ABSTRACT
PURPOSE: To evaluate the efficacy of multiple combined procedure (Pentagon approach) as single-step secondary repair in cases of extensive keratolenticular trauma in paediatric age group. METHODS: Retrospective evaluation of 18 patients of penetrating injuries with sclerokeratolenticular trauma, who underwent multiple procedure as single-step secondary repair by a single team of two surgeons during a 4 year period. Surgical procedure included reconstruction of anterior segment, synechiolysis, excision of membrane, lensectomy, open sky vitrectomy, PC IOL implantation over frill and penetrating keratoplasty. Meticulous antiamblyopia measures were applied in all cases. RESULTS: Extensive vasoproliferative membrane, complicated cataract and anterior vitreous condensation were significant intra-operative hurdles. Moderate uveitis, secondary glaucoma, persistent epithelial defects were problems noted. Eleven (61.22%) patients attained good visual outcome. Regrafting was required in remaining cases due to delayed graft failure. CONCLUSION: Despite being a highly complex technique, Pentagon approach provides effective management profile in terms of graft success and functional outcome, especially in keratolenticular trauma, in children.
Subject(s)
Amblyopia/etiology , Anterior Chamber/injuries , Cataract/etiology , Cataract Extraction/methods , Child , Child, Preschool , Eye Injuries, Penetrating/complications , Humans , Keratoplasty, Penetrating/methods , Lens Implantation, Intraocular , Prognosis , Retrospective Studies , Visual Acuity , Vitrectomy/methodsABSTRACT
Fourteen cases of orbital rhabdomyosarcoma have been studied. Clinical presentation was by way of short history, fast growing proptosis, inflammatory signs and epistaxis. Computerised tomography showed only a mass lesion without bony involvement and was very useful in follow up. Ultrasonography revealed pseudo-encapsulation of the tumour which is postulated as possibly specific of Rhabdomyosarcoma due to its fast growth, cellular content and oedema fluid. A survival rate of 21% over a 3 year period has been achieved by combined mode therapy consisting of surgery, radiation and chemotherapy.