A Comparison of Corrective Effect on Astigmatism after LASIK and LASEK

PURPOSE: We studied the effect of LASIK and LASEK for correction of myopic astigmatism and the clinical results in relation to preoperative astigmatism and operative methods. METHODS: We retrospectively analyzed the results of 176 eyes of 97 patients in the LASIK group and of 56 eyes of 29 patients in the LASEK group. All patients had undergone LASIK or LASEK for correction of myopic astigmatism with MEL-70TM (Aesculap-Meditec, Jena, Germany). Patients were divided into groups I (or=3.00D) according to preoperative astigmatism, and into groups A (LASIK) and B (LASEK) according to operative method. Each patient was followed up for over 6 months with measurements of uncorrected visual acuity, manifested refraction, and spherical equivalent at 1, 3, and 6 months after operation. RESULTS: In groups IA, IB, IIA, IIB, IIIA, IIIB, IVA, and IVB, preoperative cylindrical errors were 0.56 +/- 0.17D, 0.61 +/- 0.13D, 1.27 +/- 0.28D, 1.24 +/- 0.21D, 2.18 +/- 0.25D, 2.10 +/- 0.25D, 3.39 +/- 0.66D, and 3.50 +/- 0.61D, and postoperative 6-month astigmatism measurements were 0.33 +/- 0.49D, 0.34 +/- 0.36D, 0.28 +/- 0.30D, 0.63 +/- 0.44D, 0.48 +/- 0.42D, 0.44 +/- 0.57D, 0.86 +/- 0.42D, and 1.00 +/- 0.78D, respectively. CONCLUSIONS: The correction of myopic astigmatism in LASEK was less effective than in LASIK at early postoperative periods, but they showed similar effect on the correction of astigmatism at 6 months after surgery, especially in the group with medium to low grade of astigmatism.

Four Cases of Strabismus presenting after Cataract Surgery

PURPOSE: We report four cases of strabismus presenting after cataract surgery and review the previous reports. METHODS: We examined four cases with diplopia for three months or more following cataract surgery between March 2001 and February 2002 in our hospital. We reviewed our records to inquire the preoperative systemic and ophthalmologic exam included past and present medical history. Also, we performed the strabismus test such as prism and cover test, forced duction test, force generation test included CT scan, if necessary. RESULTS: Case 1, 2, 3 were performed by retrobulbar anesthesia. Case 1 showed left superior rectus muscle overaction, case 2 showed left inferior rectus muscle palsy, case 3 showed left inferior rectus muscle palsy and superior rectus muscle overaction. Case 4 showed irregular pattern of strabismus. In case 1, 2, 3, diplopia in primary position was improved after strabismus surgery. We have observed case 4 until the pattern of strabismus would be stable. CONCLUSIONS: After uneventful cataract surgery, persistent strabismus may be occurred. So the operator must explain the occurrence of strabismus to patient before surgery, and carefully perform pre and post operative strabismus test and retrobulbar anesthesia.

Comparison of the Clinical Effect of the 1% Rimexolone with That of 0.1% Fluorometholone Following LASIK

PURPOSE: We compared therapeutic efficacy and steroid-induced IOP elevation of 1% rimexolone with that of 0.1% fluorometholone. METHODS: Of all LASIK treated eyes from March of 2001 to December of 2002 in Sungae General Hospital, 46 eyes were treated with 1% rimexolone and 46 eyes were treated with 0.1% fluorometholone. And we measured the degree of myopic regression (1 day, 1 month, 3 month) and intraocular pressure (1 month). RESULTS: Statistically signicant difference in therapeutic efficacy of myopic regression, and no statistically signicant difference in IOP were found. The therapeutic efficacy of 1% rimexolone was higher. CONCLUSIONS: We concluded that application of 1% rimexolone was more useful in myopic regression following LASIK rather than that of 0.1% fluorometholone.

The Effect of Dopamine therapy on the Development of Retinopathy of Prematurity

PURPOSE: Since a recent study that the use of dopamine therapy for the hypotension of premature infants was a risk factor on the development of retinopathy of prematurity was reported, this study was intended to access whether treatment of premature infants with dopamine acts as a risk factor for development of retinopathy of prematurity. METHODS: We retrospectively reviewed the medical records of 123 premature infants who had been admitted in our Neonate Intensive Care Unit, and were alive and born under 36 weeks of gestational age, between January 1995 and December 1999. In comparing dopamine treated group (91) and non-treated group (31), we performed univariate and multivariate statiscal analysis for the comparisons of two groups. RESULTS: Although in the incidence of retinopathy of prematurity, dopamine treated group (51 of 91,55.4%) was higher than non-treated group (15 of 31,48.4%), statistically, it was not significantly different(P< 0.05). CONCLUSIONS: The use of dopamine therapy was not risk factor for the development of retinopathy of prematurity.

Comparision between Manifest vs. Cycloplegic Photore fraction with MTI Photoscreener in Prematurity

Amblyopia and strabismus are common in eyes of prematurity and the need for early detection of amblyopia and amblyogenic factors is widely recognized. So, we performed refraction in premature infants at the 6 months of age to evaluate the incidence and degree of myopia and the changes of refractive errors according to the development, disease course and photocoagulation therapy of retinopathy of prematurity[ROP]. It is the purpose of this study to evaluate the effectiveness of MTI[medical Technology, Inc]photoscreener by comparing the sensitivity and specificity between refractive errors determined by manifest photorefraction and cycloplegic photorefraction in 6-month-old premature infants in Sung-Ae General Hospital. Pass or fail screening data from photograph of 32 non-dilated and dilated premature infant were calculated by two masked observers, compared with the results of cycloplegic retinoscopy, and the statical analysis was carried out. In the cases of cycloplegic photorefraction, Ten eyes of myopia, 4 eyes of emetropia, and 50 eyes of hyperopia were found, and 21 eyes of astigmatism above 1.5D were also detected. Overall statistical analysis of sensitivity and specificity rate were 71.7% and 69.5%in manifest photorefraction, 87.5% and of 75%in cycloplegic photorefraction, respectively. In non-cycloplegic photorefraction, sensitivity of myopia and hyperopia were 92.8%, 65%, but in cycloplegic photorefraction, sensitivity of myopia and hyperopia were 75%, 100%, respectively. The outcomes of our study suggest that MTI photoscreener in cycloplegic photorefraction was more reliable than non-cycloplegic photorefraction. Myopia under 1D turned to hyperopia in cycloplegic photorefraction, so the sensitivity of that was not to be reliable, but the sensitivity of hyperopia was high. Thus, the authors can readily recommand this cycloplegic photorefraction in uncooperable infants to evalute the refractive error conveniently.

A Case of Intraorbital Ectopic Lacrimal Gland with Lacrimal Duct

Ectopic lacrimal gland denotes a lacrimal gland which is located anywhere other than its normal site, lacrimal fossa, and it can occur in places like conjunctiva, cornea, lid, nasal mucosa, and orbit. It is a rare congenital anomaly and needs to be differentiated form other tumors. The literature contains few reports of ectopic lacrimal gland. We experienced a case of a 28-year-old Korean man who presented with an ectopic lacrimal gland with duct at temporal aspect of bulbar conjunctiva. The glandular tissue was excised and was histopathologically confirmed as such. We report it with reviews of the literature concerned.

The Epidemiological Study on the Ocular Disorders of the Rural Aged Population

OBJECT: It is to evaluate the priority area for effective eye care service to the aged population of rural comniunity at present and in future. METHOD: Number of aged group surveyed on 60 and over 60 years age that, counted 531 among the total 580 patients. Visual acuity was tested and refractive error was measured by Retinornax (Nikon, Japan) . Ocular examination was performed to determine the causes of visual impairment. This survey was conducted under the auspices of the Korean Foundation for Prevention of Blindness with assistance of the Seoul National University Postgraduate School of Public Health from 1994 to 1996 at the Public Health Center of Chun-Cheon, Kang-Won Do(Province). RESULTS: Age distribution showed the sixties (60-69) 49,3%, the seventies (70-79) 33.9%, and the eighties (80) 16.8%. Proportion of visual acuity of 0.7 or upper in the better eyes constituted 32.2% and of 0.2 or worse 19.4%. Causes of visual impairnnente consisted of refractive errors 35. 9%, cataract 35. 9%, macular degeneration 7, 4%, and corneal opacity 3.9% in order. Contributed modes of care were spectacles 27.9%, surgeries 23.9% (cataract, operation, pterygium removal etc.), and medical treatment 23.9%. DISCUSSION: Surgery of the aged population in rural comrnunity of Chun-Cheon revealed the most. prevalent. causes of visual impairment as the refractive errors and cataract. It is suggested that. the most effective eye care would be provided systemically based 0 the result of the epidemiological study on the various ocular disorders.

The Clinical Aspects of Orbital Fractures Proven by Computed Tomography

Computed tomography can be diagnostic with orbital fractures, because it provides detailed visualization of anatomical relationship on both the bones and soft tissues of the orbits. By identifying a group of patient at high risk for enophthalmos and persistent diplopia, we were able to decise the indication of operation. From January 1991 to December 1996, the authors reviewed of 106 consecutive patients(118 eyes)with orbital fractures proven by computed tomography respectively. Among them, 13 patients were repaired surgically. The results were as follows. Orbital fractures occurred most frequently between the ages of 21 and 40 years of men, and the most common cause of those was traffic accident. The incidence of orbital fracture was higher on the left side of orbit. In single wall fractures, the most common involved wall was medial wall, followed by inferior, superior and lateral wall in order. In combined wall fractures, medial and inferior wall fractures were most common. The associated symptoms and signs of orbital fracture were periorbital swelling, lid laceration, diplopia, and enophthalmos in turn. Subciliary approach was used for repair of the fracture. The surgical intervention was done within 2 weeks.

Effect of the Illumination and the Types of the Lenses on Near Visual Acuity in Low Vison Patients

To obtain adequate information of illumination and lens types for visual acuity test of low vision patient, the relation between various illumination and vision was evaluated. Visual acuity for near and effective lens types were examined. Among the 28 patients (of 36 eyes), intensities of illumination were set at 200, 500, 1000 and 2000lux and the lenses of biconvex, aspheric and aplanatic were tested. The best visible range of illumination for the low vision patients was 500-1000lux, with lower power diopter for the same visual acuity and with aspherin and aplantic lenses. Results attained by our study may be applied for appropriate condition of illumiation and type of lens in the low vision care.

Treatment of Acute Retinopathy of Prematurity with Argon Indirect Laser Opthalmoscope

Twenty two eyes of twelve infants with threshold or prethreshold retinopathy of prematurity were treated by using the Argon laser through an indirect ophthalmoscopic delivery system. Eyes that had persistent plus disease were retreated to the missed areas. Mean follow-up period was 8.1 months. 20 of 22 eyes were regressed and all of prethreshold ROP were regressed. Our results suggest that argon laser photocoagulation is as effective as cryotherapy in the treatment of ROP and excellent results can be obtained by treating prethreshold zone I or posterior zone II ROP. And laser treatment is better tolerated by infant, accurate, easy, less destructive and not requires general anesthesia.

A Case of Congenital Cataract in Down's Syndrome

In most cases of chromosomal anomaly of congenital cataract, the cause is known as Down's syndrome. We experienced a case of bilateral congenital cataract in Trisomy 21 (Down's syndrome). A 3 year-old female who had been born from 37 year-old mother was visited to our hospital, with clinical diagnosis of bilateral congenital cataract. Her face was pathognomonic to Down's syndrome. Chromosomal study of peripheral blood showed that the total number of chromosome was 47, and karyotype was 47, XX, +21. The lens showed nuclear opacity. Aspiration and Discission of the cataract on both eyes were performed uneventfully.

Electrophysiologic Study of the Hemifacial Spasm

There has been controversy between compression of the facial nerve in the cerebellopontine recess and focal demyelination of the facial nerve on the pathogenesis of hemifacial spasm(HFS). To know the pathophysiology of HFS, we performed the facial nerve stimulation test and blink reflex test in 15 patients with HFS. And then we analyzed change of electrophysiologic findings after botulinum toxin in jection. We could not find any differences of latency between affected and unaffected side in facial nerve stimulation test(p>0.05). In the blink reflex test, there were prolonged R1 latency(p<0.01) and occurance of late response on the affected side. There has no change after botulinum toxin injection. These results suggest that there is no facial neuropathy and no electrophysiological evidence of dysfunction in the blink reflex system. Also, there may be two pathophysiologic lesions in HFS. compression and focal demyelination of the facial nerve. And we think that the botulinum toxin is no effect on facial nerve conduction itself.

A Case of Orbital Pseudotumor Associated with Periscleritis

Idiopathic orbital inflammation or pseudotumor is an inflammatory swellings of the orbital contents and has the false clinical impression of a neoplasm. Clinically, the disease can be further characterized according to which orbital structure is predominantly involved myositis, periscleritis, trochleitis, perineuritis and dacryoadenitis. The authors experienced a 22-year-old male patient who had complained of headache, proptosis, decreased visual acuity and ocular pain on his both eyes, 11 weeks before admission. According to orbital CT finding and ocular examination he was diagnosed as orbital pseudotumor associated with periscleritis. After the medical treatment his symptoms were significantly improved. In this article we present our case with a brief review of the literature related to orbital psudotumor.

The Prevalence and Morphological Characteristics of Senile Cataract in the Local Areas of Korea

The epidemiologic study to evaluate the prevalence rate and morphological characteristics of senile cataract in Korea was performed in two different geographic area with population-based study. The results of this study are as follow. In this study based on 40 years of age above, the prevalence rate of cataract was 32.8% in mountainous area (Chung Won) and 45.2% in rural area (Mun Kyung), it had a strong tendency to increase according to age in both areas. But there was no clear relationship in sexual difference. The classification of cataract to the stage showed that the incipient cataract was the most frequent stage in all age, but it was relatively decreased according to age. The immature, mature and hypermature cataract was increased according to age. In distribution of lens opacity to the morphological charactenstics, the single cortical opacity was the most frequent and the mixed opacity was the second in order, but the single nuclear and subcapsular opacity were rare. According to age, the cortical opacity was decreased, mixed opacity was increased, but nucJear and subcapsular opacity were not changed.

The Prevalence and Morphological Characteristics of Senile Cataract in the Local Areas of Korea

The epidemiologic study to evaluate the prevalence rate and morphological characteristics of senile cataract in Korea was performed in two different geographic area with population-based study. The results of this study are as follow. In this study based on 40 years of age above, the prevalence rate of cataract was 32.8% in mountainous area (Chung Won) and 45.2% in rural area (Mun Kyung), it had a strong tendency to increase according to age in both areas. But there was no clear relationship in sexual difference. The classification of cataract to the stage showed that the incipient cataract was the most frequent stage in all age, but it was relatively decreased according to age. The immature, mature and hypermature cataract was increased according to age. In distribution of lens opacity to the morphological charactenstics, the single cortical opacity was the most frequent and the mixed opacity was the second in order, but the single nuclear and subcapsular opacity were rare. According to age, the cortical opacity was decreased, mixed opacity was increased, but nucJear and subcapsular opacity were not changed.

Botulinum-Induced Changes in Orbicularis Oculi Muscle

A 60-year-old woman who had essential blepharospasm was treated with botulinum toxin A (two injections) around her orbital regions. The patient experienced reduction of blepharospsam for one month. But involutional blepharoptosis, brow ptosis and dermatochalasis had remained, so she underwent blepharoplasty. The resected orbicularis muscle during blepharoplasty was examined histopathologically. It was suggested that nonselective atrophy of the orbicularis muscles was derived from the loss of the normal neurotrophic influence of nerve on muscle by the botulinum toxin A.

Population based Study of Risk Factors and Environmental Factors Contributing to Cataractogenesis

To evaluate the prevalence and related risk factors of the senile cataract, we performed epidemiologic study in two different geographic area with population based study in the group of 40 years or more old subjects. The results of this study are as follow. The prevalence rate of senile cataract was 32.8% in mountainous area (Chung Won) and 43.3% in rural area (Mun Kyung). The prevalence rate in both area had strong tendency to increase according to age, especially after 7th decade. But there was no clear relationship between male and female. In geographic characterisitic, annual sunshine time was longer, but cloud cover was lesser in Mun Kyung. Also related risk factors of senile cataract were smoking, low education level and poor health status. The cataract was more common in patients with diabetes, hypertension and arthritis. And long term use of steroids, antihypertensive drugs and analgesics for arthritis were risk factors for the cataractogenesis. But alchol consumption and number of pregnacny were not contributing to cataractogenesis. As a result, the senile cataract has mulifactorial factors and its process is complex phenomenon which is still partially known.

Clinieal Studies in Patients with Essential Blepharospasm and with Hemifacial Spasm

This clinical investigation was undertaken to evluate the patients who had characteristic fearutes of essential blepharospasm and hemifacial spasm during the period from July, 1987 to August, 1990 in this ophthalmological department of Chung Ang University Hospital. The results were as follows; 1) The age onset of essential blepharospasm and hemifacial spasm patients were 51.3 years and 42.7 years, respectively. 2) These patients showed lid spasm, tricks, and lid or brow ptosis as common signs and complained of foreign body sensation, photophobia, and epiphora as main symptons, which were worsened by emotional stress or fatigue. 3) The BUT(tear film break-up time)under 10 seconds were 74.1% in essential blepharospasm, 69.2% in hemifacial spasm, and 55.0% in control but there was no significant difference between these patients and control(p>0.05). The Schirmer test value under 10mm was 69.7%, 66.3%, and 35.0%, respectively and there was significant difference between them(p0.05).

Clinieal Studies in Patients with Essential Blepharospasm and with Hemifacial Spasm

This clinical investigation was undertaken to evluate the patients who had characteristic fearutes of essential blepharospasm and hemifacial spasm during the period from July, 1987 to August, 1990 in this ophthalmological department of Chung Ang University Hospital. The results were as follows; 1) The age onset of essential blepharospasm and hemifacial spasm patients were 51.3 years and 42.7 years, respectively. 2) These patients showed lid spasm, tricks, and lid or brow ptosis as common signs and complained of foreign body sensation, photophobia, and epiphora as main symptons, which were worsened by emotional stress or fatigue. 3) The BUT(tear film break-up time)under 10 seconds were 74.1% in essential blepharospasm, 69.2% in hemifacial spasm, and 55.0% in control but there was no significant difference between these patients and control(p>0.05). The Schirmer test value under 10mm was 69.7%, 66.3%, and 35.0%, respectively and there was significant difference between them(p0.05).

A Statistical Analysis of Ocular Injuries of Inpatients

The authors analysed 127 patients(130 eyes) with ocular injuries among 561 inpatients who had been admitted to Chung-Ang University Hospital during the period of 3 years from January 1986 to December 1988. 1. The incidence of ocular injuries was 22.6% of all inpatients. 2. The incidence was more common in male(91.3%) and in the age of second(40.1%) and third decade(20.5%). 3. The most common cause of ocular injuries was industrial acddent(34.6%), followed by fight(22.0%) and traffic accident(18.9%). 4. The ocular injuries commonly developed between 11 and 14 o'clock(29.9%). Especially, 43.2% of the industrial ocular injuries occurred at this time. 5. The most common causative agent of ocular injuries was broken glass pieces(26.8%), followed by metal(18.9%) and fist and foot(17.3%). 6. The most common nature of ocular injuries was eyeball perforation(53.0%), followed by hyphema(18.5%). 7. The expectancy of a good visual outcome were nonperforating injury, corneal laceration and absence of severe prolapse of intraocular tissue. 8. The most common complication was corneal opacity(58.7%).