A Case of Alternaria alternata Keratitis Isolated from Corneal Tissue / 대한의진균학회지

A 71-year-old man presented with pain in the left eye that revealed a 3x3 mm deep corneal stromal infiltrate, with a 2x2 mm epithelial defect. The patient started topical moxifloxacin, voriconazole 2%, and natamycin for 2 weeks. However, the treatment was not effective and the corneal infiltration worsened. Subsequently, the patient underwent therapeutic penetrating keratoplasty. Thick brown/gray mold colonies on Potato Corn Meal Tween 80 agar was isolated from excised corneal tissue and on slide culture many septated, and club-shaped ascospores were revealed. Histological findings also showed numerous hyphae scattered in corneal tissue. A. alternata colonies were confirmed by 18S rRNA sequencing. Intracameral voriconazole was injected every other day for 2 weeks to eliminate remaining fungi on the deep corneal stroma. The remaining corneal infiltration was improved one month after the injection. During 5 months postoperative follow up, the infection did not recurred. In conclusion, deep corneal infection of A. alternata was effectively treated with intracameral voriconazole injection.

Long-Term Results of LASIK for Presbyopia Correction in Myopic Patients Using Aspheric Micro-Monovision

PURPOSE: To evaluate the efficacy, safety, and satisfaction of patients who underwent LASIK for presbyopia correction in myopic patients using aspheric micro-monovision. METHODS: LASIK for presbyopic correction using aspheric micro-monovision was performed in 18 patients between December 2010 and December 2011. Distance, intermediate, and near visual acuity, refractive change, and patient's satisfaction were evaluated for at least 12 months after the surgery. RESULTS: Among dominant eyes, 100% achieved uncorrected distance and intermediate visual acuity of 0.8 or better and 100% of the eyes achieved 0.8 or better binocularly. In the non-dominant eyes, 83% achieved uncorrected near visual acuity of J3 or better, and 94% of the eyes achieved J3 or better binocularly. Postoperatively, the mean manifest refraction spherical equivalent (MRSE) of the dominant eyes were -0.09 +/- 0.35D, -0.17 +/- 0.42D, and -0.17 +/- 0.47D at 1, 6 and 12 months, respectively. The MRSE of the non-dominant eyes were -0.94 +/- 0.53D, -1.03 +/- 0.56D, and -1.02 +/- 0.50D at postoperative 1, 6, and 12 months, respectively, without significant regression. After surgery, the patient's overall satisfaction score was good (4.2 out of 5). CONCLUSIONS: The aspheric micro-monovision protocol showed good distance, intermediate, and near visual outcomes, and was a well-tolerated, stable, and effective procedure for treating patients with myopic presbyopia.

A Case of Pupillary Block and Increased Intraocular Pressure after Nd:YAG Laser Posterior Capsulotomy

PURPOSE: To report a case of pupillary block and increased intraocular pressure caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy. CASE SUMMARY: A 70-year-old male visited the hospital for decreasing visual acuity and ocular pain in the left eye. Two days earlier, he had undergone Nd:YAG laser posterior capsulotomy in the left eye. Best corrected visual acuity (BCVA) was 0.63 in the right eye and FC 60 cm in the left eye. Intraocular pressure (IOP) was 14 mm Hg in the right eye and 64 mm Hg in the left eye. Slit-lamp examination revealed diffuse corneal stromal edema and iris bombe with vitreous prolapse in the anterior chamber. Gonioscopy confirmed a closed angle. Pupillary block and increased intraocular pressure were diagnosed. A Nd:YAG laser iridotomy was performed. Three days after the iridotomy, BCVA was 0.2 and IOP was 11 mm Hg in the treated eye. Slit-lamp examination revealed reduced vitreous prolapse in the anterior chamber. CONCLUSIONS: This is the first report of pupillary block and increased IOP caused by vitreous prolapse after Nd:YAG laser posterior capsulotomy in Korea. Physicians should be aware that pupillary block could be caused by prolapsed vitreous after Nd:YAG laser posterior capsulotomy and Nd:YAG laser iridotomy could be performed effectively in such cases.

Stenosis of Esophageal Reconstruction by Abscess / 대한흉부외과학회지

We experienced a case of unusual complication following esophageal reconstruction. In 1969, accidentally the patient swallowed lye and was developed benign esophageal stricture one year later. In 1972, esophageal reconstruction with right colon was done but pus was drained out of the abdominal wound. After then wound disruption and healing were repeated. In 1996, stenosis of colonic graft was found and resection of stenotic area and end to end anastomosis was done. We concluded that it was developed inflammatory change of graft by intraoperative infection.