Myung-Mi Kim

Surgical Outcomes of Intermittent Exotropia as a Function of Strabismic Angle

Purpose To analyze postoperative results of intermittent exotropia as a function of the difference in strabismic angles measured immediately and another time prior to the surgery. Methods We reviewed the clinical records of intermittent exotropia patients who received surgery and had differences greater than or equal to 10 prism diopters (PD) between the last preoperative measurement of strabismic angle and another previous measurement. After applying various exclusion criteria, 66 patients were entered into our study. At the last follow-up visit after surgery, we divided postoperative results into 3 categories: (1) poor; with greater than 10 PD of esotropia or angle of exodeviation of 20 PD or more (2) moderate; with 6-10 PD of esophoria/tropia or 10-19 PD exodeviation, or (3) good; with 1-5 PD of esophoria / tropia or an angle of exodeviation less than 10 PD, or orthophoria. Results Good results were higher in patients where the difference in strabismic angle was 10 PD or greater between the last measurement and any other earlier measurement. Conclusions In cases of Intermittent exotropia where the last preoperative value of strabismic angle was greater than any previous preoperative measurement, surgical dosage based on the last preoperative measurement yielded better results.

Amblyopia and Strabismus by Monocular Corneal Opacity Following Suspected Epidemic Keratoconjunctivitis in Infancy

Purpose To identify the long term clinical course of amblyopia and strabismus that developed secondary to a monocular corneal opacity following suspected epidemic keratoconjunctivitis (EKC) in infancy. Methods This was a retrospective study analyzing the medical records of seven patients, treated in our clinic, who were followed for more than five years. Results Four patients in our clinic underwent a corneal ulcer treatment following suspected EKC. Each developed a monocular corneal opacity. Three patients with a chief complaint of corneal opacity were transferred to our clinic from other clinics. These patients had documented histories of treatment for EKC in infancy. All patients were treated with early occlusion therapy, but amblyopia persisted in four patients. Furthermore, all patients had strabismus and showed a significant reduction of stereoscopic vision. Conclusions Although infants with EKC are not always cooperative, slit lamp examination should be performed as early as possible, and appropriate medical treatment should be performed, thus reducing the development of corneal opacity. Careful follow up should be regularly performed, and the occurrence of amblyopia or strabismus should be verified at an early stage using visual acuity or ocular alignment examination. Ophthalmologic treatments, including active occlusion therapy, should also be pursued.

Incidental frontoparietal parasagittal meningioma in a patient with acute bilateral optic neuritis.

Department of Ophthalmology, Daegu Veterans Health Service Medical Center, Daegu 704-802, Korea Department of Ophthalmology, Yeungnam University College of Medicine, Daegu 705-717, Korea 3Department of Ophthalmology, Inje University Busan Paik Hospital, Busan 614-735, Korea Correspondence to: Su-Ho Lim. Department of Ophthalmology, Daegu Veterans Health Service Medical Center, 60 Wolgok-Ro, Dalseo-Gu, Daegu 704-802, Korea. mdshlim@gmail.com Received: 2014-01-21 Accepted: 2014-04-22

Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes

Purpose To evaluate the effects of the surgical assistants level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia. Methods This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistants level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups. Results The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51). Conclusions No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.

A quantitative analysis method for comitant exotropia using video-oculography with alternate cover

BackgroundThe purpose of this study was to evaluate the efficacy of a quantitative analysis method for comitant exotropia using video-oculography (VOG) with alternate cover.MethodsThirty-four subjects with comitant exotropia were included. Two independent ophthalmologists measured the angle of ocular deviation using the alternate prism cover test (APCT). The video files and data of changes in ocular deviation during the alternate cover test were obtained using VOG. To verify the accuracy of VOG, the value obtained using VOG and the angle of a rotating model eye were compared, and a new linear equation was subsequently derived using these data. The calculated values obtained using VOG were compared with those obtained using the APCT.ResultsRotation of the model eye and the values obtained using VOG demonstrated excellent positive correlation (R = 1.000; p < 0.001). A simple linear regression model was obtained: rotation of the model eye = 0.978 × value obtained using VOG for a model eye – 0.549. The 95% limit of agreement for inter-observer variability was ±4.63 prism diopters (PD) for APCT and that for test-retest variability was ±3.56 PD for the VOG test. The results of APCT and calculated VOG test demonstrated a strong positive correlation. Bland-Altman plots revealed no overall tendency for the calculated values obtained from VOG to differ from those obtained using APCT.ConclusionsVOG with alternate cover is a non-invasive and accurate tool for quantitatively measuring and recording ocular deviation. In particular, it is independent of the proficiency of the examiner and, can therefore, be useful in the absence of skilled personnel.Trial registrationClinicalTrial.gov, NCT03119311, Date of registration: 04/17/2017, Date of enrolment of the first participant to the trial: 04/25/2017.