Comparison of Higher Order Aberrations and Astigmatism after On-Axis Small Incision Cataract Surgery

PURPOSE: To assess the changes of corneal astigmatism and higher order aberrations (HOAs) of the anterior and posterior corneal surface after cataract surgery with on-axis clear corneal incision in eyes with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism. METHODS: This study included 50 patients who underwent phacoemulsification and IOL insertion through a 2.8-mm on-axis clear corneal incision. The eyes were divided into two groups: (1) 26 eyes with WTR astigmatism with a superior incision and (2) 24 eyes with ATR astigmatism with a temporal incision. During the follow-up period, visual acuity was measured, and the surgically induced astigmatism (SIA) and HOAs of the anterior and posterior corneal surface were measured with Pentacam(R) (Occlus, Wetzlar, Germany) preoperatively and 1 week, 1 month, and 2 months postoperatively. RESULTS: There were no significant differences in UCVA and BCVA between the two groups. HOAs increased in both groups 1 week after surgery, but no significant differences were found between the groups (p > 0.05). Surgically induced astigmatism was larger in the WTR group than in the ATR group (p < 0.05). At postoperative 2 months, there were significant differences in HOAs between the two groups, and there were statistically significant differences in HOAs, oblique trefoil at front side, and in HOAs, horizontal coma at rear side (p < 0.05). CONCLUSIONS: In conclusion, superior incision in eyes with WTR astigmatism resulted in higher SIA compared to temporal incision in eyes with ATR astigmatism. Moreover, HOAs was significantly decreased in eyes with WTR astigmatism with superior incision. Thus, superior incision could be more effective in reducing corneal astigmatism in eyes with WTR astigmatism.

Eight-Year Follow-up of Laser Epithelial Keratomileusis for Correcting Moderate and High Myopia

PURPOSE: To evaluate the long-term prognosis and complications of laser epithelial keratomileusis (LASEK). METHODS: A retrospective study including 92 eyes of 46 myopic patients treated with LASEK from November 1999 to February 2003 was performed. Follow-up visits were at 3 months, 6 months, 1 year, and 8 years. Treated eyes were divided into 2 groups according to preoperative spherical equivalent (SE) : low and medium myopia (-6.0 D). The main outcome measures were UCVA, BCVA, postoperative SE, efficacy index, safety index, predictability, and postoperative complications. RESULTS: Preoperative visual acuity was 1.24 +/- 0.42 log MAR, and the average of SE was -5.28 +/- 1.63 D. Postoperative visual acuity log MAR was significantly improved compared to preoperative visual acuity, and the average of visual acuity was 0.12 +/- 0.13 log MAR. The percentage of eyes within +/- 1.0 D of emmetropia 8 years after having LASEK was 69.5% in the mild and moderate myopia group, and 63.6% in the high myopia group. There was no significant difference of safety index, efficacy index or complications between the 2 groups at 1 month, 3 months, 1 year, and 8 years. Safety index was maintained over 0.9 and efficacy index was larger than 0.8. There were no other complications during the observation period. CONCLUSIONS: An 8-year follow-up showed LASEK for mild to moderate and high myopia to be a safe and effective procedure.

A Giant Pleomorphic Adenoma of Lacrimal Gland Involving the Palpebral Lobe Causing Severe Mechanical Ptosis

PURPOSE: To report a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe causing severe mechanical ptosis and visual field defect, which was removed successfully. CASE SUMMARY: An 82-year-old man visited our clinic with a large protruding mass on his left upper lid that had grown for approximately 10 years causing severe ptosis. Preoperative orbital CT showed a 2.3 x 2.0 cm sized large mass which was suspicious of hemangioma. The mass was completely excised through a lid crease incision. The histopathologic examination showed typical findings of pleomorphic adenoma. After the surgery, preoperative mechanical ptosis was completely resolved and during the 6 months of follow-up, there was no abnormality of tear secretion and evidence of tumor recurrence. CONCLUSIONS: The authors experienced a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe and resolved mechanical ptosis by complete removal of the tumor through a lid crease incision.

Anterior Lumbar Interbody Fusion for Focal Type of Degenerative Flat Back: Preliminary Report

OBJECTIVE: The purpose of this study is to determine the efficacy of anterior lumbar interbody fusion(ALIF) for the patients with focal type of degenerative flat back. METHODS: The authors reviewed clinical and radiologic data of 16 patients with focal type of degenerative flat back who underwent ALIF during the period between December 1999 and November 2000. The operation procedure was ALIF using titanium or carbon fiber cages of lordotic angle, which were filled with allograft or autograft mixed with allograft through minilaparotomy. RESULTS: The majority of the patients were female(15 female: 1 male) and the mean age was 60.1 years. Six patients were operated on one level, ten on two levels. The mean follow up period was 10.7 months. The mean operation time was 131minutes and the average estimated blood loss was 133ml. Transfusion was not needed in any case. The mean preoperative lumbar lordotic angle was 4.1 degree(-7.4-41.6) and improved to 17.5 degree(-4.5-41.9) postoperatively. Radiological fusion was achieved in 13 patients(81%). The Oswestry disability index score improved from 62.5% to 23.9% and the patient's subjective improvement rate was 80%. Complications were infection in one patient, incisional hernia in one, symptomatic pseudoarthrosis in one and transient sympathetic disturbance in left leg in three. CONCLUSION: In a subset of the patients with degenerative flat back who showed disc degeneration in one or two levels, ALIF using cages improved patient's symptoms effectively. It seems that ALIF through minilaparotomy can be one of the surgical options in the treatment of the focal type of degenerative flat back.

Clinical Analysis of Anterior Fixation with Caspar Plate in Unstable Cervial Spine

The authors analyzed 19 cases of unstable cervical spine injuries who had been treated by anterolateral approach with Caspar plate at the department of neurosurgery of Hangang Sacred Heart hospital during 3 years from 1989. The results were as follows: 1) The unstable cervical spine injury was most common in 3rd decade of age. Male to female ratio was 3.75:1. 2) Regarding the level of injury, C5-6 injury was most common. 3) The most common cause of injury was fall down from height(47.4%) and the next was traffic accident(36.8). 4) In all cases received anterior reconstructive surgery using Caspar plate showed significant neurologic improvement. 5) In all cases received anterior reconstructive surgery showed a good restoration of cervical spinal stability. 6) The major surgical complication was esophageal fistula and all complications were treated without any sequelae. 7) Anterior reconstructive surgery using Caspar plate is considered one of the surgical options in patient of cervical spine injury with severe instability.

A Study on the Growth Pattern, History of Respiratory Illness and Family History in Acute Bronchiolitis

No abstract available.