Clinical Characteristics and Related Factors of Surgical Outcome in Patient who Underwent LR Recession After the age of 10 years

PURPOSE: To identify clinical characteristics and preoperative factors that influence the surgical results of an intermittent exotropia patient who underwent lateral rectus recession after the age of 10 years. METHODS: A retrospective study was performed based on the medical records of 45 patients who underwent unilateral lateral rectus recession or bilateral lateral rectus recession for intermittent exotropia after the age of 10 years and who had undergone at least three months of postoperative follow-up. The authors investigated the clinical characteristics and factors associated with surgical success according to gender, age at surgery, fusion ability, preoperative angle of deviation, preoperative difference between near and far angles of deviation, vertical deviation, spherical equivalent of refractive error, Randot stereo test and postoperative angle of deviation at one week, one month, and three months. The postoperative deviation change according to the time between groups who underwent surgery before and after 10 years of age for intermittent exotropia was also compared. RESULTS: Surgical success was defined as a final deviation of less than 10 prism diopters. Patients without vertical deviation had a better surgical outcome than did patients with vertical deviation (p=0.022). There was no significant difference in the postoperative deviation changes between groups who underwent surgery for intermittent exotropia before 10 years and after 10 years of age. CONCLUSIONS: Among the many preoperative influencing factors, vertical deviation showed a significant difference in postoperative improvement after intermittent exotropia surgery undergone after the age of 10 years. There was no difference in the aspects of surgical success between surgeries for intermittent exotropia before and after the age of 10 years.

Corneal Endothelial Changes Induced by Corneal Bee Sting Injury

PURPOSE: Corneal bee sting is a relatively rare injury. The authors report the significant endothelial changes despite complete resolution of corneal injury after a corneal bee sting. CASE SUMMARY: Two males, ages 55 and 30, presented to our clinic for unilateral decreased visual acuity and eyeball pain after bee sting injuries. At the first visit, localized corneal stromal edema and epithelial defect were detected. One week after medical treatments, both patients achieved restoration of vision and resolution of corneal injury. In one patient, specular microscopy of the traumatized eye at one and five months showed a significant decrease in endothelial densities as compared with the contralateral eye. CONCLUSIONS: Corneal bee sting may cause significant endothelial changes despite complete resolution of clinical symptoms and injury. Specular microscopy should be considered in future intraocular surgeries.