The Clinical Features of Korean Patients with Duane's Retraction Syndrome

PURPOSE: To describe the clinical features of Duane's retraction syndrome (DRS) in Korean patients. METHODS: We retrospectively analyzed the 78 DRS cases that presented to our department between 1995 and 2004. The clinical features investigated included sex distribution, laterality, type of presentation, deviation in primary position, anomalous vertical movements, face turn, amblyopia and anisometropia. RESULTS: There were 38 (48.7%) affected males and 40 (51.3%) females. Left eye predominance (83.3%) was observed, as was type I presentation (85.9%). Orthotropia was found to be the most common primary position in 46 cases (59.0%). Face turn in unilateral DRS was noted in 13 patients (17.1%). There were 6 cases (7.7%) with anisometropia and 4 (5.1%) with amblyopia. CONCLUSIONS: The clinical manifestations of DRS in our study were different from those of equivalent Caucasian studies yet similar to those previously reported for Asian groups. Racial and regional differences were noted, for which further research is needed to elaborate the reasons and mechanisms.

Concenteric Chorioretinal Atrophy after Photodynamic Therapy

PURPOSE: To report a case of chorioretinal atrophy after photodynamic therapy to subfoveal choroidal neovascular membrane. METHODS: We followed up the photodynamic treatment to a 57-year-old woman who complained of the falling of vision in her right eye for 2 months and was diagnosed with subfoveal choroidal neovascular membrane at our institution. Since the size of neovascular membrane increased 3 month after the first photodynamic treatment, the patient underwent retreatment. Concentric chorioretinal atrophy developed around the laser applied site 3 months after retreatment, and enlargement of the atrophy area occurred 2 years later. In multifocal electroretinography, the retinal function of the chorioretinal atrophic eye was not decreased compared with the other eye. RESULTS: The choroids collateral circulation damage or direct drug photochemical effect was thought to be the cause of the chorioretinal atrophy after photodynamic treatment at the laser applied site but there is no functional decline of the atrophic retina.

Removal of Deep Orbital Tumor through Small Incision Approach

PURPOSE: We report on the effectiveness of the small incision anterior approach for the deep orbital tumor. METHODS: The authors operated on 5 patients with deep orbital tumor using the small incision anterior approach. RESULTS: Five cases , 2 neurilemmomas, 1 orbital dermoid cyst, 1 angiofibroma, and 1 osteoma, were treated surgically with the small incision anterior approach and had good cosmetic result, early recovery, and showed no serious complications. CONCLUSIONS: The small incision anterior approach for the deep orbital tumor has a number of advantages over lateral orbitotomy, including shorter operation time, early recovery and good cosmetic results. Nevertheless, this technique requires a precise preoperative diagnosis.

The Clinical Study of the Exposure of Implant after Evisceration

PURPOSE: To determine the factors leading to the exposure of porous spherical orbital implants (Hydroxyapatite or Medpor(R)) after evisceration. METHODS: A retrospective analysis of evisceration cases with porous spherical orbital implant performed between January 1998 and August 2002 (n=104). Forty-five patients underwent evisceration with Hydroxyapatite implantation and 59 with Medpor(R) implantation. We analyzed the exposure rate by sex, age, size of implant, kind of implant, with or without drilling, preoperative condition of eyeball, and surgeon. RESULTS: Mean follow-up period was 18.1 months. The sex, age, size of implant, drilling, and preoperative eyeball condition showed no statistically significant difference on exposure rate, but Medpor(R) implant showed a higher exposure rate than Hydroxyapatite. The exposure rate of implant between orbital implants was mostly influenced by surgeon. CONCLUSIONS: The exposure rate of implant was mostly influenced by surgeon's factor, indicating that delicate operative technique for evisceration is necessary.