Ewing's sarcoma as second malignant neoplasm after retinoblastoma: a case report

To report a case of a child with the hereditary form of unilateral retinoblastoma [RB], who developed Ewing's sarcoma of the right fibula 3 years after the enucleation of the right eye. The child was diagnosed as a case of RB of the right eye at the age of 9 months. He was fully investigated and found to have locally advanced RB with bone marrow involvement [Reese-Ellsworth stage IVA]. Enucleation was recommended to the family, but they refused. The patient received chemotherapy and diode laser thermotherapy in Kuwait and the UK. He had a local relapse after 11 months and subsequently underwent enucleation of the right eye. After 3 years, he was investigated for a small swelling in his right lower leg. After extensive investigations, it was reported as Ewing's sarcoma. He was treated with chemotherapy, surgery [complete excision of the fibula] and high-dose chemotherapy followed by autologous stem cell transplantation. The child is now nearly 2 years after completing the treatment and is disease free. This case confirms the increased risk of a second malignant neoplasm [SMN] in children with hereditary RB. These children need a very close follow-up for the early diagnosis of SMNs or even subsequent malignancies

Kuwait cataract outcome study: a 12-month evaluation

To assess the frequency of intraopertive difficulties, postoperative complications and the visual outcome in cataract surgery performed at the Al-Bahar Eye Center, Kuwait. This case series study is comprised of 350 eyes from 325 subjects [169 male, 156 female; 30-78 years, mean age 64 years] undergoing consecutive cataract surgery performed at the Al-Bahar Eye Center, Kuwait from July 2001 to June 2002. All the eyes underwent extensive ophthalmic examinations before and after surgery. Details of surgical procedures, including the type of the cataract surgery, intraoperative difficulties or complications, postoperative complications, and the visual outcome were documented. The extracapsular cataract extraction [ECCE] technique was used for 50.2% of the eyes and for the remaining 49.8%, the small-incision phacoemulsification technique was used. Of the 350 eyes operated upon, 9.7% had coexisting ocular disease which may have affected the best spectacle corrected visual acuity [BSCVA]. Complications included posterior capsule tears and vitreous loss [10%], cystoid macular edema [0.6%] and endophthalmitis [0.9%] of the eyes. A BSCVA of 6/12 or better was achieved in 78.3% of the cases. A high success rate in terms of visual acuity outcome was achieved in the cataract surgery. The operative and postoperative complications were similar for both techniques, ECCE and phacoemulsification