Korean journal of ophthalmology : KJO最新文献

Purpose: to determine the effect of lower eyelid blepharoplasty (LEB) surgery on corneal biomechanical parameters before and four months after the procedure. Method: In this prospective longitudinal study, corneal biomechanical parameters measured by Corneal Visualization Scheimpflug Technology (Corvis ST, CVS, Oculus Optikgeräte GmbH, Germany) device were evaluated before and four months after LEB surgery.

Results: The study included 19 eyelids of the right eyes of 19 patients who underwent LEB, with a mean age of 49.0 ± 10.1 (range, 37 to 72) years. Four months after the procedure, significant increases were observed in the first applanation (A1) time (P=.007), second applanation (A2) time (P<.001), HC time (P=0.004), intraocular pressure (IOP) (P=0.009), and biomechanical-compensated IOP (bIOP) (P=0.007). In addition, the absolute value of highest concavity (HC) dArc length (P=0.021) and stress-strain index (SSI) (P=0.037) showed a significant decrease after the LEB. Other corneal biomechanical parameters did not show significant differences following the LEB procedure (P<0.05).

Conclusion: The resection and repositioning of the fat pockets in lower eyelid blepharoplasty lead to biomechanical changes of the cornea in the direction of increasing corneal stiffness.

Purpose: This study evaluated the objective changes in the contralateral eye after unilateral cataract surgery.

Methods: The study was designed as retrospective observational study. It included 44 patients who underwent unilateral cataract surgery. Collected data were uncorrected and corrected visual acuity, spherical equivalent (S.E.), intraocular pressure (IOP), contrast sensitivity (CS), stereoacuity, and anterior segment optical coherence tomography (AS-OCT) parameters. Data were collected pre-operatively, 1-week post-operatively, and 1-month post-operatively for each eye.

Results: Following unilateral cataract surgery, the pupil size of the fellow eye decreased from 3.46 mm to 3.17 mm (1-week) and 3.08 mm (1-month) post-surgery (p=0.003 and p<0.001, respectively). Anterior chamber depth (ACD) of the fellow eye increased significantly from 3.16 mm to 3.27 mm (1-week) and 3.26 mm (1-month) post-surgery (p=0.005 and p=0.001, respectively). Uncorrected distance visual acuity (UDVA) of the fellow eye improved significantly at 1-week and 1-month post-surgery (p=0.042 and p=0.044, respectively). Change of UDVA of the fellow eye at 1-month was significantly correlated with that of the treated eye (p=0.039).

Conclusions: Anterior chamber structures changed and UDVA improved in the contralateral eye after unilateral cataract surgery in our cohort. Because fellow eyes were positively affected by monocular cataract surgery, it would be good information if planning for unilateral cataract surgery due to inevitable reasons.

Introduction: Corneal Melanoma (CM) is a rare malignancy that develops from melanocytes within the cornea, constituting a minority of all ocular tumors. In this study, we sought to investigate the clinicopathological characteristics correlated with the prognosis of CM patients.

Methods: We collected patients with CM between 1983 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazards regression was used for univariate analysis to value hazard ratio (HR) of malignant CM versus spindle cell melanoma and nodular melanoma subgroups. Kaplan-Meier survival analysis and log-rank test were also performed to identify additional prognostic markers and confirm the findings of the Cox Hazard Ratio.

Results: A total of 29 eligible patients were collected in our study. Age at diagnosis, laterality, primary site, tumor size, the extent of disease, marital status, income, residential area, and treatment showed no significant prognostic factors for CM patients (P > 0.05). However, when concerned with the primary site of malignant melanoma, spindle cell melanoma (P < 0.05) and nodular melanoma (P < 0.05) were found to show significantly poorer prognosis in CM patients.

Conclusion: Age at diagnosis, laterality, primary site, tumor size, the extent of disease, and treatment were not significant prognostic indicators for CM patients. Spindle cell melanoma and nodular melanoma were notable for showing worse survival outcomes than malignant melanoma. Although the sample size in the SEER database was limited, our findings may provide motivation for tailoring individualized treatments for patients with CM with different primary sites.

Purpose: The aim of this study was to investigate the occurrence of dry eye syndrome (DES) in children under 18 years old before and during the COVID-19 pandemic using nationwide population-based cohort analysis.

Methods: This study utilized the database provided by the Korea Disease Control and Prevention Agency and the Korean National Health Insurance Service. We used claims-based data for patients diagnosed with COVID-19 between October 8, 2020, and December 31, 2021, and those without a diagnosis of COVID-19. DES cases were defined as having at least one diagnosis of H0411 or H1621 based on the International Classification of Diseases, 10th Revision codes. The primary outcome was the evaluation of the hazard ratio for DES between the COVID-19 season and the non-COVID-19 season.

Results: A total of 198,486 individuals from the COVID-19 season cohort and 211,828 individuals from the non-COVID-19 season cohort were included in the study. There were no differences in characteristics between the COVID-19 season cohort and the non-COVID-19 season cohort (all standardized mean difference, <0.1). The cumulative incidence of DES during the COVID-19 season was significantly higher than that during the non-COVID-19 season. The COVID-19 season DES incidence rate was 6,419.64 per 100,000 person-years and non-COVID-19 season DES incidence rate was 5,804.88 per 100,000 person-years. In addition, children aged 13 to 18 years, female sex, those living in metropolitan areas, and those with diabetes mellitus had a higher risk of DES.

Conclusions: The prevalence of diagnosed DES in children increased during the COVID-19 pandemic compared to previous years. Children aged 13 to 18 years, female sex, those living in metropolitan areas, and those with diabetes mellitus had a higher risk of DES. Further studies are needed to directly analyze the potential factors associated with the increased prevalence of DES.

Purpose: To evaluate the repeatability of corneal epithelial thickness (CET) measurements in normal eyes and eyes diagnosed with corneal disease using the epithelial thickness map (ETM) of anterior-segment optical coherence tomography (OCT).

Methods: In this retrospective study, patients with three OCT scans using the ETM mode of Cirrus OCT between October 2021 and January 2024 were reviewed. Two groups of subjects were included: (1) normal subjects with no history of ophthalmic surgery, corneal diseases, and topical antiglaucoma medication uses; and (2) subjects with corneal diseases including dry eye syndrome, recurrent corneal erosion, pterygium, and others. A total of 57 eyes of 57 normal subjects and 106 eyes of 76 patients with corneal disease were included. ETM was analyzed in 25 zones (one zone within 0-2 mm diameter, eight zones within 2-5 mm diameter, eight zones within 5-7 mm diameter, and eight zones within 7-9 mm diameter). Repeatability was evaluated by calculating intraclass correlation coefficient (ICC), coefficient of variation (CoV), within-subject standard deviation (Sw), and Bland-Altman plot.

Results: Among a total of 25 sectors, the normal eyes showed high repeatability (ICC, >0.75; CoV, 2.160%-5.292%; Sw, 0.760- 1.653 μm) in 23 sectors, and corneal diseases patients also showed high repeatability (ICC, >0.75; CoV, 4.167%-9.606%; Sw, 1.298-3.340 μm) in 22 sectors. However, the wide range of 95% limit of agreement width of Bland-Altman plot presented in corneal disease group and some peripheral zones in normal eyes indicates some variability of CET measurements.

Conclusions: Except for a few peripheral sectors, ETM of Cirrus OCT provides repeatable CET measurements in normal eyes; however in corneal disease group, repeatability was not consistently high. To measure CET accurately, performing multiple measurements is advised especially in patients with corneal disease and patients in whom peripheral CET values.

Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery.

Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children's Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery.

Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001).

Conclusions: Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: This study aims to evaluate the impact of upper eyelid blepharoplasty on perceived age, attractiveness, success, and overall health as rated by observers.

Methods: A web-based survey was conducted with 203 observers who were unaware of the study's purpose. They assessed preoperative and postoperative images of 12 female patients using the Delphi method to ensure appropriate image selection and unbiased ratings. Observers rated the images on a visual analog scale from 0 to 10, where higher scores indicated more favorable perceptions.

Results: The observer group consisted of 108 women (53.2%) and 95 men (46.8%), with an age range of 18 to 61 years. The mean age perceived by observers decreased from 51.75 years before surgery to 42.10 years after surgery, indicating a significant reduction in perceived age (p = 0.01). Additionally, postsurgical assessments showed significant increases in perceived attractiveness, success, and overall health.

Conclusions: Upper eyelid blepharoplasty significantly enhances how patients are perceived in terms of youthfulness, attractiveness, and success. These findings underscore the positive impact of cosmetic eyelid surgery on public perception.

Purpose: To report the proportion of ocular involvement in primary Sjögren syndrome (pSS) and to analyze various dry eye indexes and serum titers of markers depending on whether ocular involvement has occurred or not.

Methods: This retrospective study considered 214 patients referred from the rheumatology department for pSS workup. Symptom questionnaires, ocular surface stain score (OSS), Schirmer test, tear breakup time (TBUT), meibomian gland dropout, meibum quality, meibum expressibility, lid margin abnormalities, and lipid layer thickness were evaluated. Anti-Ro, anti-La, and antinuclear antibodies, rheumatoid factor, erythrocyte sedation rate, and C-reactive protein were included as systemic serum titers of markers. Patients with (group 1) and without (group 2) ocular involvement were compared. We conducted a further subgroup analysis of group 1 by dividing it into two groups based on whether or not the cases met all the ocular criteria for pSS diagnosis.

Results: Among the 214 referred patients, 118 were diagnosed as pSS: 87 out of 118 (73.7%) in group 1 and 31 (26.3%) in group 2. Group 1 showed higher meibum quality scores (p = 0.016), meibum expressibility (p = 0.010), and lid margin abnormalities on the lower lid (p = 0.029) and lower TBUT (p = 0.016) than group 2. OSS, TBUT, and the Schirmer test statistically differed (p < 0.001, p = 0.041, and p = 0043, respectively) between the patients who satisfied both ocular criteria (n = 46) and those who satisfied only one criterion (n = 41). There were no statistical differences in serum titers of markers between the two groups.

Conclusions: About half of patients referred from the rheumatology department for diagnosis of pSS were diagnosed with pSS. The proportion of ocular involvement in the pSS patients was 73.7%, and half of these patients met both ocular criteria. Only anti-Ro antibodies negatively correlated with TBUT. Also, OSS, TBUT, and Schirmer test were statistically different between the two subgroups.