Bong Leen Chang

Surgical management of congenital cataract associated with severe microphthalmos

PURPOSE To report the results of cataract surgery in children with severe microphthalmos and congenital cataract. SETTING Seoul National University, Department of Ophthalmology, Seoul, Korea. METHODS Retrospective studies were conducted by reviewing the charts of 20 eyes of 11 patients with severe microcornea and microphthalmos or severe microcornea with a corneal diameter smaller than 9.0 mm. The patient pool was divided according to surgical method, specifically by incision site: an anterior group that had corneal limbal incisions and a posterior group treated via pars plicata incisions. Preoperative examinations included bilaterality, corneal diameter, axial length, and eye and systemic abnormalities. Postoperative results and complications of the 2 operative methods were compared. RESULTS All 11 patients had bilateral congenital cataract and microphthalmos. Except in 1 case, surgeries were done in patients ranging in age from 2 to 16 months. Mean follow-up was 2 years. Corneal diameter was smaller than 9.0 mm in all 20 eyes and smaller than 7.5 mm in 11 eyes. Ten eyes were categorized into the anterior group, and the other 10 eyes were placed in the posterior group. Postoperative complications included secondary membranes in 3 eyes in the posterior group and corneal opacity in 3 eyes in the anterior group. CONCLUSION The surgical management of children with congenital cataract and severe microphthalmos is recommended as a way to improve vision but must be performed carefully to avoid complications.

Holmium:YAG Laser Thermokeratoplasty for Astigmatism in Rabbits

BACKGROUND Holmium:YAG laser thermokeratoplasty has generated considerable interest as a technique for correcting hyperopia. In this study, the effect of holmium:YAG laser on inducing astigmatism according to application patterns was evaluated. METHODS An experimental study based on the results of astigmatic holmium:YAG laser thermokeratoplasty using the Summit OmniMed laser system (Summit Technology Inc, Waltham, Mass) in 36 rabbit eyes is presented. We divided the rabbits into four groups: arcuate, reverse arcuate, linear, and control group according to application patterns. All rabbits were followed for 3 months and cycloplegic refractive measurements were carried out. RESULTS The average surgically induced astigmatism was 1.86 diopters (D) for the arcuate group, 2.93 D for the reverse arcuate group, and 1.31 D for the linear group. No significant complications related to the operation were noted. CONCLUSION The reverse arcuate pattern of holmium:YAG laser thermokeratoplasty is most effective in inducing astigmatism in rabbits.