Comparison of Surgically Induced Astigmatisms after Clear Corneal Incisions of Different Sizes

PURPOSE: This study was performed to assess efficiency and stability of astigmatic change by incision size after cataract surgery. METHODS: This work was designed as a retrospective, comparative, nonrandomized interventional study. A total of 121 cases of cataract surgery were reviewed in 98 patients performed by one surgeon at the Oregon Eye Institute in Eugene, OR, USA with 3-year follow-ups. All procedures were performed with the temporal approach of self-sealing incisions. The serial change in surgically induced astigmatisms were examined in all cases of three groups: Group A, cartridge injection of a foldable IOL through a 2.5 mm self-sealing incision; Group B, cartridge injection of a foldable IOL through a 3.0 mm self-sealing incision; Group C, cartridge injection of a foldable IOL through a 3.5 mm self-sealing incision. Keratometric data were obtained preoperatively, and 3 weeks, 3 months, 6 months, 9 months, 12 months, 24 months and 36 months postoperatively. Polar value analysis was performed to calculate the surgically induced astigmatism. RESULTS: The astigmatic change decreased over time in Group B (P<0.05). The other groups tended to remain in induced astigmatism. All groups showed anticlockwise torque at 3 weeks following surgery. Group B showed a decrease in deviation, but the other groups showed increases in their torque value at postoperative 12 months (P<0.05). CONCLUSIONS: The 3.0 mm incision size correlated with the least surgically induced astigmatism.

Use of Temporalis Fascia for Frontalis Sling

PURPOSE: A wide variety of surgical materials have been used for blepharoptosis such as catgut, silicone, 4-0 nylon polyfilament cable-type ophthalmic suture (Supramid(R)), autogenous tendon (palmaris longus),banked sclera, dura mater, fascia lata, and temporalis fascia. The aim of this study was to evaluate the effect of frontalis suspensory surgery with temporalis fascia. METHODS: The authors studied 91 frontalis slings (71 patients) performed from 1993 to 1999 at our hospital for repair of blepharoptosis. Results with temporalis fascia (group A) as the suspensory material were compared to those with autogenous (group B) and preserved (group C) fascia lata. RESULTS: The success rates of group A (31 lids 21 patients), group B (28 lids 24 patients), group C (32lids 26 patients) were 80.6%, 75%, 78.1% respectively. But there was no statistically significant difference in each groups (P>0.05). CONCLUSIONS: We concluded that temporalis fascia for frontalis sling could be used as suspensory material successfully. Moreover, long term and further evaluations must be considered.

Change of Surface Carbohyd rate during Trans differentiation of Retinal Pigment Epithelial Cell

This study was conducted to study the changes of cell surface carbohydrates during transdifferentiation of retinal pigment epithelial(RPE)cells. RPE cells were cultured from adult pig eyes. Surface carbohydrates of RPE cells from 1st, 3rd, 5th, 7th and 9th passages were assayed by lectin histochemistry and enzyme immunoassay. Changes in binding affinities to the lectins employed were demonsrated during trasdifferentiation of RPE cell. Whereas binding affinities of ConA, ECL, PNA, WGA, and UEA-I decreased graudally as the number of culture passage increased, binding properties to LCA, STL and DBA fluctuated depending on the number of passages. The results demonstrate changes of surface carbohydrates of RPE cell during trasdifferentiation. We suggest that changes of surface carbohydrates of RPE cell during trasdifferentiation may be close relations with the functional changes during transdifferentiation.

Result of Schwind Excimer Photoastigmatic Refractive Keratectomy(One year follow up)

We evaluated the safety and efficacy of photo-astigmatic refractive keratectomy(PARK) with Schwind excimer laser for one year. We performed PARK procedures on 28 eyes with compound myopic astigmatism. Twenty eight eyes were divided into two groups according to their astigmatism: low(up to -1.5D, 15 eyes), high(over -1.5, 13 eyes). Mean preoperative astigmatism was 1.17+/-0.28 in low astigmatism group and 2.67+/-0.90 in high astigmatism group. Mean one year postoperative astigmatism was 0.40+/-0.39 in low astigmatism group and 0.48+/-0.56 in high astigmatism group. Correction rate of astigmatism was 62.3% in low astigmatism group and 79.4% in high astigmatism group. Complications were loss of best corrected visual acuity 2 line or more(2 eyes), temporary increased intraocular pressure(4 eyes), over 0.25mm eccentric ablation(2 eyes). We concluded that the Schwind excimer laser PARK appeared to be a safe and relatively accurate proceudre to correct myopic astigmatism, especially predictability of astigmatism correction was very satisfactory.

Result of Schwind Excimer Photorefractive Keratectomy(One year follow up)

We evaluated the safety, stability, predictability and efficacy of photorefractive keratectomy (PRK) with Schwind excimer laser for one year. We performed one-step procedures on 114 eyes of 92 patients. They were divided into three groups according to their manifest refractive error (spherical equivalent): Group ! (-8.01 D, 35 eyes). One year after PRK, uncorrected visual acuity of 0.8 or better was achieved in 95% of eyes in group I, 97% of eyes in group I and 63% of eyes in group III. In the group I , 90% of eyes were within +/-1 D of attempted correction, as were 95% in group II and 63% in group III. Complications were corneal haze above grade 2(8.8%), temporarily increased intraocular pressure (18.4%), central island (14.9%), eccentric ablation more than 0. 5mm(34.2%) and halo (0.9%). We conclude that the Schwind excimer laser PRK appears to be 8 safe and relatively accurate procedure to correct low to moderate myopia, but long-term and more frequent follow-up is needed for high myopia.

Anticataract Effects of Bendazac Lysine on Ultraviolet Induced Rat Cataract Based on Scheimpflug Camera

It has been known that ultraviolet B(UVB) light made an oxidative damage to lens proteins, lipids and nucleic acids to induce lens opacity. The aim of the study was to investigate the effect of bendazac lysine salt (Bendaline) tot the experimental cataract developed by UV irradiation. Forty rats were exposed to 0.1mW/cm2 of UVB radiation in the range 300-320 mm for 24 hours per day. Five control rats were not exposed UVB radiation. During the investigative period, we measured lens opacity with Scheimpflug camera every other week. Rats were divided into 9 groups according to the duration of UV radiation and initial time of bendazac lysine medication. Bendazac lysine was administered orally by 25mg/kg per day for 2 months. The opacities on anterior cortex, nucleus and posterior capsule began to appear 4 months after UVB irradiation. The longer duration of radiation, the more severe opacity of lens was observed, especially at the layers of posterior supranucleus, posterior cortex and posterior capsule and in the opacity area by retroillumination image. After UVB induced cataract was developed, the lens opacity was not changed nevertheless stop the UV irradiation. Lens opacity of bendazac lysine-treated groups was not severer than that of no medication groups. There were less opacities on 4 month irradiated group rather than 6 month irradiated group at the layers of nucleus and posterior cortex and in the opacity area. Anticataract action of bendazac lysine was effective in earlier cataract. In the group of bendazac lysine medication with UVB irradiation on same time, the prophylactic evidence of bendazac lysine was not observed.

The clinical Effect of Trabeculectomy

We studied the clinical results of trabeculetomy retrospectively. The trabeculectomy was performed in 92 patients, 106 eyes and the outcome was assessed after a minimum follow-up of 12 months. The success rat was compared among the groups which had been performed trabeculectomy only, that had used mitomycin C during operation, that had used 5-FU postoperatively and that had used both mitomycin C and 5-FU. The overall success rate is 82% at 12 months postoperatively. Compared among the groups, the success rate was 85.2% in trabeculectomy only group, 81.0% in mitomycin C group, 70.6% in 5-FU group, and 85.7% in using both mitomycin C and 5-FU group, but the success rate was statistically insignificant among the groups. The complications including shallow anterior chamber and hyphema were found in 36 eyes(34.0%).

The Effects of Mitomycin C on Trabeculectomy

Mitomycin C (MMC) is an antimetabolite, antibiotic which prevents the proliferation of fibroblast and fibrosis by inhibition of DNA-dependent RNA synthesis. It has been used to increase the success rate of filtering surgery. We performed trabeculectomy and peripheral iridectomy with 0.4 mg/ml MMC application for 3 minutes in poor prognostic glaucoma patient, 26 eyes of 24 patients from February 1992 to December 1994. The postoperative change of intraocular pressure (IOP) and complications were followed up from 3 to 30 months (mean 12.4 months). The preoperative and postoperative mean IOP after 24 months were 32.3 +/- 11.4 mmHg and 12.7 +/- 3.1 mmHg, respectively. The decrease rate of IOP was 60.7% and the success rate was 71.7%. The postoperative complications were 15 eyes including 5 eyes of shallow anterior chamber, 5 eyes of hyphema, 2 eyes of conjunctival wound leakage, one eye of bleb rupture, one eye of choroidal detachment, and one eye of cataract formation.

The Measurement of Therapeutic Effect of Bendaline(R) in Early Cataract using with Scheimpflug Camera

The Scheimpflug photography was used to evauate objectively changes in lens opacity at a month interval in 143 eyes of 78 patients affected by early cataract. from Dec. 1993 to Dec. 1994. A total of 48 patients were treated daily with 1.5g bendazac-lysine, and 30 patients constituted the control group. We checked visual acuity and analyzed change of lens opacity by using axial densitometry and retroillumination of Scheimpflug photography after Bendaline(R) medication up to 9 months After treatment, improvement or no change of subjective visual acuity was observed in 65 eyes(78.3%) of treated group, whereas decrement in 35 eyes (58.3%) of control group. In the axial densitometry, the nuclear opacity began to improve after 3 months of medication and opacities of lens between anterior supranucleus and posterior capsule were statistically significant improved after 5 months of medication (p0.05). The result show that bendazac lysine may be effective in improvement of visual acuity and delay the formation of lens opacity in early cataract.