ABSTRACT.Objective: To evaluate the efficacy of the fluorescein dye disappearance test (FDDT) and measurement of tear meniscus height (TMH) in the diagnosis and postoperative assessment of nasolacrimal duct obstruction (NLDO). Methods: The study group included 42 eyes of 42 patients who had a diagnosis of primary acquired nasolacrimal duct obstruction (PANDO) or functional nasolacrimal duct obstruction (FNDO) and underwent endoscopic transnasal dacryocystorhinostomy. The control group included 38 eyes of 38 people without tearing. The values of the FDDT, TMH and tearing symptom score (TSS), which was evaluated in five levels based on patients' history taking, were measured before surgery, and 1 day, 2 weeks, 1, 3 and 6 months after surgery. The values of the FDDT, TMH and TSS in the study group were compared with those of the control group. Results: The preoperative values of the FDDT, TMH and TSS were 0.7 ± 0.4, 0.22 ± 0.08 mm and 1.6, respectively, in the control group and 3.0 ± 0.8, 0.53 ± 0.15 mm and 4.4, respectively, in the study group. These differences were statistically significant. Also, at each follow-up, the postoperative values of the FDDT and TMH decreased significantly compared to their preoperative values in the study group. The postoperative TSS decreased significantly compared to the preoperative values at each follow-up except at postoperative 1-day follow-up. There were no significant differences in the preoperative values of the FDDT, TMH and TSS between the types of NLDO. The TSS had positive correlations with the FDDT and TMH before and after surgery. Conclusion: These results suggest that the FDDT and TMH measurement might be effective in the diagnosis and postoperative assessment of NLDO.
Purpose: To compare posterior capsular opacification (PCO) between a combined procedure and a sequential procedure of pars plana vitrectomy (PPV) and cataract surgery (CS). Methods: The medical records of 89 eyes of 85 patients who underwent PPV and CS were retrospectively reviewed. There were 56 eyes of 52 patients with a combined PPV and CS (the combined surgery group), and 33 eyes of 33 patients with CS in a previously vitrectomized eye (the sequential surgery group). The control group was comprised of 130 eyes of 102 patients who underwent CS alone. All patients were followed up for at least 1 year after CS. The major outcome measures were the PCO rate and the interval between CS and PCO formation. There were no significant differences in age and the incidence of diabetes among the 3 groups. Results: The PCO rate checked at 1 year after CS was 12.5% (7/56) in the combined surgery group, 24.2% (8/33) in the sequential surgery group, and 4.6% (6/130) in the control group. The differences in the PCO rate between the subgroups as well as among the 3 groups were statistically significant (p < 0.05). There were no significant differences in the interval between CS and PCO formation among the 3 groups. Conclusion: This study demonstrates that the PCO rate may be lower in patients who have a combined procedure of PPV and CS than in those who have a sequential procedure.
Although bilateral orbital fracture can cause serious eyeball and facial skeletal problems, few reports have been issued on the topic. We analyzed the clinical features of bilateral orbital fracture by reviewing the medical records of 147 patients and compared bilateral and unilateral fractures by reviewing the literature.Bilateral orbital fracture was most common in men aged between 50 and 59 years. A traffic accident was the leading cause of trauma, and average time between trauma and surgery was 12.2 days. Bilateral medial fracture accompanied by nasal fracture accounted for the overwhelming majority, and impure blowout fracture in at least 1 eye occurred in 69.4% of the 147 patients. Associated ocular injuries seemed to be similar for bilateral and unilateral fracture. Thirty-five patients (23.8%) had other multiple traumas affecting other than the eyes, and this significantly increased the need for surgery (P < 0.05). Of the 48 patients who underwent surgery, including 4 cases of bilateral surgery, 21 patients who had ocular motility restriction with central diplopia within 30 degrees almost completely recovered. No significant relation between the timing of surgery and improvement was found. Although unilateral surgery was performed in most cases, facial asymmetry related to enophthalmos was unclear at 6 months postoperatively.In summary, bilateral orbital fracture was found to be clinically distinguishable from unilateral fracture in several aspects. We hope these findings provide a reference guide to the approach and management of bilateral orbital fracture.
Purpose: This study investigated the current situation and future trends in the field of cataract surgery in Korea. Methods: Since 1995, the members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have conducted annual surveys regarding cataract and refractive surgery. The 2007 annual survey, consisting of 85 multiple-choice questions, was mailed in February 2008 to 301 KSCRS members. Sixty-two (20.6%) members answered the questions. Current data were compared with data from previous annual surveys and with surveys in the United States and Europe. Results: Fifty-four percent of the respondents were over 50 years of age. The duration of hospital stay has decreased annually and the use of topical anesthesia (57%) has slightly increased. Self-sealing wound construction was the main wound closure technique in phacoemulsification (60%). The implantation of phakic intraocular lenses (IOL) was performed in 56% of the respondents and the most preferred IOL for small incision cataract surgery were acrylic (88%). Interest in the additional value of IOL has increased annually. Conclusions: This survey summarized current trends and changes in cataract surgery in Korea.
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