Visual Field Progression in Patients with Primary Open Angle Glaucoma, Normal Tension Glaucoma, and Primary Angle Closure Glaucoma

Purpose@#We compared visual field progression among patients with primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). @*Methods@#A total of 115 POAG, 123 NTG, and 92 PACG eyes were retrospectively analyzed. Global VF progression was evaluated by calculating the changes of mean deviations. To examine local VF deterioration, scotoma enlargement and deepening were analyzed in the superior, and inferior arcuate, and the central, zones. @*Results@#The mean global rate of change in POAG eyes was -0.52 ± 0.74 dB/year, and -0.35 ± 0.41, and -0.38 ± 0.45 dB/year in NTG and PACG eyes; POAG eyes showed significantly more rapid progression than NTG and PACG eyes (p < 0.01). The superior arcuate zone of POAG eyes, the central zone of NTG eyes, and the inferior arcuate zone of PACG eyes exhibited more scotoma enlargement and scotoma deepening than did other zones. @*Conclusions@#The superior arcuate zone of POAG eyes, the central zone of NTG eyes, and the inferior arcuate zone of PACG eyes showed greater VF progression.

Corneal Keloid Case after Laser-assisted in-situ Keratomileusis Surgery in Korea

Purpose@#We report a patient diagnosed with corneal keloid who had laser-assisted in-situ keratomileusis (LASIK).Case summary: A 41-year-old female presented with LASIK 15 years ago. Seven years later, she presented with a growing white corneal mass located in the lower periphery of the right cornea. The best-corrected visual acuity was 0.6 in the right eye and 0.7 in the left eye, and the white lesion was observed in the right cornea at the 5 o’clock position. Anterior segment optical coherence tomography revealed that the mass was invaded by the upper stroma and epithelium, and Bowmans’s membrane was destroyed. Histopathologic examination showed fusiform fibroblasts and disorganized collagen. Taken together, these findings suggested corneal keloids. @*Conclusions@#Corneal keloids is a rare disease that develops, sometimes, after LASIK surgery. Although there have been cases of this reported in the literature, there had yet to be a case of LASIK-induced corneal keloids in Korea until this study, reported here.

Corneal Keloid Case after Laser-assisted in-situ Keratomileusis Surgery in Korea

Purpose@#We report a patient diagnosed with corneal keloid who had laser-assisted in-situ keratomileusis (LASIK).Case summary: A 41-year-old female presented with LASIK 15 years ago. Seven years later, she presented with a growing white corneal mass located in the lower periphery of the right cornea. The best-corrected visual acuity was 0.6 in the right eye and 0.7 in the left eye, and the white lesion was observed in the right cornea at the 5 o’clock position. Anterior segment optical coherence tomography revealed that the mass was invaded by the upper stroma and epithelium, and Bowmans’s membrane was destroyed. Histopathologic examination showed fusiform fibroblasts and disorganized collagen. Taken together, these findings suggested corneal keloids. @*Conclusions@#Corneal keloids is a rare disease that develops, sometimes, after LASIK surgery. Although there have been cases of this reported in the literature, there had yet to be a case of LASIK-induced corneal keloids in Korea until this study, reported here.

Effect of Preoperative Factors and Gonioscopy on Intraocular Pressure Reduction after Phacoemulsification in Glaucoma

PURPOSE: To evaluate a new gonioscopy score and preoperative factors as a potential predictor for intraocular pressure (IOP) reduction after phacoemulsification. METHODS: This is a retrospective review of 182 eyes with glaucoma of either open or narrow angles that underwent phacoemulsification. Preoperative variables such as age, IOP, refractive errors, anterior chamber depth (ACD), axial length, and lens position were evaluated at 6 months after surgery. A preoperative gonioscopy score was created, summing the Shaffer gonioscopy grading in 4 quadrants. To determine variables associated with IOP change at 6 months, univariate and multivariate linear regression analysis was performed. RESULTS: The mean age of the patients was 72.8 ± 9.5 years and the average preoperative IOP was 16.4 ± 3.7 mmHg with 1.2 glaucoma medications. The mean IOP reduction after phacoemulsification was 2.7 ± 2.2 mmHg at postoperative 6 months. Preoperative IOP (β = 0.55, p < 0.001), gonioscopy score (β = −0.29, p < 0.001), ACD (β = −0.67, p = 0.02), and IOP/ACD ratio (β = 0.58, p = 0.01) were associated with IOP reduction at 6 months. CONCLUSIONS: Preoperative predictors for IOP reduction after phacoemulsification were preoperative IOP, ACD, gonioscopy score, and IOP/ACD ratio in patients with glaucoma. The IOP/ACD ratio and gonioscopy score can be easy parameters to obtain and may help clinicians to estimate the IOP reduction after phacoemulsification.

Two Cases of Intraocular Lens Pupillary Optic Capture Treated with Argon Laser Iridotomy

PURPOSE: We report two cases of intraocular lens (IOL) pupillary optic capture following IOL scleral fixation treated with argon laser iridotomy. CASE SUMMARY: (Case 1) A 69-year-old man presented with suddenly decreased visual acuity of the left eye. The best-corrected visual acuity was finger count (FC) 30 cm in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed and no specific findings were observed. During the follow-up period, pupillary optic capture was repeated without specific causes, such as trauma, or IOL decentration thus, argon laser iridotomy was performed. (Case 2) A 77-year-old man presented with a 3-day history of congestion of the left eye and decreased visual acuity. Best-corrected visual acuity was 0.4 logarithm of the minimum angle of resolution (logMAR) in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed, and no specific findings were observed. During the follow-up period, pupillary optic capture was found, and IOL repositioning and argon laser iridotomy were performed. CONCLUSIONS: Laser iridotomy can be used to prevent recurrence of pupillary optic capture in eyes with IOL scleral fixation without decentration or distortion.

A Pilot Study of Changes in Tear Film Short-term Dynamics with Infrared Imaging after Phacoemulsification

PURPOSE: To evaluate the short-term changes in tear film dynamics with non-invasive infrared imaging measurement before and after cataract surgery as a pilot study. METHODS: Seventeen eyes of 17 patients without preoperative dry eye were enrolled in this study. Non-invasive keratograph tear break-up time (NIK-TBUT) and non-invasive keratograph tear meniscus height (NIK-TMH) were measured before and 1 day, 1 week, and 1 month after cataract surgery using a keratograph. RESULTS: The mean patient age was 64.47 ± 10.28 years, and 78.95% were female. Although the mean postoperative 1 day NIK-TBUT-first value was not significantly different from the preoperative value, the mean postoperative 1 week and 1 month NIK-TBUT-first values were significantly lower than preoperative values (p < 0.05). The postoperative 1 day, 1 week, and 1 month NIK-TBUT-average and the NIK-TMH values were not different from preoperative values. CONCLUSIONS: Our study showed that cataract surgery can lead to tear film instability. And it is important to determine the long-term outcomes of surgery and whether NIK-TBUT and NIK-TMH correlate with slit lamp examination tear break-up time (SLE-TBUT) and slit lamp examination tear meniscus height (SLE-TMH).

Comparison of Anterior Chamber Depth Obtained from Applanation and Optical Principle Devices

PURPOSE: To assess the reproducibility and reliability of applanation A-scan ultrasonography (Pacscan 300A, Sonomed Inc., Chicago, IL, USA) and optical measurements with IOL Master(R) (Carl Zeiss Meditec, Germany), Pentacam(R) (Oculus, Wetzlar, Germany), and Orbscan II(R) (Orbtek Inc., Laredo, TX, USA) when measuring anterior chamber depth (ACD). METHODS: In this study of 188 eyes of 94 patients, ACD estimation prior to cataract surgery was preformed by the applanation A-scan method and IOL Master(R), Pentacam(R), and Orbscan II(R) optical methods. Repeatability from each device was evaluated by coefficient of variation, standard deviation, and intraclass correlation coefficient. RM-ANOVA on Ranks was used to compare the differences in ACD among the devices. The Bland-Altman plot was performed to assess agreement in measurements between the devices. RESULTS: The mean ACD according to the applanation A-scan method and IOL Master(R), Pentacam(R), and Orbscan II(R) optical methods were 2.89 +/- 0.49 mm, 3.25 +/- 0.45 mm, 3.21 +/- 0.46 mm, and 3.19 +/- 0.47 mm, respectively, and the differences were statistically significant (p < 0.01). The coefficient of variation for the 4 methods was 2.50% in the A-scan, 0.87% in the IOL Master(R), 1.25% in the Pentacam(R), and 1.04% with Orbscan II(R), and reproducibility was higher with the optical principle devices. The correlation coefficient between A-scan and IOL Master(R) was 0.65, between IOL Master(R) and Pentacam(R) 0.91, between IOL Master(R) and Orbscan II(R) 0.90, between A-scan and Pentacam(R) 0.69, between A-scan and Orbscan II(R) 0.71, and between Pentacam(R) and Orbscan II(R) 0.93. CONCLUSIONS: Applanation A-scan provided lower measurements for ACD compared with IOL Master(R), Pentacam(R) and Orbscan II(R). There was good agreement between results obtained with the latter 3 methods, and reproducibility was high with optical measurements. The coefficient of variation was low for IOL Master(R).