Primary Cutaneous Adenoid Cystic Carcinoma on Lower Lid

PURPOSE: Primary cutaneous adenoid cystic carcinoma(PCACC) is a very rare malignant tumor originating from the eccrine glands of skin and 39 cases have been reported in the world literature. We report PCACC on the lower lid with metastasis to the lung and brain. METHOD: 56 years old man visited because of hard mass on left lower lid which developed 18 months ago. On punch biopsy the mass showed malignant nature and it was removed by wedge resection method with clear margin. RESULT: Adenoid cystic carcinoma was diagnosed by histologic exam of removed mass and it was diagnosed PCACC because salivary gland region is normal and systemic exam shows no abnormality. After 2 years 10 months recurrent tumor developed on medial lower lid and zygomatic area. We tried to remove mass totally but it failed. Metastases to lung and brain developed.

Change of Visual Acuity and Astigmatism after Operation in Epiblepharon Children

To study the relationship between the corneal erosion by inverted eyelash and the degree of astigmatism and visual acuity, we reviewed the surgical recorders of epiblepharon children. We classified 106 eyes of 53 children as 3 groups according to the area of corneal erosion(grade I:confined below pupil, grade II:involving pupil partially, grade III:involving pupil totally). We examined uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and noncycloplegic auto-refraction test before and 1 month after surgery. Mean UCVA was increased from 0.61 before surgery to 0.71 after surgery and mean BCVA was increased from 0.82 to 0.89 and the differences were stastically significant(p0.05). The degree of visual improvement and astigmatic decrease was similar in 3 groups. In conclusion in epiblepharon children the visual acuity was poor more likely due to corneal erosion itself than due to refractive error like astigmatism. In epiblepharon children with-the-rule astigmatism was more prevalent than in normal children before and after the surgery.

Surgically Induced Astigmatism after Temporal Clear Corneal Incision in Sutureless Cataract Surgery

The purpose of the study was to evaluate the postoperative change of keratometric astigmatisms according to preoperative. A total of 254 eyes were underwent phacoemulsification and foldable silicone posterior chamber lens implantation using 3.2mm temporal clear corneal incision. The subjects were divided into five groups: Group 1(aganist the rule >1.25D), Group 2(ATR 1.25D) and emmetropia according to preoperative astigmatisms. Mean preoperative astigmatism was -0.19+/-0.97D. At 6 months after operation, mean surgically induced stigmatism(SIA) was 0.41+/-0.60, and remained astigmatism was 0.27+/-0.98D. SIA in group 1, 2 was less than in group 3, 4. The difference was stastically significant at 6 months after operation(p<0.05). The change of astigmatism in group 1 was -1.83+/-0.48D preoperatively, -0.75+/-0.50D at 6 months after operation, in group 2 -0.58+/-0.28D preoperatively, 0.02+/-0.50D at 6 months, in group 3 0.45+/-0.25D preoperatively, 0.50+/-0.43D at 6 months, and in group4 1.90+/-0.25D preoperatively, 3.17+/-0.23D at 6 months. In group 4, the proportion of patients who had astigmatism within 1D was only 20% at months after operation and none 6 months after operation. In conclusion, temporal clear corneal incision induces more astigmatisms in preoperative ATR group than in WTR group. And the Patients who have preoperative astigmatism larger than WTR 1.25D seem to be needed an additional correction of astigmatism or change the location of incision in temporal clear corneal incision cataract surgery.

Comparison of Surgically Induced Astigmatism between Superior and Temporal Clear Corneal Incision in Sutureless Cataract Surgery

Postoperative changes of keratometric astigmatism were analysed in 137 cases of phacoemulsification and foldable silicone posterior chamber lens implantation using clear corneal incision. The subjects were divided into two groups; Group 1 comprised 36 eyes which underwent surgery using a superior approach, Group 2 comprised 101 eyes which underwent surgery using a temporal approach. Surgically induced keratometric astigmatism in Group 1 was -1.14+/-1.02 diopter(D) at one day, -0.98+/-1.03 D at one week, -0.58+/-0.94 D at two months after operation, and in Group 2 was 0.69+/-0.97 D at one day, 0.96+/-1.08 at one week, 0.63+/-0.68 at two months after operation. The difference of absolute astigmatism between two groups was statistically significant(p<0.05) at one day after operation. But there was no statistically significant difference at one week and two months after operation. Temporal incision induced less astigmatism than superior incision temporarily in cataract surgery using clear corneal incision.

Lyophilized Dura Mater Patch Graft in Glaucoma Valve Implantation

This study was performed to know effectiveness and safety of cadaveric lyophilized dura mater grafts(Lyodura, B.Braun Melsungen, Germany) to cover glaucoma implant tube. Tewnty-seven eyes of 25 patients who underwent glaucoma implant surgery between April 1996 and September 1997 received a lyophilized dura mater patch graft to cover the subconjunctival portion of the tube and then followed up for clinical signs. The mean follow up visit was 10.3 months (range: 5-18 months). All eyes tolerated the lyophilized dura mater grafts well without clinical signs of graft related conjunctival, scleral, of intraocular inflammation. And no conjunctival erosion or melting of the graft was observed. The result of this study suggests that preserved dura mater is maybe a reasonable alternative to eye bank sclera for use in glaucoma implant surgery.