The Surgical Results According to the Amount of Superior Rectus Recession for Dissociated Vertical DeviationDVD

To evaluate the surgical results of superior rectus recession with different amount according to the degree of eyeball deviation.We reviewed the surgical records of 36 eyes in 23 patients who had undergone superior rectus recession and followed up for at least 6 months.Patients were divided into 3 groups according to the degree of deviation : Group 1[8-10PD, 4.0 mm recession], Group 2[11-20PD, 6.0 mmrecession], Group 3[21PD or greater, 8.0 mmrecession].Five PD or less after operation was regarded as acceptable. The success rate of Group 1 was 86.6%at the 6th month, 87.5% at the 12th month, and 83.8%at the 24th onth, respectively.In group 2 those were 87.5%, 75%, and 80%, respectively.In group 3 those were 60%, 50%, and 50%, respectively.The overall success rate as 83.3%at the 6th month, 75% at the 12th month, 75%at the 24th month.These results indicate that superior rectus recession with the different amount according to the degree of eyeball deviation is effective for the deviation under 20PD but not over 21PD.

Effectiveness of Polaroid Photoscreening for Amblyogenic Fctors in Infants & Young Children

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.

Effectiveness of Polaroid Photoscreening for Amblyogenic Fctors in Infants & Young Children

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.

The Effect of Alginic Acid Sodium Salt on Delayed Adjustable Strabismus Surgery

The purpose of this study was to evaluate the effect of the alginic acid sodium salt on the delayed adjustable strabismus surgery by preventing the post operative tissue adhesion. 30 eyes of 15 rabbits had received an adjustable suture surgery. The alginic acid sodium salt of 4% was used during operation in 16 eyes among them by injecting it around the muscle, between the sclera and the conjunctiva. In the 3rd, 5th, 7th, 10th, and 14th day postoperatively, we measured the pulling forces and the moving distances of the muscles during the adjustment. Then the eyes were enucleated and the histopathologic changes of the eyes were determined using the light microscope. The pulling forces and the moving distances of the muscles during the adjustment were significantly different between the alginic acid sodium salt free group and the alginic acid sodium salt used group. In the alginic acid sodium salt used group, the pulling forces were decreased and the moving distances were increased than those of the alginic acid sodium salt free group. The light microscopic examination showed more fibrosis in the alginic acid sodium salt free group than in the alginic acid sodium salt used group. These results suggest that the alginic acid sodium salt is an effective substance for the delayed adjustable suture surgery.

Characteristics of Tear Lipid Layer Patterns on Tearscopy and Lipid Layer Thickness

This study is to evaluate thickness of lipid layer, NIBUT (non-invasive tear film break-up time), BUT and Schirmer value according to tearscopic pattern of lipid layer.The subjects are seventy-one eyes from seventy-one people without ocular diseases.The pattern of lipid layer is observed by Tearscope(r) (Keeler, U.K.)and the thickness of lipid layer is measured by interference generated from slit lamp microscope.The thickness of lipid layer, NIBUT and BUT are respectively measured three times and averaged.In the case of the pattern of lipid layer, eighteen eyes have the close meshwork type, twenty-nine eyes have the wave type, fifteen eyes have the amorphous type and nine eyes have the color fringe type.The average value of the thickness of lipid layer, NIBUT, BUT and Schirmer test were respectively 29.3 nm, 25.9 seconds, 12.0 seconds, 18.6 mm for close meshwork;47.2 nm, 33.6 seconds, 12.5 seconds, 16.9 mm for wave;66.2 nm, 39.7 seconds, 14.9 seconds, 18.7 mm for amorphous;and 74.4 nm, 30.9 seconds, 13.9 seconds, 18.9 mm for color fringe.The thickness of lipid layer was different significantly among the patterns.NIBUT showed significant difference between close meshwork and wave, and between close meshwork and amorphous.The Cronbach alpha, reproducibility of the test, is 0.84 in the thickness of lipid layer, 0.64 in NIBUT, 0.76 in BUT and 0.94 in Schirmer test.The reproducibility of the pattern of lipid layer observed by Tearscope(r) is 95.8%.

Intermediate-term Result of e-PTFE Membrane Implant Surgery for Refractory Glaucomas

Recently, various tube-shunt implants have been used in treating refractory glaucomas.They have large volumed reservoir portion made of hard materials.We made a new implant with soft and freely malleable membrane[expanded polytetrafluoroethylene, e-PTFE]as a reservoir portion attached to the conventional silicone tube. Based on the encouraging result from experimental animal study, we performed a clinical trial for the membrane-tube implant.We performed Glaucoma Tube-Shunt Implant surgery using double layers of e-PTFE membrane and silicone tube with its one end fixed between the two layers.The subjects had refractory glaucomas without useful vision who visited our hospital from May 1991 to Sep.1995. There were 40 eyes of 37 patients and their mean follow-up period was 32.6 months.We could control the IOP within 6~21 mms of mercury in 26 eyes[65.0%, Success].In remaining 14 eyes, we could not control the IOP or additional surgery was needed to control the IOP or treat severe complications[35.0%, Failure].The Kaplan-Meier Survival for IOP control was 78.4% at 1 yr, 71.6%at 2 yr, and 60.3%at 3 yr.The complications were similar to those of other commercially available Glaucoma implants. This new implant is made of soft, freely malleable membrane for the reservoir portion with small volume which can be inserted with smaller incision on the conjunctiva with less complication.We have obtained comparable result from this membrane-tube implant to other implants, and it may be considered as an another substitute for the treatment of refractory glaucomas.