Clinical Course of Spontaneous Regression of Bilateral Retinoblastoma

PURPOSE: To report four cases of spontaneous regression of retinoblastoma. METHODS: The clinical courses of two patients were retrospectively investigated: a patient who has been diagnosed with bilateral retinoblastoma and has survived more than six years after his parents refused treatment and a patient with bilateral retinal lesions who has survived nine years whose sister was treated for unilateral retinoblastoma. RESULTS: A nine-year-old girl, diagnosed with bilateral retinoblastoma when she was three months old, remained well for nine years after her parents refused to seek treatment. The right eye had three retinal masses that had regressed, and the left eye showed signs of phthisis and was enucleated for a cosmetic purpose. Microscopic examination of the left eye showed a mass, which consisted mostly of fibroblasts and ground substance and a few retinoblasts without mitotic figures. A six-year-old boy with a family history of retinoblastoma presented with regressed retinal masses in both of his eyes at the first funduscopic examination. The retinal lesions showed no change until his ninth year. CONCLUSIONS: Two cases of spontaneous regression of bilateral retinoblastoma were observed. No distant metastasis was detected during long-term follow-up. The retinal lesions were similar to regressed masses after treatment.

Frontalis Sling Operation by Fixation of Preserved Fascia Lata to Tarsus in Congenital Blepharoptosis Patients

PURPOSE: To evaluate the efficacy of tarsal fixation of fascia in frontalis sling surgery using preserved fascia lata in congenital ptosis patients. METHODS: The authors retrospectively investigated the surgical results of congenital ptosis patients who underwent frontalis sling procedure using preserved fascia lata with or without tarsal fixation. Thirty-nine patients were included in the group with tarsal fixation of fascia and 43 in the group without tarsal fixation. The average age at operation was 59.3 months in the tarsal fixation group, and 64.7 months in the group without tarsal fixation. We compared the recurrence rates between the two groups using the survival analysis. RESULTS: Recurrence occurred in 13 patients of the tarsal fixation group (33.3%) and in 20 of the group without tarsal fixation (46.5%). The two groups' median survival times from operation to recurrence were 28.4 months and 26.1 months, respectively (p=0.64). CONCLUSIONS: Tarsal fixation of fascia did not have a significant influence on recurrence rates in congenital ptosis patients who underwent a frontalis sling operation using preserved fascia lata.

Frontalis Sling Operation Using Silicone Rod in Congenital Blepharoptosis Patients

PURPOSE: To evaluate the results of frontalis sling operation using silicone rod in congenital ptosis patients. METHODS: The authors retrospectively investigated the surgical results of congenital ptosis patients who underwent frontalis sling operation using silicone rod and were followed up for at least 12 months postoperatively. We compared their results with those of congenital ptosis patients who underwent frontalis sling operation using preserved fascia lata. RESULTS: Twenty nine patients were included in the silicone rod group and 81 in the preserved fascia lata group. The average age at operation was 70.5 months in the silicone rod group, and 62.2 months in the preserved fascia lata group. At 12-month follow-up, good lid height was achieved in 9 patients (31.0%), fair in 17 (58.6%), and poor in 3 (10.4%) among the 29 patients of the silicone rod group. Of the 81 patients with preserved fascia lata, 22 (27.2%) were good, 44 (54.3%) were fair, and 15 (18.5%) were poor at postoperative 12 months. Chronic exposure keratopathy occurred postoperatively in one patient of the preserved fascia lata group and early recurrence due to spontaneous break of silicone rod developed in one patient of the silicone rod group. CONCLUSIONS: At 12-month follow-up, frontalis sling operation using silicone rod showed equal or better results compared with the operation using preserved fascia lata. However, longer follow-up is required to confirm the long-term results of frontalis sling operation using silicone rod.