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The authors conducted a retrospective study on 120 consecutive cases of nasolacrimal duct obstructions (NLDO) in 85 children, operated on by a single surgeon (BF) from January 1988 to July 1992. Mean age at the time of surgery was 5.4 years (1 to 11 years). Seventyseven bicanaliculo-nasal intubations (BCNI) and 43 monocanaliculo-nasal intubations (MCNI) were performed. MCNI were performed using the Fayet-Bernard 'MonoKa' tubing material (FCI, Paris, France). This device permits monocanalicular intubation with meatic fixation by a punctum-plug-like extremity. Among MCNI, 39 were placed into the superior canaliculus. Nine MCNI were indicated because of a true monocanalicular agenesis (inferior canaliculus agenesis in five cases and superior canaliculus agenesis in four cases).Mean follow-up was ten months. Average duration of intubation was seven months for BCNI and 5.1 months for MCNI. BCNI and MCNI resulted in complete resolution of the epiphora in 62.2 and 67.6% of cases respectively.Intermittent tearing was observed post-operatively in 30.1% of BCNI and 23.5% of MCNI. Permanent tearing was present in 7.5% of BCNI and 8.8% of MCNI.Complications associated with BCNI were observed in 20.7% of cases and occurred an average of 96 days post-operatively. These complications included the loss of tubing (I .3Vo), stricturotomies (2.6V0), and non-reducible exteriorization of tubing (16.8%).Complications associated with MCNI were noted an average of 109 days post-operatively in 25.5% of cases. These complications included two cases (4.7%) of pyogenic granuloma, of which one was associated with the loss of the tubing. One case (2.3%) of superficial corneal erosion, eight cases (18.6%) of exteriorization resulting in loss of tubing and one case of intracanalicular migration of the tubing were also observed with MCNI. Functional results obtained with BCNI and MCNI for NLDO are comparable. However, complications associated with MCNI may be anatomically less damaging given the absence of stricturotomy.

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The surgical treatment of pathological myopia involves the placement of a band cut from donor sclera around the back of the globe to provide support and to prevent elongation that leads to retinal detachment and blindness. In the search for a synthetic material that would overcome the disadvantages of the donor tissue band, we tested 11 types of bands made from 14 polymers in rabbit eyes. Bands were cut from porous and solid materials, as well as porous materials coated with solids and solid materials with porous patches affixed to the posterior surface. Criteria for suitability and biocompatibility included ease of placement and suturing, stable positioning, and absence of long-term tissue response on a cellular level. Testing included evaluation by the surgeons performing the implantations, measurement of the distance between the band and the globe, determination of fibrous capsule thickness and amount of collagen deposition, and enumeration of macrophages accumulated at the band/capsule interface. Based on the results of these studies, two of the porous materials (expanded polytetrafluoroethylene and porous polyurethane fabric) and two of the composite materials (porous polyurethane fabric coated with polyacrylonitrile and silicone with microvilli cut into the posterior surface) were selected for further study.

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We present the results of the first evaluation of human placenta extracted basic fibroblast growth factor (bFGF) in a rabbit corneal epithelium wound-healing model. Healing dose-response experiments after selective epithelial wounding with iodine vapors demonstrated that bFGF accelerated the repair process in a saturable manner. Corneal binding of topically applied 125I-labeled bFGF was investigated using radioassay and autoradiographic techniques. Basic FGF was shown to bind specifically to denuded epithelial basement membrane in a very stable fashion and not to the intact epithelium. No transfer of the topical bFGF to the aqueous humor or any intraocular structure could be observed. The stability of this interaction was further demonstrated by reextracting and characterizing the labeled factor from treated corneas. The specificity of the fixation was documented by in vivo topical competition with unlabeled bFGF or heparin. We propose that bFGF-basement membrane interactions play a role in corneal wound healing.