Capillary hemangiomas are the most common periocular and orbital tumors of childhood that typically arise in infancy. Though the diagnosis is frequently made on clinical examination, various diagnostic modalities may be helpful in initial evaluation and follow-up. Tests may be necessary in diagnosing suspect cases or aid in the differentiation of potential malignant tumors. In the vast majority of cases these tumors undergo spontaneous involution without sequelae. However, some periocular and orbital capillary hemangiomas require intervention to prevent serious complications. Other tumors require treatment to lessen the surgical burden for cosmetic repair. When treatment is necessary, there are a number of therapeutic options available. As there is no standard, potential risks and benefits must be discussed with the family and treatment should be specific in each case. A complete understanding of the natural history of the tumor, indications for treatment, and response to different therapies is imperative in managing this common lesion.
This retrospective case series describes 7 eyes with KPros that underwent successful MMCR without compromise to the integrity of the KPro. Because these patients are at high risk for potential complications, we recommend careful patient selection, a goal of undercorrection, and consideration of supplemental procedures to the lower eyelids to minimize complications to the KPro.
T he purpose of this article is to demonstrate the utility of the large spot size (LSS) setting using a binocular laser indirect delivery system for peripheral ablation in children. One patient with bilateral retinopathy of prematurity received photocoagulation with standard spot size burns placed adjacently to LSS burns. Using a pixel analysis program called Image J on the Retcam picture, the areas of each retinal spot size were determined in units of pixels, giving a standard spot range of 805 to 1294 pixels and LSS range of 1699 to 2311 pixels. Additionally, fluence was calculated using theoretical retinal areas produced by each spot size: the standard spot setting was 462 mJ/mm 2 and the LSS setting was 104 mJ/mm 2 . For eyes with retinopathy of prematurity, our study shows that LSS laser indirect delivery halves the number of spots required for treatment and reduces fluence by almost one-quarter, producing more uniform spots.
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