Diagnosis and Treatment of Vitreomacular Traction Syndrome Using Optical Coherence Tomography

PURPOSE: To determine the benefit of optical coherence tomography (OCT) in the diagnosis of vitreomacular traction syndrome and evaluate the vitreoretinal interface before and after vitreous surgery. METHODS: Medical records of five patients with vitreomacular traction syndrome who had undergone vitrectomy were reviewed. Preoperative and postoperative visual acuity and preoperative and postoperative OCT were reviewed. In all patients OCT demonstrated posterior vitreous detachment and a focal adhesion of hyaloid membrane to macula with traction on the foveal retinal tissue. All of them underwent pars plana vitrectomy with peeling of poterior hyaloid face. RESULTS: Visual acuity improved in 4 eyes after the first vitrectomy. One eye developed postoperatively a macular hole, which was treated with the second vitrectomy and intravitreal gas tamponade with subsequent improvement in vision. In 4 eyes, OCT showed elimination of vitreous strand, relief of vitreous traction and restoration of normal foveal contour after vitrectomy. CONCLUSION: Optical coherence tomography is a useful tool in the diagnosis of vitreomacular traction syndrome and in the evaluation of status of vitreoretinal interface before and after vitrectomy. Following pars plana vitrectomy, vision improved and normal foveal contour was restored.

Clinical Analysis of Low Vision Patients

We retrospectively evaluated the 130 low vision patients on the basis of medical recordings. Men(58.5%) were more than women. The patients in teen-age(11-20yr) were most common(23.9%). Etiologies were aphakia due to congenital cataract(21.5%), macular degeneration(15.4%), and optic atrophy(13.8%) in that order. Low vision aids were prescribed for rehabilitation of the low vision. High-power plus glasses(25.4%), magnifiers(24.6%), and telemicroscope(7.9%) were low vision aids commonly prescribed for near vision, while hand-held telescope(23.8%) was the most popular for distance vision aids. High-power plus glasses were actually worn by 31 of 32 patients prescribed for them.

Corneal Endothelial Cell Change after Small Incision Cataract Surgery

Recently phacoemulsification with about 3mm small incision and implantation of foldable silicone intraocular lens (IOL) has been widely used. We performed this study to determine the changes of central corneal endothelium with time after surgery and the effect of the surgical skill and age of patient on endothelial cell loss(ECL). We evaluated 198 patients(198 eyes). The patients was randomly divided into expert(E) and biginner(B) group. The non-contact specular microscopy was performed at preoperative and postoperative 1 week, 1 month, 2 months and 3 months and ECL(%) was calculated. Mean ECL of E group was lower than that of B group. The differencewas statistically significant in the patients younger than 60 years(p<0.05). In E group, mean ECL of postoperative 1 week was higher than that of 1 month. However, the mean ECL of B group at postoperative 1 week was lower than that of 1 month. It was statistically significant in patients younger than 60 years(p<0.05). The patients older than 60 years showed higher ECL than young group. It was statistically significant at postoperative 1 week and 3 months in E gorups(p<0.05). From these results, we conclude that the changes of central corneal endothelial cell count after small incision cataract surgery are different according to the skill of surgeon and the age of patient.

The Effect on the Dryness of Eye during VDT Work

The ocular symptoms of visual display terminal (VDT) syndrome are caused by asthenopia, electromagnetic waves, and eye fatigue. To find out what cause make the fatigue of eye during VDT work, we measured frequency of blinking and height of palpebral fissure at near, reading a book, and during VDT work. Tear film break-up time(BUT) was measured immediately after the VDT work and during reading a book. The frequency of blinking during VDT work and book reading decreased significantly comparing with the one at rest (p<0.01). The average frequency of blinking is 20.52 +/- 5.89/min at rest, 8.29 +/- 4.15/min at VDT work, and 10.31 +/- 5.48/min at reading. The BUT measured immediately after VDT work decreased much more than in the resting state (p<0.01). The average BUT was 11.52 +/- 3.41sec at rest and 6.18 +/- 2.65sec immediately after VDT work. The height of palpebral fissure during VDT work increased significantly comparing with the value at rest (p<0.01). The average height of palpebral fissure was 7.39 +/- 0.78mm at rest and 8.83 +/- 0.75mm during VDT work. This study reveals the fatigue of eye during VDT work was induced by the dryness of eye resulted from the increased evaporation due to the decrement in the frequency of blinking and the widening of palpebral fissure. To prevent the fatigue of eye caused by dryness during VDT work, it is important for VDT workers to intend to blink frequently, place VDT lower than eye level to reduce the height of palpebral fissure, humidify the room adequately, put artificial eye tear in eye frequently, and take a rest after 20 mimutes work at least.

The Effects of Single Intraoperative Application of Mitomycin C Soaked Cottonoid on the Wound Healing

The histopathological changes were observed to evaluate the effect of single intraopferative application of mitomycin C soaked Cottonoid on wound healing process after strabismus surgery. A 3mm recession of the superior rectus muscle was performed after application of 0.5mg/ml mitomycin C soaked Cottonoid for 5 minutes in one eye of 15 rabbits(30 eyes) and was copiously irrigated with normal saline. The same procedure was done in the contralateral eye as a control using normal saline. The less amount of inflammatory cellular infiltration and the less granulomatous reaction to suture material were observed in mitomycin C treated eyes. The proliferation of fibroblast was considerably inhibited in mitomycin C-treated group. The postoperative adhesion, the fibrosis of extrocular muscle and the depositon of collagen fibers were also decreased in mitomycin C-treated group. Gross complications was not present in rabbit during 3 months of experiment. No pathologic sign of undesirable side effects was noted. In conclusion, the single intraoperative application of mitomycin C soaked Cottonoid could decrease the postoperative adhesion and extraocular muscle fibrosis through its inhibitory effects on the inflammatory reaction and fibroblast proliferation in strabismus surgery without any complications which were reported in subconjunctival injection of mitomycin C. Further studies investigating the optimal concentration, application method and time of mitomycin C soaked Cottonoid and its promising potential for use in humans are needed.

Glaucoma Screening: in the Outpatient Department and in the Homes for thee Aged

Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).

Glaucoma Screening: in the Outpatient Department and in the Homes for thee Aged

Glaucoma screening is an important means of detecting early cases of glaucoma. It is particularly valuable if targeted either at groups who otherwise do not have access to the health care system or at groups who have the risk factors for glaucoma such as aging, being male and having a medical history of diabetes or vascular diseases. We conducted glaucoma screenings by tonometry and direct ophthalmoscopy in the outpatient department of ophthalmology at Korea University Haewha Hospital and in the homes for the aged that are located in Seoul between Sep. 1987 and Sep. 1989. A total of 282 subjects were screened in the outpatient department and 198 subjects were screened in the homes for the aged. Referral rate was 6.7% and 3.0%, respectively. Groups who have the risk factors showed greater referral rates than groups who have not, but they are not statistically significant(p>0.05).

The Change of the Squint Angle Under General Anesthesia Using Pancronium Bromide(Myoblock(R))

The use of succinylcholine chloride(Anectin(R)) prior to intubation, can cause increased contracture of ocular muscles. Therefore the authors studied the change of the squint angle under general anesthesia using pancronium bromide (Myoblock(R)) in 81 horizontal strabismus patients who had no neurologic disease and mechanical restrictions of eye movement. We used the alternative cover test and Krimsky method to measure the eye position under general anesthesia.