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This report presents the effectiveness of 25-gauge Transconjunctival Sutureless Vitrectomy (TSV) for various vitreoretinal disorders. We performed vitreoretinal surgery on 6 patients using 25-gauge TSV. Minimal or no leakage of intraocular fluid or gas was observed at the entry site. No case required a suture to close the conjunctival or scleral opening site, and no complications resulted from the opening site. Median preoperative visual acuity was 0.04 and median postoperative best corrected visual acuity (BCVA) with a mean follow-up of 12 weeks, was 0.45. Median preoperative intraocular pressure was 12.67 mmHg, and median intraocular pressure on the first postoperative day was 15.67 mmHg. Because transconjunctival sutureless surgery is minimally invasive, it increases the efficiency of vitrectomy, hastens postoperative recovery, and improves outcomes due to the simplified surgical procedure. We feel that the adoption of the 25-gauge TSV would lead to improved patient comfort, care, and management.

Purpose:To identify socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. Methods: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012. Results: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. Conclusions: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.

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Purpose:To assess the influence of visual acuity (VA) and ocular condition on falls. Methods: We analyzed 28,899 Korean adults using cross-sectional data from the Korean National Health and Nutrition Examination Survey (2008)(2009)(2010)(2011)(2012). Associations between best corrected VA based on better or worse seeing eye and ocular condition and falls were identified using multivariable logistic regression. We included sociodemographic factors and comorbidities including hypertension, diabetes, arthritis, acute myocardial infarction/angina, and stroke as independent variables. VA was divided into 1.0, 0.8, 0.5-0.63, and <0.5. Results: Among 28,899 subjects, falls occurred in 511. In multivariable logistic regression analysis, low VA based on the better seeing eye was significantly associated with falls (VA 1.0 as a reference group; adjusted odds ratio [aOR] = 1.31, 95% confidence interval [CI], 1.00-1.72 in VA of 0.8; aOR = 1.86, 95% CI, 1.07-3.24 in VA of 0.5-0.63; and aOR = 1.21, 95% CI, 0.58-2.54 in VA of <0.5; p = 0.025 for trend). There was no association between VA based on the worse seeing eye and falls. Early age-related macular degeneration was associated with falls in univariable analysis (OR = 2.24) and age-and sex-adjusted analysis (aOR = 1.52), but not in multivariable analysis. In terms of age subgroups, subjects with VA of 0.5-0.63 were more likely to have experienced falls compared with subjects with VA of 1.0 (aOR = 5.83, 95% CI, 1.58-21.54) among subjects 50 years of age or younger. An increasing trend of falls with decreasing VA among subjects between 50 and 70 years of age was observed (p = 0.033 for trend). However, no such association was observed in elderly subjects ≥70 years of age. Conclusions: VA should be considered for preventing falls because lower VA is associated with increased risk of falls.

Purpose To examine the refractive errors, retinal manifestations, and genotype in tuberous sclerosis complex (TSC) patients in a Korean population. Materials and Methods A total of 98 patients with TSC were enrolled in Severance Hospital for a retrospective cohort study. The number of retinal astrocytic hamartoma and retinal achromic patch within a patient, as well as the size, bilaterality, and morphological type were studied. In addition, the refractive status of patients and the comorbidity of intellectual disability and epilepsy were also examined. Results Retinal astrocytic hamartoma was found in 37 patients, and bilateral invasion was observed in 20 patients (54%). TSC1 mutation was associated with myopia ( p =0.01), while TSC2 mutation was associated with emmetropia ( p =0.01). Retinal astrocytic hamartoma was categorized into three morphological types and examined as follows: type I (87%), type II (35%), and type III (14%). Single invasion of retinal astrocytic hamartoma was identified in 32% of the patients, and multiple invasions in 68%. The TSC1/TSC2 detection rate was 91% (41/45). Among them, TSC1 variant was detected in 23 patients (54%), whereas TSC2 variant was detected in 18 patients (40%). The results showed that TSC2 mutations are correlated with a higher rate of retinal astrocytic hamartoma involvement (all p <0.05), and multiple and bilateral involvement of retinal hamartomas (all p <0.05). However, the size of retinal astrocytic hamartomas, comorbidity of epilepsy, or intellectual disability did not show correlation with the genetic variant. Conclusion TSC1 variant patients were more myopic, while TSC2 variant patients showed association with more extensive involvement of retinal astrocytic hamartoma.

Purpose:To identify the factors associated with vision screening in children. Methods: This study included 4,827 young children 3-11 years of age who answered the question "Has [name] ever had an eye examination (vision screening) in the past year?" from The Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). The trained interviewer asked the questions to a member of the household familiar with the study participant. The factors related to vision screening were analyzed using multivariate logistic regression. Results: The rate of vision screening gradually increased with age in young children between 3 (25.8%) and 11 years of age (72.5%). Regarding the rate by region, Busan had the highest rate (63.5%), followed by Daegu (62.2%) and Seoul (59.9%). Chungnam had the lowest rate (43.2%), followed by Chonbuk (44.6%) and Chonnam (44.9%). Higher income was associated with increased screening rate with marginal statistical significance (adjusted odds ratio [aOR]＝1.5 for 3rd quartile, 95% confidential interval [CI], 1.0-2.4 versus 1st quartile as a reference group). Households with 5 or more members were less likely to receive vision screening compared to households with 1 child (aOR＝0.6, 95% CI, 0.4-0.8). Conclusions:The rate of vision screening differed according to age group (25.8-72.5%) and region (43.2-63.5%). Regional disparity, low household income and large number of household members were barriers for vision screening in Korean children. J Korean Ophthalmol Soc 2015;56(6):944-949

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