Morphologic Changes of Anterior Chamber Angle and Trabecular Meshwork According to Embryonic Age in Human Fetal Eyes

PURPOSE: To investigate the morphologic changes of anterior chamber angle and trabecular meshwork during development in human fetal eyes, 77 eyes was enrolled in this study. METHODS: The sequential development of iridocorneal angle and trabecular meshwork were examined using light microscopy in 77 eyes with a gestational age ranged from 7 to 40 weeks. RESULTS: It was found that the presence of openings in the anterior chamber angle lining and aqueous humor drainage was effective by 20~22 weeks of fetal life and intercellular gaps become larger and more frequent as development progresses. During the gestational age(28~30 week), the anterior ahamber was located at the middle of the trabecular meshwork. During the gestational age(32~38 week), the intertra-becular space was widen with the apparent presence of the Schlemm's canal. CONCLUSIONS: The arrest or abnormal differetiation during the gestational period may cause the dysfunction of aqueous humor outflow, to develop congenital glaucoma.

The Effect of Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

The purpose of this study was to validate the efficacy of transscleral diode laser cyclophotocoagulation (CPC)procedure in refractory glaucoma cases for which conventional medical or surgical filtering procedures had failed or were thought to have a poor likelihood of success. Thirty-eight eyes of 38 consecutive patients with refractory glaucoma received transscleral diode CPC. Patients were followed for a mean of 5.5 months. We reviewed available data at preoperative state and at 1 day, 1week, 1 month, 2 months and 4 months postoperatively. Data analyzed were visual acuity, intraocular pressure(IOP)and postoperative complications. There was a statistically significant decrease in IOP at postoperative 1day, 1 week, 1 month, 2 months and 4 months compared with preoperative IOP. Postoperative complications were hyphema in 4 eyes and fibrinousuveitis in 1 eye but all of these complications were controlled with medical treatment. We concluded that transscleral diode CPC could be a good treatment proce-dure for the IOP control in refractory glaucoma cases.

The Measurement of Ocular Blood Flow Velocity using Doppler Ultrasound in Normal Tension Glaucoma Patients

To evaluate the implication of vascular factors in normal tension glaucoma, the authors measured ocular blood flow velocity in normal tension glaucoma patients using Doppler Ultrasound. Seventeen consecutive patients(29 eyes) of normal tension glaucoma were studied. The peak systolic and diastolic velocities of ophthalmic artery in normal tension glaucoma were 25.48 +/- 4.09cm/sec and 5.48 +/- 1.16cm/sec, respectively; there were statistically significant decrease of blood flow velocities compared to those of primary open angle glaucoma(30.83 +/- 5.38cm/sec, 9.10 +/- 3.25cm/sec)(p<0.05) and normal group(38.12 +/- 6.42cm/sec, 9.77 +/- 2.64cm/sec)(p<0.05). The peak systolic and diastolic velocities of central retinal artery in normal tension glaucoma were 5.95 +/- 1.05cm/sec and 2.14 +/- 0.83cm/sec, respectively; there was statistically no significant decrease of blood flow velocities compared to those of normal group and primary open angle glaucoma group. Above results imply that the blood flow velocity of ophthalmic artery decrease significantly in normal tension glaucoma and local vascular factors are somewhat related to the development of the normal tension glaucoma. Further studies are necessary to validate these preliminary findings.

The Surgical Effect of Full-Thickness Eyelid Resection in Traumatic Blepharoptosis

There are various surgical methods to correct blepharoptosis. Traumatic blepharoptosis is often the most difficult to correct. The authors experienced three cases of traumatic blepharoptosis, which had lid laxity, poor levator function and were severe in degree. Full-thickness eyelid rese ctions were performed and good cosmetic results were obtained. We report three cases of traumatic blepharoptosis treated with full-thickness eyelid resection and reviewed the literatures.

A Case of Steroid-induced Glaucoma

The prolonged use of steroids, especially the topical administration of ccrticosteroid, will causes an intraocular pressure(IOP) devation in some patients with clinical finding that typically resemble primary open-angle glaucoma. The authors experienced a case of steroid-induced glaucoma following systemic and topical use of dexamethasone for seborrheic dermatitis of both eyelids 3 years previously. During the past few months patient had noted complete lloss of vision in right eye and decrease of vision considerably, in left eye and a trabeculectomy was done on the left eye. We report a case of steroid-induced glaucoma and the literatures were reviewed briefly.