PurposeTo evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features.MethodsPatients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated.ResultsPunctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type.ConclusionsAcquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.

Purpose. To examine the demographic characteristics, clinical features, surgical outcomes, and long-term prognoses of epiblepharon in Korean children. Methods. Epiblepharon patients who were followed for ≥ 6 month following surgical correction between January 2005 and December 2013. The patient demographics, clinical features, concomitant disorders, surgical outcomes, and complications were retrospectively reviewed. Results. A total of 768 epiblepharon records were included in the analysis. The mean patient age was 6.55 ± 2.37 years. At presentation, 712 patients (92.8%) complained of typical epiblepharon symptoms. The mean patient age at surgery was 6.95 ± 2.52 years, with 629 patients (81.9%) on the lower lid and 72 patients (9.4%) on the upper lid and 82 patients (10.7%) undergoing surgery on both lids. The eyelid was well everted with no recurrence in 740 patients (96.4%). Conclusion. Epiblepharon frequently occurs in Korean children and is correctable with a simple surgery. Recurrence and serious complications do not occur often, and any suspicions of epiblepharon should be investigated. A thorough ocular examination can lead to a correct diagnosis and timely corrective surgery. Most procedures are successful and prevent secondary complications that often occur with uncorrected epiblepharon.

To establish the clinical relevance of the changes in the complement system in patients with thermal injury, we studied 20 patients who had third-degree burns on more than 60% of total body surface area. Their levels of the C3, C4, soluble C5b-9, and functional hemolytic activities of total (CH50) and alternative (AH50) complement pathways were sequentially measured for 2 weeks after thermal injury. All patients showed low C3 levels initially but increased C3 levels in the following days. The increasing trend of C3 levels was prominent in survivors but transient and diminished in nonsurvivors. The change of levels of C3, CH50, and AH50 was closely associated with one another, and their chronological trends related to the survival of patients (P =.0060,.0064 and.0066, respectively). The recovery of C3, AH50, and CH50 to normal or supranormal level during the early treatment period relates to the survival of patients with thermal injury. The failure of recovery of the complement system indicates a poor prognosis for patients and the monitoring of complement system might be beneficial in the care of patients with thermal injury.

The aim of the study is to evaluate the change in thickness of the retinal nerve fibre layer following acute traumatic optic neuropathy using optical coherence tomography. Twenty-eight patients who had unilateral decreased visual acuity and who were diagnosed with traumatic optic neuropathy were evaluated. Twelve eyes in the 28 patients who had trauma to the orbit or head resulting in traumatic optic neuropathy were serially examined every 2 weeks for 6 weeks and again at 12 and 24 weeks after the trauma. The progressive axonal change in retinal nerve fibre layer thickness was examined with disc optical coherence tomography. The mean age of the 12 patients was 48.58 ± 21.64 years. The mean retinal nerve fibre layer thickness at the second week after trauma was 95.03 ± 5.93 μm; this mean thickness decreased sequentially over the next 6 months and was 50.61 ± 5.99 μm at 24 weeks after trauma. Retinal nerve fibre layer thickness decreased at a faster rate during the first 6 weeks after trauma than in any other period, and the rate of this decrease became stable 6 months after the trauma. The superior and inferior portions of the optic disc showed greater reductions in retinal nerve fibre layer thickness than other areas. The authors conclude that in cases of traumatic optic neuropathy, retinal nerve fibre layer thickness decreased sequentially for 6 months. Most of this decrease occurred during the first 6 weeks after trauma.

Purpose: To evaluate the changes in break-up time (BUT) and corneal sensitivity following LASIK surgery for refractive error correction with presbyopia in patients older than 45 years. Methods: The authors of the present study measured the BUT and corneal sensitivity of 92 eyes that received LASIK surgery for correcting refractive error with presbyopia. The eyes were divided into groups according to gender and preoperative refractive error before surgery and 1, 3, 6 and 12 months after LASIK. Results: The mean age of patients was 52.01 ± 5.51 years, and the male to female eye distribution was 31:61. The value of BUT before surgery and 1, 3, 6, and 12 months postoperative was 5.31 ± 2.03 sec, 4.47 ± 1.67 sec, 4.04 ± 1.58 sec, 4.53 ± 1.51 sec, and 4.87 ± 1.46 sec, respectively; corneal sensitivity was 56.35 ± 5.94 mm, 40.07 ± 14.21 mm, 46.42 ± 10.41 mm, 50.75 ± 8.04 mm, and 52.92 ± 7.51 mm, respectively. BUT was not significantly different relative to refractive error and was significantly shorter in the female group than the male group at 1 month postoperative. Corneal sensation of myopia at 12 months postoperative was statistically higher than at other time points; however, there was no difference between genders. BUT and corneal sensitivity at 12 months postoperative recovered to 91.6% and 93.9% of the preoperative value, respectively. Conclusions: BUT and corneal sensitivity after LASIK for presbyopia were decreased until 12 months postoperative and recovered slowly, but did not return to preoperative levels.