Purpose Conjunctival retention cysts may recur if not completely removed. However, the cyst wall often ruptures during surgical excision, making complete removal difficult. In order to ensure complete cyst excision, we used a method of staining the inner cyst wall using trypan blue augmented by Methyl cellulose. Observation Interventional study. Staining was performed by injecting trypan blue using an insulin needle. Then the needle was kept in place and methyl cellulose was injected to make the cyst content viscous to avoid its collapse after removing the needle. By using this technique, it was possible to excise the lesion as a whole. Three patients were included (unilateral). Two patients had cysts that were secondary to trachoma and were followed for up to 2 years without recurrence. A third patient had a conjunctival cyst following strabismus surgery was not successfully removed. Conclusion This method is simple and effective for complete excision of conjunctival retention cysts exception for cysts post strabismus surgery.

Background:The cataract surgery anesthesia should be to make the procedure as safe and as satisfactory as possible for all concerned. The recent progress in anesthesia and surgery now allow cataract extraction to be done with minimal physiological changes to the patient. We aimed in the study to compare between two different doses of dexmedetomidine combined with lidocaine and bupivacaine during retrobulbar anesthesia for cataract extraction by phacoemulsification.Materials and Methods:This study was done on forty patients with cataract. The patients were enrolled in two groups: Group (A):Twenty patients were received 1.5 ml 2% lidocaine + 1.5 ml 0.5% bupivacaine + 0.25 μg/kg of dexmedetomidine and Group (B): Twenty patients were received 1.5 ml 2% lidocaine + 1.5 ml 0.5% bupivacaine + 0.5 μg/kg of dexmedetomidine.Results:The globe anesthesia duration, globe, and lid akinesia were significantly longer in the Group B than in the Group A (P < 0.05). Intraocular pressure decreased through the first 15 min after anesthesia in the two groups, and the changes were not significant between the two groups but highly significant in every group when compared to its baseline reading. As regards the conscious level in the two groups, there was a significant difference (P < 0.001). Group A is higher regarding score 2 and 3, and Group B higher in score 4.Conclusions:We concluded that dexmedetomidine 0.25 μg/kg, when added to retrobulbar block for cataract surgery, will significantly increase the duration of retrobulbar block and improve both the surgeon and the patient satisfaction.

Background Dissociated strabismus complex (DSC) is an enigmatic form of strabismus that includes dissociated vertical deviation (DVD) and dissociated horizontal deviation (DHD). We employed magnetic resonance imaging (MRI) to evaluate the extraocular muscles in DSC. Methods We studied 5 patients with DSC and mean age of 25 years (range, 12–42 years), and 15 age-matched, orthotropic control subjects. All patients had DVD; 4 also had DHD. We employed high-resolution, surface coil MRI with thin, 2 mm slices and central target fixation. Volumes of the rectus and superior oblique muscles in the region 12 mm posterior to 4 mm anterior to the globe–optic nerve junction were measured in quasi-coronal planes in central gaze. Results Patients with DSC had no structural abnormalities of rectus muscles or rectus pulleys or the superior oblique muscle but exhibited modest, statistically significant increased volume of all rectus muscles ranging from 20% for medial rectus to 9% for lateral rectus (P < 0.05). Conclusions DSC includes various combinations of sursumduction, excycloduction, and abduction not conforming to Hering’s law. We have found modest generalized enlargement of all rectus muscles. DSC is associated with generalized rectus extraocular muscle hypertrophy in the absence of other orbital abnormalities.

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