PurposeA case study and literature review of alveolar rhabdomyosarcoma (RMS) in an adult.MethodsA 48-year-old male patient presented at our clinic complaining of proptosis that had persisted for 2 weeks in his left eye. A computed tomography (CT) scan revealed a destructive soft-tissue mass in the left ethmoid sinus with invasion of the left orbit and compression of the medial rectus muscle. Endoscopic intranasal biopsy revealed alveolar RMS. Conservative debulking and orbital wall decompression were performed.ResultsImmunohistochemical testing was positive for desmin, S-100, and smooth muscle actin (SMA), supporting the diagnosis of RMS. Since ipsilateral cervical and spinal metastasis was detected, systemic treatment was administered simultaneously.ConclusionsAlthough rarely found in adults, RMS should be considered in the differential diagnosis of orbital tumors. Immunohistochemical analysis plays an important role in the definitive diagnosis of RMS.
Purpose: To compare the effect of volumes used in sub- Tenon’s anesthesia on efficacy and intraocular pressure (IOP) in vitreoretinal surgery. Methods: A prospective clinical trial was conducted on patients undergoing sub-Tenon’s anesthesia for vitreoretinal surgery. Patients were randomized to receive either 3-, 5- or 7-ml volumes of anesthetic solution. IOP were measured immediately prior to injection, immediately after injection and at 2, 5 and 10 min after injection. Pain scores were assigned using a numerical visual analogue scale immediately after surgery, and again on postoperative day 1. Results: A total of 108 patients (119 eyes) were studied, including 35 eyes in the 3-ml group, 48 eyes in the 5-ml group, and 36 eyes in the 7-ml group. There were significant elevations in mean IOP following injection in all groups, and a trend for larger rises in IOP with larger volumes of anesthesia (p < 0.01). Mean IOP were elevated after injection, and reduced at all time intervals. However, the reduction in the 3-ml group took levels to preinjection amounts. There were no significant differences in patient-reported pain scores among the groups when assessed immediately after surgery or on postoperative day 1. The incidence of chemosis and high IOP elevations (≥40 mm Hg) were more frequent in the 7-ml group (p < 0.05). Conclusions: Sub-Tenon’s anesthesia is effective in vitreoretinal surgery. It would appear that a 3–5-ml volume of anesthetic is safe, when considering the associated complications.
Eyelid splitting coupled with follicular extirpation via cautery with a monopolar needle, a procedure which requires no sutures, constitutes a simple and effective method for the treatment of both trichiasis and distichiasis and is associated with favorable functional and cosmetic results.
A 33-year-old woman visited our clinic with blurry vision and periorbital swelling after experiencing blunt trauma to left eye. Ten months earlier, she had implantable contact lens (ICL) implantation in the left eye. Biomicroscopic examination showed that that 1 footplate of the ICL was entrapped in the pupillary aperture at the 7 o'clock position and the ICL was placed vertically. The patient had limited ocular movement in lateral gaze, and the computed tomography showed a medial orbital wall fracture. Pupillary capture of the ICL was surgically corrected with an iris manipulator under topical anesthesia. After the ICL was repositioned, the patient's uncorrected visual acuity was restored to 20/32, as before the injury. Pupillary capture of the ICL may occur after blunt ocular trauma.
PurposeTo evaluate the efficacy and safety of angle-supported phakic anterior chamber intraocular lenses in amblyopic adult eyes with very high myopia.MethodsWe evaluated 12 eyes in nine patients with very high myopic amblyopia who received angle-supported phakic intraocular lenses (Phakic 6H®) and followed them for more than six months. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and complications were evaluated. A satisfaction score was rated by patients using a 5-point (1~5) numeric scale.ResultsThe mean age of patients was 37.3±9.4 years, ranging from 29 to 59 years old. The preoperative mean refraction (spherical equivalent, SE) was -20.10±5.41 diopters (D). The postoperative mean refraction (SE) was -1.75±0.76 D at six months. The postoperative BCVA improved an average 3.92±1.24 lines over preoperative values, and mean endothelial cell loss was 8.9% at six months. Development of cataracts, glaucoma, and pupil abnormalities were not demonstrated in any case during the study. The patients were all very satisfied, as the average satisfaction score was 4.3.ConclusionsThis study indicates that angle-supported phakic anterior chamber intraocular lens implantation may be an effective surgical alternative for the correction of amblyopic adult eyes with very high myopia. However, long-term evaluation is necessary to assess possible complications and long-term safety.
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