Long-term Results of Selective Laser Trabeculoplasty versus Latanoprost or Dorzolamide/Timolol Fixed Combination

PURPOSE: To compare the efficacy of selective laser trabeculoplasty (SLT) in patients treated with either latanoprost or dorzolamide/timolol fixed combination (DTFC) for primary open-angle glaucoma. METHODS: This retrospective study included 92 consecutive patients who underwent a 180-degree SLT for the first time. The subjects divided into two groups:patients who received latanoprost (n = 63) or DTFC (n = 29) before and after SLT. The main outcome measure was intraocular pressure (IOP) decrease over five years after SLT. The mean IOP change, mean percentage of IOP reduction, and success rates were compared between the patients treated with latanoprost and the patients treated with DTFC. Success was defined as an IOP decrease ≥ 3 mm Hg or IOP reduction ≥ 20% without additional medications, laser surgery, or glaucoma surgery. RESULTS: At the postoperative one-year follow-up, the mean IOP was 15.7 ± 2.2 mm Hg in the latanoprost group and, 16.2 ± 2.4 mm Hg in the DTFC group. At the postoperative five-year follow-up, the mean IOP was 15.1 ± 2.5 mm Hg in the latanoprost group and, 14.6 ± 1.7 mm Hg in the DTFC group. There were no statistically significant differences in IOP change, percentage IOP reduction, or success rate between the groups at each time point after the SLT (p > 0.05). CONCLUSIONS: Selective laser trabeculoplasty showed a reasonable efficacy in lowering the IOP over a five-year follow-up period. There were no significant differences in IOP lowering effect or success rate between the patients treated with latanoprost or DTFC.

Outpatient Distribution for Glaucoma Evaluation

PURPOSE: To analyze the reasons for glaucoma evaluation and distribution of new patients visiting the glaucoma department. METHODS: In a retrospective study, 330 new patients underwent ocular examination using Goldmann applanation tonometry, gonioscopy, optic disc analysis, optical coherence tomography, and Humphrey perimeter under suspicion of glaucoma for the first time in the Glaucoma Department from January 2013 to December 2013. We analyzed the reasons and their diagnostic outcomes. RESULTS: The reasons for glaucoma evaluation were health screening (103 patients, 32.49%), other symptoms (102 patients, 31.55%), known glaucoma (56 patients, 17.67%), pre-refractive surgery evaluation (31 patients, 9.78%), family history (19 patients, 5.99%), and high myopia (6 patients, 1.89%). The diagnostic outcomes were as follows: glaucoma (139 patients, 43.85%), glaucoma suspect (60 patients, 18.93%), ocular hypertension (9 patients, 2.84%), neither glaucoma nor ocular hypertension (79 patients, 24.92%), normal (30 patients, 9.46%). The percentages of confirmed glaucoma according to the reasons for glaucoma evaluation were as follows: health screening, 26.21%; other symptoms, 40.20%; known glaucoma, 85.71%; pre-refractive surgery evaluation, 58.06%; family history, 15.79% and high myopia, 33.33%. CONCLUSIONS: The reasons for glaucoma evaluation were diverse. Glaucoma was confirmed in 43.85% of the patients and the predicted value of positive test for glaucoma including glaucoma suspect and ocular hypertension was 65.62%.

Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

PURPOSE: To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. METHODS: A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. RESULTS: The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). CONCLUSIONS: There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

Prevalence and Characteristics of Glaucoma among Korean Adults

PURPOSE: The purpose of this study was to investigate the prevalence and characteristics of glaucoma in the population of the rural Korean town, Sangju. METHODS: Residents of Sangju aged greater than 50 years old were included in this study. Participants completed an interview examining their medical and ophthalmic history Information was collected on the participants' uncorrected and best corrected vision scores, slit lamp examination results, angle width measurements using the Van Herick technique, gonioscopy if the angle width was less than 1 / 4 angle, intraocular pressure (IOP) assessed with the Goldmann applanation tonometry, optic disc examination results, and a visual field test results using frequency-doubling perimetry in cases in which glaucoma was suspected. Glaucoma was diagnosed according to the criteria described by the International Society for Geographic and Epidemiological Ophthalmology. RESULTS: 1,118 residents aged greater than 50 years were examined initially from a population of 2,984 people. Of these, 671 subjects (60%) participated in this study. The prevalence of glaucoma was determined to be 3.4% (95% confidence interval [CI], 2.1-4.8). Open-angle glaucoma with low IOP was determined to be the most common form with a prevalence rate as high as 2.5% (95% CI, 1.8-3.7). Additionally, primary angle closure glaucoma was determined to have a prevalence rate of 0.3% (95% CI, 0.1-0.9). Open-angle glaucoma with low IOP accounted for 94.4% of the open-angle glaucoma cases. CONCLUSIONS: The prevalence of glaucoma among the population of rural Sangju was 3.4%, and open-angle glaucoma with low IOP was the most common form accounting for 94.4% of the total number of cases.

Cytomegalovirus as a Cause of Recurrent Anterior Uveitis in Immunocompetent Patients

PURPOSE: This study aimed to identify various infectious causes in unilateral recurrent hypertensive anterior uveitis in immunocompetent individuals. METHODS: Twenty eyes of 20 patients diagnosed with recurrent hypertensive anterior uveitis, who had negative systemic uveitis lab results, were enrolled. Polymerase chain reaction (PCR) was performed in the aqueous humor and peripheral blood specimens to detect the following infectious agents: cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), varicella zoster virus (VZV), toxoplasma. RESULTS: The mean age of 20 patients was 41.8 +/- 15.9 year (19-77 year), and 14 (70%) patients were male. CMV was positive in 7 eyes (35%) and was detected only in aqueous humor. HSV-1 was positive in 5 (25%) eyes; only in aqueous humor in 2 eyes, only in blood in 1 eye, and in both specimens in 2 eyes. Only 1 (5%) eye was positive for toxoplasma in the aqueous humor. CONCLUSIONS: This study demonstrated that CMV might be another major infectious cause in recurrent hypertensive anterior uveitis in immunocompetent patients. If CMV is detected, it might be reasonable to add appropriate antiviral agents, rather than treating only with immunosuppresive and hypotensive drugs.

Relationship between the Retinal Thickness Analyzer and the GDx VCC Scanning Laser Polarimeter, Stratus OCT Optical Coherence Tomograph, and Heidelberg Retina Tomograph II Confocal Scanning Laser Ophthalmoscopy

PURPOSE: To assess the relationship between the retinal thickness analyzer (RTA) parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC), Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal tomograph II confocal scanning laser ophthalmoscopy (HRT II). METHODS: Twenty-nine primary open-angle glaucoma patients were retrospectively included in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT, and HRT II. We calculated the correlation coefficients between the parameters of RTA and those of the other studies. RESULTS: Among the optic disc parameters of RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated (R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004). CONCLUSIONS: Many RTA optic disc parameters were significantly correlated with those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness parameters were significantly correlated with those of the GDx VCC, Stratus OCT and HRT II. The RTA optic disc and posterior pole retinal thickness parameters may be valuable in the diagnosis of glaucoma.

Evaluation of a New Scoring System for Retinal Nerve Fiber Layer Photography Using HRA1 in 964 Eyes

PURPOSE: To evaluate retinal nerve fiber layer (RNFL) defect by a new scoring system for RNFL photography using the Heidelberg Retina Angiograph 1 (HRA1). METHODS: This retrospective study included 128 healthy eyes and 836 primary open-angle glaucoma eyes. The RNFL photography using HRA1 was interpreted using a new scoring system, and correlated with visual field indices of standard automated perimetry (SAP). Using the presence of RNFL defect, darkness, width, and location, we established the new scoring system of RNFL photos. RESULTS: The mean RNFL defect score I in the early, moderate, severe, and control groups were 7.3, 9.2, 10.4, and 3.6, respectively. The mean RNFL defect score II in the early, moderate, severe, and control groups were 14.5, 28.5, 43.4, and 3.4, respectively. Correlations between the RNFL defect score II and the mean deviation of SAP was the strongest of the various combinations (r=-0.675, P<.001). CONCLUSIONS: Using a new scoring system, we propose a method for semi-quantitative interpretation of RNFL photographs. This scoring system may be helpful to distinguish between normal and glaucomatous eyes, and the score is associated with the severity of visual field loss.

Outcome of Ahmed Valve Implantation in Refractory Glaucoma

PURPOSE: To evaluate the outcome of Ahmed valve implantation as a primary or secondary glaucoma surgery to treat refractory glaucoma patients. METHODS: A total of 101 eyes of 101 patients with refractory glaucoma, who received Ahmed valve implantation between March 1995 to September 2004 were included. We divided cases into primary surgery group, who had no trabeculectomy, and secondary surgery group, who had trabeculectomy before Ahmed valve implantation. Successful operation was defined as having the following outcomes: (1) postoperative intraocular pressure (IOP) sustained between 5 and 21mmHg and reduced 30% from the baseline IOP with or without medication, (2) no visual decline due to IOP or complications, and (3) no additional filtering surgery. Clinical records were reviewed, and IOP, antiglaucoma medications, and complications were recorded. Kaplan-Meier survival analysis was used to calculate the overall probability of success. RESULTS: In primary surgery group, overall success rate was 57.6%, 46.7%, 39.7%, and 39.7% at 1, 3, 5, and 7 years, respectively. In secondary surgery group, overall success rate was 67.8%, 58.1%, 52.4%, and 43.5% at the same time points. There was, however, no statistical difference in success rates between two groups. The incidence of complications were as follows: 4.2% of endophthalmitis, 4.2% of valve exposure, 4.2% of hypotony was found in the primary surgery, and 3.8% of endophthalmitis, 1.9% of valve exposure, 9.4% of hypotony were found in the secondary surgery. There were no statistical differences in the incidences of complications between the two groups. CONCLUSIONS: Ahmed valve implantation was effective for IOP control in refractory glaucoma patients. Success rate did not show significant difference between primary and secondary Ahmed valve implantation group.

Recurrent Intraocular Pressure Elevation during Hemodialysis in a Patient with Neovascular Glaucoma

PURPOSE: To report a patient with symptomatic intraocular pressure (IOP) elevation in an eye with neovascular glaucoma (NVG) during hemodialysis. METHODS: Case report. RESULTS: Recurrent episodes of severe ocular pain and elevated IOP in the NVG eye were noted during hemodialysis in a 29-year-old man. The patient was recently diagnosed at our ophthalmology clinic with NVG due to central retinal vein occlusion. IOP was temporarily controlled after the Ahmed valve implantation. However, after the fibrous membrane developed and occluded the tip of the Ahmed valve, IOP elevation during hemodialysis recurred. Further treatments with intravenous mannitol, oral carbonic anhydrase inhibitor, topical antiglaumatic agents and subconjunctival 5-fluorouracil (5-FU) injections all failed to control relapsing pain and IOP elevation. Eventually, evisceration and hydroxyappatite implantation were performed. CONCLUSIONS: Physicians must be alert to the possibility of IOP elevation in glaucomatous eyes during hemodialysis.

Ahmed Valve Implantation Result and TGF-beta and VEGF in the Aqueous Humor of Neovascular Glaucoma Patients

PURPOSE: To assess the relationship of transforming growth factor-beta (TGF-beta) and vascular endothelial growth factor (VEGF) levels in the aqueous humor of neovascular glaucoma (NVG) patients and the results of Ahmed valve implantation surgery. METHODS: We compared surgical outcomes of NVG patients who underwent Ahmed valve implant surgery from January 2002 through October 2002 at severance hospital with levels of TGF-beta1, TGF-beta2 and VEGF in the aqueous humors of these patients. RESULTS: Nineteen eyes (19 patients) were analyzed in the study. The success of surgery was defined as intraocular pressure maintained as 6-20 mm Hg regardless of additional glaucoma medications taken. Twelve eyes (63%) satisfied successful surgery. TGF-beta1 concentration was 1.51 ng/ml in the success group and 2.31 ng/ml in the failed group (p=0.295). TGF-beta2 concentration was 5.19 ng/ml in the success group and 5.73 ng/ml in the failed group (p=0.367). VEGF concentration was 10.21 ng/ml in the success group and 9.87 ng/ml in the failed group (p=0.516). All showed no statistical difference between the groups. CONCLUSIONS: In our study, no significant relationship between levels of TGF-beta1, TGF-beta2, or VEGF in the aqueous humor and the surgical outcomes of Ahmed valve implantation were found in patients with NVG.

Surgical Results of Repeated Trabeculectomy in Congenital Glaucoma

PURPOSE: To investigate the surgical results of repeated trabeculectomy in primary congenital glaucoma. METHODS: The authors retrospectively reviewed the data of 16 patients (23 eyes) who underwent two or more trabeculectomies with or without mitomycin C for primary congenital glaucoma between 1990 and 2004. Surgical success rate and postoperative complications were assessed. The relationship between the use of mitomycin C and the surgical outcomes was also studied. RESULTS: Among the 23 eyes, 10 had a history of previously failed goniotomy or trabeculotomy and 6 eyes had undergone trabeculectomy more than 3 times. The overall success rate of repeated trabeculectomy was 63.9% and the success rate of the 14 eyes operated on with mitomycin C was not higher than that of the 9 eyes that did not receive mitomycin C (p=0.166). Two eyes were reported to have postoperative hypotony and there was one case of endophthalmitis after trabeculectomy; however, the use of mitomycin C did not increase the overall rate of surgical complication (p=1.00). CONCLUSIONS: Repeated trabeculectomy can be considered as a procedure to treat primary congenital glaucoma, particularly in severe cases of congenital glaucoma.

The Differences in Results of Short Wavelength Automated Perimetry According to Lens Opacities

PURPOSE: Perimetric examination plays an important role in the diagnosis of glaucoma, which is among the leading causes of blindness worldwide. Several examination methods have been developed for early detection of glaucoma. Among those, short-wavelength automated perimetry (SWAP) is the most widely investigated. In this study, the effects of nuclear opacities on SWAP were examined. METHODS: Lens opacities were divided into cortical and nuclear opacity groups ; each group consisted of fifteen eyes. The eyes studied underwent standard white-on-white perimetry and SWAP exams before and after cataract operation. The differences in the results of the examinations were compared between the two opacity groups. The t test was used for comparing the data. RESULTS: In the cortical opacity group, the average difference between the mean deviation before and after the operation was 5.46dB in white-on-white perimetry and 5.02dB in SWAP. In the nuclear opacity group, the average difference between the mean deviation before and after the operation was 4.01dB in white-on-white perimetry and 10.82dB in SWAP. There was no statistically significant difference in the cortical opacity group (p=0.6575). However, there was a statistically significant difference in the nuclear opacity group (p<0.0001). CONCLUSIONS: In clinical situations, more caution should be taken when interpreting the SWAP results of nuclear cataract patients in order to make an accurate decision.

Optic Nerve Head Topographic Measurements and Retinal Nerve Fiber Layer Thickness in Physiologic Large Cups

PURPOSE: To evaluate the parameters of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) in patients with large cup/disc ratio (CDR) and normal neuroretinal rim configuration who have normal perimetry (physiologic large cups, LC) and to compare these parameters with those of the normal and early glaucoma patients. METHODS: Using Heidelberg retinal tomography (HRT) and optical coherence tomography (OCT), 30 patients with LC, 29 normal subjects, and 31 early glaucoma patients were examined. One eye from each subject was randomly selected. RESULTS: Significant differences between LC and glaucomatous eyes (GE) were found in parameters indicating loss of nerve fibers, such as rim area, rim volume, and mean RNFL thickness. However, there was no difference between LC and normal eyes (NE) in RNFL thickness, rim area, and rim volume. LC was able to be defined as a normal central excavation with a large disc and large CDR with a normal rim area. CONCLUSIONS: HRT ONH parameters and RNFL thickness obtained with OCT may be useful for differentiating between glaucoma and LC eyes.

Clinical Application of Pressure Phosphene Tonometer: Comparison with Goldmann Applanation Tonometer in Normal Subjects

PURPOSE: To assess the clinical usefulness of the pressure phosphene tonometer (Proview(R)) compared with the Goldmann applanation tonometer. METHODS: Ninety four eyes of 50 patients, aged from 3rd decade to 6th decade and with intraocular pressure (IOP) ranging from 9 to 21 mmHg, were measured by Proview(R) 5 times each. The average of these values was compared with the value measured with the Goldmann applanation tonometer. Twenty eyes of 10 patients, aged from 3rd decade to 4th decade, were trained repeatedly and measured again by the same method after 1 month. RESULTS: IOP measured by Proview(R) was statistically higher than that with the Goldmann applanation tonometer (p<0.05). The difference between the two measurements for patients in their 5th and 6th decades was more than in their 3rd and 4th decades. Nevertheless, the measurement difference decreased and the correlation coefficient increased between the devices in the repeatedly trained group (r=0.923). CONCLUSIONS: In measuring IOP, the pressure phosphene tonometer (Proview(R)) is not suitable in elderly or newly adapted patients, but it provides significant values in young and repeatedly trained group.

Appropriateness Ratings in Cataract Surgery

This study aimed to evaluate the appropriateness of cataract surgery and identify the characteristics of patients and surgeons, clinical and functional outcomes, and surgical methods associated with appropriate cataract surgery. For this purpose, Korean cases of cataract surgery were rated as either 'necessity', 'appropriate', 'uncertain' or 'inappropriate', based on RAND/UCLA Ratings. For this assessment, the cases of 222 patients who underwent cataract surgery, on either one or both eyes, were studied. The surgeries were performed by 20 ophthalmologists practicing at one of fourteen medical institutions (university hospitals and general hospitals). Patients were interviewed and clinical data collected. The Doctors were questioned with self-entered questionnaire forms. The medical records were also examined to gain an understanding of the surgical process. The ratings were as follows: 30.6% (68 patients) of surgeries belonged to the bracket "necessity", 46.4% (103 patients) to "appropriate", 15.3% (34 patients) to "uncertain" and 7.7% (17 patients) to "inappropriate". In this study, "necessity" and "appropriate" were defined as "appropriate" (77.0%, 171 patients), and "uncertain" and "inappropriate" as "inappropriate" (23.0%, 51 patients). The low preoperative Snellen visual acuity and visual function, advanced age and male patients were associated with appropriate surgery. It is concluded that appropriate surgery was related to the clinical and functional outcomes (visual acuity and visual function) and patient characteristics (age and male).

Primary Trabeculectomy with Mitomycin C for Medically Uncontrolled Angle Closure Glaucoma

PURPOSE: To report the results of primary trabeculectomy with mitomycinmitomycin C (MMC) for medically uncontrolled, primary angle-closure glaucoma. METHODS: A retrospective study of 20 eyes from 18 consecutive patients with medically uncontrolled primary angle-closure glaucoma who underwent trabeculectomy with MMC, from 1997 to 2000. RESULTS: The mean follow up was 33.9 +/- 12.9 months (range 24~60). After trabeculectomy with MMC, IOP remained below 22 mmHg in 17 eyes (85%) with or without medication. Postoperative complications occurred in 5 eyes (25%). CONCLUSIONS: Trabeculectomy with MMC resulted in favorable long-term IOP control and relatively low complications in medically unresponsive acute angle-closure glaucoma.

Comparison of Short-term Surgical Outcomes of Ahmed Glaucoma Valve Implant between 96 mm2 and 184 mm2 of the Surface Area

PURPOSE: To compare the short-term surgical outcomes of Ahmed glaucoma valve implant with a surface area between 96 mm2 and 184 mm2. METHODS: The outcomes of thirteen eyes of 13 patients with refractory glaucoma who had undergone 96 mm2-sized Ahmed glaucoma valve implantation were compared with those of 13 eyes of 13 patients with 184 mm2-sized Ahmed glaucoma valve implantation. RESULTS: Average age and preoperative intraocular pressure (IOP) were statistically indistinguishable between the two groups (p=0.54 and 0.40, respectively). Average follow-up period and final IOP were also statistically similar (p=0.15 and 1.00, respectively). Comparing the overall IOPs and the numbers of antiglaucoma medications, the IOP of postoperative day 1 with the 184 mm2-group was only relatively lower (p=0.07). The 2-year success rates were 18.0% for the 96 mm2-group and 69.2% for the 184 mm2-group (Ed-there is no respective comparison here) with Kaplan-Meier survival analysis (p=0.0018). The rates of complications and re-operation were similar between the two groups. CONCLUSIONS: The average postoperative IOPs were not statistically different between the two groups. However, the success rate was better in the 184 mm2-group than in the 96 mm2-group.

Surgical Outcomes of Conventional Trabeculectomy Converted from Deep Sclerectomy with Collagen Implant (DSCI)

PURPOSE: To assess the surgical outcomes of the conventional trabeculectomy converted from DSCI due to a perforation of trabeculo-descemet's membrane during surgery. METHODS: We retrospectively analyzed the surgical outcomes of 9 patients (11 eyes) who underwent the conventional trabeculectomy converted from DSCI during surgery. RESULTS: The mean age of the subjects was 44.6+/-17.8 years. The types of glaucoma of the subjects were primary open angle glaucoma in nine eyes and secondary glaucoma in two eyes. The mean preoperative intraocular pressure(IOP) was 23.4+/-9.5mmHg with 3.0+/-1.2 of mean anti-glaucoma medications. The mean immediate postoperative IOP was 7.7+/-5.3mmHg and 10.5+/-3.9 mmHg with 0.5+/-0.5 of mean anti-glaucoma medications after 12.0+/-6.6 months of mean follow-up period. Defining the qualified success to be 6 to 21 mmHg of IOP with 2 or lower glaucoma medication without complications such as hypotony maculopathy, the success rate was 82%. There were four eyes (36%) having IOP below 4 mmHg and shallow anterior chamber at one day postoperatively. Two eyes of them recovered within 2 weeks, but the other two (18%) developed hypotony maculopathy. Cataract progressed in two eyes (18%). CONCLUSIONS: The surgical outcomes of conventional trabeculectomy converted from DSCI during surgery was comparable to the elective trabeculectomy, but there was a tendency to have more complications associated with hyperfiltration at the immediate postoperative period.

Phacoemulsification using Iris Hook in Patients with Secondary Angle-Closure Glaucoma Associated with Lens Subluxation

PURPOSE: To evaluate the effect on the intraocular pressure after the phacoemulsification on the secondary angle-closure glaucoma associated with lens subluxation. METHODS: We reviewed the clinical records of 8 patients (9 eyes) prospectively who's intraocular pressure (IOP) didn't controlled with medication, so received the lens removal by the phacoemulsification. We reviewed their intraocular pressure, visual acuity, and complications before and after the surgery. RESULTS: The patients' mean age was 60.4 +/- 11.9. Initial mean IOP was 41.2 +/- 15.0 mmHg with mean of 1.1 +/- 1.8 medication and mean preoperative IOP was 30.4 +/- 11.2 mmHg with mean of 1.2 +/- 1.1 medication. Postoperative IOP was 16.2 +/- 2.8 mmHg with usage of 0.6 +/- 0.9 medication during the follow-up of 4.6 +/- 1.4 months, and the IOP of 6 eyes (66.7%) were controlled under 21 mmHg without any medication. With anti-glaumatic medication, the IOP of all patients were controlled under 21 mmHg. The best corrected visions were also improved after the surgery in all patients. The complications occurred in 5 eyes (55.6%), temporarily increased IOP in 4 eyes (44.4%), and hyphema in 1 eye (11.1%). CONCLUSIONS: The phacoemulsification in the secondary angle-closure glaucoma with the lens subluxation showed relatively satisfactory results, but thorough follow-up would be needed due to the recurrence of elevated IOP afterward.

Serum Concentration of Antioxidant Minerals in Cataract Patients

PURPOSE: To determine the levels of antioxidant minerals in serum of normal subjects and patients with cataract. METHODS: Concentrations of antioxidant minerals such as selenium, manganese, copper, zinc were measured with atomic absorption spectrophotometer (AAS) 4110ZL in serum of 45 normal subjects (group 1) and 34 patients (group 2) with cataract, and Cu/Zn ratio was calculated. RESULTS: Serum concentrations of copper were 108.9 +/- 5.48 (male) and 106.9 +/- 5.25 microgram/dl (female) in group 1, 100.9 +/- 5.87 (male), 105.6 +/- 3.68 microgram/dl (female) in group 2, respectively. For zinc they were 105.8 +/- 7.33 (male) and 103.7 +/- 4.24 microgram/dl (female) in group 1, 80.0 +/- 5.78 (male) and 95.1 +/- 6.18 microgram/dl (female) in group 2, respectively. Zn/Cu ratio were 0.98 +/- 0.02 (male) and 1.05 +/- 0.08 (female) in group 1, 1.58 +/- 0.29 (male) and 1.19 +/- 0.09 (female) in group 2, respectively. CONCLUSIONS: Serum zinc concentration in male was significantly lower in cataract patients than in normal subjects (p<0.01). Cu/Zn ratio was lower in cataract patients than in normal subjects in male, but not in female. Further nutrional survey is necessary to determine the relationship between level of antioxidant minerals and development and progression of cataract.