Evisceration for Intractable Endogenous Endophthalmitis

PURPOSE: To evaluate the clinical aspects of severe endogenous endophthalmitis requiring evisceration,particularly underlying disease, causative microorganisms, and infection focus, and to assess the outcome of evisceration. METHODS: The records of 13 patients who were diagnosed with endogenous endophthalmitis requiring evisceration and treated at Yeungnam University Hospital from July 1994 to April 2007 were retrospectively reviewed. RESULTS: Of the 13 patients, all patients had diabetes mellitus, five had advanced liver disease, and one had aplastic anemia. Infection foci were pyelonephritis, pneumonia, and liver abscess. Five cases were confirmed with positive culture of lebsiella pneumoniae. Ten cases underwent evisceration with hydroxyapatite implantation, and three cases were treated conservatively because the patient was in poor systemic condition. Of the 10 patients who underwent evisceration, ocular implants were exposed in five cases. CONCLUSIONS: This study suggests that evisceration with primary orbital implant insertion for endogenous endophthalmitis involves the risk of implant exposure, but after secondary repair, all patients have stable clinical courses.

Non-Hodgkin's Lymphoma of the Orbit and Ocular Adnexa: Clinical Analysis of 22 Cases / 대한혈액학회지

BACKGROUND: Non-Hodgkin's lymphoma presenting in the eye is a rare disorder. The aim of this study was to evaluate the clinical features, treatment outcome and complications of patients with non-Hodgkin's lymphoma of the eye. METHODS: We designed retrospective, observational case study. The participants included 22 consecutive patients with non-Hodgkin's lymphoma of the orbit and ocular adnexa treated at the Yeungnam University Hospital between 1992 and 2001. RESULTS: There were 16 males (73%) and 6 females (27%). The median age at ocular presentation was 47. The most common presenting complaint was slowly growing mass at the eye. Histopathologic studies revealed extranodal marginal zone B-cell lymphoma, MALT type in 19 cases (86%), B-cell small lymphocytic lymphoma in one case, diffuse large B-cell lymphoma in one case, and lymphoplasmacytoid lymphoma/immunocytoma in one case. The stages of lymphomas were IA(E) in 17 cases (82%), IIA(E) in 2 cases (9%), IIIA(E) in 2 cases (9%). Radiotherapy alone was employed in 17 cases, chemoradiotherapy was done in 3 cases, chemotherapy alone was administered in one case. Nineteen out of 21 cases (90%) achieved a complete remission, and 5 year survival rate was approximately 90%. Subgroup analysis of the patients with lymphomas in stage IA(E) revealed that complete response rate was 100% and 5 year survival rate was 100% CONCLUSION: Radiotherapy alone can produce durable remission in the majority of the patients with localized extranodal marginal zone B-cell lymphoma, MALT type. However, combination chemotherapy or chemoradiotherapy should be considered in the patients with aggressive lymphomas or indolent lymphomas with systemic manifestation.