Periorbital changes associated with prostaglandin analogs in Korean patients.

BACKGROUND: Prostaglandin analogs (PGAs) are commonly used to treat glaucoma because of their powerful intraocular pressure lowering effect. However, various periorbital changes associated with the use of PGAs have been reported. We investigated the incidence of periorbital changes in Korean patients who were treated with PGAs, and analyzed clinical factors associated with superior sulcus deepening. METHODS: This study included 58 glaucoma patients who were treated with latanoprost, travoprost, or bimatoprost unilaterally. Face photographs were collected, and periorbital changes such as superior sulcus deepening, eyelid pigmentation, ptosis, lid retraction, dermatochalasis, and redness were evaluated by two oculoplastic specialists. For each patient, the contralateral eye served as a control. The frequency of ptosis, dermatochalasis, pigmentation, erythema, and superior sulcus deepening were analyzed. Demographic and ocular factors were compared between patients who showed superior sulcus deepening and those who did not. RESULTS: Thirty-one patients (53.4%) showed one or more periorbital changes associated with PGAs. The most common change was superior sulcus deepening (24.1%), followed by eyelid pigmentation (19.0%), eyelid erythema (19.0%), dermatochalasis (10.3%), eyelid retraction (5.2%), and ptosis (3.4%). The age of the patient and the duration of PGA administration was significantly correlated with superior sulcus deepening (p = 0.007, p = 0.002, respectively). CONCLUSIONS: Periorbital changes are frequently seen in patients who use PGAs, and superior sulcus deepening is the most common change in Korean patients. Long-term use of PGAs and old age were associated with superior sulcus deepening.

Type of the recurrent exotropia after bilateral rectus recession for intermittent exotropia.

BACKGROUND: The aim of this study was to investigate the type of exotropia (XT) based on the distance-near (D/N) difference in recurrent XT after bilateral lateral rectus (BLR) recession to treat intermittent XT (IXT) to look into the possibility of secondary convergence insufficiency (CI)-type strabismus. METHODS: A total of 121 patients with recurrent XT after BLR recession for basic-type and divergence excess (DE)-type IXT were retrospectively enrolled at a single institution. The distributions in the XT types were compared according to the D/N difference between primary and recurrent XT. RESULTS: Preoperatively, the population comprised 14 divergence excess (DE) types and 107 basic types. After the BLR recession, the XT-type composition changed to 59 basic types, 33 CI types, and 29 DE types. In one of the 14 preoperatively identified DE-type XT cases, the XT type changed to CI type, it changed to basic type in four cases, and the remaining nine cases showed no change in the DE type. The 107 preoperatively identified basic-type XT cases postoperatively became 55 basic-type, 32 CI-type, and 20 DE-type recurrent XT cases, and their postoperative distance XT control grades and near stereoacuity values did not significantly differ. CONCLUSION: The XT type composition changed after the BLR recession. The XT types in recurrent XT after BLR recession showed an increasing proportion of CI-type. We suspect that an individual fusion mechanism might also influence the XT-type in recurrent XT in view of the somewhat increased DE-type in recurrent XT.