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Purpose: To compare the accuracy of refractive outcome measured by Ultrascan (Alcon, Fort Worth, TX, USA) and partial coherence interferometers after phacovitrectomy. Methods: We performed a retrospective study in 74 eyes of 74 patients who underwent phacovitrectomy. SRK-T formula was used to predict intraocular lens (IOL) power. The difference between the predicted and postoperative refractive outcomes for the 2 methodologies (Ultrascan and IOL Master [Zeiss, Carl Zeiss, Jena, Germany]) were compared. The predicted refractive outcome was defined as the estimated refractive error when the selected IOL was inserted. Results: The axial length measured using IOL Master was statistically longer than when measured using Ultrascan (23.85 ± 0.15 mm, 23.56 ± 0.15 mm, p < 0.001). Based on keratometry, statistically significant difference between the 2 groups was not observed. The postoperative refractive error was more accurate when using the IOL Master than Ultrascan (0.08 ± 0.74, 0.47 ± 0.69, p < 0.001). However, in cases of vitreous hemorrhage, the postoperative refractive error was 0.42 ± 0.49 with the IOL Master and 0.07 ± 0.54 with the Ultrascan. Conclusions: Generally, IOL Master is a more accurate method for calculating the IOL power prior to phacovitrectomy. However, in cases of vitreous hemorrhage, Ultrascan appears superior to IOL Master when calculating the IOL power. J Korean Ophthalmol Soc 2015;56(7):1059-1064

Purpose: To report the clinical finding of 3 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). Case summary: Five eyes of 3 patients with focal choroidal excavation detected by SD-OCT were enrolled in the present study. All patients had myopia (average refractive power -5.60 diopter). Two of the 3 patients had focal choroidal excavation in both eyes. All 5 eyes revealed foveal pigmentary changes on fundus examination. The excavation area in the autofluorescence image was hypofluorescent. Fluorescein angiographic finding was normal to various degrees of hyperfluoresence. Indocyanine green angiography revealed hypofluoresence at the excavation area. The excavation involoved from the retinal pigment epithelium layer to the external limiting membrane or outer nuclear layer and average choroidal thickness at excavation were statistically thinner than the uninvolved area based on SD-OCT (p = 0.002). Retinoschisis, serous pigment epithelial detachment and choroidal neovascularziation (CNV) were detected individually in 3 eyes. The other 2 eyes had no specific abnormalities. Conclusions: During the follow-up period, the choroidal excavation remained relatively stable in 4 of 5 eyes, but CNV developed in 1 eye. Therefore, intravitreal bevacizumab injection was performed. Longer follow-up periods are necessary to determine the etiology, clinical course and visual prognosis of eyes with focal choroidal excavation. J Korean Ophthalmol Soc 2014;55(6):941-946

Purpose: This study was designed to compare the outcomes in idiopathic epiretinal membrane (ERM) surgery according to solvents of indocyanine green (ICG) for internal limiting membrane (ILM) peeling. Methods: The medical records of 27 patients (27 eyes) with idiopathic ERM who had undergone pars plana vitrectomy with ICG staining for ILM peeling were retrospectively reviewed. The patients were divided into two groups according to solvents of 0.25% ICG solutions. Solvents used were balanced salt solution (BSS) in group I (15 eyes) and 5% glucose in group II (12 eyes). The severity of ERM, the duration of symptoms, the preoperative and postoperative best corrected visual acuity (BCVA) values, the visibility of the stained ILM (Good, Fair, Poor), and the postoperative complications were compared in the two groups. Results: There was no statistically significant difference in the severity of ERM, the duration of symptoms and the preoperative BCVA in the two groups. The postoperative BCVA was significantly improved in both groups, and the difference was not statistically significant (p = 0.675). There was a significantly smaller number of eyes with poor ILM staining in group II than in group I (p = 0.014). No complications such as recurrence of ERM, atrophy of the retinal pigment epithelium (RPE) or retinal detachment were observed in the two groups. Conclusions: The higher specific gravity of 5% glucose compared with that of BSS as ICG solvents allows for improved ILM visualization. Therefore using the 5% glucose-ICG solution for staining ILM improved the visibility of ILM compared BSS-ICG solution and led to comparable visual recovery. J Korean Ophthalmol Soc 2014;55(6):847-853

We report a case of Valsalva retinopathy associated with esophagogastroduodenoscopy (EGD) under propofol sedation. A 43-year-old woman who had no previous history of systemic or ocular disease presented with a complaint of decreased vision in her left eye, which developed one day after EGD under propofol sedation. According to the referring physician, the patient had experienced multiple sustained Valsalva maneuvers during EGD. The fundus examination of the left eye showed a large preretinal hemorrhage surrounded by multiple small retinal hemorrhages in the posterior pole. One month later, fundus examination revealed a floating organized vitreous hemorrhage. The pars plana vitrectomy was performed to treat persistent vitreous hemorrhage. One month after vitrectomy, fundus examination showed normal retina and the patient’s vision recovered to 20/20. Valsalva maneuver can occur during EGD under sedation, and Valsalva retinopathy should be considered as a possible cause. Valsalva retinopathy should be included in the differential diagnosis when a patient complains of blurred vision following EGD.

Purpose: To evaluate the effectiveness of intralesional triamcinolone acetonide injection for chalazia in pediatric patients. Methods: We performed a retrospective chart review of 58 patients (70 lesions) under fifteen years of age and 40 patients (50 lesions) aged fifteen and over, who underwent intralesional triamcinolone acetonide injections and performed follow-ups for at least three months between January 2007 and October 2008. Data regarding age, sex, lesion size, location, number of injections, treatment success, surgery, and complications were evaluated. Results: Cumulative treatment success of TA was 64.3% with the first injection, 82.9% with a second injection, and 88.6% with a third injection in patients under fifteen years of age. The average number of TA injections was 1.671.03 in primary chalazia and 1.480.87 in recurrent chalazia, while the cumulative treatment success until third TA injection was 89.8% in primary chalazia and 85.7% in recurrent chalazia inpatients under fifteen years old. The average number of TA injections was 1.951.18 in primary chalazia and 1.801.14 in recurrent chalazia, while the cumulative treatment success until the third TA injection was 82.5% in primary chalazia and 70.0% in recurrent chalazia in patients aged fifteen and over. No complications were noted with TA injections. Conclusions: Intralesional triamcinolone acetonide injection in chalazia is an effective and safe treatment in pediatric patients.