Ki Yup Nam

Clinical features of infectious endophthalmitis in South Korea: a five-year multicenter study.

BackgroundTo investigate clinical features of infectious endophthalmitis over five years in a South Korean population.MethodsMedical records of consecutive patients diagnosed with infectious endophthalmitis at eight institutions located in Gyeongsangnam-do and Pusan city between January 1, 2004 and July 31, 2010 were reviewed.ResultsA total of 197 patients were diagnosed and treated. An average of 30.0 infectious endophthalmitis per year was developed. The annual incidence rate of postoperative endophthalmitis during 2006 ~ 2009 was 0.037%. The ratios of male to female and right to left were 50.2%: 49.8 % and 54.8%: 43.2%, respectively. Eighth decade and spring were the peak age (36.6%) and season (32.0%) to develop the infectious endophthalmitis. The most common past history in systemic disease was hypertension (40.4%), followed by diabetes (23.4%). Cataract operation (60.4%) was the most common cause, among which most of them was uneventful phacoemulsification (95.9%). Corneal laceration (51.6%) and liver abscess (42.9%) were the most common causes of traumatic and endogenous endophthalmitis, respectively. The percentages of patients with initial and final visual acuity less than counting fingers were 62.6% and 35.2%, respectively. Treatment with vitrectomy with or without intravitreal antibiotics injection was administered to 72.6% of patients, while 17.3% received intravitreal antibiotics only.ConclusionsOur study revealed that the development of infectious endophthalmitis was related with seasonal variation and increased during our study period. Pars plana vitrectomy was preferred for the treatment of infectious endophthalmitis in South Korea.

CT-Based Morphological Analysis of Isolated Inferior and Medial Blow-out Orbital Fractures in Korean Adults.

Abstract Purpose: To evaluate morphologic differences in isolated inferior medial orbital wall fractures (OWF) based on computed tomography scans. Methods: This was a retrospective observational case study of 22 patients with an isolated inferior OWF and 32 patients with an isolated medial fracture between January 2008 and August 2010. We analyzed patient demographics and bony radiologic characteristics on CT scans, including the length and height of the lamina papyracea, the number of ethmoid air cell septa, the length of the anterior and posterior border of the orbital floor, the thickness of the orbital floor maxillary bone, and the axial length of the eyeball. Results: There were no significant differences in sex, laterality, or concomitant intraocular injury between the two groups. The anteroposterior length (p = 0.391), the number of ethmoid septa (p = 0.869), and the thickness of the orbital floor (p = 0.419) did not differ significantly. The anterior (p < 0.001) or posterior (p = 0.014) height of the lamina papyracea, the lamina papyracea area (p < 0.001), and the lamina papyracea area/ethmoid air cell septa (p = 0.024) were significantly higher in the medial OWF group, while the anterior (p = 0.026) or posterior (p < 0.001) border length of the orbital floor and the axial length (p = 0.047) and volume (p = 0.034) of the eyeball were longer and smaller, respectively, in the inferior OWF group. Conclusions: Patients with a longer anterior or posterior border of the orbital floor, a shorter axial length, and a smaller eyeball volume are more likely to incur an isolated inferior OWF than an isolated medial OWF.

Time Series Changes in Cataract Surgery in Korea

Purpose We analyzed time series changes in cataract surgeries in Korea, and provide basic data to enhance the efficiency of medical services for cataract surgery. Methods Among cataract surgery statistics registered in the Korean National Health Insurance Cooperation from 2006 to 2012, we used data regarding the number of patients and operations and the number of patients and operations per 100,000 people. We analyzed various time series changes, including differences by sex and age. Results The total numbers of patients from 2006 to 2012 by year were 207,370; 228,170; 250,289; 268,548; 289,867; 308,111; and 302,182, respectively. The total numbers of operations from 2006 to 2012 by year were 272,920; 305,807; 338,332; 365,874; 398,338; 428,158; and 420,905, respectively. The number of patients and operations per 100,000 people were highest in men 80 to 84 years old and women 75 to 79 years old. Comparing the number of operations in 2006 and after, the patient age group with the highest increase rate changed from over 85 years old to 75–79 years old since 2010 in men and from over 85 years old to 50–54 years old since 2009 in women. For each year investigated, the number of operations performed was higher than the number of patients who received operations. Conclusions Over the study period, the number of cataract surgeries increased, while the age of cataract patients decreased. Additionally, the number of cataract-related surgeries increased in relation to the number of patients.

Comparison of the most common isolates of postoperative endophthalmitis in South Korea; Enterococcus species vs coagulase-negative staphylococci

BackgroundTo compare the related factors or manifestations of the two most common isolates of post-operative endophthalmitis, which were Enterococcus spp. and coagulase-negative staphylococci (CNS) in South Korea.MethodsMedical records were reviewed for cases of post-operative endophthalmitis caused by Enterococcus spp. and CNS at eight institutions between January 2004 and July 2010. Various factors including age, sex, residence, systemic diseases, smoking and drinking history, and best corrected visual acuity, and length of time between causative intraocular surgery and symptom development were compared between the two groups.ResultsThe total number of post-operative endophthalmitis cases was 128 and in 116 cases, microbiological culture tests from the aqueous humor or vitreous were performed. Among these cases, 67 (57.8%) were culture proven. Among these 67 cases, 19 (28.4%) were caused by Enterococcus spp., 14 (20.9%) were caused by Staphylococcus epidermidis endophthalmitis, and 5 (7.5%) were caused by other CNS spp. Age, sex, causative procedure, past medical history, social history, and laterality were not different in the two groups. Mean initial and final visual acuity were significantly worse in the Enterococcus spp. endophthalmitis group than in the CNS group (p = 0.049, 0.042, respectively). Length of time between the causative procedure and symptom development was significantly shorter in cases of Enterococcus spp. endophthalmitis (p = 0.004).ConclusionsEnterococcus spp. induce more severe and rapid-onset postoperative endophthalmitis than CNS. Infectious endophthalmitis developed within 2 days after cataract operation could be caused by Enterococcus spp. and have chance to be poor prognosis in South Korea.

A case of acute retinal toxicity caused by an intraocular foreign body composed of cobalt alloy

Abstract Context: We describe a case of acute retinal toxicity caused by an intraocular foreign body composed of a cobalt alloy. Case presentation: A 36-year-old man presented to an outside clinic with a traumatic cataract and corneal laceration of his left eye, which had occurred while grinding a shelf. The lacerated cornea was closed primarily and the traumatic cataract was phacoemulsified. He was transferred to our hospital due to identification of a metallic intraocular foreign body in the vitreous. On arrival at our institution, the intraocular foreign body was removed as soon as possible after vitrectomy. On the first postoperative day, vasculitis and serous retinal detachment were observed on the retina at the previous site of the foreign body. Two months after surgery, atrophy of nearly half of the inferior retina was noted on funduscopy, and visual acuity was such that the patient could only count fingers at 30 cm. Analysis of the foreign body revealed that it was composed of 84.99% tungsten carbide, 15% cobalt and had traces of titanium and alumina. Discussion: Cobalt containing metallic foreign bodies should be immediately removed, as they have the potential to cause permanent visual disturbance.