Jae Ryong Han

Purpose: This study aims to present the therapeutic outcomes of benign eyelid margin tumors treated with laser ablation, offering an alternative approach to traditional shaving biopsy. Methods: In all patients, tumors were eliminated through either laser ablation or shaving biopsy. Comparative analysis was conducted between two patient groups: the laser-assisted ablation group (Group 1) and the shaving excision surgery group (Group 2). A total of 66 patients with 67 benign eyelid margin tumors were retrospectively included in this study (2019-2023). Thity-four cases underwent laser ablation, and 33 cases were subjected to shaving excision biopsy. Postoperatively, histologic confirmation was obtained in 11 out of the 33 cases that underwent shaving excision. Results: In Group 1, no functional or cosmetic complications were observed. The wound margin was clear after laser-assisted ablation in all cases. In Group 2, there was one instance of eyelid notching, loss of cilia, and two pigmentations. No wound infections were reported. The average wound epithelialization duration was 3.3 weeks in Group 1, significantly faster than 4.2 weeks in Group 2 (p < .01). The average lesion size was 3.0 x 2.9 mm in Group 1, significantly smaller than 3.5 x 3.4 mm in Group 2 (p < .05). No recurrences were observed during the follow-up period. Conclusions: Laser ablation for small benign eyelid margin tumors may be a favorable alternative to shaving excision biopsy surgery. All patients were satisfied with the cosmetic result. There was no definitive postoperative or intraoperative complication during or after laser application.

Purpose: We report two cases of corneal neovascularization (NV) after burn injury successfully treated by subconjunctival bevacizumab injections at 2-week intervals.Case summary: Three bi-weekly subconjunctival injections of bevacizumab were administered to two patients with corneal NV after burn injury. In our first patient, corneal NV was markedly reduced by bevacizumab injection. The patient exhibited with a clear cornea and improved visual acuity (20/30) after treatment. Eleven weeks after the last injection, the cornea remained clear, with clinical regression of smaller vessels; the improvement in visual acuity was maintained. In the second case, the diameter of the vessels, hemorrhagic lesions, and corneal edema decreased/regressed, with improvement of the visual acuity to 20/25; these improvements persisted for 12 weeks after the last subconjunctival injection.Conclusions: Our results suggest that bi-weekly subconjunctival injection of bevacizumab is well-tolerated and effective for inhibiting chronic corneal NV after burn injury.

Background: To evaluate functional and structural abnormalities in patients with acute central serous chorioretinopathy (CSC) with multifocal electroretinography (mfERG) and enhanced depth imaging optical coherence tomography (EDI-OCT)Methods: This prospective observational study included 57 patients with unilateral CSC. Both eyes underwent mfERG and EDI-OCT. Peak amplitudes and implicit times of the first kernel responses were analyzed and compared with those in 25 age-matched normal controls. Correlational analyses were performed between the mfERG results and EDI-OCT parameters. The thicknesses of the central retina, subretinal fluid, and choroid was measured at baseline and 3 months later.Results: Compared with the normal controls, the amplitude and implicit time on mfERG were significantly impaired in the area with serous retinal detachment (SRD). The P1 amplitude and implicit time of the areas beyond the SRD were also found to be significantly impaired in the affected eyes. Eyes with a greater reduction in SRD had a less impaired mfERG response in fellow eyes than those whose retinal detachments were not spontaneously decreased by more than 90% after 3 months. Correlational analysis did not reveal any significant correlations between mfERG values and OCT parameters except for central choroidal thickness. The subfoveal choroidal thickness was negatively correlated with the mfERG parameters.Conclusions: The findings of this study indicate diffuse functional impairment in acute CSC involving both eyes and areas beyond the SRD. The retinal response of the unaffected eye was associated with regression of SRD. Functional retinal abnormality was found to correlate with pathological changes in the choroid.

Purpose: To compare the surgical results of pars plana vitrectomy (PPV) and scleral buckling (SB) using the same vitreoretinal viewing system for rhegmatogenous retinal detachment (RRD) Methods: The study was a retrospective analysis of the medical records of 52 eyes (52 patients) with uncomplicated RRD located in superior quadrants. Eyes with pseudophakia or complications were not included. Thirty-one eyes underwent PPV using a wide-angle viewing system (WAVS) and 21 eyes received SB using the same WAVS combined with a chandelier endoilluminator. The primary anatomical success rate was the main outcome, defined as the proportion of eyes with successful reattachment of the retina. Results: The primary anatomical success rate was 90.5% in the SB group and 90.3% in the PPV group. Both groups achieved 100% of the final success rate. Although no significant difference was observed between the two groups, temporary intraocular pressure elevation and post-operative cataract formation were more frequent in the PPV group. In patients under the age of 55, post-operative cataract formation was significantly less common in the SB group. (P = .045) Conclusions: Under the same vitreoretinal visualization techniques, both SB and PPV had similar anatomical success rates. Chandelier‑assistance WAVS may increase the popularity of SB to treat primary RRD, allowing many patients to receive the benefits of SB surgery.

Purpose To investigate the efficacy and safety of primary intravitreal triamcinolone acetonide (IVTA) in eyes affected by diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) therapy. Study design Retrospective observational study Methods The medical records of patients who attended our clinic from March 2013 to September 2018 with refractory macular were reviewed. We included the patients who were injected at least one IVTA and completed 6 months of observation. Best-corrected Snellen visual acuity (VA), central macular thickness (CMT), intraocular pressure (IOP), and adverse events (AEs) were examined at baseline and at 1 month, 2 months, 3 months, and 6 months. Results Sixty-four eyes of 54 subjects were included. The mean VA was improved significantly at all time points compared to pre-treatment (P < 0.0001), with the greatest mean improvement at 1 month (0.3 logMAR). The reduction in mean CMT was also significant at all follow-up examinations compared to baseline (P < 0.0001), with the greatest decrease at 1 month (113.68 ± 53.78 μm). A poorer VA before injection was a factor that influenced visual gain 1 month post treatment (0.247 logMAR units/unit increase in baseline VA, P = 0.006). The most common AE associated with IVTA treatment was elevated IOP (11 eyes), observed significantly more often after IVTA injections containing a preservative (25.8%) than after those that were preservative-free (9.1%) (P = 0.033). Conclusion IVTA injection can be an alternative steroid treatment for DME refractory to anti-VEGF therapy.

Purpose: To assess treatment efficacy of scleral buckling surgery with wide-field surgical microscope and 27-gauge (G) chandelier illumination for rhegmatogenous retinal detachment (RRD). Methods: This study is a retrospective chart review of 29 eyes in 29 patients with RRD who underwent scleral buckling surgery with a wide-field surgical microscope and 27-G chandelier illumination fiber inserted into the sclera at the pars plana. Results are expressed as mean ± standard deviation. Data were analyzed using the paired sample t test. Statistical significance was considered if p value was less than 0.05. Results: The mean age of patients was 43.5 ± 3.5 years, and the mean follow-up time was 10.4 ± 2.5 months. Retinal reattachment was achieved in 27 of 29 eyes at initial surgery. The mean best corrected visual acuity improved from 0.38 ± 0.29 (logMAR) preoperatively to 0.19 ± 0.21 at 6 months after surgery. Two eyes underwent vitrectomy with silicone oil tamponade because of development of proliferative vitreoretinopathy. There was no complication such as choroidal hemorrhage, hypotony, or vitreous herniation at the end of surgery. Conclusion: Scleral buckling with a wide-field surgical microscope and 27-G chandelier illumination has the advantage of offering exact identification of retinal tears and determination of the adequacy of buckle height and position in retinal detachment surgery compared to conventional scleral buckling surgery.

The objective of this study was to evaluate tear dysfunction of burn patients objectively. We retrospectively reviewed medical records of patients who had been examined within 1 week after burn injury. Visual acuity, intraocular pressure, cilia burned state, tear film break-up time (TBUT), and fluorescein corneal staining were evaluated. Sixty-four eyes of 32 patients (man 27, female 5) were included. Mean age was 44.41 ± 12.76 years old. Mean best corrected visual acuity was logMAR 0.04 ± 0.08, mean intraocular pressure was 13.41 ± 3.13 mm Hg, and mean TBUT was 5.48 ± 3.18 seconds. Thirty-four eyes (53.13%) showed burned cilia, 36 eyes (56.25%) showed corneal erosion on fluorescein stating. Intraocular pressure and TBUT were lower in TBSA with burn involved ≥ 10% group than TBSA with burn involved < 10% group (P = .000; P = .058). The percentage of TBSA of burn involved and tear break up time showed statistically significant negative correlations (r = -0.262; P = .037). Many burn patients have discomfort due to tear dysfunction syndrome. Tear dysfunction may be caused by direct injury of eye burn itself and body fluid deficiency. We recommend that when we treat burn patients, we have to pay attention to their symptoms and manage patient’s eye symptoms properly such as routine artificial tear lubricant treatment.

Suh W, et al. J Korean Med Sci. 2017 Apr;32(4):666-671. https://doi.org/10.3346/jkms.2017.32.4.666