Purpose: To evaluate current patient demographics and surgical outcomes from a large series of 733 surgically treated orbital fractures from an ophthalmologist’s perspective. Methods: We reviewed the medical records of 733 patients with orbital fracture, who were treated surgically by one of the authors at Gil Hospital, Gachon University, from May 2000 until September 2007. Data regarding patient demographics, signs and symptoms at presentation, cause of injury, nature of fracture, associated ocular and nonocular injury, surgical outcome and complications were collected. Results: Male patients outnumbered female patients, and blowout fracture occurred most frequently between the ages of 20 and 29 years (mean age 30.7 years). Violent assault was the leading cause of the fractures, followed by fall/slip and traffic accidents. Common signs and symptoms were periorbital ecchymosis, ocular motility restriction, diplopia and enophthalmos. In the pediatric group, diplopia and ocular motility restriction were the most common. Subconjunctival hemorrhage, hyphema and commotio retinae were the most commonly associated ocular injuries. As for the location of fractures, medial wall fractures were the most common, followed by fractures of the inferior wall, and both medial and inferior walls, in order. The most common type of fracture was the ‘comminuted’ one. In the pediatric group, the percentage of trapdoor-type fracture was higher than in the adult group. Forty-four percent of the patients had diplopia preoperatively and 8.7% postoperatively. The average measurement of difference in the enophthalmos (≧2 mm) patient population was improved from 2.62 (±SD 0.9) to 1.73 (±SD 1.3) after surgery. Ocular motility restriction was preoperatively noted in 297 patients (40.5%), and only 18 patients (2.5%) showed restriction after surgery. Conclusion: Young male individuals are at the highest risk for orbital fractures. There are marked differences in the clinical symptomatology and findings between pediatric and adult orbital fractures. Diplopia, enophthalmos and ocular motility restriction improved by repair of fracture.

Background: Although the eradication of Helicobacter pylori infection benefits patients with gastric or duodenal ulcers, the value of eradicating the infection in the patients with functional dyspepsia (FD) remains controversial. Aims: To determine whether eradicating H. pylori can prevent the subsequent development of ulcers or relieve the symptoms of functional dyspepsia patients. Methods: In a double‐blind, placebo‐controlled trial, 161 patients infected with H. pylori who had functional dyspepsia were randomly assigned to 7 days of treatment with a lansoprazole‐based triple therapy or placebo and then followed for 1 year. The main outcome measures were the development of peptic ulcers and the resolution of symptoms. Results: H. pylori was eradicated in 63 out of 81 patients (78%) in the treatment group and none of the 80 patients (0%) in the placebo group. During the follow‐up period, two patients in the treatment group and six patients in the placebo group developed peptic ulcers at repeat endoscopy (2.5% vs. 7.5%; 95% CI: –12 to 2). The reduction in ulcer rates was statistically significant in the ‘ulcer‐like’ sub‐group (0% vs. 16.7%; 95% CI: –32 to –2), but not in the ‘dysmotility‐like’ and ‘unclassifiable’ sub‐groups. Regarding symptom response, the resolution rates of symptoms were similar between the treatment and placebo groups (58.0% vs. 55.0%, 95% CI: –12 to 18). Additionally, no significant differences existed in the symptom responses between the treatment and control arms in each of the dyspepsia sub‐groups. Conclusions: Eradicating H. pylori can prevent the subsequent development of peptic ulcers in the patients with ‘ulcer‐like’ functional dyspepsia. However, this approach does not significantly reduce the symptoms of functional dyspepsia patients.

Minimal fluid-air exchange in combined 23-gauge sutureless vitrectomy and cataract surgery may reduce postoperative hypotony and intraocular lens-related complications.

의 외사시 및 3PD의 상사시가 관찰되었다 (Fig. 1). 세극등 검사는 정상소견을 보였고, 동공검사상 좌안의 상대 구심성

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Purpose: To compare the rate of intraoperative sclerotomy-related retinal breaks (SRRB) between 20-and 23-gauge vitrectomy for proliferative diabetic retinopathy (PDR). Methods: Medical records of 62 consecutive eyes of 54 patients who underwent 20-gauge pars plana vitrectomy (PPV) and 63 consecutive eyes of 55 patients who received 23-gauge transconjunctival sutureless vitrectomy were retrospectively reviewed. Results: Three (4.8%) out of 62 eyes in the 20-gauge group had SRRB and 1 (1.6%) eye developed retinal detachment at 4 months postoperatively, while 2 (3.2%) out of 63 eyes in the 23-gauge group had SRRB and 1 (1.6%) eye developed retinal detachment at 3 months postoperatively. Conclusions: There were no significant differences in the rates of sclerotomy-related retinal breaks and sclerotomy-related retinal detachments between 20-gauge PPV and 23-gauge PPV for PDR.

Purpose: We present a case of endogenous endophthalmitis in which the patient presented with an overall clinical picture suggestive of bacterial endophthalmitis but was subsequently found to have Candida endophthalmitis. Case summary: A 50-year-old man with hepatic encephalopathy and alcoholic liver cirrhosis who was treated in gastroenterology presented with reduced vision in both eyes. Indirect ophthalmoscopy showed bilateral massive submacular abscesses and surrounding retinal hemorrhage. In view of the initial fundal picture of a submacular abscess lesion, the subacute course of the disease, and a medical history of diabetes and liver cirrhosis, a provisional diagnosis of bacterial endophthalmitis was made. Treatment with topical and systemic empirical antibiotics was immediately initiated. Despite the treatment, the patient's condition worsened, and the patient underwent diagnostic and therapeutic vitrectomy. Vitreous cultures revealed the growth of Candida albicans. With a diagnosis of endogenous candida endophthalmitis, he was treated with intravitreous amphotericin B and intravenous fluconazol. Conclusions: Candida albicans should be considered in the differential diagnosis of endogenous endophthalmitis when massive submacular abscesses and hemorrhage are seen.