Clinical Features of Benign Essential Blepharospasm in Korean Patients

PURPOSE: To analyze the clinical features of benign essential blepharospasm in Korean patients. METHODS: Patients diagnosed with benign essential blepharospasm in Kim's Eye Hospital from November 2014 to December 2016 were evaluated using a clinical examination and questionnaire. The questionnaire reviewed personal medical history, demographic factors, risk factors for blepharospasm development, and relieving and aggravating factors. RESULTS: Of the 101 patients enrolled, 78 (77.2%) were women. The mean age was 64.9 years old. Hypertension was the most common medical disorder (42.6%), followed by diabetes mellitus. The majority of the patients were non-smokers (83.2%) and drank less than a cup of a caffeinated beverage a day (30.7%). Fifty-seven percent of patients reported no stressful events immediately prior to symptom development. Fatigue and stress were aggravating factors in more than 55% of patients; rest was the most common relieving factor (35.6%). CONCLUSIONS: Here, we report the clinical features of benign essential blepharospasm in Korean patients for the first time. The results were consistent with previous reports showing that the majority of benign essential blepharospasm patients are women and non-smokers. In contrast to previous reports though, fatigue and stress were aggravating factors, and the most common relieving factor was rest. No stressful events had immediately preceded the development of blepharospasm in 57.4% of patients. This report may aid in treating and counseling patients with benign essential blepharospasm.

Comparison of the Efficacies of 0.94 mm and Double Silicone Tubes for Treatment of Canalicular Obstruction

PURPOSE: To compare the clinical effects of the single wide-diameter bicanalicular silicone tube and the double bicanalicular silicone tube in endonasal dacryocystorhinostomy (DCR) with canalicular trephinization for canalicular obstruction. METHODS: We retrospectively reviewed the records of 121 patients with monocanalicular or common canalicular obstruction who had undergone endonasal DCR with random bicanalicular insertion of either double silicone tubes (insertion of two tubes into each canaliculus) or a single wide-diameter (0.94 mm) silicone tube. The tubes were removed at around 3 months after surgery. RESULTS: This study included 79 eyes of 61 patients in the double-tube intubation group and 68 eyes of 60 patients in the single wide-diameter tube intubation group. Anatomical success, evaluated by syringing, was achieved in 72 of the 79 eyes (91.1%) in the double-tube intubation group and 60 of the 68 eyes (88.2%) in the single wide-diameter tube intubation group. Functional success was achieved in 65 of the 79 eyes (82.3%) in the double-tube intubation group and 61 of the 68 (89.7%) eyes in the single wide-diameter tube intubation group. There were no significant differences in the success rates of surgery between the two groups. One patient in the double-tube intubation group underwent conjunctivodacryocystorhinostomy (CDCR) and two in the wide-diameter tube intubation group underwent CDCR or reintubation to treat recurrence. CONCLUSIONS: Intubation using a single wide-diameter tube during endonasal DCR is as effective as double-tube intubation for the treatment of canalicular obstruction, with a lower rate of complications such as inflammation or patient discomfort.

Causes and Surgical Outcomes of Lower Eyelid Retraction

PURPOSE: To investigate the causes of lower eyelid retraction and evaluate the outcomes of various surgical procedures. METHODS: We conducted a retrospective medical record review of patients who underwent lower eyelid retraction surgery performed by a single surgeon at Kim's Eye Hospital between 2006 and 2013. We investigated the causes of lower eyelid retraction, clinical history, characteristics, treatment, and surgical outcomes. Preoperative and postoperative margin reflex distance 2 and inferior scleral show were measured for each eyelid. Success was defined as a positive eyelid elevation and a decrease in inferior scleral show. RESULTS: A total of 19 lower eyelids were treated in 14 patients with lower eyelid retraction. For cosmetic reasons, surgical correction for congenital lower eyelid retraction was performed on seven eyelids (36.8%). Ten eyelids (52.6%) exhibited secondary lower eyelid retraction after surgery. One eyelid (5.3%) was affected by facial palsy and one eyelid (5.3%) exhibited exophthalmos of an unknown origin. We adopted a selective approach based on lower eyelid retraction severity. Spacer grafting via a subconjunctival approach was the most commonly performed surgical technique (13 eyelids, 68.4%). The lateral tarsal strip procedure was used to horizontally tighten three eyelids (15.8%). At the time of the procedure, one of these eyelids (5.3%) also received an adjuvant suborbicularis oculi fat lift. Autogenous dermis fat grafting was performed on two lower eyelids (10.5%), whose retraction was caused by fat and soft tissue loss. Cosmetic outcomes were satisfactory in all cases. CONCLUSIONS: To achieve satisfactory surgical outcomes, surgeons should adopt an approach based on the severity of lower eyelid retraction. Mild lower eyelid retraction can be corrected without grafts. When retraction is severe and exceeds 2 mm, spacer grafts that push the lower eyelid margin upwards and support it from below are required.

Cause and Management of Patients With Failed Endonasal Dacryocystorhinostomy

OBJECTIVES: Endonasal dacryocystorhinostomy (DCR) is a well-established treatment method in patients with nasolacrimal duct obstruction. However, there are a few reports about the overall management of failed endonasal DCR. We investigated the causes and management strategies of failed endonasal DCR. METHODS: This retrospective review included 61 patients (61 eyes) who had undergone revision surgery by the same surgeon after failed endonasal DCR between January 2008 and December 2012. The appropriate revision method was determined after analysis of the etiology of failure by the fluorescein dye disappearance test, nasal endoscopy, lacrimal irrigation, and probing. The criteria for success of the revision surgery were defined by the passage of fluid without resistance upon lacrimal irrigation and normalization of the tear meniscus height. RESULTS: The mean duration between the primary endonasal DCR and revision surgery was 15.3 months. The average follow-up period after revision surgery was 12.2 months. The most common cause of endoscopic revision surgery was membranous obstruction. Endoscopic revision surgery was performed in 48 patients, while lacrimal silicone tube intubation under endoscopy was performed in 13 patients. The most common indication for lacrimal silicone tube intubation was functional epiphora. The overall success rate of the revision surgery was 89%. CONCLUSION: The most common cause of failed endonasal DCR was membranous obstruction. When patients with failed endonasal DCR presented at the clinic, it is important to identify the cause of the failure. Revision surgery could increase the final success rate of endonasal DCR.

Preoperative Computed Tomography Findings for Patients with Nasolacrimal Duct Obstruction or Stenosis

PURPOSE: To identify and analyze the role of preoperative computed tomography (CT) in patients with tearing symptoms with nasolacrimal duct obstruction (NLDO). METHODS: We retrospectively reviewed the medical records and CT results on 218 patients who complained of tearing symptoms with NLDO between January 2014 and December 2014. All patients were recruited from Kim's Eye Hospital's outpatient clinic and assessed by clinical history, examination, and CT to evaluate periocular pathology and nasolacrimal drainage system. Patients with abnormal findings assessed by preoperative CT were further reviewed. RESULTS: CT was performed on 218 patients (average age, 58.2 ± 11.9 years). Of these, 196 (89.9%) had endonasal dacryocystorhinostomy, 14 (6.4%) declined surgery, and 8 (3.7%) were inoperable due to abnormal CT findings. Soft tissue opacity was the most common finding which 243 cases (85.9%) of 283 obstructed nasolacrimal duct and 89 cases (81.7%) of 109 non-obstructed nasolacrimal duct showed it. Thirty-nine (17.8%) of 218 patients showed either maxillary sinusitis or ethmoidal sinusitis and 32 (14.7%) of 218 patients presented with periocular inflammation. Other abnormal CT findings included septal deviations, previous fractures, masses, and structural abnormalities of nasal cavity. CONCLUSIONS: Preoperative CT imaging is useful in the assessment of both nasolacrimal drainage and nearby anatomical structures. This information will be helpful in planning surgical interventions and management of NLDO.

Predictors of Silicone Tube Intubation Success in Patients with Lacrimal Drainage System Stenosis

PURPOSE: To evaluate prognostic factors affecting silicone tube intubation outcomes in Asian patients with lacrimal drainage system stenosis. METHODS: A retrospective review was conducted on the medical records of 822 patients (1,118 eyes) who had undergone silicone tube intubation to treat lacrimal drainage system stenosis between January 2011 and December 2012. Patients were divided into two groups: a success group and a failure group. Success was defined as the disappearance of epiphora symptoms, normalization of tear meniscus height, and the easy passage of fluid without resistance on the postoperative syringing test. Patient and ocular parameters were compared between the success and failure groups. RESULTS: A total of 994 eyes of 727 patients were included in analyses. Patients had a mean follow-up period of 34.11 ± 18.70 weeks. Silicone tube intubation was successful in 67.2% of participants. Significant differences between the success and failure groups were found for age (p < 0.001), history of ipsilateral facial palsy (p = 0.028), follow-up period (p < 0.001), and degree of passage on the preoperative syringing test (p = 0.001). Only age (p < 0.001) and degree of passage on the preoperative syringing test (p = 0.002) remained significantly associated with silicone tube intubation success in multivariate analysis. CONCLUSIONS: Age was negatively associated with silicone tube intubation success in patients with lacrimal drainage system stenosis. The success rate was higher in patients who showed easy passage of fluid without resistance on the preoperative syringing test. These factors should be considered by surgeons planning silicone tube intubation in patients with lacrimal drainage system stenosis.

Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction

PURPOSE: This study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique. METHODS: We retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient's subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon. RESULTS: Functional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test). CONCLUSIONS: The success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.

Reconstruction of Orbital Medial Wall Fracture with Absorbable and Non-Absorbable Orbital Implant: Comparative Study

PURPOSE: To compare the surgical results and complications of medial wall fracture reconstruction using non-absorbable porous polyethylene implants (Medpor(R), Stryker Instruments, Kalamazoo, Michigan, USA) and an absorbable polymer of polyglycolic acid (PGA) and polylactic acid (PLA) (Mesh plate(R), Inion Ltd, Tampere, Finland). METHODS: We retrospectively reviewed the data of patients who underwent reconstruction of medial wall fracture between January 2007 and June 2012 and divided them into 2 groups according to orbital implant type (Medpor(R), Mesh plate(R)). RESULTS: Among the 86 patients, 37 were treated with Medpor(R) and 49 with Mesh plate(R). There was no statistically significant difference in limitation of motion or diplopia score between the 2 groups at postoperative 6 months (Fisher's exact test, p = 0.192, p = 0.128, respectively). Mean postoperative exophthalmometry differences between the eyes were 0.49 +/- 1.04 mm and 0.37 +/- 0.62 mm in Medpor(R) and Mesh plate(R) groups, respectively, showing no statistically significant difference (independent t-test, p = 0.512). Postoperative complications such as inflammation or implant malposition were observed only in 3 patients in the Medpor(R) group. CONCLUSIONS: No difference was observed between Medpor(R) and Mesh plate(R) in terms of surgical results during the postoperative 6 month period after reconstruction of orbital medial wall fracture. However, postoperative complications were observed in 3 patients in the Medpor(R) group.

Reconstruction of Orbital Medial Wall Fracture with Absorbable and Non-Absorbable Orbital Implant: Comparative Study

PURPOSE: To compare the surgical results and complications of medial wall fracture reconstruction using non-absorbable porous polyethylene implants (Medpor(R), Stryker Instruments, Kalamazoo, Michigan, USA) and an absorbable polymer of polyglycolic acid (PGA) and polylactic acid (PLA) (Mesh plate(R), Inion Ltd, Tampere, Finland). METHODS: We retrospectively reviewed the data of patients who underwent reconstruction of medial wall fracture between January 2007 and June 2012 and divided them into 2 groups according to orbital implant type (Medpor(R), Mesh plate(R)). RESULTS: Among the 86 patients, 37 were treated with Medpor(R) and 49 with Mesh plate(R). There was no statistically significant difference in limitation of motion or diplopia score between the 2 groups at postoperative 6 months (Fisher's exact test, p = 0.192, p = 0.128, respectively). Mean postoperative exophthalmometry differences between the eyes were 0.49 +/- 1.04 mm and 0.37 +/- 0.62 mm in Medpor(R) and Mesh plate(R) groups, respectively, showing no statistically significant difference (independent t-test, p = 0.512). Postoperative complications such as inflammation or implant malposition were observed only in 3 patients in the Medpor(R) group. CONCLUSIONS: No difference was observed between Medpor(R) and Mesh plate(R) in terms of surgical results during the postoperative 6 month period after reconstruction of orbital medial wall fracture. However, postoperative complications were observed in 3 patients in the Medpor(R) group.

Causes and Treatments of Entropion and Ectropion in Adults

PURPOSE: To evaluate the causes and treatments of entropion and ectropion in adults. METHODS: A retrospective review was performed of 397 patients (490 eyes) with entropion and 109 patients (138 eyes) with ectropion who underwent corrective surgery at Kim's Eye Hospital from January 2009 to December 2012. RESULTS: The surgical correction of entropion was 3.5 times greater than that of ectropion. The causes of entropion were classified as senile (98.4%), cicatricial (1.4%) and spastic (0.2%). The causes of ectropion were classified as cicatricial (60.1%), paralytic (23.2%) and senile (16.7%). CONCLUSIONS: The main causes of entropion and ectropion were senile and cicatricial, respectively. Specifically, senile entropion was more common than senile ectropion, which is considered to be related to the lid anatomy of Asian patients.

Outcomes of Isolated Medial Orbital Wall Fracture Reconstructions

PURPOSE: To evaluate surgical results after the reconstruction of isolated medial orbital wall fractures. METHODS: We performed a retrospective chart review of patients with isolated medial orbital wall fractures who underwent reconstruction using the transcaruncular approach from March 2012 to October 2013. Computed tomography (CT) was performed before and after surgery. Postoperative follow-ups were conducted at 1 week, 1 month, and 3 months. Diplopia, ocular motility, postoperative complication, and exophthalmometry were recorded at each follow-up visit. Preoperative and postoperative enophthalmos was quantified using Hertel exophthalmometry and a quantitative method for the area of the circular sector under the chord (CA)/orbital area (OA) ratio at the CT scan. Patients were divided into either the incomplete or complete reduction groups based on the degree of reduction observed on postoperative CT. RESULTS: We evaluated 55 patients (42 males, 13 females) with an average age of 36 years. Five of 55 patients with preoperative enophthalmos of more than 2 mm obtained good symmetry after surgery. Diplopia at primary gaze was resolved in 9 of 9 patients and 2 patients had residual diplopia on lateral gaze. The difference of exophthalmometry and CA-to OA ratio between before and after reconstruction was not significantly changed in either the incomplete or complete groups. CONCLUSIONS: Enophthalmos and diplopia were well corrected in all subjects. If reduction was successfully performed in the anterior portion of medial orbital wall fracture, clinically significant enophthalmos might be preventable even if complete reduction was not obtained.

Clinical Results of Nasopore(R) Nasal Packing on Endonasal Dacryocystorhinostomy

PURPOSE: To investigate the effects of Nasopore(R) as a nasal packing material on the surgical success rate and prevalence of postoperative complications after endonasal dacryocystorhinostomy (DCR). METHODS: The present study included a total of 558 patients (699 eyes) with primary acquired nasolacrimal duct obstruction who underwent endonasal DCR; 227 eyes were packed with Nasopore(R) and 472 eyes were packed with Merocel(R). The surgical success rate and postoperative complications such as synechiae, granulation, wound healing (osteal mucosal epithelium epithelialization), postoperative bleeding, infection, and revision rate were compared between the packing materials. RESULTS: The surgical success rate of the Nasopore(R) group (99.1%, 98.6%) showed significantly better results than the Merocel(R) group (97.2%, 95.1%) at postoperative 1 and 3 months (p = 0.04, 0.03 Pearson chi-square test), whereas there was no statistically significant difference between the 2 groups in postoperative surgical success rate at 1 week and 6 months. In comparison of postoperative complications, the Nasopore(R) group (0%) showed a lower incidence of delayed wound healing (delayed epithelialization of osteal mucosal epithelium) than the Merocel(R) group (2.3%; p = 0.013), whereas there was no difference in granulation, synechiae, postoperative bleeding, infection and revision rate (p > 0.05). CONCLUSIONS: The Nasopore(R) group showed a lower proportion of delayed wound healing and improvement of the surgical success rate at an early postoperative period after endonasal DCR compared to non-absorbable nasal packing material.

Repeated Infection and Inflammation in a Case with Bilateral Congenital Lacrimal Fistula after Complete Fistulectomy

PURPOSE: To report a case of bilateral congenital lacrimal fistula that presented with repeated infection and inflammation after complete fistulectomy, which required an incision and drainage of pus from the operation site. CASE SUMMARY: A 22-year-old male without any medical history presented with repeated erythematous swelling and inflammation, resulting in tenderness around the opening of congenital lacrimal fistula. The lacrimal fistula opening was located approximately 12 mm inferiorly apart from the medial canthus. The complete excision of lacrimal fistula was performed without any inter-operative events. However, 4 days postoperatively, the patient complained of discomfort and swelling, with purulent discharge from the bilateral operation site. There was no improvement although treatment with antibiotics, incision and drainage was performed. After 1 month, an additional incision and drainage was necessary due to inflammation in the left operation site. One month later, pus and purulent discharge were occurring from the right operation site, requiring an additional incision and drainage. At that time, Actinomyces israelli was identified on wound culture examination. One month later, an additional incision and drainage was performed due to repeated inflammation in the left operation site. In the present case, we hypothesized the opening site of congenital lacrimal fistula was relatively far apart from the medial canthus and played a role in atypical repeated inflammation and infection on the operation site. CONCLUSIONS: In surgical treatment of congenital lacrimal fistula, careful preoperative observation of the location of the lacrimal fistula's opening site would be helpful in prediction of postoperative complication, such as wound infection and inflammation, as well as in educating and informing the patient.

Prediction of Prognosis for Children Cared in Intensive Care Unit (ICU) after Hematopoietic Stem Cell Transplantation (HSCT) / 대한구급학회지

BACKGROUND: Pediatric Index of Mortality 2 (PIM2) is a useful scoring system for the prediction of prognosis, and Oncological Pediatric Risk of Mortality (O-PRISM) for ICU support in children with HSCT. We investigated prognostic prediction and risk factors for survival through early detection of admission to ICU after HSCT. METHODS: We reviewed retrospectively medical records of children cared for in ICU after HSCT between 2004 and 2010. Patients who died within 2 hours after admittance to ICU were excluded. We analyzed the worst parameters in ICU by a t-test, Cox-regression, multiple logistic regression and a receiver operating characteristics curve (ROC). RESULTS: 54 children, with fifty-five disease events, were admitted to ICU after HSCT. Sixteen children were diagnosed with high-risk disease status and 8 with non-malignant diseases. Stem cells were sourced from 14 matched siblings, 22 unrelated donors and 19 cord bloods. The median duration in ICU was 8.5 days (0.5-110). The reasons for admission to ICU were 32 pulmonary, 14 neurologic, and 9 hemodynamic events. Six patients (11.1%) survived after intensive care. The factor indicating discharge with survival was mental status (p = 0.04), although other factors included FiO2, prothrombin time, potassium, and pupil reflex in univariate analysis. In multiple logistic regression, there were significant factors of PaCO2 (p = 0.028), O-PRISM (p = 0.039), and PIM2 (p = 0.004) for prognosis. For prediction of prognosis, O-PRISM (p = 0.019) was superior to PIM2 (p = 0.435) in intensive care children after HSCT. CONCLUSIONS: O-PRISM might be a predictable scoring system for children with ICU support, and the Glasgow coma scale and PaCO2 were more reliable prognostic factors in the post-HSCT period.

Integrated analysis of copy number alteration and RNA expression profiles of cancer using a high-resolution whole-genome oligonucleotide array

Recently, microarray-based comparative genomic hybridization (array-CGH) has emerged as a very efficient technology with higher resolution for the genome-wide identification of copy number alterations (CNA). Although CNAs are thought to affect gene expression, there is no platform currently available for the integrated CNA-expression analysis. To achieve high-resolution copy number analysis integrated with expression profiles, we established human 30k oligoarray-based genome-wide copy number analysis system and explored the applicability of this system for integrated genome and transcriptome analysis using MDA-MB-231 cell line. We compared the CNAs detected by the oligoarray with those detected by the 3k BAC array for validation. The oligoarray identified the single copy difference more accurately and sensitively than the BAC array. Seventeen CNAs detected by both platforms in MDA-MB-231 such as gains of 5p15.33-13.1, 8q11.22-8q21.13, 17p11.2, and losses of 1p32.3, 8p23.3-8p11.21, and 9p21 were consistently identified in previous studies on breast cancer. There were 122 other small CNAs (mean size 1.79 mb) that were detected by oligoarray only, not by BAC-array. We performed genomic qPCR targeting 7 CNA regions, detected by oligoarray only, and one non-CNA region to validate the oligoarray CNA detection. All qPCR results were consistent with the oligoarray-CGH results. When we explored the possibility of combined interpretation of both DNA copy number and RNA expression profiles, mean DNA copy number and RNA expression levels showed a significant correlation. In conclusion, this 30k oligoarray-CGH system can be a reasonable choice for analyzing whole genome CNAs and RNA expression profiles at a lower cost.

Clinical Manifestation of Primary Headache with Epigastric Pain or Tenderness in Children / 대한소아신경학회지

PURPOSE: Population-based studies have shown positive associations between migraine and irritable bowel syndrome, colitis and peptic ulcer and migraine prevalence was higher among patients with dysmotility-like dyspepsia or nausea/vomiting. The aim of this study was to investigate clinical manifestation between primary headache with epigastric pain or tenderness(EPT) and primary headache without EPT. METHODS: We retrospectively reviewed the medical records of 58 patients who were diagnosed primary headache[by ICHD-II(2004)] at Incheon St. Mary Hospital from January, 2006 to December, 2007. Their clinical characteristics such as age, sex, frequency & severity of headache and associated symptoms & signs were analysed. RESULTS: The rate of headache associated with EPT were 36% of migraine cases, 50% of tension-type headache cases, and 100% of unclassified headache cases. Headache with EPT were at a high rate in female. Headache with EPT were more severe than one without EPT. Regulation of behavior, diet and sleep pattern had improved severity of headache in 71% of migraine without EPT and 94% of tension-type headache without EPT, but in 12% of migraine with EPT and 18% of tension-type headache with EPT. Headache disappeared in 64% of migraine with EPT and 53% of tension-type headache by additional regular antiacid medication. CONCLUSION: Our study supports any specific correlation between headache and EPT, but further studies are needed.

Removal of Deep Orbital Tumor through Small Incision Approach

PURPOSE: We report on the effectiveness of the small incision anterior approach for the deep orbital tumor. METHODS: The authors operated on 5 patients with deep orbital tumor using the small incision anterior approach. RESULTS: Five cases , 2 neurilemmomas, 1 orbital dermoid cyst, 1 angiofibroma, and 1 osteoma, were treated surgically with the small incision anterior approach and had good cosmetic result, early recovery, and showed no serious complications. CONCLUSIONS: The small incision anterior approach for the deep orbital tumor has a number of advantages over lateral orbitotomy, including shorter operation time, early recovery and good cosmetic results. Nevertheless, this technique requires a precise preoperative diagnosis.

Surgical Outcomes of Implantation of Newly Designed T-shaped Intraocular Lens in Congenital Cataract

PURPOSE: We evaluated the surgical outcomes and complications of new pediatric intraocular lens in congenital cataract. METHODS: A retrospective study was carried out on 29 eyes of 22 patients diagnosed with congenital cataract that underwent optic capture following lens emulsification. New pediatric intraocular lens (LJC 575A, Lucid Korea, Seoul, Korea) implantation into the bag was performed with posterior capsulorrhexis and anterior vitrectomy. RESULTS: After follow-up of 17.79+/-7.08 months, 15 eyes showed a visual acuity of 0.5 or above, and 10 (71.4%) of the 14 eyes showed a visual acuity of 20/470 or above. As for complications, posterior synechia developed in 8 eyes, exudative membrane was found in 3 eyes, iris capture by IOL haptic was found in 1 eye, and slight opacification of posterior capsule was identified in 1 eye. CONCLUSIONS: Use of new 8 mm pediatric intraocular lens in congenital cataract may be considered selectively.

Ocular Motility Disturbance and Strabismus caused by High Myopia in Siblings

PURPOSE: Acquired ocular motility disturbance or strabismus in adult can be often diagnosed as paralytic strabismus, endocrine ophthalmopathy such as thyroid ophthalmopathy or myasthenia gravis etc. We present the diagnosis and treatment of two cases of high myopia with esotropia, hypotropia and abduction deficiency in siblings. METHODS: Two middle-aged women in siblings visited our hospital for evaluation of progressive esodeviation of eyeball. Ophthalmologic evaluations were performed including manifest refraction, duction test, prism cover test, fundus examination and ocular imaging study. Endocrinologic evaluations including thyroid function test and neostigmine test were also performed. RESULTS: Both patients had high myopia, esotropia and severe abduction deficiency, and one of them had hypotropia. Their thyroid function tests were normal and neostigmine test was negative. Ocular imaging study showed the orbits filled with the enlarged globes and lateral rectus muscles compressed by globes. Primarily, recession of bilateral medial rectus muslces was performed in both patients. Secondarily, recession of the ipsilateral inferior rectus muscle was performed in one patient who had hypotropia, and transposition of superior rectus muscle and inferior rectus muscle to lateral rectus muscle insertion site was performed in the other patient. The results were acceptable.

Clinical Results of Unilateral Implantation of AMO Array Multifocal Intraocular Lens

PURPOSE: We evaluated the clinical results of unilateral implantation of AMO Array(r) intraocular lens in unilateral or bilateral cataract patients with minimum follow-up of 6 months. METHODS: This prospective study comprised two groups of 20 eyes each: one with AMO Array(r) intraocular lens(multi group) and the other with monofocal silicone intraocular lens(mono group). Main outcome measures were Snellen distance visual acuities; near acuities with Birkhauser reading chart. RESULTS: The difference between two groups in mean distance visual acuity was not statistically significant. Both monocular and binocular uncorrected near visual acuity in the multi group were significantly better than mono group. Four of 20 patients(20%) in monofocal group and 13 of 20 patients(65%) in multifocal group noticed light sensation(glare, halo etc.) after surgery, with the majority not being bothered by all of these. More than 90% patients were satisfied after surgery in both groups. CONCLUSIONS: With appropriate patient selection, near vision without spectacles was functionally acceptable in a majority of unilateral multifocal intraocular lens implantation cases. And, there was no significant problem in unilateral implantation of AMO Array intraocular lens. AMO Array lens can be used in unilateral cataract surgery.