Purpose: We analyzed the epidemiologic and clinical characteristics of ocular trauma patients presenting to a regional emergency medical center in Gangwon Province.Methods: Our retrospective study included 5,305 patients diagnosed with ocular trauma who visited Chuncheon Sacred Heart Hospital between January 2015 and August 2025. Patients were categorized by injury severity as mild (group 0), moderate (group 1), or severe (group 2). Clinical variables analyzed included sex, age, site of injury, cause of trauma, association with occupational or leisure activities, and visual acuity.Results: Of the 5,305 patients, 4,670 (88.0%) were classified as group 0, 540 (10.2%) as group 1, and 95 (1.8%) as group 2. The overall mean age was 39.5 ± 20.4 years and 74.0% of patients were male. Patients in group 2 were older with a mean age of 54.7 ± 15.7 years and predominantly male (98.9%, p < 0.001). Occupation-related ocular trauma accounted for 15.3% of all cases and was significantly more frequent in group 2 (33.7%, p < 0.001) with manufacturing being the most common industry (32.7%). Sports/leisure-related ocular trauma accounted for 13.2% of cases and demonstrated an increasing trend from 11.8% in 2016 to 16.7% in 2024 (p = 0.022). The most common injury types were corneal abrasion (51.6%), ocular contusion (20.6%), and orbital wall fracture (9.5%).Conclusions: Most ocular trauma cases presenting to the regional emergency medical center in Gangwon Province were mild. Severe ocular trauma was associated with older age, male sex, and occupational causes. In addition, the incidence of occupation-related and sports/leisure-related ocular trauma exhibited an increasing trend over the past decade.
Purpose: We evaluated the effect of internal limiting membrane (ILM) flap size on anatomical and functional outcomes of macular hole surgery, to determine the optimal flap size according to hole size.Methods: This retrospective study included 145 patients (147 eyes) with idiopathic full-thickness macular holes who underwent pars plana vitrectomy with ILM flap covering, followed for ≥6 months between January 2015 and August 2025 at a single center. Macular holes were classified as medium (250–400 μm) or large (400–800 μm) by minimum linear diameter. Patients were categorized by flap size into a standard group (≤1.5 disc diameters [DD]) and an extended group (>1.5–3 DD). Postoperative best-corrected visual acuity (BCVA), closure rate, foveal contour (U-, V-, or W-type), restoration of the external limiting membrane and ellipsoid zone, and complications were compared at 1 and 6 months.Results: In medium holes, both groups achieved 100% closure and comparable visual improvement, with no significant between- group differences. In large holes, the extended flap group showed greater BCVA improvement (ΔBCVA at 6 months, 0.49 vs. 0.12), higher closure rate (94.0% vs. 86.8%), more U-shaped foveal contours (48.0% vs. 13.2%), and higher external limiting membrane restoration (56.0% vs. 15.8%) than the standard group (p < 0.05). Multivariable analysis identified extended flap as an independent predictor of closure (adjusted OR, 6.77; 95% CI, 1.49–30.79; p = 0.013) and external limiting membrane restoration (adjusted OR, 10.42; 95% CI, 2.77–39.15; p = 0.001).Conclusions: In large macular holes, an extended ILM flap of approximately 1.5–3 DD improved anatomical stability and visual recovery, representing an effective surgical strategy. In medium holes, the standard flap achieved comparable outcomes, suggesting flap size modification may not be necessary for optimal results.
Purpose: To describe a rare case of optic neuritis in a Morning glory syndrome (MGS) patient and to highlight the diagnostic challenges posed by congenital optic disc anomalies.Case summary: A 45-year-old woman presented with a 5-day history of an inferonasal visual field defect, blurred vision, and ocular pain in the right eye. Best-corrected visual acuity was 20/20 in both eyes; however, a relative afferent pupillary defect (RAPD) was detected in the right eye. Fundus examination revealed a morning glory disc anomaly, and visual field testing demonstrated blind spot enlargement with an inferonasal defect. Magnetic resonance imaging showed focal T2-weighted high signal intensity with mild gadolinium enhancement in the retrobulbar optic nerve, without lesions, suggestive of multiple sclerosis or neuromyelitis optica. The patient was diagnosed with retrobulbar optic neuritis and treated with high-dose intravenous methylprednisolone. Following treatment, both the visual field defect and RAPD showed improvement.Conclusions: MGS is a rare congenital anomaly characterized by a funnel-shaped excavation of the optic disc and anomalous peripapillary vasculature. These structural abnormalities may obscure typical clinical signs of optic neuritis, such as optic disc swelling, thereby complicating early diagnosis. In this case, the diagnosis was supported primarily by the presence of RAPD, visual field abnormalities, and magnetic resonance imaging. This report demonstrates the importance of multimodal evaluation, particularly magnetic resonance imaging, in assessing acute vision loss in eyes with congenital optic disc anomalies. To our knowledge, this is the first reported case of optic neuritis associated with MGS in South Korea.
Purpose: We report a rare case of bilateral internuclear ophthalmoplegia (INO) associated with progressive supranuclear palsy (PSP).Case summary: An 83-year-old man presented with progressive binocular diplopia over 2 years. He had no history of systemic diseases, including diabetes mellitus, hypertension, or thyroid disorders, and the diplopia did not exhibit diurnal variation. The patient reported slowness of movement and frequent falls during ambulation which had begun 3–4 years earlier. He had no history of musculoskeletal disorders or neurological diseases such as a stroke. Brain magnetic resonance imaging demonstrated moderate midbrain atrophy consistent with PSP and mild atrophy of the frontal and temporal lobes. Ophthalmologic examination revealed visual acuity of 1.0 in the right eye and 0.8 in the left eye with normal fundus findings. Alternate cover testing exhibited 40 prism diopters of exotropia at both near and distance. Ocular motility assessment demonstrated limitations of adduction (–4), elevation (–3), and depression (–3), with absent convergence. Preservation of the doll’s eye reflex indicated a supranuclear lesion.Conclusions: Our case highlights PSP as a rare cause of bilateral INO. In older patients presenting with progressive diplopia, a comprehensive assessment including detailed ocular motility examination, thorough history of extrapyramidal symptoms, and neuro-ophthalmologic evaluation is essential to identify a potential underlying neurodegenerative disorder such as PSP.
Purpose: We compared cup-to-disc ratio estimates obtained using wide-field fundus photography and optical coherence tomography (OCT), both of which are widely used for fundus examination.Methods: In total, 130 eyes from 65 patients were included and categorized as 53 right eyes and 53 left eyes from patients with diabetes mellitus, and 12 right eyes and 12 left eyes from patients without diabetes mellitus. Vertical cup-to-disc ratios (VCDRs) were measured using wide-field fundus photography and OCT. Differences in VCDR measurements between the two modalities were analyzed using generalized estimating equations with an exchangeable working correlation structure to account for within-subject correlation between fellow eyes.Results: Mean VCDRs measured using wide-field fundus photography were 0.64 ± 0.17 and 0.61 ± 0.16 for diabetic right and left eyes, respectively, and 0.69 ± 0.14 and 0.64 ± 0.21 for non-diabetic right and left eyes, respectively. Corresponding VCDRs measured using OCT were 0.69 ± 0.12 and 0.67 ± 0.13 for diabetic right and left eyes, respectively, and 0.60 ± 0.24 and 0.68 ± 0.12 for non-diabetic right and left eyes, respectively. OCT significantly overestimated VCDRs in diabetic eyes compared to wide-field fundus photography. In contrast, OCT underestimated VCDRs in non-diabetic right eyes and overestimated VCDRs in non-diabetic left eyes; however, these differences were not statistically significant. Generalized estimating equation analysis demonstrated that diabetes mellitus was a significant factor associated with differences in VCDR measurements between wide-field fundus photography and OCT.Conclusions: VCDRs measured using OCT in patients with diabetes mellitus were greater than those estimated using wide-field fundus photography. These findings emphasize the importance of carefully selecting and interpreting diagnostic, screening, and follow-up modalities for VCDR assessment in patients with diabetes mellitus.
Purpose: To compare ocular biometric measurements and postoperative refractive prediction accuracy between swept-source optical coherence tomography (Anterion®) and low-coherence reflectometry (Lenstar LS900®) using five intraocular lens (IOL) power calculation formulas.Methods: This retrospective study included 72 patients (72 eyes) who underwent phacoemulsification with IOL implantation. Axial length, keratometry, anterior chamber depth, lens thickness, white-to-white distance, and central corneal thickness were measured using both devices. Mean prediction error and mean absolute error were calculated based on postoperative spherical equivalent using the SRK/T, Hoffer Q, Holladay 1, Haigis, and Barrett Universal II formulas.Results: Axial length and white-to-white distance showed no significant differences between the two devices, whereas keratometry, anterior chamber depth, lens thickness, and central corneal thickness differed significantly (p < 0.05). Bland-Altman analysis demonstrated wider limits of agreement for keratometry and white-to-white distance than for the other biometric parameters. Mean prediction error showed a myopic shift with both devices across all formulas, with Anterion® demonstrating a significantly greater myopic bias than Lenstar LS900® (p < 0.001). Mean absolute error was significantly lower with Lenstar LS900® for the SRK/T, Hoffer Q, and Holladay 1 formulas but did not differ significantly between devices for the Haigis or Barrett Universal II formulas. Among all formulas, Barrett Universal II yielded the lowest mean absolute error for both devices.Conclusions: The two devices demonstrated strong agreement for most ocular biometric measurements despite significant differences in several parameters. Under the conditions of this study, Lenstar LS900® achieved lower mean absolute error with some IOL power calculation formulas than Anterion®, indicating that interdevice differences in refractive prediction should be considered when the two devices are used interchangeably.
Purpose: To evaluate the clinical characteristics, etiologies, and treatment outcomes of pediatric macular holes (MHs).Methods: The medical records of pediatric patients under 18 years of age diagnosed with MHs at Severance Hospital between January 2005 and December 2022 were retrospectively reviewed. Data regarding etiology, MH diameter, treatment methods, and both visual and anatomical outcomes were analyzed.Results: Among 15 patients (16 eyes), traumatic MHs were identified in 7 cases (46.7%), while non-traumatic causes included Stargardt disease, familial exudative vitreoretinopathy, and vitreomacular traction. No statistically significant differences were observed between the traumatic and non-traumatic groups in terms of age, MH diameter, or initial and final best-corrected visual acuity (BCVA). However, there was a significant difference in sex distribution, with all traumatic cases occurring in males, whereas only 3 of the 9 non-traumatic eyes were male (p = 0.01). Surgical intervention was performed in 13 eyes, achieving anatomical closure in 62.5% (10 eyes). The three eyes without closure (37.5%) were all non-traumatic cases. BCVA (logMAR) significantly improved from a median of 1.00 preoperatively to 0.70 postoperatively (p = 0.013). Among the three eyes that did not undergo surgery, one demonstrated spontaneous closure, and another achieved closure following medical treatment.Conclusions: Pediatric MHs may arise from various ocular conditions beyond trauma. Surgical intervention was effective, particularly for traumatic MHs, while non-traumatic cases demonstrated a lower closure rate. In some instances, spontaneous or medically induced closure occurred without surgical management. Further multicenter studies with larger cohorts are warranted to establish definitive management guidelines for pediatric MHs.
Purpose: Our study identified prognostic factors affecting visual outcomes in patients with unilateral indirect traumatic optic neuropathy (TON), determined the risk of legal blindness, and assessed changes in visual acuity, visual fields, retinal structure, and the therapeutic effect of high-dose corticosteroid treatment.Methods: We retrospectively reviewed the medical records of 52 patients (52 eyes) diagnosed with TON between 2014 and 2023. Patients were categorized into two groups according to the final best-corrected visual acuity (BCVA): Group 1 (BCVA ≥0.1) and Group 2 (BCVA <0.1). Prognostic factors were analyzed using logistic regression, and receiver operating characteristic curve analysis was performed to determine optimal cutoff values. Longitudinal changes in visual acuity, visual field index (VFI), and retinal structural parameters were assessed using a generalized linear mixed model.Results: Factors significantly associated with Group 1 included the absence of intracranial hemorrhage, administration of high-dose steroids within 24 h, and better logMAR visual acuity and VFI within 4 weeks post-trauma. In multivariate analysis, VFI within 4 weeks remained significantly associated with favorable visual outcomes (p = 0.008). The optimal VFI cutoff value for predicting a good prognosis was 13%, yielding a sensitivity of 90% and specificity of 93.3%. Visual acuity outcomes over time differed significantly according to the timing of high-dose steroid administration.Conclusions: VFI within 4 weeks after injury was the most reliable prognostic indicator, demonstrating high sensitivity and specificity for predicting legal blindness. Early administration of high-dose steroids within 24 h helped prevent visual deterioration. These findings emphasize the importance of early quantitative assessment of visual function and prompt therapeutic intervention to guide treatment strategies in patients with TON.
Purpose: We investigated the level of glaucoma awareness and identified associated factors among Korean adults aged ≥40 years using data from the Korea National Health and Nutrition Examination Survey (KNHANES).Methods: Among the 16,154 individuals aged ≥40 years who underwent ophthalmic examinations in the 2017-2020 KNHANES, 825 participants diagnosed with glaucoma by an ophthalmologist were included. Glaucoma awareness was defined as a self-reported history of physician-diagnosed glaucoma. Associations between glaucoma awareness and sociodemographic variables including age, sex, education level, income level, and recent ophthalmic examination were evaluated using chi-square tests and logistic regression analyses.Results: Among the 16,154 participants, 825 (5.1%) were diagnosed with glaucoma. However, only 19.8% were aware of their condition and 14.0% reported were receiving treatment. In logistic regression analysis, older age was significantly associated with greater awareness (≥80 years vs. 40-49 years; p < 0.001). Recent ophthalmic examination within 1 year was significantly associated with higher awareness (≤1 year vs. 1-3 years; p < 0.001). Sex, education level, and income level were not independently associated with glaucoma awareness.Conclusions: Although glaucoma awareness among Korean adults has more than doubled compared to the 8.0% reported in previous KNHANES analyses, over 80% of affected individuals remain unaware of their diagnosis. Awareness was significantly associated with older age and recent ophthalmic examination emphasizing the importance of regular eye screening. Considering the anticipated rise in glaucoma prevalence, incorporating systematic ophthalmic screening into the national health check-up program should be considered to enhance early detection and management.
Purpose: We present a case of dupilumab-associated ocular surface disease presenting as atypical superior filamentary keratitis and describe our treatment approach.Case summary: A 20-year-old male receiving dupilumab for atopic dermatitis was referred for bilateral ocular discomfort 2 months after treatment initiation. Examination revealed follicular hyperplasia of the left superior palpebral conjunctiva, limbal elevation and hyperemia, corneal infiltration, and superficial neovascularization, consistent with severe atopic keratoconjunctivitis. Considering the inflammation was refractory to prior long-term therapy, the patient was treated with topical corticosteroids, antibiotics, and a sub-Tenon triamcinolone injection; however, the clinical course fluctuated with repeated improvement and deterioration. Despite subsequent tacrolimus therapy, characteristic filaments developed in the superior cornea of both eyes with significant exacerbation following dupilumab administration. Subjective symptoms improved after the patient voluntarily discontinued dupilumab. Subsequently, the condition stabilized after extending the dupilumab dosing interval and the patient remains under observation with ongoing medication adjustments.Conclusions: Dupilumab treatment can induce corneal filament formation, particularly in the superior area. Patients with a history of ocular disease or those receiving ophthalmic medications should be monitored closely during therapy.
Purpose: We investigated the ophthalmic manifestations of Korean patients with Williams syndrome registered at a single regional rare disease center over the past 30 years. Methods: We conducted a retrospective analysis of the medical records of 19 patients who underwent complete ophthalmic examinations among 56 patients diagnosed with Williams syndrome and enrolled between September 1994 and August 2024. Results: Nineteen patients with Williams syndrome (7 boys and 12 girls) underwent their first ophthalmic examination at a mean age of 2.6 +/- 2.8 years and were followed for 5.5 +/- 5.1 years. Of these, 16 patients (84%) had cardiovascular abnormalities, 2 (11%) had infantile hypercalcemia, and 17 (89%) exhibited developmental delay. All patients displayed characteristic facial features with puffy eyelids. Congenital nasolacrimal duct obstruction occurred in 3 patients (16%) and resolved spontaneously. A stellate iris pattern involving approximately half the iris width was observed in 10 patients (53%). Strabismus was present in 13 patients (68%), including 6 with exotropia (1 with Duane retraction syndrome type 2) and 7 with esotropia. At the final refractive assessment (mean age 8.1 +/- 2.5 years), 4 patients had hyperopia, 4 had myopia (including 1 with high myopia), 4 had astigmatism, and 3 had anisometropia; 7 patients (37%) required spectacle correction. Of the 11 patients with measurable visual acuity, 5 (45%) had amblyopia. Retinal vascular tortuosity was observed in 11 patients (58%), and attenuated retinal vessels in 10 (53%). Optical coherence tomography performed in 5 patients with normal visual acuity revealed markedly reduced central macular thickness in all, and a wide foveal pit in 1 patient. Conclusions: Williams syndrome is associated with diverse ophthalmic manifestations that warrant regular and comprehensive ophthalmic follow-up.
Purpose: To compare the clinical outcomes of early pars plana vitrectomy versus intravitreal antibiotic injection in patients who developed infectious endophthalmitis after cataract surgery.Methods: The medical records of patients diagnosed with infectious endophthalmitis following cataract surgery between 2006 and 2023, whose initial best-corrected visual acuity (BCVA) values were 0.48 to 2.3 in LogMAR units, were retrospectively reviewed. Final BCVA and the degree of visual improvement were compared between early vitrectomy and intravitreal antibiotic injection-only groups. Additionally, patients who underwent delayed vitrectomy within 3 days after the initial intravitreal antibiotic injection (delayed vitrectomy group) were separately analyzed and compared.Results: At 6 months post-treatment, the mean BCVA values were significantly better in the early vitrectomy group (0.37 ± 0.27) than in the injection group (1.02 ± 0.81) (p = 0.004); the early vitrectomy group also had greater visual improvement at both 1 week and 6 months after treatment (p = 0.004, p < 0.001). Compared to the delayed vitrectomy group, the early group demonstrated significantly greater visual improvement at both time points (p = 0.010, p = 0.001). The retreatment rate was higher in the injection group than in the early vitrectomy group.Conclusions: In patients who developed infectious endophthalmitis after cataract surgery and had an initial visual acuity between light perception or better and 20/60, early vitrectomy resulted in better visual outcomes compared to intravitreal antibiotic injection alone or delayed vitrectomy.
Purpose: Cyclodialysis can occur after ocular trauma or intraocular surgery and can lead to persistent hypotony and vision loss if not treated appropriately. In eyes with prior trabeculectomy, conventional cyclopexy requires a conjunctival incision, which may compromise a functioning filtering bleb. We present a case in which a capsular tension ring (CTR) was inserted into the ciliary sulcus to repair cyclodialysis without conjunctival incision, preserving the filtering bleb.Case summary: A 65-year-old man developed hypotony, a shallow anterior chamber, and cataract progression after trabeculectomy. Swept-source anterior segment optical coherence tomography revealed approximately 200° of cyclodialysis involving the nasal and temporal quadrants. The patient had already lost vision in the left eye, and the right eye represented the only eye with preserved visual potential. As preservation of the filtering bleb in the right eye was essential, phacoemulsification with intraocular lens implantation was performed, and a CTR was inserted into the ciliary sulcus without conjunctival incision. One day after surgery, anterior segment optical coherence tomography confirmed complete reattachment of the ciliary body. At the 1-year follow-up, the ciliary body remained well attached with no recurrence of cyclodialysis. The filtering bleb appeared clinically diffuse and healthy, and both visual function and intraocular pressure remained stable throughout the follow-up period.Conclusions: Insertion of a CTR into the ciliary sulcus without conjunctival incision enabled successful closure of the cyclodialysis cleft while preserving filtering bleb function, offering a practical treatment option for eyes with prior trabeculectomy.
Purpose: We evaluated the long-term clinical outcomes of pars plana Ahmed glaucoma valve (AGV) implantation combined with vitrectomy in patients with glaucoma.Methods: We included 25 eyes of glaucoma patients requiring pars plana vitrectomy who underwent combined pars plana AGV implantation and vitrectomy due to uncontrolled intraocular pressure (IOP) despite maximal medical therapy. Surgical success was defined as maintaining IOP between 6 and 21 mmHg, irrespective of topical IOP-lowering medication use. Surgical failure was defined as inadequate IOP control or a decline in visual acuity to no light perception. Preoperative and postoperative parameters, including visual acuity, IOP, number of topical IOP-lowering medications, surgical success rate, corneal endothelial cell density, and postoperative complications, were analyzed.Results: The mean follow-up period was 49.5 ± 12.5 months. The mean preoperative IOP of 32.4 ± 8.4 mmHg significantly decreased to 18.0 ± 9.2 mmHg at the final visit (p < 0.001). Based on Kaplan–Meier survival analysis, the cumulative surgical success rates were 80% at 1 year, 72% at 2 years, and 68% at 5 years postoperatively. The overall success rate at the final follow-up was 76%. Corneal endothelial cell density decreased by 16.5% compared to preoperative values. Early postoperative complications (within 1 month) included hypotony in 16% of eyes, choroidal detachment in 12%, vitreous hemorrhage in 12%, and hyphema in 4%. Late complications included corneal endothelial dysfunction in one eye (4%).Conclusions: In glaucoma patients requiring pars plana vitrectomy combined pars plana Ahmed glaucoma valve implantation and vitrectomy achieved sustained IOP reduction with a relatively low rate of complications. This combined surgical approach appears to be a safe and effective long-term treatment option for refractory glaucoma cases requiring posterior segment intervention.
Purpose: To report a case of oncocytic and inverted Schneiderian papilloma originating from the lacrimal sac. Case summary: A 70-year-old male presented with a 5-year history of bilateral epiphora. Best-corrected visual acuity was 0.9 in the right eye and 1.0 in the left eye, and intraocular pressure was 12 mmHg in the right eye and 14 mmHg in the left eye. The findings of nasolacrimal duct probing, the irrigation test, and dacryoscintigraphy suggested partial obstruction of the right nasolacrimal duct. Computed tomography and magnetic resonance imaging revealed a mass measuring approximately 2.5 cm in the right lacrimal sac. Surgical excision of the mass was planned in collaboration with the otolaryngology department, followed by histopathologic examination of the resected specimen. The otorhinolaryngology team removed the lacrimal sac mass endoscopically through the nasal cavity and submitted the specimen for histopathologic analysis. Subsequently, endoscopic dacryocystorhinostomy was performed. Postoperatively, the patient's epiphora resolved, and histopathologic evaluation confirmed the diagnosis of oncocytic and inverted Schneiderian papilloma. Conclusions: Schneiderian papilloma can originate from the nasolacrimal duct and should be considered in the differential diagnosis of patients presenting with epiphora. J Korean Ophthalmol Soc 2026;67(6):213-217
Purpose: To report a rare case of invasive sino-orbital aspergillosis initially presenting with orbital apex syndrome and subsequently progressing to facial nerve palsy and ischemic stroke.Case summary: A 58-year-old man presented with right-sided ptosis, upper eyelid swelling, and diplopia. Imaging and clinical findings were consistent with orbital apex syndrome. Intravenous antibiotic therapy was initiated; however, there was rapid deterioration in vision and ocular motility. After consultation with the otolaryngology department, high-dose intravenous corticosteroids were administered. Subsequently, the patient developed right-sided facial nerve palsy, central retinal artery occlusion, and right internal carotid artery occlusion, indicating disease progression. Histopathological examination later confirmed invasive aspergillosis. Corticosteroids were discontinued, and antifungal therapy combined with orbital exenteration led to clinical improvement.Conclusions: Invasive aspergillosis can rapidly extend to the orbit and intracranial structures, and corticosteroid administration without first excluding fungal infection may accelerate disease progression. The presence of facial nerve palsy and cerebrovascular complications suggests extensive angioinvasive spread, highlighting the importance of early diagnosis, prompt antifungal therapy, and surgical debridement. In patients with immunocompromising conditions, such as diabetes mellitus, fungal infection should always be strongly suspected and excluded at the outset to prevent severe complications.
Purpose: To report a modified four-point flanged intrascleral fixation technique using an existing plate-haptic toric multifocal intraocular lens (IOL) without eyelets in a case of IOL dislocation.Case summary: A 56-year-old male presented with dislocation of a previously implanted toric multifocal IOL (Lentis Mplus Toric) without eyelets. Instead of performing an IOL exchange, a modified Canabrava technique was employed, utilizing four-point fixation with 6-0 polypropylene sutures and creating flanges at each fixation site. Postoperatively, the IOL remained well-centered and maintained alignment with its original axis (90°) for 12 months. Both distance and near visual acuity were well preserved throughout the follow-up period.Conclusions: Plate-haptic toric multifocal IOL without eyelets can be successfully stabilized using a modified four-point flanged fixation technique. Sustained axis alignment and favorable visual outcomes suggest that this approach may have clinical utility in carefully selected cases.
Purpose: This study investigated the results of antinuclear antibody (ANA) testing in Korean patients with uveitis, examining its relationship with the clinical course of uveitis and systemic diseases. Methods: We conducted a retrospective analysis of the medical records of 64 patients with noninfectious uveitis who underwent ANA testing and were followed for at least 6 months at the Department of Ophthalmology at Seoul St. Mary's Hospital from January 2006 to December 2021. Patients were divided into ANA-positive and ANA-negative groups and correlations between uveitis-related factors and ANA status were assessed. Results: Among the 516 patients tested for ANA, 6.58% (34/516) were positive. The initial visual acuity (logMAR) before treatment was significantly better in the ANA-positive group (0.21 +/- 0.20) than in the ANA-negative group (0.59 +/- 0.68) (p = 0.002). However, the final visual acuity after treatment showed no statistically significant difference between the two groups. Additionally, no statistically significant differences were observed in terms of immune deficiency status, types of associated rheumatic disease, rheumatoid factor positivity, erythrocyte sedimentation rate, C-reactive protein (define) levels, or treatment modalities. No significant correlation was found between ANA titers and the severity of uveitis. Conclusions: Relationships between ANA positivity and the etiology, treatment outcomes, and systemic diseases associated with uveitis are unclear. Routine ANA testing is not recommended for the diagnosis of uveitis. J Korean Ophthalmol Soc 2026;67(4):110-117
Purpose: To report a case of recurrent hypotony and exudative choroidal detachment in a patient with pseudoexfoliation glaucoma following the use of a topical preservative-free prostaglandin-timolol fixed combination eye drop. Case summary: A 74-year-old diabetic patient with a history of trabeculectomy for pseudoexfoliation glaucoma presented with conjunctival hyperemia, ocular pain, and blurred vision 3 months after using a preservative free prostaglandin-timolol fixed combination. Intraocular pressure (IOP) was markedly reduced to 6 mmHg and fundus examination revealed severe exudative choroidal detachment involving three quadrants. Treatment with oral and topical corticosteroids, cycloplegics, and non-steroidal anti-inflammatory drugs normalized his IOP to 15 mmHg and resolved the detachment within 3 weeks. Two weeks later, the patient inadvertently reused the same medication mistaking it for artificial tears. Symptoms recurred the following day with his IOP dropping to 2 mmHg and choroidal detachment affecting all four quadrants. Re-treatment led to full recovery within 3 weeks. Conclusions: Choroidal detachment following use of combination therapy with a prostaglandin analog and an aqueous suppressant is a rare complication. Patients with pseudoexfoliation syndrome and diabetes may be particularly susceptible. Vigilant monitoring of IOP and fundus status is recommended when prescribing these agents to individuals with multiple risk factors. J Korean Ophthalmol Soc 2026;67(4):137-142
Purpose: To compare the surgical outcomes of two modified Yamane techniques for sutureless scleral fixation of intraocular lenses (IOL): trocar-cannula-based fixation and 26-gauge needle-based fixation. Methods: A retrospective analysis was conducted on patients who underwent modified Yamane scleral IOL fixation between January 2023 and June 2024 with a minimum follow-up of 6 months. The outcomes assessed included best corrected visual acuity (BCVA), spherical equivalent, astigmatism, astigmatism, and postoperative complications. Measurements were taken preoperatively and at 1 day, 1 week, 1 month, and 6 months after surgery. Results: Among 86 eyes included, 44 received trocar-cannula-based fixation (trocar group) and 42 received 26-gauge needle-based fixation (needle group). Both groups showed significant improvements in BCVA and spherical equivalent at 6 months postoperatively (BCVA: p = 0.013, p = 0.001; spherical equivalent: p < 0.001, p = 0.014), with no statistically significant differences between the groups (BCVA: p = 0.139; spherical equivalent: p = 0.595). The trocar group demonstrated significantly greater improvement in astigmatism at both 1 month and 6 months (p = 0.046, p = 0.048), as well as in IOL astigmatism at 6 months (p = 0.049). Complication rates did not significantly differ between the groups. Conclusions: Both modified Yamane techniques effectively improved BCVA and spherical equivalent. However, the trocar-cannula-based method yielded superior outcomes in astigmatism correction, suggesting a potential advantage in postoperative refractive stability.
