The Comparision of Surgical Results of Endonasal Dacryocystorhinostomy in Childen and Adults

PURPOSE: This study evaluated the success and complication rates of endonasal dacryocystorhinostomy (DCR) in children and adults. METHODS: Fifty-six children (57 eyes) and 843 adults (870 eyes) who underwent endonasal DCR to treat nasolacrimal duct obstruction (NLDO) at the Department of Ophthalmology between April 1994 and March 2004 were included in this retrospective study. RESULTS: The mean age of patients was 7.7+/-2.83 years (2~15 years) in children and 51.8+/-14.10 years (16~81 years) in adults, with mean follow-up periods of 28.4+/-23.62 months (10~91 months) and 14.7+/-11.08 months (9~120 months), respectively. The primary success rate in children (94.7%) was significantly higher than that in adults (86.0%). Significantly more synechia formation was found in children (26.3%) than in adults (10.4%). However, granuloma and membranous obstruction in children (respectively 21% and 7.1%) were significantly less than in adults (respectively 37.9% and 15%). CONCLUSIONS: Although endonasal DCR in children has problems such as technical difficulty due to a narrower nasal cavity, postoperative care difficulties and higher rates of synechia formation, endonasal DCR is a safe and effective means of treating NLDO in children, with higher success rates than those in adults.

The Effect of L-dopa in Amblyopic Children for Whom Occlusion Therapy Failed

PURPOSE: This study was undertaken to evaluate the effect of L-dopa in amblyopic children for whom occlusion treatment failed. METHODS: We studied nine amblyopic children (11 eyes) for whom part-time occlusion (4~8 hours/day) treatment for a minimum period of 6 months had failed. The types of amblyopia included: anisometropic (1 patient, 1 eye), stimulus deprivation (4 patients, 6 eyes) and mixed (anisometropic and strabismic: 2 patients, 2 eyes; anisometropic and organic: 2 patients, 2 eyes). Best corrected visual acuity before treatment was between 0.05 and 0.5. They received, with full informed consent of the parent, levodopa (2~4 mg/kg) for 8 weeks combined with part-time occlusion. RESULTS: The children were between 4 and 11 years old (mean 5.8+/-2.05). Of the subjects, 45.5% (4 patients, 5 eyes) had improved visual acuity after 8 weeks of treatment. In one patient with anisometropic, two patients with mixed (anisometropic and strabismic), and one patient with stimulus deprivation (ametropic) amblyopia, visual acuity improved by one to five lines. CONCLUSIONS: In anisometropic, strabismic amblyopes and mild deprivational amblyopes for whom occlusion treatment failed, L-dopa improved visual acuity. L-dopa may be an additional option for treatment of amblyopic patients with a guarded visual prognosis.

Clinical Results of Pars Plana Vitrectomy on Posterior Segment Complications in Posterior Uveitis

PURPOSE: This study was undertaken to evaluate the clinical results of pars plana vitrectomy on posterior segment complications in posterior uveitis. METHODS: We reviewed the records of 20 eyes of 19 uveitis patients who were followed up for 6 months or more after vitrectomy. RESULTS: The mean follow-up period was 20 months. Final visual acuity improved in 10 eyes (50%), was maintained in 6 (30%), and decreased in 4 (20%). The mean improvement of vision was 1.6 lines (p=0.019). Detached retina was reattached in 8 (80%) among the 10 eyes with primary surgery. Postoperative complications were cataract (7 eyes), macular degeneration (2 eyes), retinal detachment (2 eyes), and recurrence (1 eye). CONCLUSIONS: These results suggest that pars plana vitrectomy may be a safe and effective treatment for posterior segment complications in posterior uveitis, but that early and complete vitrectomy should be considered for a better visual prognosis.