Jaeduck Kim

Primary Pterygium Surgery Using the Inferior Conjunctival Transposition Flap

The authors investigated a surgical method for primary pterygium without adjunctive therapy and devised a technique called the inferior conjunctival transposition flap. The procedure was performed by making a flap of the inferior conjunctiva after excision of the pterygium, and transpositioning it to make a covering for the bare sclera and donor site and a barrier to pterygium tissue. This method has been used on 54 eyes of 50 patients (mean age 47 years, range 18 to 69 years) with primary pterygium. All of these patients were treated by one surgeon. During a follow-up period of 12 to 26 months (mean 20 months), the pterygium recurred in 3 (5.6%) of the 54 eyes. In all other cases good anatomic and cosmetic results were achieved without any serious complications. The authors concluded that the inferior conjunctival transposition flap is an encouraging technique for the treatment of primary pterygium.

Tolerance of patients and postoperative results : Topical anesthesia for strabismus surgery

PURPOSE To assess patient tolerance and the postoperative results of intraoperative adjustment of strabismus surgery under topical anesthesia. METHODS Twenty-four patients with strabismus underwent rectus muscle recession under topical anesthesia without the use of additional systemic analgesics and sedatives. Patient tolerance was estimated according to the sites of procedure. In addition, the angle of strabismus was measured 1 day, 6 weeks, and 1 year postoperatively. RESULTS Of the 24 patients identified (11 men and 13 women; mean age: 24 years), 16 had exotropia, 7 were esotropic, and 1 was hypertropic. During the operation, 17 patients never expressed any pain, and 7 patients complained of discomfort on muscle manipulation. Postoperatively, the success rate was 95.8% (23 patients) the first day after surgery, 79.2% (19 patients) after 6 weeks, and 70.8% (17 patients) after 1 year. CONCLUSION Intraoperative adjustment performed with the patient under topical anesthesia is recommended in all cooperative cases of strabismus surgery and is comfortable for patients.

Visualization of retinal and choroidal blood flow with fluorescein leukocyte angiography in rabbits

Abstract• Purpose: To visualize the retinal and choroidal leukocytes in rabbits with a new technique, fluorescein leukocyte angiography using a scanning laser ophthalmoscope. • Methods: Blood was withdrawn from an ear vein of a rabbit (New Zealand White), mixed with fluorescein dye in a test tube and centrifuged. The yellow-brown coat layer containing fluorescein-stained leukocytes was collected and injected into the ear vein of the same rabbit while performing fluorescein angiography with a scanning laser ophthalmoscope. The angiographic image displaying circulating fluorescent leukocytes in retinal and choroidal vessels was recorded on a videotape. • Results: Fluorescent leukocytes were clearly visible in the retinal arteries, capillaries, veins and choroidal vessels for more than 1 h. Plugging of leukocytes was seen throughout this period of time in choroidal vessels, while plugging was rare in retinal vessels. • Conclusions: Fluorescein leukocyte angiography is a new technique which can be used for visualization of the leukocytes in retinal and choroidal vessels non-invasively and in vivo.

Visualization and Flow of Platelets and Leukocytes in vivo in Rat Retinal and Choroidal Vessels

PURPOSE To directly visualize the flow of leukocytes in choroidal vessels and the flow of platelets in retinal vessels in a rat without incision by fluorescein leukocyte angiography (FLA) using a scanning laser ophthalmoscope (SLO). METHODS Blood was withdrawn from a tail vein of a Sprague-Dawley rat with a tuberculin syringe traced with sodium heparin and mixed with sodium fluorescein. The fluorescent plasma layer was diluted with saline solution, centrifuged and then the overlying plasma discarded. The remaining cell suspension was diluted with saline to create the original hematocrit, then infused into the vein of the same rat while performing fluorescein angiography with an SLO. The angiographic image was recorded on a videotape using time-lapsed photography. RESULTS Fluorescent platelets were detected and the flow within the retinal vessels traced over time. Fluorescent leukocytes in the choroidal vessels were also detected and the flow of a leukocyte was traced and its relative velocities were plotted against the time sequence. The relative size and fluorescence intensities of the platelets and leukocytes in the angiographic image corresponded well with the smear of the blood preparation. CONCLUSIONS FLA using an SLO can be used to detect the flow of platelets in the retinal vessels and the flow of leukocytes in the choroidal vessels in the experimental rat eye model.

Relation of crystallin and ischemia/Reperfusion injury model of the rat retina

Purpose: Ischemic damage of organs has hypoxic stress and reperfusion of the organs induces oxidative stress. Crystallin family is known as a protector of various kind of stress. We wanted to investigated crystallin expression and what kind of crystallin is associated to the ischemia/reperfusion injury (I/R injury) of retina. Methods: Twenty four Sprague-Dawley (SD) rats were used in this study. I/R injury was made by clamping optic nerve with central retina artery for 30min and then set free. Groups were divided into normal control, 24h and 72h after I/R injury, 24h and 72h after I/R injury with pretreatment of Sn(IV) protoporphyrin IX dichloride(SnPP) and 24h, 48h and 72h after I/R injury with pretreatment of hemin. All of the vitreous bodies were obtained and two-dimensional electrophoresis (2-DE) was performed. Results: Twenty-three spots were identified by MALDI-TOF/MS. Anti alpha A-, alpha B-, beta-, phospho (ser19)-alpha B-, phospho (ser45)-alpha B-, phospho (ser59)-alpha B-crystallin, extracellular signal-regulated kinases (ERK1/2), phospho-ERK1/2 and heme oxigenase-1 (HO-1) antibody were used for Western blotting. Beta-crystallins were increased 1.7 fold and 1.3 fold in the groups of I/R injury and I/R injury with SnPP pretreatment, respectively. Interestingly, I/R injured vitreous body showed the increased ERK1/2. However, I/R injured vitreous body pretreated with hemin for 24 h showed highly phosphorylated ERK1/2. Conclusions: This result might indicate that crystallin family is related to I/R injury. Phosphorylation of ERK1/2 was related with the hemin pretreatment.