Accuracy of Three Intraocular Lens-power Formulas in Predicting Refractive Outcomes in Different Intraocular Lenses

PURPOSE: To compare the accuracy of different power-calculation formulas in predicting the postoperative refraction of three-piece and one-piece intraocular lenses (IOL). METHODS: We retrospectively reviewed the medical records of 74 eyes (62 patients) that had undergone cataract surgery involving implantation of one of two IOLs―the SENSAR® AAB00 1-Piece Acrylic IOL (44 eyes), or the Hoya® VA60BB 3-Piece Acrylic IOL (30 eyes)―between October 2014 and March 2015. Axial length was measured using an optical low-coherence refractometry (Lenstar®), and biometry was then calculated by the pre-installed Lenstar program, which used the SRK/II, Sanders-Retzlaff-Kraff/Theoretical (SRK/T), and Hoffer Q formulas. Mean absolute error (MAE) and mean numeric error (MNE) were measured 1 day, 1 week, 1 month, and 2 months after surgery. RESULTS: Using the SRK/T and Hoffer Q formulas, the one-piece IOL group differed significantly from the three-piece IOL group in terms of the MNE obtained 1 month and 2 months after surgery. Across all formulas and time points, there were no significant differences between the groups in terms of MAE. CONCLUSIONS: There was no significant difference between the different power-calculation formulas. Starting 1 month after surgery, the three-piece IOL group showed myopic postoperative refraction compared to the predictive spherical equivalent using the SRK/T and Hoffer Q formulas.

A Case of Hydrophilic Acrylic Intraocular Lens Opacification in a Patient with Proliferative Diabetic Retinopathy

PURPOSE: To report a case of hydrophilic acrylic intraocular lens (IOL) opacification in a patient who underwent vitrectomy and cataract surgery for the treatment of diabetic retinopathy. CASE SUMMARY: A 54-year-old female complained of blurred vision for 15 months after having combined vitrectomy and phacoemulsification with IOL (Rayner(R) Superflex(R) 620H) implantation for the treatment of high-risk proliferative diabetic retinopathy. On slit-lamp examination, IOL opacification was evident. IOL exchange was performed and the explanted IOL analyzed. Scanning electron microscopy (SEM) revealed the presence of translucent granular deposits on the anterior subsurface of the IOL. Energy dispersive X-ray spectroscopy (EDS) demonstrated calcium and phosphate deposition within the IOL optic.

Intravitreal Bevacizumab Injection for Choroidal Neovascularization Secondary to Laser Photocoagulation for Central Serous Chorioretinopathy

PURPOSE: To report a case of intravitreal bevacizumab injection for choroidal neovascularization following direct laser photocoagulation for central serous chorioretinopathy. CASE SUMMARY: A 44-year-old male patient with an 8-month history of metamorphopsia in his left eye visited our clinic and was diagnosed with central serous chorioretinopathy after performing refraction, fundus examination, fluorescein angiography (FAG) and optical coherence tomography (OCT). After 1 month, laser photocoagulation of the leaking point observed on the FAG was performed. After 8 weeks following laser photocoagulation, visual acuity was reduced to 0.4, subretinal hemorrhage accompanied by choroidal neovascularization was observed on FAG and OCT, and an intravitreal bevacizumab injection was administered. After 4 weeks following the injection, macular edema and subretinal hemorrhage decreased, visual acuity increased to 1.0 and was maintained properly. However, after 2 years, the central serous chorioretinopathy recurred and after 3 months, healed spontaneously. CONCLUSIONS: Intravitreal bevacizumab injection is a safe and effective treatment for secondary choroidal neovascularization occurring after direct laser photocoagulation for central serous chorioretinopathy. In addition, a single treatment can maintain the patient's status with no recurrence of choroidal neovascularization over a long-term period.

Ciliary Sulcus Ahmed Valve Implantation

PURPOSE: Ahmed glaucoma valves were implanted into the ciliary sulcus of two patients diagnosed with neovascular glaucoma with favorable outcomes. METHODS: The study patients presented to our hospital with ocular pain caused by increased intraocular pressure (IOP). A thorough history was taken, and an ophthalmic examination was performed. RESULTS: A 71-year-old male patient and a 57-year-old female patient visited our hospital for ocular pain and persistent, elevated IOP. Each were diagnosed with neovascular glaucoma and underwent an Ahmed glaucoma valve implantation to the sulcus. After surgery, the patients maintained stable IOPs without major complications. CONCLUSIONS: The method of Ahmed glaucoma valve implantation into the ciliary sulcus could reduce complications caused by implantation to the anterior chamber. It is thought to be an efficient method for the maintenance of appropriate IOP after surgery.

Acquired Brown Syndrome After Retinal Detachment Surgery

PURPOSE: To report a case of acquired Brown syndrome found in the left eye of a female patient who had undergone surgery for proliferative vitreoretinopathy. METHODS: A 41-year-old female patient presented with right hypertropia and esotropia. We reviewed her history, conducted an ophthalmic examination and performed surgery. RESULTS: Prior to presentation, the patient experienced a sudden decrease in visual acuity. She was diagnosed with proliferative vitreoretinopathy caused by rhegmatogenous retinal detachment, and underwent scleral buckling. After surgery, with the eye in the primary position, the right hypertropia was 9 prism diopters and the esotropia was 30 prism diopters. The patient was unable to elevate the eye in the adducted position. A forced duction test was performed and we detected a restricted elevation in adduction. By performing a tenectomy of the superior oblique muscle and a recession of the medial rectus muscle, orthophoria was obtained in the primary position, and the elevation in adduction improved. CONCLUSIONS: Herein, we report satisfactory results of a procedure in one case of acquired Brown syndrome following retinal detachment surgery.

The Effect of Graded Recession and Anteriorization on Unilateral Superior Oblique Palsy

PURPOSE: We wanted to examine the effect of graded recession and anteriorization of the inferior oblique muscle on patients suffering from unilateral superior oblique palsy. METHODS: Inferior oblique muscle graded recession and anteriorization were performed on twenty-two patients (22 eyes) with unilateral superior oblique palsy. The recession and anteriorization were matched to the degree of inferior oblique overaction and hypertropia. The inferior oblique muscle was attached 4 mm posterior to the temporal border of the inferior rectus muscle in six eyes, 3 mm posterior in five eyes, 2 mm posterior in five eyes, 1 mm posterior in five eyes, and parallel to the temporal border in one eye. RESULTS: The average angle of vertical deviation prior to surgery was 11.3+/-3.9 prism diopters (PD). The total average correction in the angle of vertical deviation after surgery was 10.8+/-3.8 PD. In the parallel group, the average reduction was 14 PD. After surgery, normal inferior oblique muscle action was seen in eighteen of twenty-two eyes (81.8%). CONCLUSIONS: Graded recession and anteriorization of the inferior oblique muscle is thought to be an effective surgical method to treat unilateral superior oblique palsy of less than 15 PD.

Age and Gender Distribution of Patients with Acute Myocardial Infarction Admitted to University Hospitals during the Period of 1990-1999

BACKGROUND AND OBJECTIVES: The prevalence of coronary disease in Korea, with the consequent morbidity and mortality, has rapidly risen during the last two decades. This study aimed to describe the changing pattern in the demographic composition during the 1990s of patients presenting with acute myocardial infarction (AMI) in Korean metropolitan cities. SUBJECTS AND METHODS: Data from the medical record of patients with AMI, admitted to five University Hospitals in Busan and Daegu between January 1990 and December 1999, were sorted according to their age (75 years) and gender. RESULTS: During the last decade, the number of cases of AMI increased from 283 in 1990, to 988 by 1999 (ratio of AMI/medical patients admitted; 1.68% in 1990 to 2.52% in 1999). The most prevalent age group was 6074 yrs (46.1%), followed by 4559 yrs (34.2%). Generally, the male cases were twice as prevalent as female (68.2% : 31.8%), but the gender ratio was reversed in the highest age group (>75 yrs) (44.6% : 55.4%). During the period in question, the gender ratio and age distribution remained reasonably constant throughout. The proportion of younger AMI patients (<45 yrs) did not increase. CONCLUSION: Admissions due to AMI increased substantially during the 1990s. Almost half the cases were from the 6074 yrs age group, and two third were male. There were little changes in the compositions of age and gender of the AMI cases during this period.

Four cases of ticlopidine-induced cholestatic hepatitis / 대한내과학회지

Ticlopidine, a potent antiplatelet agent, is widely used for treatment of coronary artery disease and cerebrovascular disease. Adverse effects has been reported in 10% to 20% of patients receiving ticlopidine. The most commom adverse effects were gastrointestinal disturbance, skin rash, but cholestatic hepatitis with jaundice was rare (0.1% incidence). We have recently experienced four cases of ticlopidine-induced cholestatic hepatitis after coronary artery stent insertion. Jaundice developed within 1 month of starting ticlopidine at recommended daily doses. In all cases, jaundice resolved and serum liver enzymes improved over a period of months after drug withdrawal. Therefore, clinicians should be aware of the reversible condition of ticlopidine-induced cholestatic jaundice that slowly resolves after drug withdrawal.

A Case of Chronic Myelogenous Leukemia Associated with Rheumatoid Arthritis / 대한류마티스학회지

Rheumatoid arthritis (RA) is though to be a collagen disease induced by auto-immune mechanism of unknown etiology. Chronic myelogenous leukemia (CML) is a disease characterized by overproduction of cells of the granulocytic, especially the neutrophilic series and occasionally the monocytic series, leading to marked splenomegaly and very high white blood cell counts. There's no consensus on the risk of leukemia in RA. There are some reports ragarding the relationship between low dose of methotrexate (<20 mg weekly) and the development of leukemia in RA. Although RA is a complex process, it can be considered initially as a stem cell disorder requiring treatment similar to that administered to transplant patient. We experienced a case of CML associated with RA. A 60-year-old woman with RA was treated with low dose methotrexate (7.5 mg weekly), hydroxychloroquine (HCQ), non-steroidal anti- inflammatory drug (NSAID) and low dose steroid. This therapy was continued for 3 years. She was diagnosed CML after 3 years of therapy. CML was confirmed by bone marrow biopsy and the presence of the Philadelphia chromosome.

Methicillin-Resistant Staphylococcus aureus Endocarditis Involving Tricuspid Valve in Ventricular Septal Defect with Multiple Pulmonary Embolism / 감염

We report a case of methicillin-resistant Staphylococcus aureus (MRSA) endocarditis involving tricuspid valve in small ventricular septal defect with multiple pulmonary embolism. A 36-years-old woman presented with 7 days course of fever and mental abnormality. She had small-sized ventricular septal defect (VSD) and no risk factors for the infection such as history of intravenous drug abuse and hospitalization. Methicillin- resistant Staphylococcus aureus was isolated from all three sets of blood culture drawn on admission and from the huge pulmonary embolus retrieved during operation. Resection of pulmonary emboli and patch repair of ventricular septal defect were done. Teicoplanin was administered for a total of 28 days due to febrile rash associated with vancomycin treatment after operation. She was discharged without complication.

Neutron therapy for prostatic cancer / 대한비뇨기과학회지

The neutron beam has higher relative biological effectiveness (RBE) than conventional X or gamma ray because it is densely ionizing radiation which is presented by high linear energy transfer (LET). This physical and radiobiological characteristic plays an important role in killing of cancer cells in the state of biologically radio-resistant to the conventional radiation. The rationale of high LET radiation in the application to clinical radiotherapy is summarized as, high oxygen enhancement ratio (OER), less repair of cell damage, and less dependence of radio-sensitivity on cell cycle. Neutron therapy alone or combined with conventional radiotherapy was performed in 12 patients with stage C or D1 prostatic cancer from Mar. 1987 to Dec. 1989 in Korea Cancer Center Hospital. Local control rate at the time of 24 months after therapy was 67% (4/6) in stage C and 67% (4/6) in stage DI. Two-year actuarial survival rate after therapy was 82% in stage C and 67% in stage D1. The problem of neutron therapy was relatively high incidence of major complication rate, but it could be lessened by the accumulation of experience for neutron therapy. We think neutron therapy to be one of adequate treatment modalities for local control of stage C or Dl prostatic cancer.