Purpose:To retrospectively analyze the relative frequency and describe the clinical features of sagging eye syndrome in Korean patients from a single center. Methods:We retrospectively analyzed the medical records of patients with diplopia, aged over 40 years, who visited our hospital from January 2018 to December 2020. The relative frequency of sagging eye syndrome was examined by classifying the cause of diplopia. Clinical features, such as age, sex, strabismus type, angle of deviation, treatment method, and prognosis, were evaluated.Results: A total of 128 patients were identified, of which 23 (18%) were diagnosed with sagging eye syndrome, including 12 males (52.2%) and 11 females (47.9%). Their mean age was 74.6 ± 7.6 (61~89) years, and all patients were >60 years. Among the 62 patients with diplopia and age over 60 years, the relative frequency of sagging eye syndrome was 23 (37.1%), the highest among all age groups. Among the 23 patients with sagging eye syndrome, 9 (39.1%) patients had only distance esotropia, with a mean distance esotropia value of 10.1 ± 8.6 (4~25) prism diopters (PD) at the first visit; 9 (39.1%) patients had a combination of esotropia and vertical strabismus, with a mean esotropia value of 6.2 ± 4.8 (2~12) PD and a vertical angle of 4.7± 3.2 (2~10) PD; and 5 (21.7%) patients had only vertical strabismus, with an average vertical strabismus angle of 3.3 ± 1.6 (4~8) PD. Furthermore, 17/23 (73.9%) patients used prism glasses, in whom the symptoms of diplopia disappeared. Finally, only 3 (13.0%) patients underwent surgery. Conclusion:Sagging eye syndrome in Korean patients was identified in those >60 years with a similar male-to-female ratio. Moreover, nonsurgical treatments, such as prism glasses, largely helped relieve the symptoms of sagging eye syndrome.

This study aimed to develop a new type of drug delivery system (DDS) for treatment of dry eye.Methods: A new lens-type biodegradable DDS was manufactured using GelMA, antibiotics, and conjunctival epithelial cells as bio-inks in a Bio X 3D BIOPRINTER (Cell link corporation, Phoenix, USA). GelMA was used as a base, and the conditions were analyzed to maintain the overall shape by using a mixture of 0.1%, 0.15%, and 0.3% hyaluronic acid. In addition, an experiment was conducted to measure the appropriate concentration by evaluating its cytotoxicity according to the concentration of antibiotics mixed therein to prevent infection. The degree of degradation according to the storage temperature and post-processing of the new lens-type biodegradable DDS was measured.Results: Optimal conditions were maintained when using a nozzle pressure of 80 kPa and speed of 4 mm/s, nozzle pressure of 50 kPa and speed of 3 mm/s, nozzle pressure of 60 kPa and speed of 8 mm/s for 0.1%, 0.15%, and 0.3% hyaluronic acid concentrations, respectively. Degradation did not occur at 4℃ and all the lenses were degraded at 37℃ within 24 hours. In addition, the degradation rate was delayed according to the UV crosslink treatment time. Tobramycin 1% was used as an antibiotic during manufacture. Conclusions:A new lens-type biodegradable DDS that can control the degree of degradation was designed using a 3D bioprinter. This DDS will contribute to ease of treatment, protection of the cornea, and regeneration of the epithelium in patients with dry eye.