Sungmo Eye Hospital

Thiamine deficiency may cause Wernicke encephalopathy (WE) characterized by ataxia, ophthalmoplegia, and confusion. Aside from the triad of cardinal symptoms, selective or predominant impairments of bilateral horizontal canals may be observed in WE. Here, we report a patient with gastric mucosa-associated lymphoid tissue (MALT)-lymphoma complicated by an early stage of WE due to thiamine deficiency manifesting bilateral vestibular dysfunctions. A 78-year-old man recently diagnosed gastric MALT-lymphoma presented with dizziness and disequilibrium for several weeks. He showed mild imbalance while tandem walking and abnormal catch-up saccades bilaterally during bedside head impulse test (HIT). Video HIT revealed decreased vestibulo-ocular reflex gains with catch-up saccades for the bilateral horizontal and several vertical canals. Diagnostic work-up demonstrated decreased serum thiamine and lesions in the mammillary body and periaqueductal gray matter on brain magnetic resonance images. Furthermore, with thiamine replacement, his clinical symptoms were markedly improved. Also, vestibular symptoms and signs may be an early manifestation of WE, and video HIT could be a useful diagnostic tool to aid early detections.

Purpose: We investigated the the effect of wearing a loose mask on tear-film break-up time using cross-sectional and experimental methods.Methods: This was a comparative analysis of non-invasive tear-film break-up time (NIBUT) after wearing no mask, loose mask, and tight mask for 10 minutes each in 60 eyes with or without dry eye syndrome. NIBUT measurements were performed using a keratograph.Results: The NIBUT values were 7.53 ± 0.83 seconds, 6.19 ± 0.78 seconds, and 7.36 ± 0.68 seconds for the no mask, loose mask, and tight mask groups, respectively. There was no significant difference between the no mask and tight mask groups (<i>ρ</i>-value = 0.517), but the loose mask group had a significantly reduced NIBUT compared with the other groups (<i>ρ</i>-value = 0.013 and 0.022, respectively).Conclusions: Wearing a loose mask reduced the tear-film break-up time regardless of the presence or absence of dry eyes and may cause or worsen dry eye symptoms.

The strut iliac bone graft has been widely used to achieve fusion in various anterior cervical spinal surgeries but some complications often remain, such as pain and gross deformity. Considering these, we designed a new technique to restore the iliac ridge, using the outmost part of the iliac crest. We aim to assess the efficacy of our new restoration technique of the iliac ridge after harvesting strut bone graft for anterior cervical fusion. The clinical and radiological outcomes of our hinged roof method were evaluated. A retrospective review was conducted of 29 patients who underwent hinged roof reconstruction of the iliac ridge after harvesting a bicortical strut bone graft for anterior cervical fusion using a cervical plate system. The clinical outcome for pain and gross appearance and radiological results were evaluated. Three months after the surgery, pain at the donor site became minimal or absent in all cases. At 1 year follow-up, no patient had reported pain and palpable discomfort, such as step-off on the donor site. Final X-ray and follow-up computed tomography revealed a bony union of the reconstructed iliac ridge to both margins. By showing good clinical and radiological outcomes, the authors' hinged roof reconstruction of the iliac crest after harvesting strut bone graft seemed to be a simple and effective technique that can reduce complications, such as pain and deformity on the donor iliac crest.

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ëª©ì  드루ì 환자의 ìœ ë¦¬ì²´ì ˆì œìˆ ë° ë§‰ì œê±°ìˆ í›„ 드루ì 의 변화를 ê´€ì°°í•˜ê³ , ìˆ˜ìˆ í›„ 결과를 ë¹„êµí•˜ê³ ìž 한다. 대상과 방법 드루ì ê³¼ 함께 í™©ë°˜ì „ë§‰ì´ 있는 환자 20안과 드루ì 이 없는 í™©ë°˜ì „ë§‰ì´ 있는 환자 25안을 대상으로 ìœ ë¦¬ì²´ì ˆì œìˆ ë° ë§‰ì œê±°ìˆ ì„ 시행하였다. 드루ì 이 있는 ë§ë§‰ì „ë§‰êµ°ê³¼ 드루ì 이 없는 ë§ë§‰ì „ë§‰êµ°ì—ì„œì˜ ìˆ˜ìˆ ì „, ìˆ˜ìˆ í›„ 1주, 1개월, 3개월, 6개월에서의 ìµœëŒ€êµì •ì‹œë ¥, 중심황반두께를 비교하였으며 드루ì 이 존재하는 군에서는 65 μm를 기준으로 크기가 작은 êµ°ê³¼ 큰 군을 나누어 비교하였다. 드루ì 크기 별로 ìˆ˜ìˆ ì „í›„ 최대 크기 드루ì 의 크기 변화를 비교하였으며, 드루ì 이 존재하는 군에서 ìˆ˜ìˆ ì „ 망막내 ë‚­ì¢ ê³¼ 시세포수용체 ë‹¨ì ˆì˜ ìœ ë¬´ì— 따른 ìµœëŒ€êµì •ì‹œë ¥ì˜ 변화를 비교하였다. ê²°ê³¼ 최대 크기 드루ì 의 í‰ê· í¬ê¸°ëŠ” ìˆ˜ìˆ ì „ 198.23 ± 27.34 μm, ìˆ˜ìˆ 6개월 후 192.23 ± 26.12 μm였으며, 드루ì 사이즈별 최대 크기 변화는 ìœ ì˜í•œ 차이를 보이지 않았다. 드루ì 이 있는 ë§ë§‰ì „ë§‰ 환자에서 망막내 ë‚­ì¢ ì˜ 존재 ìœ ë¬´ì— 따른 비교에서 ìˆ˜ìˆ 6개월 후 í†µê³„ì ìœ¼ë¡œ ìœ ì˜í•œ ìµœëŒ€êµì •ì‹œë ¥ì˜ í˜¸ì „ì„ 보였으며, ìˆ˜ìˆ ì „ 시세포수용체 ë‹¨ì ˆì´ 관찰된 경우에는 ë‹¨ì ˆì´ 관찰되지 않은 안과 비교하여 ìˆ˜ìˆ ì „í›„ ìµœëŒ€êµì •ì‹œë ¥ì€ 낮았지만 ìˆ˜ìˆ 6개월 후 ìœ ì˜í•œ ì‹œë ¥í˜¸ì „ì´ 관찰되었다. ê²°ë¡ ìœ ë¦¬ì²´ì ˆì œìˆ ë° ë§‰ì œê±°ìˆ í›„ 최대크기 드루ì 의 크기 변화는 관찰되지 않았으며, 드루ì ê³¼ 함께 ìˆ˜ìˆ ì „ 망막내 ë‚­ì¢ ë˜ëŠ” 시세포수용체 ë‹¨ì ˆì´ 관찰된 경우 ìˆ˜ìˆ í›„ ì‹œë ¥íšŒë³µì˜ 소요 기간이 길었다. Keywords: Central foveal thickness, Drusen, Drusen size, Epiretinal membrance, Vitrectomy

PurposeTo investigate the association between intraocular pressure (IOP) and serum testosterone according to the severity of obesity.Materials and MethodsWe investigated the correlation of IOP-testosterone according to the anthropometric obesity indices, such as obesity index (OI), body mass index (BMI), and waist circumference to height ratio (WtHR). Each of the obesity indices was classified into three groups: normal, overweight, and obesity. In additional, the association of IOP-testosterone was compared between testosterone 3.0 ng/mL below and above.ResultsTotal of 3,949 participants, the mean age was 58.86±10.06 years, mean IOP was 14.40±2.61 mmHg, mean arterial blood pressure (MAP) was 93.67±11.47 mmHg, and mean serum testosterone was 4.21±1.83 ng/mL. The association of MAP and IOP was significantly positively correlated according to the severity of obesity, but testosterone showed a significant negative relationship (p<0.05). IOP was significantly correlated with OI and BMI, but MAP and testosterone were correlated with all anthropometric obesity indices (p<0.05). The relationship of IOP and testosterone was significantly associated with only normal groups according to the degree of obesity (p<0.05). The IOP in patients with testosterone above 3.0 ng/mL was significantly higher than testosterone below 3.0 ng/mL (p<0.05).ConclusionsThe correlation of IOP-testosterone has a significantly positive relationship, in case of healthy men with normal weight by OI or BMI.

Purpose: We evaluated results of arthroscopically assisted volar and dorsal scapholunate(SL) ligament reconstruction using flexor carpi radialis(FCR). Methods: We reviewed 31 cases who had been operated from August 2015 to June 2018. Two cases were excluded and 4 cases lost contact. Twenty five wrists were included. The average follow-up duration was 25.3months. Diagnostic arthroscopy was performed to evaluate EWAS stage of SL instability and the reparability of SL ligament. The SL reconstruction was performed for the cases which showed EWAS stage IIIC, IV having gap over 3mm and irreparable SL ligament. The interval between the diagnosis and operation was 5.9 days in average. We modified the arthroscopic Corella technique by repairing the graft tendon to FCR. Results: All SL joints were stabilized to EWAS stage I arthroscopically after reconstruction. DASH score changed from 32.7 to 9.7. Grip power changed from 74.1% to 93.3%. Modified Mayo Wrist score was 83.8. Preoperative SL angle was 53.8。, postoperative 49.6。 and the last was 51.2。. The improvement between preoperative and last follow-up SL angle was statistically significant(p&lt;0.05). The SL angle from operation to last follow-up has increased by 1.67。(39.8%, p&lt;0.01). Twelve cases showed SL gap over 2mm in clenched fist view before operation, but no case at follow-up. Conclusions: Volar and dorsal SL reconstruction using FCR should provide more stability and strength than only dorsal SL reconstruction. Arthroscopic technique has the merit that it causes minimal damage to extrinsic carpal ligaments and posterior interosseous nerve and can provide rapid recovery.

PurposeTo evaluate the use of the precision pulse capsulotomy (PPC) device for challenging cataract surgery cases.Patients and methodsThis single-center retrospective case series study comprised of 43 eyes (from 35 patients) that were challenging cataract surgery cases with poorly dilated pupils, anterior subcapsular opacity, white cataract, brunescent cataract, and corneal opacity. This was conducted at the Busan Sungmo Eye Hospital (Busan, Republic of Korea) to assess the performance of the PPC device through a 2.2-mm clear corneal incision width, followed by the phacoemulsification technique and intracapsular intraocular lens fixation. The main outcome measurement was the anterior capsulotomy performance of the PPC device and the development of intraoperative complications. At postoperative 2 months, visual acuity, endothelial cell count, and refractive error were measured.ResultsNo cases of anterior capsule tears or tags occurred. All 43 eyes received circular, 360-degree, free-floating, and appropriately sized anterior capsulotomies. During 2 months of follow up, no postoperative complications occurred in association with the PPC device.ConclusionThe PPC device facilitated the creation of a precise, round, appropriately sized anterior capsulotomy in challenging cataract surgery cases. Further investigations are required to understand the long-term safety and efficacy of the PPC device.

To investigate the efficacy of combined topical 0.05% cyclosporine A (CsA; Restasis®, Allergan pharmaceuticals, USA) and 0.1% sodium hyaluronate treatment in dry eyes with meibomian gland dysfunction (MGD). In a retrospective analysis, 53 patients (106 eyes) with MGD were enrolled and performed lid warm massage for 10min daily and be instilled preservative free sodium hyaluronate 0.1% eye drops 4 times daily. Patients were divided into subjects treated with topical 0.05% CsA and preservative free sodium hyaluronate vehicle (experimental group, n=74 eyes) and subjects treated with the preservative free sodium hyaluronate vehicle (control group, n=32 eyes). They were evaluated at baseline and 1, 2, and 3mo for subjective symptoms and objective signs including tear film break-up time (tBUT), Schirmer test, corneal staining (CS) score, lid margin telangiectasia (LMT), meibomian gland secretion (MGS), and conjunctival injection (CI). In the short-term treatment, the experimental group showed a statistically significant improvement in the ocular surface disease index (OSDI; P<0.001), tBUT (P=0.004), Schirmer test score (P=0.008) and LMT (P=0.021) by repeated measure ANOVA. Additionally, mean changes from baseline in OSDI (P<0.001), tBUT (P=0.001), Schirmer test score (P=0.029), CS score (P=0.047), LMT (P=0.002), CI (P=0.030) were improved better in the experimental group than in the control group at 3mo. However, there was no significant difference between the two groups in MGS (P=0.67). In dry eyes with MGD, 0.05% CsA improves the tear film stability as well as subjective ocular discomfort, and is effective in controlling lid margin inflammation.