Surgical Results Following Cataract Surgery in Diabetic Patients

The authors retrospectively evaluated 75 diabetic patients (92 eyes) who underwent cataract surgery between January 1995 and December 1997. The minimum follow up period was one year. We analysed retrospectively the final visual cuity, the incidence and risk factors of progression of diabetic retinopathy after cataract surgery. The improvement of visual acuity more than 2 lines was achieved in 81 eyes (88.0%). Seventy two eyes (78.3%) achieved the final visual acuity of more than 0.5. In moderate or severe nonproli- ferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy(PDR)groups, visual acuity improvement was less than in no or mild NPDR group (p=0.001). Progression of retinopathy occurred in 21 out of 82 eyes (25.6%)one year following surgery and was associated with presence of diabetic nephropathy (p=0.018). The rates of retinopathy progression were higher in patients with longer duration of diabetes or insulin treatment than shorter duration of diabetes, or dietary or oral hypoglycemic treatment, but differences did not reach a significant level.

A Case of Central Serous Chorioretinopathy with Bullous Retinal Detachment

Central serous chorioretinopathy(CSC) is a retinal disorder that typically affects young and middle-aged adults. It is characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, causing a circumscribed area of retinal detachment. It is essentially benign and self-limited, generally requiring no treatment. However, a few patients have permanent visual loss because of subretinal fibrosis following a nonrhegmatogenous, bullous retinal detachment with shifting subretinal fluid. The authors experienced a case of CSC with bilateral bullous retinal detachment in a 36 year old male patient. A subretinal fibrotic band developed in both maculae and permanent visual loss of both eyes occurred. We report this unusual case with literature review.

Impression Cytology Study of Conjunctival Cytotoxicity Caused by Instillation of Low-Dose Mitomycin C

We conducted a prospective case-control study to evaluate the conjunctival cytotoxicity of low-dose mitomycin C instillation by impression cytology which was performed preoperatively, postoperative 1 week and 2 weeks in patients undergoing pterygium excision. The case group consisted of 35 patients with postoperative 0.02% topical mitomycin C for 1 week and the control group consisted of 10 patients without postoperative mitomycin C. Impression cytologic findings were graded to 4 scores. Compared to preoperative values there was stastically significant difference in grading scores at postoperative 1 week and 2 weeks (P=0.001, 0.0026) between the groups. Within the case group, the grading scores after 1 week were significantly higher than preoperative values (P=0.0001), but grading scores a 2 weeks decreased significantly compared to those at 1 week and the prevalence of grade 2 or more was also decreased from 40% to 20%. The patients over 50 years of age showed significantly higher gading scores than the patients below 50 years of age (P=0.0038) up to 2 weeks within the case group. Our results revealed that the conjunctiva could be damaged by lowdose mitomycin C and this damage may be more severe and persist longer in elderly. This study suggests that the possible conjunctival cyotoxicity should be considered when using topical mitomycin C eyedrops in management of glaucoma.