Autoconjunctival grafting is regarded as the gold standard for preventing pterygium recurrence following excision. This study suggests that the experience of the surgeon can influence success rates and complications. There is a significant learning curve indicating the need to supervise trainee surgeons.
BackgroundTo describe the first reported case of toxic optic neuropathy secondary to docetaxel (Taxotere®) chemotherapy.Case presentationA 53-year-old female presented with predominantly unilateral visual loss, but extensive bilateral visual field defects and bilateral optic nerve head swelling 2 weeks after first dose of docetaxel (Taxotere®) and trastuzumab (Herceptin®) chemotherapy for a left sided node-positive, HER2 positive breast cancer. Extensive investigation ruled out other causes of optic neuropathy. She was treated with high dose corticosteroids intravenously for 1 week then a tapering oral dose over 8 weeks. Visual field defects gradually resolved and visual acuity improved. Docetaxel chemotherapy was discontinued but targeted therapy with trastuzumab continued without further complication.ConclusionDocetaxel can cause a toxic optic neuropathy possibly due to an ischemic or neurotoxic mechanism at the optic nerve head. With cessation of docetaxel therapy and treatment with systemic corticosteroids, visual recovery can occur without significant residual visual deficit.
Conjunctival mucoepidermoid carcinoma is a very rare but highly aggressive conjunctival neoplasm with 42 previously reported cases. We report the case of a 56-year-old male with a left ocular surface squamous neoplasm, which was subsequently treated with excision and autoconjunctival graft. Histopathology of the operative specimen reported a low-grade conjunctival mucoepidermoid carcinoma, and the patient was then treated with an adjunctive course of mitomycin C. On review 10 months after lesion excision, there was no recurrence, and the patient was otherwise well. Due to its rare incidence, difficult clinical diagnosis, and accompanying poor prognosis, conjunctival mucoepidermoid carcinoma should always be considered in the differential diagnosis of conjunctival neoplasms, and full histopathologic examination, including mucin-staining techniques, of all suspicious conjunctival biopsies should occur.
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