The Effect of Vascular Endothelial Growth Factor on Vascularization in Porous Polyethylene Orbital Implant (Medpor(R))

PURPOSE: We investigated the effect of VEGF usage and the method of surgery on the vascularization rate of the porous orbital implant (Medpor(R)). METHODS: Thirty six Newzealand white rabbits were randomized into 2 groups according to the method of surgery (evisceration and intrascleral implantation and evisceration and retroscleral implantation). Each group was subdivided into two groups, a group treated with VEGF, and the other without VEGF treatment. The degree of vascularization was observed in the four groups at 1, 2, 4 weeks by using cryofilm transfer kit (Finetec, Tokyo, Japan). The implant was sliced at the equator with cryomicrotome and stained with Hematoxylin and Eosin, Masson's trichrome and reticulin. The sample was observed to assay the degree of fibrovascular ingrowth with light microscope. RESULTS: The group in which VEGF was used and the implant was inserted retrosclerally (n=9) showed significantly higher vascularization rate than the other three groups (P0.05). CONCLUSIONS: After using VEGF or inserting the implant retrosclerally, the vascularization of the implant was significantly incresed.

Effect of Corneal Epithelial Flap on the corneal wound healing of canine eyes

PURPOSE: LASEK is a newly developed refractive surgery technique that can make up for the complications from PRK and LASIK. The most unique procedures in LASEK is covering of the cornea with epithelial flap after keratectomy. We examined the effect of corneal epithelial flap on the wound healing of canine cornea. METHODS: Operation was performed in eyes from 12 dogs, and the 12 eyes were recovered with epithelial flap and the remaining 12 eyes were recovered without epithelial flap. Wound healing process was compared using fluorescein staining, light and transmission electron microscopic examination. RESULTS: Fluorescein stained area of the cornea was reduced with time in both groups, and from 9 hours after the operation, it was significantly reduced in the group with epithelial flap compared with those of the group without epithelial flap (p< 0.05). On light microscopic examination of the group with epithelial flap, and normal epithelial structure was found at 24 and 48 hours, respectively. However, in the group without epithelial flap, no complete reepithelialization had occurred on center at 48 hours after the operation. On transmission electron microscopic examination, eyes of the group with epithelial flap showed hemidesmosomes in the area where epithelial flap was closely contacted with the stroma at 24 hours, and they were completely developed at 48 hours. On the other hand, in the group without epithelial flap, hemidesmosomes developed only in the proximal portion but not at the leading edge even at 48 hours. CONCLUSIONS: These results suggest that corneal epithelial flap accelerate the wound healing process of the cornea and the wound healing process depend on the vitality of the epithelial flap.

Clinical Results of Primary Posterior Chamber Intraocular Lens Insertion in the Setting of Penetrating Ocular Trauma: whether PCL insertion or not

PURPOSE: To evaluate the clinical outcome of patients who underwent a lensectomy and IOL implantation at the time of the primary repair due to a penetrating ocular injury. METHODS: We analyzed the records of 25 eyes of 25 perforating injury patients[Group A (13 eyes)-who had undergone simultaneous corneal laceration repair, cataract extraction and IOL implantation, and Group B (12 eyes)-who had undergone corneal laceration repair, cataract extraction and had their refractive error corrected by contact lens or glasses later]. retrospectively from March, 1991 to June,1999. We examined the relationship between their final visual acuity and the influencing factors such as cause of injury, length and feature of the lacerated cornea, initial visual acuity and postoperative complications, etc. RESULTS: The average age of patients was 36.8 and 25.7 years in group A and B, respectively. The major cause of injury was a metallic foreign body. In group A, the wound is relatively short and has a linear shape. In group B, it is a nearly curved line. An anterior vitrectomy was done in 6 patients in both groups, respectively. Nine patients (69%) achieved a final visual acuity of 10/20 or better in group A and only four patients (33%) in group B. The postoperative complications were transient elevation of IOP (1 eye) and corneal ulcer (1 eye) in group A, and vitreous opacity (1 eye) and retinal detachment (1 eye) in group B. CONCLUSIONS: It is recommended for visual rehabilitation and attainment of binocular visual function to implant the IOL at the time of primary repair caused by a penetrating ocular injury.

A Case of Episcleritis with Relapsing Polychondritis

PURPOSE: Relapsing polychondritis is a progressive inflammatory disorder of unknown cause affecting predominantly the cartilage of the ears, nose, and tracheobronchial tree as well as internal structures of the eyes and nose. Episcleritis is the most common ocular manifestation. We experienced a case of relapsing polychondritis with episcleritis and it's treatment. Therefore, we report this case with literature review. METHODS: Seventy-year-old woman presented with ocular pain and redness in right eye which had developed one week before. She had bilateral auricular chondritis, vertigo, saddle nose deformity, polyarthritis and respiratory difficulty. Relapsing polychondritis was diagnosed by typical clinical features. RESULTS: The patient was started on systemic steroid therapy and 0.1% dexamethasone in the right eye four times daily as well as oral ibuprofen 600 mg four times daily, which were slowly tapered off over the next four weeks with the resolution of the episcleritis.

Treatment of Posterior Epistaxis with Posterior Endoscopic Laser Photocoagulation / 대한이비인후과학회지

Epistaxis is a common otolaryngologic emergency. Posterior epitaxis is more frequent in the elderly and associates with hypertension and arteriosclerosis. This is apt to be more vigorous in volume, is more difficult to identify the active bleeding point, and is more troublesome to contol. A number of different treatments are used to control the posterior epistaxis. Some of these are deep anterior packing, posterior packing, nasal balloon tamponade, arterial ligation, arterial embolization and posterior endoscopic cautery. Recently we directly photocoagulated the bleeding points in 7 cases of posterior epistaxis using endoscope and KTP/532 laser. The epistaxis was controlled in all cases without any significant complication.