Clinical Outcomes of Intrascleral Fixation of Intraocular Lens Compared to Ciliary Sulcus Implantation and Transscleral Fixation

Purpose@#To compare the clinical outcomes of intrascleral fixation of the three-piece intraocular lenses (IOLs) 2.5 mm posterior to the limbus with ciliary sulcus implantation and transscleral fixation 2.5 mm posterior to the limbus. @*Methods@#Sixty-five eyes of 65 patients who underwent ciliary sulcus implantation or transscleral or intrascleral fixation of the AMO Sensar AR40e IOL were retrospectively reviewed. The postoperative refractive prediction error, back-calculated effective lens position (ELP), corrected distance visual acuity (CDVA), and postoperative residual cylinder were compared. @*Results@#There were significant differences in the median (interquartile range) postoperative refractive prediction error (diopters [D]) among the three groups (p < 0.001): for ciliary sulcus implantation (33 eyes), −0.89 D (−1.21 to −0.56 D); for transscleral fixation (10 eyes), −0.40 D (−0.78 to −0.22 D); and for intrascleral fixation (22 eyes), 0.01 D (−0.28 to 0.34 D). Significant differences (p < 0.001) were observed in the median back-calculated ELP: for ciliary sulcus implantation, 4.35 mm (3.95 to 4.55 mm); for transscleral fixation, 4.51 mm (4.34 to 4.76 mm); and for intrascleral fixation, 4.90 mm (4.56 to 5.35 mm). There were no differences in the median postoperative CDVA (0, 0.10, and 0 logarithm of the minimum angle of resolution, respectively; p = 0.083) and the residual cylinder (−0.75, −1.50, and −0.63 D, respectively; p = 0.074) among three groups. @*Conclusions@#Intrascleral fixation showed no myopic shift and the most posterior lens position, while ciliary sulcus implantation induced the greatest myopic shift and the most anterior lens position. However, there was no significant difference in the postoperative CDVA or astigmatism among the eyes with different IOL insertion methods, demonstrating good IOL stability and vision outcomes.

Effect of Personalized Blue-Enriched White Light Intervention on Rest–Activity and Light Exposure Rhythms in Mild and Moderate Alzheimer’s Disease

Objective@#We aimed to examine the effectiveness of personalized light intervention using a blue-enriched light-emitting-diodes device on rest–activity rhythm (RAR) and light exposure rhythm (LER) in patients with mild and moderate Alzheimer’s disease (AD). @*Methods@#AD patients with poor sleep quality and/or insomnia symptoms were assigned into either an experimental group (EG) or control group (CG) in a single-blind design. Personalized light intervention was given at 9–10 h after individual dim light melatonin onset, lasting for 1 h every day for two weeks in the EG (77.36±5.79 years, n=14) and CG (78.10±7.98 years, n=10). Each patient of CG wore blue-attenuating sunglasses during the intervention. Actigraphy recording at home for 5 days was done at baseline (T0), immediate postintervention (T1), and at four weeks after intervention (T2). The variables of RAR and LER were derived using nonparametric analysis. @*Results@#We found a significant time effect on the intradaily variability (IV) of RAR at T2 with respect to T0 (p=0.039), indicating reduced IV of RAR at four weeks after personalized light intervention regardless of blue-enriched light intervention. There was a time effect on the IV of LER at T1 with respect to T0 (p=0.052), indicating a reduced tendency in the IV of LER immediately after intervention. @*Conclusion@#Our personalized light intervention, regardless of blue-enriched light source, could be useful in alleviating fragmentation of RAR and LER in AD patients.

Trichofolliculoma in the Medial Canthal Area

Purpose@#We report a case of trichofolliculoma located in the medial canthal area that was initially clinically suspected to be basal cell carcinoma.Case summary: A 93-year-old female patient presented to our hospital with a 1.2 × 1.4 cm mass in the right medial canthal area that had been present for 8 months. She had experienced continuous bleeding-like secretions during this time, leading to suspicion of basal cell carcinoma due to the absence of hair and a painless central ulcer lesion. Excision and biopsy were performed; the biopsy results revealed trichofolliculoma. The patient underwent complete resection and has remained recurrence-free for 6 months with regular follow-up observations. @*Conclusions@#Trichofolliculoma is a rare follicular hamartoma characterized by a nodule with dilated pores and dense hair in the center. Given its clinical similarity to benign and malignant tumors, such as basal cell carcinoma and squamous cell carcinoma, it is essential to differentiate this condition through excision and biopsy.

Clinical Manifestations and Prognosis in Patients with Infectious Endophthalmitis after Ahmed Glaucoma Valve Implant Surgery

Purpose@#We studied the clinical features and assessed the treatment outcomes of infectious endophthalmitis subsequent to Ahmed glaucoma valve (AGV) implant surgery. @*Methods@#We performed a retrospective review of the medical records of patients who underwent AGV implant surgery between January 1, 2010 and May 31, 2022. Clinical course, microbiological lab results, and the treatment data of patients who developed infectious endophthalmitis were analyzed. @*Results@#Of 310 eyes that underwent AGV implant surgery, 9 (2.90%) developed endophthalmitis. The average time interval between AGV implant surgery and the diagnosis of endophthalmitis was 3.59 years. As initial treatment, all affected eyes received injections of intravitreal antibiotics, while four underwent primary pars plana vitrectomy. The implanted valve was removed in seven instances. Microorganisms were found in cultures from four cases. Two patients achieved a final best-corrected visual acuity (BCVA) above 20/200, while the other five had a final BCVA of hand motion or worse. @*Conclusions@#AGV implant-related endophthalmitis is uncommon and often results in poor visual outcomes, with unpredictable onset. Consequently, it is crucial to educate patients undergoing AGV implant surgery during regular follow-ups. Immediate evaluation and treatment are necessary for patients exhibiting symptoms after surgery.

Changes in Macular Thickness and Microvasculature in Koreans with Early Parkinson’s Disease

Purpose@#To investigate the thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and microvascular macular changes in Korean patients with early Parkinson’s disease using optical coherence tomography (OCT) and OCT angiography (OCTA). @*Methods@#Forty-three eyes of 22 patients with early Parkinson’s disease were included. A control group of 20 patients (40 eyes) was also recruited. The thickness of the NFL-GCIPL macular complex was measured using OCT, and the densities of the superficial and deep macular retinal vessels were evaluated via OCTA in all subjects. @*Results@#The NFL-GCIPL thicknesses of the superior, inferior, temporal, and nasal sectors were 94.70 ± 9.35, 93.32 ± 9.16, 90.18 ± 6.32, and 93.11 ± 8.75 μm in the control group and 92.05 ± 4.96, 91.32 ± 7.48, 84.74 ± 6.82, and 91.32 ± 7.47 μm in the Parkinson’s disease group, respectively; all thicknesses were significantly greater in the control group. The superficial and deep retinal vessel densities did not differ between the two groups. @*Conclusions@#Neurodegenerative macular changes are more obvious than microvascular changes in patients with early Parkinson’s disease. Such neurodegenerative changes should be further evaluated in future cohort studies.

Effect of Intravitreal Dexamethasone Implant Injection in a Patient with Recurrent Nodular Anterior Scleritis

Purpose@#To report the use of intravitreal dexamethasone implant injection in a patient with recurrent nodular anterior scleritis.Case summary: A 16-year-old patient presented with persistent eye pain and conjunctival injection in the left eye, which were diagnosed as nodular anterior scleritis. The clinical features improved with topical and systemic steroid treatment, but the patient developed side effects related to steroid use, including elevated intraocular pressure and skin rash. The steroid dose was reduced which led to frequent recurrence. Immunosuppressive agents were added to the treatment regimen, but there was no improvement; the patient developed intermediate uveitis and vitreous hemorrhage. Scleritis and intermediate uveitis continued despite vitrectomy; therefore, intravitreal dexamethasone implant injection was performed. There was no scleritis recurrence within 1 year after injection, which allowed tapering of steroids and immunosuppressive drugs. @*Conclusions@#Intravitreal dexamethasone implant injection may be effective for recurrent nodular anterior scleritis in patients who exhibit complications, such as intermediate uveitis.

The Utility of Peripheral Vitrectomy Featuring Scleral Indentation during Scleral Fixation of Intraocular Lenses

Purpose@#We evaluated the utility of peripheral vitrectomy featuring scleral indentation; we compared a group who underwent peripheral vitrectomy to a control group for whom vitrectomy was combined with scleral fixation of intraocular lenses (IOLs) in patients exhibiting IOL dislocations. @*Methods@#From January 2018 to December 2020, 20 eyes of patients evidencing IOL dislocations that underwent total vitrectomy, IOL removal, and IOL scleral fixation were evaluated; peripheral vitrectomy with scleral indentation was performed in 10 patients. All operations were performed by the same surgeon. We excluded patients with follow-up periods less than 6 months, those with a history of retinal and/or glaucoma surgery, and patients with retinal abnormalities or glaucoma that might significantly compromise visual acuity. The postoperative best-corrected visual acuity, intraocular pressure, astigmatism changes, and complications were retrieved from the medical records. @*Results@#Six months after surgery, the best corrected visual acuity was 0.95 (the Snellen measure) in the group who underwent peripheral vitrectomy featuring scleral indentation, and 0.60 in the control group (p = 0.029). The total astigmatism values were 0.48 diopter in the former and 2.80 diopter in the latter group; the difference was significant (p < 0.001). @*Conclusions@#In patients with IOL dislocations who underwent vitrectomy combined with IOL scleral fixation, improvements in visual acuity were further enhanced when peripheral vitrectomy was combined with scleral indentation. Complete removal of the peripheral vitreous may stabilize IOL positioning by the remnant vitreous.

Development of a High-Yield Isolation Protocol Optimized for the Retrieval of Active Muscle Satellite Cells from Mouse Skeletal Muscle Tissue

Background and Objectives@#Difficulties often encountered in separating and purifying active muscle satellite cells (MSCs) from skeletal muscle tissues have limited the supply of cells for muscle therapy and artificial meat production. Here, we report an effective isolation protocol to economically and conveniently retrieve active MSCs from skeletal muscle tissues in mice. @*Methods@#and Results: We optimized an enzyme-based tissue digestion protocol for isolating skeletal muscle-derived primary cell population having a large number of active MSCs and described a method of differential plating (DP) for improving purity of active MSCs from skeletal muscle-derived primary cell population. Then, the age of the mouse appropriate to the isolation of a large number of active MSCs was elucidated. The best isolation yield of active MSCs from mouse skeletal muscle tissues was induced by the application of DP method to the primary cell population harvested from skeletal muscle tissues of 2-week-old mice digested in 0.2% (w/v) collagenase type II for 30 min at 37℃ and then in 0.1% (w/v) pronase for 5 min at 37℃. @*Conclusions@#The protocol we developed not only facilitates the isolation of MSCs but also maximizes the retrieval of active MSCs. Our expectation is that this protocol will contribute to the development of original technologies essential for muscle therapy and artificial meat industrialization in the future.

Endophthalmitis and Retinal Detachment after Ocular Injury by Animal Inoculation Needle

Purpose@#To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. @*Conclusions@#This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

Squamous Cell Carcinoma in the Lacrimal Sac of Young Patient Who Had Conjunctival Squamous Papilloma

Purpose@#To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. @*Conclusions@#Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes

Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.

Clinical Features and Antibiotic Susceptibility of Culture-proven Infectious Keratitis: a Multicenter 10-year Study

Purpose@#To analyze the clinical manifestations of culture-proven infective keratitis patients over a recent 10-year period. @*Methods@#We retrospectively reviewed the medical records of 956 cases of infective keratitis between January 2008 and December 2017 at eight tertiary hospitals. The study was performed to analyze the risk factors, causative microbial organisms, therapeutic outcomes, and prognosis. @*Results@#The most common risk factor of keratitis was trauma (33.2%). Initial visual acuity (V/A) was finger count or less in 449 eyes (47.0%). The common location of keratitis was central, and the size was 4 mm2 or less. Hypopyon was observed in 295 eyes (30.9%). Of the 1,039 cultured isolates, 443 (42.6%) grew Gram-negative bacteria with the most common being Pseudomonas aeruginosa. The most prevalent Gram-positive bacteria was Staphylococcus epidermidis, and fungi was Fusarium species. Surgical treatments were performed in 201 eyes (21.0%), followed by amniotic membrane transplantation (66 eyes) and evisceration (44 eyes). Final V/A was 20/100 or more in 422 eyes (44.1%). Gram-positive organisms were highly susceptible to moxifloxacin and vancomycin, and Gram-negative organisms were highly susceptible to levofloxacin and ceftazidime. An increase in resistance to these antibiotics was detected for Enterococcus and Pseudomonas. @*Conclusions@#In South Korea, infective keratitis occurs frequently in eyes with trauma. Staphylococcus epidermidis, Pseudomonas aeruginosa, and Fusarium species are commonly identified etiologies of microbial keratitis. The appropriate administered medical and surgical treatments of suspected infectious keratitis can lead to visual improvement with particular care taken to minimize infection related to resistant bacteria and fungal microbes as needed. An initial V/A of 0.02 or less, the presence of hypopyon, age of 65 years or more, and a central lesion were associated with poor clinical outcome of bacterial keratitis. Age of 70 years or more was a significant risk factor for poor clinical outcome of fungal keratitis.

Endophthalmitis and Retinal Detachment after Ocular Injury by Animal Inoculation Needle

Purpose@#To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. @*Conclusions@#This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

Squamous Cell Carcinoma in the Lacrimal Sac of Young Patient Who Had Conjunctival Squamous Papilloma

Purpose@#To report a squamous cell carcinoma in the lacrimal sac of a young patient.Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. @*Conclusions@#Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes

Purpose@#To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). @*Methods@#Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. @*Results@#Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. @*Conclusions@#These results suggest that neurodegeneration might be an early change in the development of DR.

Clinical Features and Antibiotic Susceptibility of Culture-proven Infectious Keratitis: a Multicenter 10-year Study

Purpose@#To analyze the clinical manifestations of culture-proven infective keratitis patients over a recent 10-year period. @*Methods@#We retrospectively reviewed the medical records of 956 cases of infective keratitis between January 2008 and December 2017 at eight tertiary hospitals. The study was performed to analyze the risk factors, causative microbial organisms, therapeutic outcomes, and prognosis. @*Results@#The most common risk factor of keratitis was trauma (33.2%). Initial visual acuity (V/A) was finger count or less in 449 eyes (47.0%). The common location of keratitis was central, and the size was 4 mm2 or less. Hypopyon was observed in 295 eyes (30.9%). Of the 1,039 cultured isolates, 443 (42.6%) grew Gram-negative bacteria with the most common being Pseudomonas aeruginosa. The most prevalent Gram-positive bacteria was Staphylococcus epidermidis, and fungi was Fusarium species. Surgical treatments were performed in 201 eyes (21.0%), followed by amniotic membrane transplantation (66 eyes) and evisceration (44 eyes). Final V/A was 20/100 or more in 422 eyes (44.1%). Gram-positive organisms were highly susceptible to moxifloxacin and vancomycin, and Gram-negative organisms were highly susceptible to levofloxacin and ceftazidime. An increase in resistance to these antibiotics was detected for Enterococcus and Pseudomonas. @*Conclusions@#In South Korea, infective keratitis occurs frequently in eyes with trauma. Staphylococcus epidermidis, Pseudomonas aeruginosa, and Fusarium species are commonly identified etiologies of microbial keratitis. The appropriate administered medical and surgical treatments of suspected infectious keratitis can lead to visual improvement with particular care taken to minimize infection related to resistant bacteria and fungal microbes as needed. An initial V/A of 0.02 or less, the presence of hypopyon, age of 65 years or more, and a central lesion were associated with poor clinical outcome of bacterial keratitis. Age of 70 years or more was a significant risk factor for poor clinical outcome of fungal keratitis.

Effect of Aralia Elata on the Expression of Hyperosmolarity-induced TonEBP Protein and Inflammatory Mediators in Corneal Epithelial Cells

Purpose@#To investigate the effect of Aralia elata (AE) on hyperosmolar stress-induced tonicity response enhancer-binding protein (TonEBP) expression and changes in the levels of proinflammatory cytokines in immortalized human corneal epithelial cells (hCECs). @*Methods@#Immortalized hCECs were cultured with either 5 or 10 μg/mL AE for 24 hours, and the medium then changed to a hyperosmotic medium (500 mOsM/L). After hyperosmolar treatment, cell viability and wound-healing assays were performed, and cell proteins subjected to Western blot analysis, immunocytochemistry for TonEBP and NF-κB, and tests measuring changes in the levels of oxidative stress markers and inflammatory mediators. @*Results@#AE pretreatment ameliorated hyperosmolarity-induced cell death and the delay in wound-healing in a dose-dependent manner. AE inhibited TonEBP and phospho-NF-κB p65 subunit upregulation. AE significantly decreased the expression levels of Bax, 4-HNE, and IL-1β; but increased those of Bcl-2, Bcl-xl, and Gpx. @*Conclusions@#AE increased cell viability and wound-healing, and inhibited the hyperosmolar stress-induced upregulation of TonEBP and NF-κB. AE may be useful for treatment of patients with certain ocular surface diseases.

Changes of Anterior Chamber Depth and Refractive Error after Phacovitrectomy with and without Posterior Capsulotomy

Purpose@#To compare the effect on changes in anterior chamber depth (ACD) and refractive error between subjects after combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe and control subjects after combined phacovitrectomy without posterior capsulotomy. @*Methods@#A total of 20 eyes of 20 subjects who underwent combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe were compared with 20 eyes of 20 control subjects who underwent only phacovitrectomy without posterior capsulotomy. The ACD was measured with Scheimpflug imaging (Pentacam ® ; OCULUS Optikgeräte GmbH, Wetzlar, Germany) before and after surgery. Also the preoperative desired refraction and postoperative refraction were compared using an auto keratorefractometor. @*Results@#The preoperative ACD of subjects with posterior capsulotomy was 2.56 ± 0.233 mm. The ACD was 3.54 ± 0.366 mm and 3.71 ± 0.424 mm at one and three months after surgery in subjects with posterior capsulotomy. The preoperative ACD of subjects without posterior capsulotomy was 2.53 ± 0.204 mm. The ACD was 3.09 ± 0.197 mm and 2.95 ± 0.295 mm at one and three months after surgery in subjects without posterior capsulotomy. There was no significant difference between the two groups in preoperative ACD, but ACD at one and three months after surgery was significantly different between the two groups.The desired refractory error was -0.32 ± 0.124 D in subjects with posterior capsulotomy, and -0.33 ± 0.142 D in the control group.The postoperative refraction was -0.62 ± 0.132 D in patients who underwent phacovitrectomy with posterior capsulotomy, and -0.91 ± 0.292 D in the control group. There was a significant difference in refraction three months after the surgery. @*Conclusions@#Combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe may be a useful way to prevent myopic change caused by anterior migration of an intraocular lens compared with control subjects, without posterior capsulotomy, for three months after surgery.

Genes Expressed in Steroid-exposed Lens Epithelial Cells as Revealed by Polymerase Chain Reaction

Purpose@#We investigated the expression levels of 84 genes in dexamethasone-exposed human lens epithelial cells using polymerase chain reaction (PCR) array analysis. @*Methods@#The viability and motility of lens epithelial cells were examined after treatment with dexamethasone at 0.01, 0.1, and 1 mg/mL; Western blot was used to evaluate the expression levels of fibronectin, α-smooth muscle actin (α-SMA), and E-cadherin. After 24, 48, and 72 hours of dexamethasone treatment at 0.1 mg/mL, the expression levels of 84 growth factors were analyzed using PCR array. @*Results@#Cell viability did not change significantly at dexamethasone levels of 0.01 or 0.1 mg/mL, but decreased markedly at 1 mg/mL; motility increased in a concentration-dependent manner at 0.01 and 0.1 mg/mL. Western blot showed that fibronectin levels increased significantly at all dexamethasone concentrations tested; the α-SMA level increased only at 0.01 mg/mL, and E-cadherin levels decreased significantly at all tested concentrations. PCR showed that the levels of FGF1, FGF2, IL-11, regulators of apoptosis (GDNF, IL-1β, and NRG2), and regulators of cell differentiation (BMP5, FGF1, FGF2, and FGF5) decreased more than twofold, whereas the levels of FGF9 and FGF19 increased more than twofold. @*Conclusions@#PCR performed after exposure of lens epithelial cells to dexamethasone may identify the genes involved in the development of steroid-induced cataracts.

Stromal Keratitis in a Patient with Congenital Hypogammaglobulinemia

Purpose@#We report a case of stromal keratitis in a patient with congenital hypogammaglobulinemia.Case summary: A 15-year-old boy presented with decreased visual acuity in the right eye. He had been diagnosed with congenital hypogammaglobulinemia at about 16 months of age and had received regular doses of intravenous immunoglobulin. The best-corrected visual acuity of the right eye was 0.02 and the intraocular pressure 11 mmHg. On anterior segment examination, thinning combined with stromal infiltration of the paracentral cornea was evident, but no epithelial defect was apparent. We scheduled detailed systemic examinations and laboratory investigations to rule out infectious keratitis. His serum immunoglubulin G (IgG) level was 328.9 mg/dL, thus less than that 3 months priorly (434.8 mg/dL). The lesion did not improve after prescription of topical antibiotics and steroid. The serum IgG level gradually increased to 394.4 mg/dL after immunoglobulin administration, and the corneal infiltration gradually decreased. After 5 months of treatment, the serum IgG levels ranged between 480 and 530 mg/dL; we noted no recurrence or worsening of the corneal lesion. @*Conclusions@#We report a case of stromal keratitis in a patient with congenital hypogammaglobulinemia; we prescribed intravenous immunoglobulin.