ABSTRACT
Objectives: to study the incidence and technique for repair of lacrimal canalicular laceration at the Royal Medical Services military hospitals in Jordan
Methods: a retrospective chart review of patients who underwent mono-canalicular or bicanalicular laceration microscopic repair with or without stenting consecutively between May 2003 and March 2014 at Royal Medical Services Military hospitals was conducted. Collected data included: age, gender, cause of injury, time between injury and surgical treatment, affected canaliculus, other adnexal injury, coexisting ocular injury, type of stent used, duration of stenting, anatomical and functional success after removal of stent
Results: forty- four patients were included in this study. The mean age was 18 .2 years [range 1.5- 63 year]. Males represented 88.6% of the patients and females 11.4% with a ratio of 7.8: 1. The lower canaliculus was injured in 68.2%, the upper canaliculus in 27 .7%, and both upper and lower in 4.5% of cases. Associated ocular injuries were seen in 29.5% of cases. The most common cause of injury was falling down with direct injury to the canaliculus, 47 .7%. Mini-Monoka stent was used in 75% and Mono-stent in 25% of cases. Premature stent extrusion was noticed in 18 .2% of cases. The stent was removed between 3 and 6 months in 81.8% of cases. All cases had patent lacrimal drainage system after removal of stent. Postoperative epiphora not subjectively annoying to the patient was found in 61.4% of cases. Duration of follow up after stent removal ranged between 3 and 12 months, mean 6.4 months
Conclusion: the study showed that Mono-canalicular stent for canalicular laceration is a suitable alternative to bi-canalicular stent. It is easy to perform, avoids risk of uninvolved canaliculus damage, avoids the nasal manipulation, and has no risk of punctal and canalicular cheese-wiring that lead to upper lacrimal drainage system slitting
ABSTRACT
To evaluate the effect of oral propranolol in the treatment of infantile peri-orbital and/ or orbital capillary hemangioma. We conducted a prospective study at Prince Rashid Bin Al Hassan military hospital between 5[th] of August 2012 and 29[th] of January 2013. Eleven patients with peri-orbital and/or orbital capillary hemangiomas were included in this study. All patients underwent complete ophthalmic examination. Capillary hemangiomas were assessed, reporting their size, location, extension, and effect on the surrounding structures. Follow up duration ranged from two to six months. The age of patients with peri-orbital and/ or orbital capillary hemangiomas ranged from three to 17 months with a mean of 7 +/- 4.92 months. Male: female ratio was 1: 1.75. The upper eyelid was involved in seven [64%] cases, all of them had ptosis, three [43%] had dystopia, one [14%] had imbrication, and one [14%] had squint. The lower eyelid was involved in two [18%] cases; one of them was associated with lower lip capillary hemangioma. Orbital involvement was seen in eight [73%] cases, six [75%] of them were associated with upper eyelid involvement and two [25%] with lower eyelid involvement. Concurrent extra-ocular localization of hemangiomas was present in five [45%] cases [one in lip, one in tongue, 2 in forehead, and one in cheek]. Duration of treatment ranged between one and 30 weeks with an average of 14.2 +/- 11.4 SD weeks. The dose of propranolol ranged between 1- 2 mg/kg with an average of 1.2 mg/kg and only one patient with upper eyelid and forehead extension needed 4 mg/kg. The color blanched in all patients after one week. The capillary hemangioma decreased in size after one week of treatment in two [18%] patients, and in all of them after one month. Complete regression of the hemangioma was seen in two [18%] cases one after two months and the other after 4 months of treatment. Five [45%] cases had astigmatism before the start of treatment [mean +/- SD, 0.9 +/- 0.379 D] diopters and improved to mean +/- SD, 0.56 +/- 0.586 D. Oral propranol can be used as a modality for therapy of infantile capillary hemangioma