Comparison of the Variability of Standard Automated Perimetry between Preperimetric Glaucoma Patients and Normal Controls

PURPOSE: To compare the variability of standard automated perimetry (SAP) between patients with preperimetric glaucoma (PPG) and normal controls. METHODS: This study included 67 eyes, classified into the following groups: 30 eyes, normal controls; and 37 eyes, PPG. All subjects were examined with 24-2 Humphrey static perimetry. The visual field was divided into superonasal, superotemporal, inferonasal, and inferotemporal sectors. The variability of SAP was obtained using the standard deviation of sensitivity points at each location. We compared the variability of SAP between the normal controls and PPG patients. RESULTS: The variability of SAP was higher in the PPG group compared with the normal control group (p < 0.001). There was also a significant correlation between the variability of SAP and intraocular pressure fluctuations and retinal nerve fiber layer thickness (both p < 0.05). The variability of SAP in the PPG group was higher (p < 0.05) in all areas except the inferotemporal sector compared with the normal control group. CONCLUSIONS: The variability of the SAP increased in PPG patients compared with normal controls, even when the visual field test results were normal.

Higher-Order Aberrations and Visual Acuity with Wavefront-Guided and Wavefront-Optimized Ablation in Laser Keratorefractive Surgery

PURPOSE: To compare higher-order aberrations (HOAs) and visual acuity after wavefront-guided and wavefront-optimized laser keratorefractive surgery. METHODS: This retrospective study consisted of consecutive cases of eyes that underwent wavefront-guided (VISX S4 CustomVue(R)) or wavefront-optimized (WaveLight(R) EX500) laser assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and preoperative and 3 month postoperative HOAs were compared. RESULTS: There were no statistical differences in UCVA, BCVA, MRSE, or total HOAs in either the LASIK and PRK groups (all p > 0.05). Induced amount of spherical aberration (SA) was significantly lower in the wavefront-optimized LASIK and PRK than wavefront-guided LASIK and PRK. CONCLUSIONS: In laser keratorefractive surgery, wavefront-guided and wavefront-optimized platforms produced equivalent visual outcomes and no differences in total HOAs. However, the wavefront-optimized platform caused less spherical aberration 3 months after operation.

Effects of Topical Tranilast on Corneal Haze with the Pentacam(R) after Photorefractive Keratectomy

PURPOSE: To evaluate the inhibitory effect of tranilast on formation of corneal haze using the Pentacam(R) after photorefractive keratectomy (PRK). METHODS: A prospective, randomized, paired eye study was performed. A total of 60 eyes from 30 patients were enrolled in the present study. Eyes were categorized as myopic eyes or =-5 D. Patients undergoing PRK were randomized to receive tranilast in one eye and no medication in the contralateral eye. Three months postoperatively, corneal haze was measured with the Pentacam(R) and compared between the 2 groups. RESULTS: Statistical differences were not found in preoperative data in the tranilast or control groups (all P > 0.05). There was a strong decreasing density trend from the apex to the 3 mm radius in both groups (P 0.05). CONCLUSIONS: The use of tranilast after PRK did not inhibit corneal opacity. Additionally, Pentacam(R) can provide a useful objective measure of corneal haze.

Accuracy of Ocular Biometry and Postoperative Refraction in Cataract Patients with AL-Scan(R)

PURPOSE: To compare the axial lengths, anterior chamber depths, and keratometric measurements and to predict postoperative refractions of AL-Scan(R), IOL master(R), and ultrasound. METHODS: A total of 40 eyes in 30 patients who received cataract surgery were included in the present study. The axial length, anterior chamber depth, and keratometry were measured by 2 types of partial coherence interferometry (AL-Scan(R) and IOL master(R)) and ultrasound. The SRK/T formula was used to calculate IOL power, and the predictive error which subtracts predictive refraction from postoperative refraction was compared among the ocular biometry devices. RESULTS: Axial lengths were 23.08 +/- 0.62 mm, 23.09 +/- 0.62 mm, and 22.99 +/- 0.62 mm measured by AL scan(R), IOL master(R), and ultrasound, respectively. Axial length measured by ultrasound was statistically significantly shorter than AL scan(R) and IOL master(R) (p < 0.001, p < 0.001, respectively). The anterior chamber depth and keratometry were 3.11 +/- 0.06 mm and 44.82 +/- 1.34 D measured by AL scan(R), and 3.13 +/- 0.06 mm and 44.85 +/- 1.26 D measured by IOL master(R), respectively. The differences of anterior chamber depth and keratometry between the 2 devices were not statistically significant (p = 0.226, p = 0.331, respectively). The mean absolute prediction errors were 0.44 +/- 0.35 D, 0.40 +/- 0.34 D, and 0.39 +/- 0.30 D in AL-Scan(R), IOL master(R) and ultrasound, respectively, and were not statistically significantly different (p = 0.843, p = 0.847, p = 1.000, respectively). CONCLUSIONS: The ocular biometric measurements and prediction of postoperative refraction using AL-Scan(R) were as accurate as IOL master(R) and ultrasound.

Lacrimal Gland Ductulitis: Clinical Features and Management

PURPOSE: To describe the clinical characteristics and management of a group of patients who had infection of the lacrimal gland ductules. METHODS: We performed a retrospective chart review of 12 patients who had infection of the lacrimal gland ductules and were managed at Saevit Eye Hospital from June 2010 to May 2012. RESULTS: The patients' mean age was 31.8 +/- 17.7 years, and 7 were male and 5 were female. Common symptoms were a painful, swelling mass with mucous discharge (8 eyes) and conjunctival injection (4 eyes) at the lateral canthal area. All patients underwent surgical intervention by incision and curettage. Eleven patients (91.7%) had typical sulfur granule of actinomyces, and 8 patients (66.7%) had many cilia in the expressed debris from the ductule. All patients had resolution of symptoms after the procedure and showed no recurrence. CONCLUSIONS: Infective lacrimal gland ductulitis should be considered when a painful swelling mass with mucous discharge at the lateral canthal area is present. Surgical intervention by incision and curettage can be attempted preferentially as a minimally-invasive treatment option.

The Effects of Laser Refractive Surgery for Correcting Residual Refractive Error after Implantation of ReSTOR(R) Multifocal IOL

PURPOSE: To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses. METHODS: We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error. RESULTS: After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 +/- 0.89 D and the mean astigmatism was 2.08 +/- 0.55 D. Six months after laser surgery, the mean SE was -0.33 +/- 0.30 D (p = 0.354) and the mean astigmatism was 0.23 +/- 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 +/- 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100). CONCLUSIONS: On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses.

Preventive Effect on Inflammation and Anti-Inflammatory and Anti-Microbial Effects of Garlic Extract in a Rat Model of Chronic Bacterial Prostatitis

PURPOSE: Garlic has anti-microbial and anti-inflammatory effects. We investigated its actions and preventive effects on chronic bacterial prostatitis (CBP) using a rat model. MATERIALS AND METHODS: Bacterial suspension was inserted into the prostatic urethra of 75 rats. Then 15 were grouped as garlic group, and 60 as control group. Garlic and saline were given to each group for 4 weeks, respectively. After partial resection of the prostate, microbiological culture and histological examination were done. The incidence of CBP was compared between two groups. To evaluate the anti-microbial and anti-inflammatory effect of garlic, the 41 rats proved as CBP models among the control group were divided into 4 groups randomly: I, control; II, garlic; III, ciprofloxacin; IV, garlic plus ciprofloxacin. After 3 weeks of treatment, microbiological cultures of urine, prostate and histological examination of prostate were done. RESULTS: In study of the preventive effects, 5 rats in garlic treatment group and 41 rats in control group were shown to be CBP models. In anti-microbial and anti-inflammatory evaluation, positive urine culture rate and prostate tissue show no significant difference among four groups, but bacterial growth in urine and prostate tissue were lower in groups II, III, and IV than group I. Bacterial growth was the slowest in prostate tissue of group IV. Histologic findings were more improved in groups II, III and IV than group I, with Group IV being the most improved. CONCLUSIONS: These results show that garlic has preventive and therapeutic effects on CBP. Combination treatment with antibiotics may be considered in the future.

Oncologic Outcome following Laparoscopic Radical Prostatectomy and the Difference in Oncologic Outcomes according to the Site of the Positive Margin: Comparison of the Apical Positive Margin with the Non-Apical Positive Margin

PURPOSE: The aim of this study was to analyze oncologic outcomes based on 7 years of consecutive experience with laparoscopic radical prostatectomy (LRP) and to assess the prognostic difference between an apical positive margin and a non-apical positive margin. MATERIALS AND METHODS: We reviewed 202 patients who underwent LRP between July 2001 and July 2007 (pathologic stage: T2-T3b, without any adjunctive therapy). Biochemical recurrence (bR) was defined as two consecutive prostate-specific antigen (PSA) values greater than 0.2 ng/ml. We analyzed the differences in bR among the negative margin group (N), the apical positive margin group (A), and the non-apical positive margin group (NA) and factors predicting bR. RESULTS: Overall 3-year probability of bR-free survival (bRFS) was 78% (pT2, 83.7%; pT3, 60.9%). For low-, intermediate-, and high-risk cancer, 3-year bRFS was 94.7%, 82.8%, and 60.7%, respectively. Of the 155 men who had negative and single-site positive margins, the numbers in the N, A, and NA groups were 108, 19, and 28, respectively. bR rates for the N, A, and NA groups were 14.8%, 36.8%, and 46.4%, respectively. Kaplan-Meier curves showed that a positive surgical margin had a significant higher bR compared with the N group; however, the A group experienced a similar bRFS compared with the NA group (p=0.613). Multivariate Cox proportional hazards analysis indicated no significant difference of effect on time to bR between the A and NA groups (hazard ratio=1.213; 95% confidence interval: 0.482-3.052). CONCLUSIONS: Our results were almost identical to previous reports of radical prostatectomy in pT2 disease. With increasing experience, we could expect improved oncologic outcomes. In comparison with the NA group, the A group did not show a significant prognostic difference.

The Effect of Cardiovascular Risk Factors on the Patient with Erectile Dysfunction and Diabetes and the Response to Phosphodiesterase Type 5 Inhibitors / 대한남성과학회지

PURPOSE: Erectile dysfunction (ED) is a common comorbidity with diabetes mellitus (DM). The goal of this study was to evaluate the effect of cardiovascular risk factors (CVRF) on ED patients with DM and the response to phosphodiesterase type-5 (PDE5) inhibitors. MATERIALS AND METHODS: We performed a retrospective study on 32 patients with ED and type II DM. The CVRFs were defined as hypertension, coronary artery disease, hyperlipidemia, smoking and obesity. All the patients were checked for CVRFs and the erectile function was assessed with the International Index of Erectile Function (IIEF) score. Tadalafil (20mg) was taken for 3 months, and then the IIEF score was checked again. The scores of the IIEF-EF, Q3 and Q4 and the number of risk factors were analyzed. RESULTS: The scores of the IIEF-EF, Q3 and Q4 were higher in the non-risk factor group than that in the risk factor group. After Tadalafil treatment, the score of the group that had less than 1 risk factor was significantly improved, but the score of the group that had more than 2 risk factors showed little change. CONCLUSIONS: To treat ED patients with DM, their cardiovascular risk factors must be assessed.