Background and objective: To review the results after small glass bead implantation in the scleral cavity during evisceration.
Materials and methods: In this retrospective study, we retrieved the follow-up data of 17 patients who underwent evisceration with glass bead implantation from 1993 to 1996.
Results: All patients achieved good cosmetic results with good motility of the prosthesis. Complications included transient chemosis at the early postoperative period in 3 patients (17.6%), 1 patient (5.9%) with local dehiscence of the wound, 1 patient developed a cyst in the socket (5.9%), and 1 patient was afflicted with thinning of the conjunctiva over the surgical wound.
Conclusion: The use of glass beads to fill the scleral cavity during evisceration has the advantage of an excellent fit in accordance with the scleral cavity volume, as well as ease of treatment in case of extrusion. The prosthesis movement is good because of its engagement with the scleral bulges caused by the glass beads.
Background and objective: To describe the use of fascia lata to cover the polypropylene knots of scleral fixated posterior chamber intraocular lenses (PCIOL).
Patients and methods: Fascia lata was used to cover the knots of scleral fixated PCIOL in 5 eyes with significant scleral thinning. Four of the 5 eyes had the PCIOL insertion and the fascia lata patching in the same setting. The fifth eye previously had scleral fixated PCIOL with late suture erosion through a partial thickness scleral flap.
Results: There was no suture exposure or graft thinning throughout a follow-up period of 8 to 16 months. The eyes tolerated the fascia lata well with no early or late postoperative complications.
Conclusion: Fascia lata provides an effective means to cover the knots of scleral fixated PCIOL, especially in aphakic patients with significant scleral thinning.
A successful surgical treatment (vitrectomy) for bilateral bullous retinal detachment in a patient with Vogt-Koyanagi-Harada (VKH) disease is reported. A 78-year-old woman had severe reduction of visual acuity in both eyes because of an extremely bullous nonrhegmatogenous retinal detachment accompanied by VKH disease. We performed lens extraction and vitrectomy on both eyes combined with systemic and topical corticosteroid therapy. The retina was reattached immediately after the surgery and her visual acuity promptly improved in both eyes. She had no recurrence of retinal detachment even after tapering the dose of corticosteroid. We suggest that vitrectomy may be an effective therapeutic option in the treatment for severe bullous retinal detachment associated with VKH disease.
A 17-year-old male patient was referred for poorly controlled glaucoma on maximal medication, congenital aniridia, cataract, nystagmus, and hypoplasia of the macula. A bilateral filtering procedure was performed to control the glaucoma. Three months later, a slow motion phacoemulsification and implantation of a brown diaphragm intraocular lens (IOL) was attempted. Despite the presence of nystagmus and hypoplasia of the macula, the visual acuity improved from 20/300 to 20/100 in the right eye and from 20/400 to 20/150 in the left eye. Both aniridia IOLs were well centered, the anterior segment was quiet with normal intraocular pressure without medication, and all of the patient's glare symptoms disappeared. A single-piece iris diaphragm and optical lens offer a safe alternative for patients who previously had no viable options for iris reconstruction. The most serious postoperative problem, glaucoma, should be addressed before the cataract and lens implantation is performed to avoid a possible acceleration of the glaucoma progression by the large aniridia IOL.
Lung cancer commonly affects middle-aged and elderly smokers. Metastatic disease involving the orbit is uncommon. We report the unusual occurrence of a 25-year-old male nonsmoker with an aggressive form of lung cancer who developed metastatic orbital disease involving the medial rectus.