Clinical Manifestation and Result of Vitrectomy of Vitreomacular Traction Syndrome

PURPOSE: To investigate the clinical manifestation and the result of vitrectomy in patients with vitreomacular traction syndrome. METHODS: Optical coherent tomography (OCT) was used to evaluate the clinical manifestation and the results of vitrectomy for 26 eyes with vitreomacular traction syndrome. RESULTS: Spontaneous relief of vitreomacular traction was achieved in 3 of 8 eyes after a mean follow-up duration of 9 months. One eye recovered visual acuity, but the other 2 eyes could not attain better visual acuity because of persistent sponge-like macular edemas. Six of 13 eyes (46%) improved by two or more lines of visual acuity after vitrectomy. The presence of simple macular cysts without sponge-like macular edemas or tractional retinal detachment seemed to be related to good results after vitrectomy. CONCLUSIONS: Vitrectomy is a preferable way to treat vitreomacular traction syndrome. Preoperative OCT could predict the surgical prognosis.

Two Cases of Ocular Ischemia following Scleral Encircling

PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.

Analysis of Tear Composition in Chronic Blepharitis

PURPOSE: To analyze the changes of tear composition in chronic blepharitis patients. METHODS: Tear samples were collected from 30 eyes of 29 patients diagnosed as chronic blepharitis by slit-lamp examination, and from 30 eyes of 30 normal volunteers. Chronic blepharitis group was subdivided into untreated group (10 eyes; tear sampling before the initiation of treatment) and treated group (20 eyes; tear sampling after the initiation of treatment). Tear pH, concentration of ions (Na+, K+, Cl-, Ca2+), total protein concentration and tear protein fraction (TPF) were measured. Statistical analysis was done by using Mann-Whitney U test and Kruscal-Wallis test, and p-value

Correlation between the Thyroid Associated Ophthalmopathy and Thyroid Function State

PURPOSE: To determine the prevalence of thyroid-associated ophthalmopathy (TAO) and the correlation between TAO and the thyroid function state. METHODS: 40 patients with TAO were selected among 2,000 patients of thyroid disease between September 1, 1995 and December 31, 2000, and classified by the Van Dyk's ''NOSPECS and RELIEF'' classification. T3, T4, TSH and Thyroid stimulating antibody (TSAb) levels were examined before and after treatment of TAO and thyroid disease. Relationship between TAO and thyroid function state was evaluated by using paired t-test and logistic regression test. RESULTS: The prevalence of TAO was about 2% in thyroid disease patients. Clinical manifestations of TAO were eyelid retraction (75%), exophthalmos (62.5%), soft tissue periorbital swelling (42.5%), diplopia and extraocular muscle restriction (20%), keratopathy (2.5%) and optic neuropathy (2.5%). Thyroid function state decided by T3, T4 and TSH level had no correlation with the improvement of TAO (p<0.05). But, TSAb level in improved TAO group (n=8) significantly decreased after treatment of TAO and thyroid disease (p<0.05). CONCLUSIONS: Thyroid function restoration may not help to improve the course of TAO. But, low TSAb level can be thought as a significant marker in improvement of TAO.

Clinical Features of Risk factors and Regression of Retinopathy of Prematurity

PURPOSE: To determine the recent incidence and spontaneous regression rate of retinopathy of prematurity(ROP) and risk factors associated with ROP. METHODS: Medical records of 510 eyes of 255 premature infants under 36 weeks of gestational age(GA) who had taken retinal examination between January 1, 2000 and Febrary 28, 2001 were retrospectively reviewed. Incidence, various associated medical conditions and spontaneous regression rates of ROP were investigated. The statistical analysis methods in the study were t-test and multiple logistic regression for risk factors, ANOVA for the duration to spontaneous regression of ROP. RESULTS: Total incidence rate of ROP was 12.2%. The significant risk factors related to ROP were low birth weight, low GA, mechanical ventilation and surfactant(p<0.05). Spontaneous regression rate of ROP was 74.2%. Mean duration to spontaneous regression was 14.1 weeks. CONCLUSIONS: This report about the risk factors and the clinical features of ROP may help to establish the therapeutic plan of ROP.

Morphological Study of Removed Silicone Tube from Nasolacrimal Duct Obstruction Patients

PURPOSE: To search the histopathologic change of the nasolacrimal duct after silicone tube intubation by the microscopic examination of removed silicone tube. METHOD: Sixty nasolacrimal duct obstruction (NLDO) patients (11 congenital and 49 acquired NLDO) operated by silicone tube intubation and conventional dacryocystorhinostomy were participated. Duration of silicone tube intubation and the length of the removed silicone tube were measured. Removed silicone tubes were stained with H and E to inspect cellular components and Alcian-blue to evaluate mucin contents. By the microscopic findings, all patients were classified to inflammatory and non-inflammatory group. Various factors contributing to occur inflammation were statistically evaluated by t-test and Fisher's exact test. RESULTS: Frequencies of inflammatory group were 27.3% (3 cases) in congenital NLDO and 34.7% (17 cases) in acquired NLDO. Five cases of acquired NLDO group showed much inflammatory cells and bacterial colony and 32 cases (65.3%) showed squamous and columnar epithelial cells and mucin in three cases. Inflammatory response of the nasolacrimal duct was not related with duration, degree, location of NLDO, duration of silicone tube intubation and length of silicone tube. CONCLUSION: Re-epithelization and mucin formation of the nasolacrimal duct may be predicted after silicone tube intubation in NLDO patients without severe inflammation.

A Case of Morphological and Chemical Analysis of Recurrent Dacryoliths after Dacryocystorhinostomy

PURPOSE: To present the morphological and chemical analysis of dacryoliths and review factors contributing to form dacryoliths with previous studies. METHODS: From a 58-year-old female patient operated with dacryocystorhinostomy, dacryoliths were obtained during the procedure and postoperative follow-up period. Morphological and microbial analysis of the dacryoliths was performed by culture and light microscopic examination. Various electrolytes in the dacryoliths were analyzed by flame atomic absorbable spectrometry(FAAS) for Na+ and K+ and by inductively coupled plasma atomic emission spectrometry(ICPAES) for Ca2+ and Mg2+. RESULTS: No bacterial and fungal organisms were cultured, but multiple bacterial colonies were found by H&E stain. Chemical analysis revealed mainly organic composition 97.91% and inorganic composition 2.09%. Inorganic composition was consisted with Ca2+ 0.82%, Na+ 0.76%, Mg2+ 0.27%, and K+ 0.24% in order. CONCLUSIONS: To prevent the recurrence of the nasolacrimal duct obstruction by the dacryoliths after dacryocystorhinostomy, pathogenesis of the dacryoliths formation may be studied with morphological and chemical analysis of the Dacryoliths.