Management of Severe Cicatricial Entropion Using Shared Nasal Turbinate Mucosal Graft

PURPOSE: Nasal turbinate mucosal graft provides an appropriate sturdiness and smooth mucosal surface and has added benefit of mucus production. We report one case of correction of severe upper and lower cicatricial entropion with shared nasal turbinate mucosal graft procedure. METHODS: A 40-year-old male patient who had past medical history of Stevens-Johnson syndrome in his early twenties had severe upper and lower cicatricial entropion and trichiasis irritating the cornea. We corrected the severe upper and lower entropion simultaneously with shared inferior nasal turbinate mucosal graft. RESULTS: A successful correction of severe upper and lower cicatricial entropion and improvement of dry eye symptom by plentiful mucus secretion were achieved and there was no recurrence during the followup of 14 months. CONCLUSIONS: We report a case of good anatomical, functional and cosmetic results achieved by shared nasal turbinate mucosal graft procedure in the correction of severe upper and lower cicatricial entropion which cannot be corrected successfully with other conventional methods.

Three Cases of LASIK for Myopia and Astigmatism after Penetrating Keratoplasty

PURPOSE: To report three cases of LASIK (Laser in situ keratomileusis) for myopia and astigmatism after PKP (penetrating keratoplasty). METHODS: We performed LASIK in three eyes with myopic astigmatism following PKP which could not be corrected with spectacles or contact lens due to high anisometropia and contact lens intolerance. Visual acuity with or without correction, manifest refraction, corneal topography were checked before and after LASIK. The surgical complications were also monitored intraoperatively and postoperatively. RESULTS: There was no remarkable complications concerning LASIK. Mean follow-up period after LASIK was 8.7 months. Spherical equivalent was reduced from -11.5, -10.3, -5.5 D to -6.5, +0.62, -2.0 D and astigmatism was also reduced from -3.0, -4.5, -8.0 D to -1.0, -1.25, -3.0 D in each case. Uncorrected visual acuity was improved in all three cases and best spectacle-corrected visual acuity was not reduced in all cases. Postoperative corneal topography showed reduced central keratometric powers and astigmatism, but there was a tendency toward irregular astigmatism compared with that of normal LASIK eyes. CONCLUSIONS: LASIK can be a relatively safe and effective procedure in treating high myopia and astigmatism following PKP when contact lenses are not indicated. Further investigations are required for the timing of surgery, different nomogram compared with normal eyes, tendency toward irregular astigmatism and long-term follow-up results.

The Effectiveness of Surface Area Extension with Pericardial Membrane in Ahmed Glaucoma Valve Implant Surgery

PURPOSE: To assess the effect of surface area extension with pericardial membrane on the hypertensive phase and surgical success in Ahmed glaucoma valve implant surgery. METHODS: This prospective study included 10 eyes of 8 patients who underwent Ahmed glaucoma valve implant surgery with pericardial membrane(Preclude(R)) which were designed to have surface area of 300 mm2 (Group I) and 10 eyes of 9 patients who underwent Ahmed glaucoma valve implant surgery without surface area extension (Group II). The mean follow-up was 11.5+/-5.1 months and 14.9+/-4.3 months for the group I and group II, respectively. RESULTS: Two eyes (20%) exhibited hypertensive phase in group I and 8 eyes (80%) in group II (p=0.007). The complete success rate was 90% in group I and 70% in group II (p=0.291). The mean number of preoperative antiglaucoma medication was 2.4+/-0.5 and 1.9+/-0.3 for the group I and group II, respectively, and the mean number of postoperative antiglaucoma medication was 0.1+/-0.3 and 0.4+/-0.7 for the group I and group II, respectively. CONCLUSIONS: Surface area extension with pericardial membrane (Preclude(R)) in Ahmed glaucoma valve implant surgery affords statistically significantly lower hypertensive phase rate and trends toward high complete success rate and less number of postoperative antiglaucoma medications.