Young-Soo Yun

Electrolytes and Electrophoretic Studies of Tear Proteins in Tears of Patients with Nasolacrimal Duct Obstruction

This study was performed to determine whether there are differences in tear constituents between normal persons and patients with primary acquired nasolacrimal duct obstruction (PANDO) and to correlate differences in tear composition with the degree of PANDO. We tested 30 normal persons (mean age 42.0 ± 21.4 years) and 34 PANDO patients (mean age 44.8 ± 17.9 years) consisting of 18 cases with complete obstruction and 16 cases with partial obstruction. We measured the pH, the concentration of Na+, K+, Cl–, total calcium and total protein of the tears. The composition of tear protein was assessed by cellulose acetate electrophoresis. The data were analyzed by a t test. The pH was more alkaline in patients with PANDO (7.11 ± 0.38), especially in cases with complete obstruction (7.14 ± 0.30, p = 0.47) compared with the normal persons (6.94 ± 0.35). The concentration of Na+, K+, Cl– and total protein were similar in normal and PANDO cases, while total calcium concentration was significantly higher in PANDO (2.62 ± 1.70 mg/dl) compared with the normal cases (1.73 ± 0.97 mg/dl), (p = 0.015). This change was found in both cases with complete obstruction (2.47 ± 1.25 mg/dl, p = 0.027) and cases with partial obstruction (3.00 ± 2.16 mg/dl, p = 0.009). PANDO patients had lower levels of tear protein fraction (TPF) 1 (p = 0.006) and higher levels of tear TPF 4 (p = 0.000) than normal persons. Tears in PANDO cases were more alkaline, higher in calcium concentration, and unstable in the proportion of tear proteins compared with normal persons. These results may improve our understanding of tear physiology and the pathogenesis of PANDO.

Ultrasonographic Measurement of Upper Eyelid Thickness in Korean Children with Epicanthus

Purpose Upper eyelid thickness was measured to determine whether there is a difference in the thickness of the upper eyelids in children with and without epicanthus. Methods Children were enrolled into the epicanthus group or non-epicanthus (control) group. The children with epicanthus were classified into four subgroups according to the Duke-Elders classification. The thickness of the upper eyelid was measured at five points with A-scan ultrasonography. Results There was no significant difference in upper eyelid thickness between the epicanthus group and control group (P>0.05) or between the subgroups of the epicanthus group (P>0.05). Conclusions This result suggests that the etiology of epicanthus may not be hypertrophy of soft tissue.

Correction of Epiblepharon of the Upper Eyelid by the Buried Suture Technique : Correlation with Morphological Features of the Upper Eyelid

Aims: To investigate the correlation between morphological features of the upper eyelid and surgical results of the correction of epiblepharon by the buried suture technique. Methods: This retrospective study was conducted from March 2001 to June 2005. One hundred and one patients (202 eyes) with upper eyelid epiblepharon were enrolled in this study. Surgical amount, lid thickness and height of the tarsal plate were measured. Eighty-four cases with epiblepharon were corrected by full-thickness buried sutures with 6/0 Vicryl, and 118 cases with epiblepharon were corrected by full-thickness buried sutures with 6/0 Prolene. They were followed up for a minimum of 9 months. Results: The skin crease of the upper eyelid disappeared in 18 eyes of 9 patients (8.9%). Eight patients were free from lash-cornea touch, and 1 recurrent case underwent successful reoperation. Clinical factors such as sex, age, suture material, and amount of surgery did not have an effect on the rate of recurrence. However, the thickness of lateral eyelid and height of the tarsal plate significantly contributed to the recurrence of upper eyelid epiblepharon. Conclusion: Upper eyelid thickness and height of the tarsal plate are considered as valuable factors to predict the result of the correction of upper eyelid epiblepharon by the buried suture technique.

Binocular photophobia after surgical treatment in intermittent exotropia.

Purpose. This study examined the rate of binocular photophobia in intermittent exotropia patients before surgical correction, and the factors affecting this rate. The study also investigated the factors affecting postsurgical disappearance of binocular photophobia. Methods. The study involved 162 basic type intermittent exotropia patients who underwent surgical correction between March 2001 and January 2006. The study did not include patients with entropion, congenital cataract, or retinal abnormalities. Parents of the patients were questioned to determine which patients had monocular eye closure in bright light and which had disappeared after bilateral lateral rectus recession. Data was analyzed to determine the factors affecting monocular eye closure before surgery and disappearance after surgery. Results. Of 162 patients, 96 patients had binocular photophobia (60.2%). Photophobia was found to be associated with an angle of exodeviation at distance >25 Prism Diopter (&Dgr;) (p = 0.02), and stereoacuity worse than 60 s (p = 0.02). We defined satisfactory surgical outcome as a deviation of <10 &Dgr;. Of the 81 patients with satisfactory outcomes, 46 showed disappearance of binocular photophobia (53.5%). No factor was found to be associated with loss of binocular photophobia. Conclusion. The angle of strabismus and stereoacuity were found to affect the occurrence of binocular photophobia. Successful surgery treated binocular photophobia in 53.5% of patients. Regardless of the surgical result, clinicians should educate patients in terms of the possibility of persistence of postsurgical photophobia.

Acknowledgement to the Reviewers

Iester Michele M., Genoa (Italy) Jandeck Claudia, Dillenburg (Germany) Jonas Jost B., Mannheim (Germany) Jordan Jens, Freiburg (Germany) Kashii Satoshi, Osaka (Japan) Katori Nobutada, Hamamatsu (Japan) Kazim Michael, New York, N.Y. (USA) Kishi Shoiji, Gunma (Japan) Kita Mihori, Shiga (Japan) Kitaoka Takashi, Nagasaki (Japan) Klauss Volker, München (Germany) Kniestedt Christoph, Zürich (Switzerland) Koh Adrian, Singapore (Singapore) Kohnen Thomas, Frankfurt (Germany) Konstas Anastasios G.P., Thessaloniki (Greece) Kotecha Aachal, London (United Kingdom) Kroll Peter, Marburg (Germany) Küchle Michael, Erlangen (Germany) Kurz Schmitz Sabine, Mainz (Germany) Kusaka Shunji, Osaka (Japan) Lagrèze Wolf A., Freiburg (Germany) Langmann Andrea, Graz (Austria) Lee Shu-Yen, Singapore (Singapore) Lorenz Birgit, Giessen (Germany) Lüchtenberg Marc, Frankfurt (Germany) Mackey David A., East Melbourne, Vic. (Australia) Menapace Rupert, Vienna (Austria) Mennel Stefan, Marburg (Germany) Mermoud André, Lausanne (Switzerland) Mester Ulrich, Sulzbach/Saar (Germany) Meyer Carsten H., Bonn (Germany) Meyer Peter, Basel (Switzerland) Meyer-Rüsenberg H.-W., Hagen (Germany) Michels Stephan, Zürich (Switzerland) Mimura Osamu, Hyogo (Japan) Mizota Atsushi, Urayasu (Japan) Mochizuki Manabu, Tokyo (Japan) Mohamed Moin, Leeds (United Kingdom) Mojon Daniel S., St. Gallen (Switzerland) Morse Lawrence S., Sacramento, Calif. (USA) Moshirfar Majid, Salt Lake City, Utah (USA) Murdoch Ian, London (United Kingdom) Nao-i Nobuhisa, Miyazaki (Japan) Ness Thomas, Freiburg (Germany) Olson Randall J., Salt Lake City, Utah (USA) Otani A., Kyoto (Japan) Pauleikhoff Daniel, Münster (Germany) Abe Haruki, Niigata (Japan) Alió Jorge L., Alicante (Spain) Araie Makoto, Tokyo (Japan) Augustin Albert J., Karlsruhe (Germany) Baatz Holger, Recklinghausen (Germany) Behrens-Baumann Wolfgang, Magdeburg (Germany) Birnbaum Florian, Freiburg (Germany) Blumberg Dana, Baltimore, Md. (USA) Brookes John, London (United Kingdom) Brusini P., Udine (Italy) Callizo Planas Josep, Marburg (Germany) Catoira-Boyle Yara, Indianapolis, Ind. (USA) Chee Soon-Phaik, Singapore (Singapore) Cheng Bobby, Singapore (Singapore) Chihara Etsuo, Kyoto (Japan) Clemens Stefan, Greifswald (Germany) Crandall Alan, Salt Lake City, Utah (USA) Cunha-Vaz José G., Coimbra (Portugal) Degenring Robert, Mannheim (Germany) Deuter Christoph, Tübingen (Germany) Dick H. Burkard, Bochum (Germany) Duncker Gernot I.W., Halle (Germany) Emmerich K.-H., Darmstadt (Germany) Esser Joachim, Essen (Germany) Forlini Cesare, Ravenna (Italy) Friedburg Dieter, Krefeld (Germany) Fries Ulrich, Bonn (Germany) Frisen Lars, Göteborg (Sweden) Geerling Gerd, Würzburg (Germany) Gelisken Faik, Tübingen (Germany) Goldblum David, Basel (Switzerland) Grunz Christiane, Marburg (Germany) Güell Joseph L., Barcelona (Spain) Gümbel Hermann O. C., Ulm (Germany) Guthoff Rudolf, Rostock (Germany) Hammer Beat, Aarau (Switzerland) Hansen Lutz Lothar, Freiburg (Germany) Haritoglou Christos, München (Germany) Hattenbach Lars-Olof, Ludwigshafen (Germany) Heiligenhaus Arnd, Münster (Germany) Helbig Horst, Regensburg (Germany) Hesse Lutz, Heilbronn (Germany) Holló Gábor, Budapest (Hungary) Holmes Jonathan, Rochester, N.Y. (USA) Holz Frank G., Bonn (Germany) Honda Shigeru, Kobe (Japan) Hörle Steffen, Marburg (Germany)