The Clinical Observation of Cataract Surgery in Leprosy Patients

In leprosy patients, the cataract surgery may be combined with additinal manipulation for presenting miosis such as iris surgery. The authors have studies retrospectively the incidence, surgical results, and postperative complications of extracapsular cataract extraction and posterior chamber IOL implantation combined with iris surgery of 50 eyes with a follow-up period of more than 3 months. Pupil dilatation procedure was necessary for miotic pupils in 31 eyes and in 8 cases pupilloplasty also was performed. The average visual acuity was 0.1 preoperatively and 0.6 postoperatively. The common postoperative complications included after-cataract in 28 eyes(56%) and iris capture and/or synechia in 9(18%) eyes. After-cataract developed more frequently in eyes with a history of uveitis(92.6%) or those that received iris surgery(71%). Iris capture developed in those who received cataract surgery with pupil dilatation procedure and did not develop in those with additional pupilloplasty. Also pupilloplasty patients complained of less photophobia. In conclusion, pupil dilatation procedures may be required in cataract surgery of leprosy patients and is related with the development of aftercataract, but to prevent iris capture and photophobia additional pupiolloplasty is recommended.

A Case of Congenital Lacrimal Amniotocele

Congenital obstruction of the lacrimal system is common at the valve of Hasner. When a concomitant obstruction exists at the opening of the canaliculi in the tear sac, fluid accumulates and causes a distension of the lacrimal sac at birth. This condition is variously called congenital lacrimal amniotocele, mucocele or dacryocele. We have experienced a case of congenital lacrimal amniotocele that showed epiphora and tense blue-gray swelling over the right lacrimal sac since birth in a 24 day old boy. He has been treated with probing and topical antibiotic and has remained asymptomatic for six months.

Scanning Laser Ophthalmoscopic Examination on Circulation in Primary Open Angle Glaucoma

To investigate the retinal hemodynamics in chronic primary open angle glaucoma (POAG), high-quality video fluorescein angiograms using a scanning laser ophthalmoscope(SL0 101, Rodenstock, Munich, Germany) were obtained from 22 eyes of 16 patients with POAG and 14 eyes of 14 healthy subjects. From these angiograms, the arm to retinal time (ART), arteriovenous passage time (AvFT), venous fulling time(VFT) and arteriovenous fulling time (AvFT) were quantified. And these parameters of retinal circulation of the group of patients with POAG were compared with those of the age-matched group of healthy subjects. There were no significant differences in the ART between two groups (p=0.09). But significant prolongations of the AvPT, VFT and AvFT of the group of patients with POAG(2.5 +/- 1.1, 8.4 +/- 1.8 and 10.9 +/- 2. sec, respectively) were observed compared to the values (1.8 +/- 0.7, 6.4 +/- 2.2 and 8.1 +/- 2. 4 sec, respectively) obtained among the healthy subjects (p=0.04, p=0.007 and p=0.0008, respectively). These results indicate that a significant retinal microcirculatory deficit exists in the eyes of POAG, and the VFT and AvFT may be good indices of retinal microcirculatory deficit in the eyes of POAG.