Purpose: Mucormycosis is an infection caused by fungi to the class Zygomycetes that usually appears in immunosuppressed patients. Diagnostic confirmation is often delayed, with fatal prognosis in cases in which treatment is not rapidly established. Case report: We present two clinical cases of rhino-orbito-cerebral mucormycosis with an atypical presentation form, consisting of a unilateral complete sudden vision loss. Intravenous treatment with liposomal amphotericin B was started and total orbital exenteration surgery was performed. The removed surgical area was filled with gauze impregnated with liposomal amphotericin B and was left open for cures every 12 hours. Due to the good clinical evolution, a reconstruction of the orbital exenteration defect was performed in Case 1 with a temporal muscle flap and a skin island pedicled flap. In Case 2, reconstruction was not performed due to the poor evolution of the patient. Discussion: As it is a very aggressive surgery, the aesthetic and functional sequelae are very important. When the survival of the patient is achieved, we should offer reconstructive solutions that improve their quality of life. The reconstruction carried out using a flap of the temporal muscle can be made in a single act without requiring microvascular surgery.
Mencía-Gutiérrez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Methods:We describe 4 patients suffering from open-angle glaucoma and cataract, and one patient with secondary glaucoma after Fuchs' heterochromic uveitis. All of them underwent phacoemulsification and non-penetrating deep sclerectomy with 5-fluoracil. Two patients presented hematoma in scleral lake 24 h after surgery, other 2 of them presented it one week after the intervention, and one of them presented it 2 weeks after the surgery. The hematoma was found by gonioscopy in all cases. Moreover, all patients had elevated intraocular pressure. Result: Hematoma usually appears within 2 weeks after surgery. Goniopunctures were performed in 5 patients within 5 months of the complication. A second goniopuncture was needed for one of them. Bleb needling was made in one of them. Three of the patients required treatment with beta-blocker eye drops since intraocular pressure exceeded pre-set values. Conclusion: Hematomas in scleral lake are a rare complication that may appear within 2 weeks after non-penetrating deep sclerectomy. They may cause surgery malfunction and antihypertensive eye drops might be required for tensional control. Goniopuncture could be used for solving the complication.
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