Usefulness of Two-dimensioanl CT & Three-dimensional CT in Blow-out Fracture

The purpose of this study is to compare the diagnostic accuracy and usefulness of three-dimensional CT, two-dimensional CT in case of blow-out fracture. Two-dimensional CT, three-dimensional CT images of twenty-four blow-out fracture and soft tissue incarceration. Two dimensional CT was superior to three-dimensional CT in evaluating orbital bone fracture and soft tissue incarceration. But, three-dimensional CT was more useful to identify of orbital bone fracture than two-dimensional CT in associated facial bone fracture. Coexamination with two-dimensional axial & three-dimensonal CT was useful not only in the detection of fracture but in the evaluation of soft tissue incarcerated blow-out fracture.

A Clinical Study on the Endonasal Microdrill-assisted Dacryocystorhinostomy

As noe of causes of epipora, anatomic abnormality of nasolacrimal duct, has been treated with dacryocystorhinostomy. Recently, the development of nasal endoscopy has made it easy to observe the intranasal sturcture. Thus, authors investigated the effect of nasal endoscopic dacryocystorhinostomy used in combination with microdrill and nasal endoscopy in those patients, with nasolcrimal obsturction at the time of dacryocystorhinography. From 1995 to April 1997, twenty-four patients have been treated by the intranasal dacryocystorhinostomy using the microdrill with follow up more than six months. All patients had been tested by preoperative intranasal exam and was measured radiologically preoperative`s size of lacrimal sac. The nasal endoscopy using microdrill had shown success rate of 83.3 percent and the surgerywas more successful as the size of preoperative lacrimal sac was larer without any complication. The formation of accurate bone foramen did not remarkably differ from the skin incisio at the time of operation. Therefore, dacryocystorhinostomy using microdrill can be useful for the treatment of lacrimal canal obstruction, especially with the proper operating equipment.

Changes of Astigmatism and Visual Rehabilitation Following Small Incision Cataract Surgery and Implantation with Silicone or PMMA Intraocular Lenses

We analyzed early postoperative astigmatic changes, visual rehabilitation and complications with silicone intraocular lenses implanted through 3.2mm scleral pocket incision (group I. 68 eyes) and PMMA intraocular lenses implanted through 5.5mm scleral pocket incision(group 2. 103 eyes). Surgically induced astigmatism in group 1 was -0.17D at two days, -0.12D at one week, and -0.51D at two months. In group 2, it was -0.36D at two days, -0.46D at one week, and -0.72D at two months. There was a statistically significant difference between the two groups at 2 days and 1 week (p0.05). 0.5 or better uncorrected visual acuity in group I was 74% at 2 weeks, 87% at 2 months while in group 2, it was 69% at 2 weeks, and 77% at 2 months. Postoperative complication in group I were two cases of IOL decentration(2.9%), two cases of anterior capsule contraction (2.9%), three cases of anterior chamber inflammation (4.4%), and two cases of posterior capsule opacity (2.9%). In group two, it were one case of hyphema (1%), one case of wound dehiscence (1%) , one case of anterior chamber inflammation (1%), and seven cases of posterior capsule opacity (6.8%). Our results indicate the 3.2mm scleral tunnel incision (group 1) was associated with a lower surgically induce astigmatism at 2 days and 1 week, and 8 faster visual rehabilitation than 5.5mm scleral tunnel incision (group 2), but anterior chamber inflainmation, anterior capsule contraction and IOL decentrations were more frequently developed in group 1.

A survey of the Refractive State of Elementary School Children in Rural Area

To evaluate the refractive error and glasses wering state, we performed screening eye examination on elementary school children living in rural area. Among 1254 shcool children(male : 542, female : 712), 352(28.1%) children were emmetropia and 902(71.9%) children ametropia. Three hundred ninety two(72.3%) of 542 male students and 510(71.6%) of 712 female students were not emmetropia. There was no statistical significance in sexual difference of refractive errors. As refractive errors, 38.3%(481) were myopia, 27.8%(348) hyperopia, and 5.8%(73( mixed astigmatism respectively. In diopteric distribution of refractive errors, refractive error under +/-2.0D was 72.0%(650/902). Among children with refractive errors, 333(36.9%) children did not require glasses, but rest of childfen needed glasses. Three hundred nine(34.3%) children did not wear glasses inspite of refractive errors, 33(3.7%) children were wearing incorrect glasses and 2 children were wearing glasses unnecessarily. In children, early eye examination is essential for their eye health. Therefore attention to early eye examination and correct glasses wearing seem to be very important especially for child living in rural area.

The Effect of Pterygium on Corneal Astigmatism and Visual Acuity

To evaluate the effect of pterygium on corneal astigmatism and visual acuity, we checked the corneal curvature and visual acuity before and after the operation for pterygium in 126 eye. In the cases of Grade I, the mean change of the horizontal corneal curvature was +0.32D and the mean change of the vertical corneal curvature was +0.07D (P0.5).

P100 Latency in Normal Persons by Pattern Reversal VEP and Flash VEP

The Flash Light Emitted Diode Flash Visual Evoked Potential(Flash VEP) is useful when patients are unable to cooperate sufficiently for a Pattern Reversal Visual Evoked Potential(RP-VEP). In order to evaluate the clinical utility of Flash VEP, we performed the PR-VEP and Flash VEP in 208 eyes of 104 normal persons. The average P100 latency(LaP100) was analyzed according to check size, age, sex, and the laterality of the eye. The LaP100 of PR-VEP stimulated with 8 X 8(120' X 96'), 16 X 16(60' X 48'), 32 X 32 (30' X 24') and 64 X 64(15' X 12') check size were 98.88 +/- 7.57msec(mean S.D msec) , 97.68 +/- 7.44msec, 96.31 +/- 7.21msec, 101.20 +/- 7.81msec, respectively. The LaP100 of PR-VEP stimulated with 32 X 32 check size at 3rd, 4th, 5th, 6th and 7th decades were 93.95 +/- 5.61msec, 94.70 +/- 7.71msec, 92.92 +/- 6.28msec, 97.78 +/- 6.24 msec, 102.79 +/- 5.27msec, respectively. The LaP100 of PR-VEP remained relatively stable until over 6th decade when it increased significantly (p0.05), and between male and female(p>0.05) in the LaP100 of both VEP. These results showed that LaP100 of PR-VEP changes according to the check size and patient's age. We should interprete the LaP100 of PR-VEP or Flash VEP after the processing of averaging its P100 according to the patient's.

The Effect of Aminocaproic Acid and Prednisolone in the Traumatic Hyphema

It is recognized that rebleeding of traumatic hyphema may predispose patients to several complications including decreased visual acuity. We reviewed the medical records of 92 patients(92 eyes) with the diagnosis of nonperforating traumatic hyphema. The relative efficiencies of Aminocaproic acid and systemic Predisolone for reducing rate of rebleeding and their side effects were evaluated under the statistical analysis. Fourty-seven patients received an oral dosage of 50 mg/kg of Aminocaproic acid every 4 hours for 5 days(up to a maximum 30 gm/day), and fourty-five patients took an oral dosage of 0.6 mg/kg of Prednisolone daily in two devided doses. The frequency of rebleeding was not statistically significantly different between the aminocaproic acid treated group(4.3%, 2/47 patients) and the prednisolone treated group(6.7%, 3/45 patients). The developing rates of their acute adverse reaction were statistically different between the aminocaproic acid treated group(44.7%, 21/47 patients) and the prednisolone treated group(20%, 9/45 patients).

The Effect of Topical Dapiprazole on Phenylephrine and Tropicamide-induced Mydriasis

In order to evaluate the effect of topical dapiprazole, an alpha-adrenergic receptor blocker, in reversing mydrisis by 1% tropicamide and 2.5% phenylephrine, we studied 89 subjects. 0.5% dapiprazole in one eye of each subject after full dilatation of both pupils. The pupillary diameter was calibrated, and thereafter statistical analysis was performed with student paired t-test. Thirty minutes after instillation of dapiprazole, there was a highly significant difference of the decreasing rate in pupil size between the dapiprazole treated eyes and the control eyes(p<0.001). The time for complete reversal of mydriasis was also at least 4 hours shorter in the dapiprazole treated eyes than the control eyes(p<0.006). This study suggests that 0.5% dapiprazole is effective in reversing mydriasis caused by 1% tropicamide and 2.5% phenylephrine, and also effective in making the eyes comfortable in a shorter time.

A Clinical Study of Central Retinal Vein Occlusion

Central retinal vein occlusion(CRVO) is a common retinal vascular disorder with potentially blinding complications. Author evaluated the 21 cases of central vein occlusion in aspects of age, laterality, change of visual acuity, axial length, associated diseases and complications. The results were as follows; 1. The patients were comprised of 8 males and 13 females and the average age was 49.2 +/- 12.5 years. 2. The left eye was affected more than the right eye. 3. The initial visual acuity was below 0.1 in 76.2%. 4. The mean axial length of the aftected eyes(23.03 +/- 0.69mm) was shorter than that of their control group(23.53 +/- 0.69mm) (P=0.01). 5. The most common associated disease was hypertension (33.3%) and the next was diabetes mellitus (9.5%) and arteriosclerosis (9.5%). 6. The most common complication was cystoid macular edema (42.9%). Retinal and disc neovascularization was occmed in 19.4%.