Atypical Congenital Hypertrophy of the Retinal Pigment Epithelium in Gardner's Syndrome

Congenital hypertrophy of the retinal pigment epithelium (CHRPE)is a well circumscribed, flat, pigmented fundus lesion that have a variety of shapes. It is the most common extracolonic manifestation of Gardner's syndrome. The number and shape of CHRPE should arouse suspicion of increased risk of polyposis.We experienced one case of Gardner's syndrome in a family history of colonic carcinoma that showed atypical congenital hypertrophy of the retinal pigment epithelium, osteoma, epidermal cyst and polyposis combined with colonic carcinoma.A total colectomy and ileostomy were performed.So we reported it with the review of literature of clinical value of CHRPE as a predictive marker of Gardner's syndrome.

Effect of Topical Povidone-Iodine during the First Week after Cataract Surgery

Topical povidone-iodine ophthalmic solution prevents a proliferation of con-junctival bacterial colony-forming units and decreases the species compared with antibiotic. We sought to determine whether these beneficial effects of povidone-iodine could be sustained during the first postoperative week. In 36 eyes of 28 consecutive patients, one or two drops of either a broadspectrum antibiotics[Ofloxacin(r)] or povidoneiodine 5% were placed in the treated eye or eyes at the conclusion of cataract surgery and three times daily during the first postoperative week. Bacterial cultures were taken from both eyes at the end of surgery before instillation of the eyedrops and again 1 week later. Twenty untreated eyes served as a control group. During the first postoperative week, the number of colonyforming units and species increased in both treatment groups. Relative to the control group, both medications effectively reduced the mean number of colonyforming units at 1 week, but their effects on colony-forming units did not significantly differ from each other. At 1 week, the species count increased 242% in the antibiotic group but only 104% in the povidone-iodine group. Compared to the control group, eyes that received povidoneiodine had a significantly lower species count[p<0.0 5]. Povidone-iodine ophthalmic solution is an alternative to postoperative topical antibiotics because of its effectiveness in controling conjunctival bacterial colony-forming units and species, its relatively low cost, and its easy availability.

Electromyographic Evaluation of Extraocular Muscle Contractibility after Artificial Muscle Incarceration in the Rabbit

The orbital blowout fracture has been increasingly noticed due to trauma and traffic accidents. The diagnostic confirmation is early established by CT scan, but indication for surgical treatment, the technique for repair, and timing of repair are still controversial. The main symptoms of orbital fracture include diplopia, enophthalmos and hypesthesia in distributions of the infraorbital nerve. These are usually accompained by other symptoms such as emphysema of the eyelids, ptosis, epistaxis and ocular injury. Among these diplopia and enophthalmos are considered as main surgical indications. Especially operation is performed when the contractibility of extraocular muscle(EOM) is changed due to incarceration of EOM and persistent diplopia at straight forward gaze or downward gaze. Many theories for sugical repiar timing are insisted but at present the accepted timing for operation is posttraumatic 1-2 weeks. To prevent the fibrosis and atrophy of extraocular muscle from the incarceration of EoM due to orbital fracture is the indication of surgery. To estimate the optimal time to perform the operation, we checked the EOM contractivilty by electromyography before and after artificial muscle incareceration in the rabbit. The results were as follows. The differences in RMS(root mean square) and MRV(mean rectified voltage) were not shown before or after the artivicial incarceration of extraocular muscle until the 5th day of the surgery. But the RMS and MRV measurements performed on the 7th day decreased significantly and these decreases were sustained. According to the results of this experiment. if the incarceration of the extraocular muscle due to the orbital fracture is diagnosed, relieving the incarceration by surgery before the 7th day can prevent the change of EOM contractibility. It will provide significant benefit, in maintaining the normal functioin of the extraocualr muscle.