of their conjunctiva and eyelids, but about 3 hours later, there were no remained symptoms except hyperemia of their conjunctiva.

Experimental Glaucoma Induced by The Use of Alpha-Chymotrypsin

Glaucoma was attempted to induce in rabbits by the injection of alpha-chymotrysin into the poster ior chamber. The enzyme solution, 80 units and 375 units, dissolved in 0.2 ml, were used and the changes in the intraocular pressure were recorded. Of 7 eyes injected with 80 units, three eyes showed moderate elevations which lasted 4 to 7 days. Of 3 eyes which received 375 units solution, two eyes showed moderate rise in the intraocular pressure with the duration of 2 to 4 days. There can be found nothing characteristic for the glaucoma...cupping of the disk and degeneration of the optic nerve fiber, etc...in eyes with elevated intraocular pressure. The possible explanations of these transient rise in the intraocular pressure were discussed.

Acute Osteomyelitis of Superior Maxilla, Zygomatic and Frontal bone of Orbital Margin

We experienced one case of an unusual acute osteomyelitis of orbital margin, of which frontal, zygomatic and maxillary bone was involved in 10-month old infant. His clinical symptomes were similar to the acute osteomyelitis of superior maxilla but the primary site seemed to be in the frontal bone by history. We treated him with massive antibiotics and surgery (anterior approach). The causative organism was staphylococcus sureus, being very sensitive to penicillin. Also we reviewed the literatures of the orbital osteomyelitis comparing with thia case.

Effect of the Korean Ginseng on the Normal Dark Adaptation

The dark adaptation processes of the eight normal persons were investigated after ingestion of 700mg of Korean Ginseng extract. The decrease of the thresholds was found particulary during the early phase of dark adaptation in six cases, and in the remaining two cases, these effects were doubtful. The significance of these results in terms of the neural mechanism of the dark adaptation is discussed.

Mitomycin Instillation After Pterygium Surgery

There have been several methods to prevent the recurrence after pterygium surgery, but no satifactory method has been brought forth. The value of mitomycin, which appeares to offer an important contribution to control the recurence of pterygium postoperatively, seems to be due to its anticancerous effect. Also it can be used himself easily. 1. We instilled Mitomycin solution after Pterygium surgery to the 85 eyes (77 Patients) visited to the department of Ophthalmology, Seoul National Univ. Hospital from July, 1969 to March, 1971. 2. Mitomycin solution was instilled three times a day since postoperative first day for one to two weeks. The solution was prepared by solving the Mitomycin-S in the 5cc of distilled water or Mitomycin-C in the 5cc of of physiologic saline sloution, so the concentration of solution was 0.4mg per cc. 3. We used bare sclera method in pterygium surgery and all the members of staffs and residents participated in. 4. Follow-up study was done by direct examinations or questionnaires. The period of the follow-up was at least 6 months to 26 months. We recieved the answers of 58 eyes, among which 56 eyes(96.6%) did not recur and only 2 eyes (3.4%) recurred. Of no recurrent cases 42 eyes (75%) were cosmetically satisfactory and 14 eyes (25%) were moderately satisfactory by means of the patients themselves evaluation. 5. Many authors said that the operative technique contributes to the rate of recurrence, so we compared the result of staffs' cases with that of residents' in 58 eyes. There was no significant difference in the recurrence rate between staff' and residents' cases inspite of the unskillful techniques of residents. 6. Sid effects of Mitomycin solution appeared in 2 eyes; one had corneal erosion and edema, another severe conjunctival congestion and chemosis which disappeared within a few days by ceasing the instilltation of mitomycin solution.