Clinical Evaluationnof Monovision Induced by Laser Thermal Keratoplasty (LTK)

PURPOSE: To evaluate clinical effects of laser thermal keratoplasty (LTK), LTK was performed in patients with presbyopia or hyperopia. METHODS: LTK was performed in 38 patients who was older than 45 between May and December 2001. Preoperative contact lens fitting and wearing for patients to experience the monovision was tried in all patients for one week. With LTK, we intended patients used dominant eyes for distance vision and nondominant eyes for near vision. Patients' satisfaction, refractive change and near visual acuity were evaluated for least 3 months after surgery. RESULTS: The mean improvement of near vision was 5.16 lines by test with Korean near vision chart. 79% (30 of 38) of patients were satisfied with the results of LTK. CONCLUSIONS: Monovision with LTK is thought to be a good option in patients with presbyopia.

The clinical outcomes of Occlusion for Monocular Amblyopia in Children More than 8 years

PURPOSE: We schemed to help the therapeutic plan in amblyopic children of old age group by analyzing the clinical outcomes of occlusion therapy in amblyopic children more than 8 years old. METHODS: In 104 unilateral amblyopic children whose occlusion therapy had been finished, the retrospective study was performed. The average age at the beginning of treatment was 5.9 years (1.2~15.2 years). We divide the patients into three groups on the basis of age at the beginning of treatment: below 4 years (group 1, N=41), 5~7 years (group 2, N=44), more than 8 years (group 3, N=19). The success rate of occlusion therapy in group 3 was compared with the success rate of other groups, and the clinical features of group 3 were analyzed. RESULTS: The success rate of occlusion therapy in group 3 (68.4%) was significantly low compared with other groups (p<0.05). In group 3, the success rate of anisometropic amblyopia (90.0%) was significnatly higher compared with the success rate of strabismic amblyopia (44.4%)(P<0.05), and it was similar to the success rate of anisometropic amblyopia of other groups. CONCLUSIONS: The success rate of occlusion therapy in amblyopic children more than 8 years old was significantly lower compared with other groups. But the clinical outcomes were fair, especially in anisometropic amblyopia. We suggest to enforce occlusion therapy in amblyopic children more than 8 years old.

Clinical Results of Penetrating Keratoplasty after Glaucoma Surgery

PURPOSE: We retrospectively reviewed the medical records of the patients who had undergone penetrating keratoplasty after glaucoma surgery, to evaluate the surgical outcome of penenetrating keratoplasty associated with glaucoma surgery. METHODS: Twelve patients, 12 eyes were reviewed. Graft status and postoperative intraocular pressure were main outcome measures. And success was defined as thin, clear corneal graft and IOP control between 6 and 21 mmHg after at least 6 month follow-up. RESULTS: The mean age of the patients was 40 year old and male to female ratio was 9 to 3. Mean postoperative follow up time was 12 months for Penetrating keratoplasty and the mean period between glaucoma surgery and penetrating keratoplasty was 12 months. Seventy five percent(9 eyes) maintained clear corneal graft and 67%(8 eyes) showed successful IOP control and both clear graft and IOP control in 58%(7 eyes). CONCLUSIONS: Fifty-eight percent(58%) of our cases showed successful outcome. With the knowledge of better timing for a surgical intervention and an improvement of surgical techniques, there will be an increased success rate.