Detection of Hepatitis B Virus DNA in Tear of the patients with Hepatitis Surface Antigen Positive in Serum by Polymerase Chain Reaction

In order to examine a possibility of hepatitis B virus(HBV) transmission via tears, detection of HBV DNA in tear was esamined using polymerase chain reaction (PCR) in 39 patients with HBsAg positive in serum. The detection of HBV DNA in tears was compared that in serums. The patients were divided into group I (n=21, serum HBsAg+HBeAg-) and group II (n=18, serum HBsAg+/HBeAg+). The total detection rates of HBV DNA in tears and serums were 76.9% and 92.3%, respectively. In detail, detection rates of HBV DNA in tears were 71.4% (group I) and 83.3% (group II) and those in serums were 85.7% (group I)and 100% (group II). There was no statisticlly significant difference in detection rate between group I and group II (p>0.05). However, mean values for serum aminotransferase activities in group II were higher than those in group I (p<0.05). The titer of HBsAg or HBeAg did not influence on the detection rate of HBV DNA. With these results, it was found that HBV DNA would be easily detected in tear of patients with HBV infection and HBV could be transmitted via ophthalmic instruments touched with ocular surface. Therefore, history taking concerning hepatitis B, screening test for hepatitis B, chemical or physical sterilization of ophthalmic instruments, and vaccination for workers in ophthalmologic department would be important in prophylactic aspects.

Aponeurotic Ptosis Surgery

Sixty-five levator aponeurotic surgeries were carried out to treat acquired and congenital blepharoptosis including those with very poor levator function. Margin reflex distance(MRD) was measured and postoperative drooping of the upperlid was observed carefully during the follow-up period of 6 months to 1 year. Most of these cases had a stationary level of MRD or less than 1 mm change of MRD but three cases resulted in more than 1.5 mm postoperative fall of the upperlid. This procedure also proved the excellent surgical efficacy in severe congenital ptosis with very poor levator function. In our experience, about 1 mm overcorrection at surgery provided a more satisfactory result.

The Effect of the Experimental Parotid Duct-conjunctivoplasty Using Saphenous Vein Graft

Experimental parotid duct-conjunctivoplasty was carried out using great saphenous vein graft in six dogs. After the operation, the tear meniscus level in the operated eye was higher than that of the control eye. The parotid secretion was noticed through the conjunctival opening of the vein graft in the lower lateral fornix. Profuse tearing was not detected during the time of having meal, which was supposed due to a good lacrimal drainage. In Schirmer test of the operated eye, the preoperative mean value was similar to the postoperative value. But, the intraprandial mean value of Schirmer test was measured as slightly higher than the preprandial value. In paired t-test, no significant difference could be detected. On scintigraphic study with 99mTc-O4, three cases of the four dogs revealed the parotid flow with good patency of the grafted vein. These results suggest that the parotid duct-conjunctivoplasty will be an effective surgery for dry eye syndrome, if the grafted vein could be kept from an obstruction for a prolonged period.