Clinical Factors Affecting Subfoveal Choroidal Thickness and Choroidal Vascularity Index after Phacoemulsification for Cataracts

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

Clinical Factors Affecting Subfoveal Choroidal Thickness and Choroidal Vascularity Index after Phacoemulsification for Cataracts

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

Clinical Characteristics of Intermittent Esotropia

Purpose@#To evaluate clinical findings and surgical outcomes of intermittent esotropia. @*Methods@#We retrospectively reviewed the medical records of 23 patients (aged 9-42 years) who presented with intermittent esotropia between January 2007 and December 2020. We analyzed the age at onset, angle of deviation, presence of symptomatic diplopia, fusional state, near stereoacuity, and surgical results. @*Results@#The mean age at onset was 19.9 ± 8.0 years and mean duration of esodeviation was 23.4 ± 27.1 months. Mean follow-up time was 13.0 ± 15.6 months. All patients except three had symptomatic diplopia, and 78.3% showed intermittent diplopia. Mean angles of deviation were 21.6 ± 10.3 prism diopters (PD) at distance and 20.2 ± 10.4 PD at near. Twenty-one patients (91.3%) were myopia. No patients had amblyopia and one had dissociated vertical deviation. On Worth’s four-dot test, five patients (21.7%) showed diplopia and four showed suppression at both distance and near. The other patients showed fusion at near or distance. Eleven patients underwent surgical correction. At the final examination, all patients achieved successful motor alignment and fusion with resolution of diplopia. Only two patients (18.2%) achieved normal 60 arcsec stereopsis, and six attained subnormal stereopsis. @*Conclusions@#The main symptom of intermittent esotropia was diplopia. Surgical treatment was effective in achieving good postoperative motor alignment and fusion. However, successful motor alignment did not guarantee recovery of fine stereopsis.

Serial Follow-up of Commotio Retinae Using Ultra-wide Field Imaging

PURPOSE: To quantify the size of commotio retinae and investigate its spontaneous resolution over time using ultra-wide field (UWF) color fundus photography.METHODS: We analyzed serial UWF color fundus photographs of 33 eyes of 33 ocular trauma patients with commotio retinae. Total visible retinal areas and the areas of commotio retinae were measured at baseline, 3 days, 1 week, and 4 weeks from the initial traumatic event.RESULTS: The median time of observation was 10.8 ± 12.1 (4-44) weeks. Spontaneous resolution of commotio retinae was observed in all patients, and no patients experienced any complications during the follow-up period. The mean percentage of commotio retinae at 3 days significantly decreased compared to the baseline (8.51 ± 9.66% versus 12.23 ± 10.39%; p < 0.001), and more decreased at 1 week (1.04 ± 2.75%; p < 0.001), but no significant differences were observed between 1 week and 4 weeks (0.00 ± 0.00%; p = 0.219). The spontaneous resolution percentages during the first 3 days, between 3 days and 1 week, and during the next 4 weeks were 12.97 ± 13.44%/day, 19.62 ± 9.22%/day, and 0.87 ± 1.87%/day, respectively (p = 0.192 and p < 0.001, respectively). The resolution rate was higher during the first 1 week.CONCLUSIONS: We quantified the size of commotio retinae using UWF color fundus photography. Most patients with commotio retinae resolved spontaneously during the first 1 week following trauma, and all cases completely resolved at 1 month without any complications.

Effect of Acetazolamide on Choroidal Morphology in Central Serous Chorioretinopathy

PURPOSE: We sought to elucidate the influence of acetazolamide on choroidal structure changes during the treatment of central serous chorioretinopathy (CSC).METHODS: This was a retrospective study of 45 eyes from 45 patients with acute CSC who were divided into an acetazolamide group (group 1, n = 20) and an observation group (group 2, n = 25). The main outcome measures were the changes in best-corrected visual acuity, subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) at one week, one month, two months, and three months, respectively.RESULTS: Although statistical significance was not reached, best-corrected visual acuity improved in both groups at month 3 (from 0.06 ± 0.07 to 0.01 ± 0.03 in group 1 and 0.17 ± 0.24 to 0.09 ± 0.18 in group 2; p = 0.083 and 0.183, respectively). Separately, SRF height and CVI showed a significant decrease at three months in both groups (all p < 0.05), while a significant SRF height decrease was also noted in group 1 at one month (p = 0.038). In group 1, a significant decrease in the SFCT and CVI started at one week and one month (p = 0.021 and 0.008), respectively. However, in group 2, a significant decrease in the SFCT and CVI started at one month and two months (p = 0.005 and 0.015), respectively.CONCLUSIONS: Acetazolamide has no effect on final functional or anatomical status at three months in eyes with CSC but does shorten the time for SRF absorption and accompanying choroidal structural changes.

Intravitreal Dexamethasone Implantation in a Behcet's Disease Patient with Macular Edema, Vasculitis after Cataract Surgery

PURPOSE: To report a case of macular edema and retinal vasculitis treated with intravitreal dexamethasone implantation in a Behcet's disease patient after cataract surgery. CASE SUMMARY: A 26-year-old male with Behcet's disease, without recurrence of uveitis for 3 months, underwent phacoemulsification and posterior chamber intraocular lens implantation for a cataract in the left eye. The preoperative best corrected visual acuity (BCVA) of the left eye was 0.15. At day 1 after surgery, his BCVA was 0.4, and slit lamp examination of his left eye revealed a mild anterior chamber reaction. At 1 week after surgery, he presented with left vision impairment, his BCVA was 0.04, and mild inflammation was observed in both the anterior chamber and the vitreous in his left eye. Unilateral macular edema was confirmed with optical coherence tomography, and fluorescein angiography revealed retinal vasculitis on the fovea and peripheral retina. Intravitreal dexamethasone implantation was performed in his left eye, 1 month after treatment, the macular edema and retinal vasculitis had improved, and the BCVA of his left eye was 0.8. CONCLUSIONS: In patients with Behcet's disease, intravitreal dexamethasone implantation can be an effective treatment option for macular edema and retinal vasculitis after cataract surgery.

Surgical Outcomes of Intermittent Exotropia According to the Constancy

PURPOSE: To investigate how the constancy of intermittent exotropia affects postoperative motor and sensory outcomes. METHODS: A retrospective analysis was conducted of 44 patients with intermittent exotropia (IXT group) and 16 patients with constant exotropia with a previous history of intermittent exotropia (CXT group). All patients were followed up for more than 1 year postoperatively. Successful postoperative motor alignment was defined as within 8 prism diopters of exo- or esotropia at 6 meters and 33 centimeters. Successful sensory outcome (bifixation) was considered as stereoacuity < or =60 seconds of arc. The influence of constancy, age at surgery, duration of strabismus, preoperative gross stereopsis, preoperative distant deviation, and preoperative distant fusion to surgical outcomes were evaluated using logistic regression analysis. RESULTS: Mean age at surgery and follow-up periods was 9.34 years and 37.8 months in the IXT group, and 10.19 years and 45.7 months in the CXT group. Successful motor alignment rates of the IXT and CXT groups were 65.9% and 48.3%, respectively. Postoperative bifixation rates of the IXT and CXT groups were 70.5% and 12.5%, respectively. The IXT group showed significantly better successful sensory outcome (p = 0.000), but no significant difference in motor outcome (p = 0.121). Constancy and preoperative distant fusion were associated with post-operative bifixation in univariate regression analysis (p = 0.001, 0.025, respectively). However, only the constancy was strongly associated with successful sensory outcome in multivariate regression analysis with an odds ratio of 20.138 (p = 0.008). CONCLUSIONS: Surgical correction of intermittent exotropia during the intermittent period showed better sensory outcome than in constant deviation period.

Astigmatic Changes after Horizontal Rectus Muscle Surgery in Intermittent Exotropia

PURPOSE: To evaluate the changes of refractive astigmatism after horizontal rectus muscle surgery in intermittent exotropic children. METHODS: Sixty-nine exotropic patients were retrospectively reviewed. Of those, 35 patients received unilateral lateral rectus recession (BLR group, 35 eyes) and 34 patients received unilateral lateral rectus recession and medial rectus resection (R&R group, 34 eyes). Non-cycloplegic refractions were measured until 6 months postoperatively. Spherical equivalent (SE), J0 and J45 using power vectors were calculated to determine and compare the changes of refractive astigmatism and axis in both groups. RESULTS: SE significantly decreased after surgery for the first week and did not changed thereafter in both groups (p = 0.000 and p = 0.018, respectively). In BLR group, J0 showed significant changes at the first week and 1 month after surgery (p = 0.005 and p = 0.016, respectively), but in R&R group, J0 changed significantly between 1 week and 3 months postoperatively (p = 0.023 and p = 0.016, respectively). J45 did not change significantly as time passed in both groups (all p > 0.05). There was no statistically significant difference in the magnitude of changes in SE, J0 and J45 between the two groups after the 6-month follow-up (p = 0.500, p = 0.244 and p = 0.202, respectively). CONCLUSIONS: Horizontal rectus muscle surgery in intermittent exotropic children tends to induce a statistically significant change in astigmatism in the with-the-rule direction and myopic shift in SE. This astigmatism change seems to occur within the first 3 months after surgery. Thus, astigmatism induced by surgery should be checked and corrected at least 3 months after horizontal strabismus surgery.

Excision with Corneoscleral Lamellar Keratoplasty and Amniotic Membrane Transplantation of a Corneal Displaced Recurrent Conjunctival Melanoma

An 81-year-old woman with a raised pigmented nodule over her left cornea for 7 months duration was examined. Dark conjunctival pigmentation was observed in the upper bulbar fornix conjunctiva. She had previously undergone primary surgical excision of a malignant conjunctival melanoma four years earlier. The tumor separated easily from the corneal surface, but remained slightly attached to the corneoscleral surface. A corneoscleral lamellar dissection of 3 mm in width and 2 mm in depth as well as a corneoscleral lamellar keratoplasty for the reconstruction of the corneoscleral defect were performed. The wide upper bulbar and fornix conjunctiva were excised, and an amniotic membrane transplantation was performed. Biopsy revealed an invasive melanoma with a depth of 1 mm. Left, right, and inferior tumor margins of the corneoscleral lesion and the pigmentary lesion in the conjunctiva were free of the tumor. After surgery, 0.04% mitomycin was administered topically 4 times daily for 4 weeks. There was no recurrence 2 years after surgery, and systemic evaluation revealed no metastasis.

A Case of Congenital Monocular Elevation Deficiency Associated with Inferior Rectus Anomaly

PURPOSE: To report a congenital monocular elevation deficiency (MED) associated with inferior rectus anomaly. CASE SUMMARY: A 3-year-old, otherwise healthy boy presented with left hypotropia. He showed chin-up and left head turn with left pseudoptosis. On examination, there was a left hypertropia of 60 prism diopters (PD) and esotropia in primary position. Upgaze -4 limitation in abduction and -3 from primary position, poor Bell's phenomenon, and normal vertical saccadic velocity until midline were observed. On orbital CT, thin and nasally displaced left inferior rectus showing enlargement at its posterior segments near the orbital apex was observed. Forced duction test at surgery revealed a strong positive restriction and thin, taut, fibrotic inferior rectus was inserted and displaced nasally. CONCLUSIONS: Left inferior rectus recession of 5.5 mm with 2.0 mm of temporal transposition improved elevation deficiency, but consecutive exotropia and hypotropia remained. Knapp procedure combined with left lateral rectus recession of 5.5 mm and left medial rectus resection of 4.5 mm, and right superior rectus recession of 9.5 mm were additionally performed. Pseudoptosis and chin elevation resolved but left hypotropia 10PD, and exotropia 6PD remained. Elevation restriction in primary position and abduction were improved but still persisted. This case indicated that MED may accompany congenital inferior rectus anomaly. If severe inferior rectus restriction is observed during the forced duction test, a structural anomaly of the inferior rectus causing motility defects of MED.

A Case of Congenital Monocular Elevation Deficiency Associated with Inferior Rectus Anomaly

PURPOSE: To report a congenital monocular elevation deficiency (MED) associated with inferior rectus anomaly. CASE SUMMARY: A 3-year-old, otherwise healthy boy presented with left hypotropia. He showed chin-up and left head turn with left pseudoptosis. On examination, there was a left hypertropia of 60 prism diopters (PD) and esotropia in primary position. Upgaze -4 limitation in abduction and -3 from primary position, poor Bell's phenomenon, and normal vertical saccadic velocity until midline were observed. On orbital CT, thin and nasally displaced left inferior rectus showing enlargement at its posterior segments near the orbital apex was observed. Forced duction test at surgery revealed a strong positive restriction and thin, taut, fibrotic inferior rectus was inserted and displaced nasally. CONCLUSIONS: Left inferior rectus recession of 5.5 mm with 2.0 mm of temporal transposition improved elevation deficiency, but consecutive exotropia and hypotropia remained. Knapp procedure combined with left lateral rectus recession of 5.5 mm and left medial rectus resection of 4.5 mm, and right superior rectus recession of 9.5 mm were additionally performed. Pseudoptosis and chin elevation resolved but left hypotropia 10PD, and exotropia 6PD remained. Elevation restriction in primary position and abduction were improved but still persisted. This case indicated that MED may accompany congenital inferior rectus anomaly. If severe inferior rectus restriction is observed during the forced duction test, a structural anomaly of the inferior rectus causing motility defects of MED.

Idiopathic Orbital Inflammation Presenting as Unilateral Dacryoadenitis in a Child

PURPOSE: To report a case of idiopathic orbital inflammation presenting as unilateral acute dacryoadenitis in a child. CASE SUMMARY: A nine-year-old boy presented with painful swelling and redness in the right upper eyelid and temporal conjunctiva without systemic symptoms for five days. Acute orbital cellulitis was suspected but did not respond to systemic antibiotics. An orbital computed tomogram and magnetic resonance imaging revealed a diffusely enlarged and inflamed right lacrimal gland. The patient showed dramatic response to systemic corticosteroids, and acute dacryoadenitis due to idiopathic orbital inflammation was diagnosed. Treatment with oral corticosteroids for two months resolved the inflammation. No relapse was observed during four months of follow-up. CONCLUSIONS: Although rare, acute dacryoadenitis as a localized nonspecific orbital inflammation should be considered in the differential diagnosis of acute orbital cellulitis in pediatric patients.

Comparison of Fibrin Glue and Sutures for Conjunctival Wound Closure in Strabismus Surgery

PURPOSE: To evaluate and compare the efficacy and tolerance of fibrin glue and sutures for closing conjunctival wounds in strabismus surgery. METHODS: In a prospective trial, we performed strabismus surgery using limbal incisions. Conjunctival wounds were closed with fibrin glue in 20 eyes of 20 patients (fibrin group) and 8-0 polyglactin suture in 20 eyes of 20 patients (suture group). Postoperative pain, tearing, and inflammation were compared at 1 day, 1 week, 3 weeks, and 6 weeks after surgery. Conjunctival incision healing was also investigated. RESULTS: One day and one week post-operatively, pain and tearing scores were lower in the fibrin group (p = 0.000, respectively). Mean surgery time was significantly shorter in the fibrin (48 +/- 5 minutes) than the suture group (63 +/- 7 minutes) (p = 0.000). Inflammation was significantly more severe in the suture group until 3 weeks postoperative (p = 0.000, respectively), but conjunctival healing did not differ between the groups. Hyperemia appeared more prominent in the fibrin group 3 and 6 weeks after surgery (p = 0.087 and 0.000, respectively). Two eyes in the fibrin group showed conjunctival gaps of more than 2 mm, which closed spontaneously by three weeks after surgery. No allergic reactions or infections developed. CONCLUSIONS: Fibrin glue proved to be as effective as sutures in closing conjunctival wounds. It provides more comfortable early postoperative courses and might be considered as an alternative to sutures in strabismus surgery.

Successful Removal of Apocrinehydrocytoma Using Indocyanine Green and Sodium Hyaluronate

PURPOSE: To report a new modified method using a mixture of sodium hyaluronate and indocyanine green solution to facilitate the complete removal of a large conjunctival cyst. CASE SUMMARY: Two patients with a large conjunctival cyst on the bulbar conjunctiva were treated. In order to achieve complete removal, a mixture of 1% sodium hyaluonate and indocyanine green solution was injected through a 27-G needle into the cyst. The procedure provided excellent visualization of the cyst boundaries while maintaining cyst integrity allowing for an easy and complete resection. Apocrine hidrocystoma and a simple retention cyst were confirmed on histopathologic examination, respectively. CONCLUSIONS: During the removal of a large cyst, injecting a mixture of sodium hyaluronate and indocyanine green is effective in delineating the cyst capsule while preserving its integrity, thus aiding in the complete removal of the cyst wall.

Clinical Outcomes of Refractive Accommodative Esotropia in Korean Adolescent Patients

PURPOSE: To report the clinical course of refractive accommodative esotropia (AE) and to determine whether the strabismus resolves during the adolescent years in Korean patients. METHODS: A total of 32 adolescent patients with AE associated with hyperopia were retrospectively reviewed. Ocular alignments, amblyopia, stereopsis, changes in refractive error with time after glasses prescribed, and clinical characteristics were studied. RESULTS: The mean age and follow-up were 14.9 and 10.1 years, respectively at the final visit. The Initial and final refractive errors were 5.16 and 2.52 diopters (D), respectively. Spectacles were initiated at a mean age of 4.7 years, and intentional undercorrection initiated from a mean age of 6.3 years. Hyperopic reduction after prescribing glasses followed the formula: Diopter (D) = 5.23 - 0.02 (Time) - 0.03 (Time)**2. Initially, 16 out of 32 patients (50%) showed fully corrected hyperopia, and eventually, 71.9% wore partially corrected spectacles. The mean change of hyperopia per year was 0.26 D. Six out of 32 patients (18.8%) were successfully discontinued from hyperopic spectacles and the mean age of weaning was 14.7 years. Intentional initial undercorrection did not affect hyperopic reduction (p = 0.123). CONCLUSIONS: AE persists through adolescence for a majority of Korean patients. These patients need to be carefully monitored during follow-up periods because most do not outgrow their hyperopia and need to using spectacles.

Changes of Ocular Version with Aging in Normal Korean Population

The purpose of this study is to estimate normative values of maximum versions in healthy Koreans and investigate age-associated changes in eye movement, using lateral and vertical version light-reflex (LVR) test. Two hundred forty normal healthy subjects whose corrected visual acuity was better than 20/50 in both eyes, from 4 to 79 yr old (30 subjects in each decade) were studied. Maximum sustained values of dextroversion, levoversion, supraversion, and infraversion in each eye were measured using LVR test. Changes of versions according to age were analyzed. Mean normal value of dextroversion, levoversion, supraversion, and infraversion in normal Koreans was 7.7 mm, 41.6degrees, 33.9degrees, and 7.7 mm respectively. Contrary to values of Caucasians, levoversion (adductive movement) was more excessive and infraversion (depression) was smaller in Koreans. All versions were decreased with aging (P<0.001 for all). Levoversion had the largest decrease with aging compared with other versions (P<0.001, respectively) and infraversion had the least decrease with age than levoversion (P<0.001), supraversion (P<0.001). All maximal sustained versions were decreased with aging but the ranges of ocular movements in Koreans were different with Caucasians as version least affected and most affected by age was infraversion and levoversion in Koreans. The study standardized normal maximal versions and aging changes of versions in Koreans.

A Case of Nodular Fasciitis in the Upper Eyelid

PURPOSE: To report a rare case of nodular fasciitis in the upper eyelid. CASE SUMMARY: A 42-year-old woman presented with rapid enlarging mass, 15x12 mm in size at left upper eyelid. Orbit CT disclosed an enhanced, well-circumscribed preseptal lid mass. The histopathologic and immunohistochemical analyses after excisional biopsy were consistent with nodular fasciitis. There was no recurrence of the tumor after excision. CONCLUSIONS: For rapidly enlarging lid mass, nodular fasciitis should be considered as a differential diagnosis of sarcoma.

Effect of topical nonsteroidal anti-inflammatory drugs versus topical steroids after strabismus surgery

PURPOSE: The purpose of this study is to compare the effect of topical nonsteroidal anti-inflammatory drugs (NSAID) with topical steroid in conjunctival inflammation, wound healing, and intraocular pressure when used after strabismus surgery. METHODS: Twenty five patients who received bilateral horizontal rectus muscle recession were selected. 0.1% prednisolone acetate (Optilon(R), Chongkundang Pharma Corporation) was applied to the right eye of each patient and 0.1% pranoprofen (Pranopulon(R), Choongwae Pharmacology Corporation) was applied to the left eye four times a day after surgery. Both eyes were compared at one day, 1 week, 2 weeks and 4 weeks after surgery to measure the extent of inflammation (injection, chemosis, discharge), pain and conjunctival incisional healing. The intraocular pressure was compared at the day before surgery and 1 week, 2 weeks and 4 weeks after surgery. RESULTS: The steroid group showed earlier improvement of inflammation and pain and faster conjunctival incisional healing than the NSAID group (p>0.1). The steroid group showed a significantly higher IOP than the NSAIDs group throughout the periods (p<0.001), and showed a progressive increasement in IOP during the study periods (p<0.001). CONCLUSIONS: Topical NSAIDs were proved to be as effective as topical steroids in controlling inflammation and pain, and in the healing of conjunctival wounds. In addition, topical NSAIDs showed no side effect of increasing IOP. Therefore, topical NSAIDs may be a safe alternative to topical steroids after strabismus surgery in children who have difficulty in measuring IOP.

Bilateral Optic Neuritis Following Measles

PURPOSE: We report a case of bilateral optic neuritis without encephalomyelitis, following measles that has recently spread in our country. METHODS: Nine-year-old male patient diagnosed as measles based on the typical symptoms and serum IgM positivity complained of sudden decrease in visual acuity of both eyes (FC/50 Cm in both eyes). Bilateral afferent pupillary defect were detected and visual evoked potentials show the delayed P100 latency and the decreased amplitude in both eyes. We diagnosed his case as the bilateral optic neuritis and treated with the high dose steroid therapy. RESULTS: At 2 months after visual loss, the afferent pupillary defect disappeared and the visual evoked potentials returned to normal. At 6 month, the visual acuity of the right and left eyes improved to 0.9 and 1.0, respectively. CONCLUSION: Optic neuritis following measles is a rare entity, and it is the first time such a case has been reported in Korea. This is a rare case where optic neuritis occurred without the symptoms or signs of encephalitis. In this study, we diagnosed and treated the first case of optic neuritis following measles in korea, with satisfactory results.

Effect of the Local Doxorubicin Injection on the Extraocular Muscle

To investigate the chemomyectomy effect of doxorubicin on extraocular muscle, we injected 0.05ml doxorubicin into right superior rectus muscle for the experimental group and 0.05ml balanced salt solution into left superior rectus muscle for the control group of 12 rabbits. The gross and histologic examinations were done at 1, 2, 4 and 8 weeks after the injection. The results were as follows; 1. On gross examination, thickness of muscle mass at injection site was decreased with the time in the experimental group, and neither conjunctival adhesion and symblepharon nor scleral necrosis was found in both groups. 2. On microscopic examination, the degree of muscle fragmentation and necrosis was increased with the lapse of time in the experimental group. But there was no observable change with the lapse of time in the control group. These results suggested that doxorubicin was such a selective myotoxin to extraocular muscles that it could be used for nonsurgical treatment of chronic paralytic and restricted form of strabismus.