The Comparison of Surgical Outcomes in the Inferior Rhegmatogenous Retinal Detachment With Medium Severity

PURPOSE: To compare the surgical results between scleral buckling (SB) and pars plana vitrectomy (PPV) for patients with inferior rhegmatogenous retinal detachment (RRD) of medium severity. METHODS: Two different types of surgery was performed on patients with inferior RRD of medium severity and divided into group 1 (PPV) and group 2 (SB). The preoperative clinical features, anatomical success rate, and changes of visual acuity (VA) were retrospectively evaluated. RESULTS: Preoperative phakic status in group 2 was statistically significantly high, as compared to the group 1 (p=0.02), but other preoperative clinical features were not different between the 2 groups. The primary surgical success rates were 88% and 92% in group 1 and 2, respectively. The final success rate was 100% in both groups. No statistically significant correlation between surgical method and recurrence was found. The preoperative logMAR VA was 0.96 in group 1 and 0.71 in group 2 and improved postoperatively to 0.42 and 0.40, respectively; these were statistically significant changes. However, the final VA between the 2 groups showed no statistically significant difference. CONCLUSIONS: No statistically significant differences of primary and final success rate between SB and PPV groups were found for inferior RRD associated with medium severity. However, preoperative phakic status could influence the selection of the surgical method for RRD.

Acute Comitant Esotropia in a Child With a Cerebellar Tumor

We report a case of acute comitant esotropia in a child with a cerebellar tumor. A 3-year-old boy was referred for management of a 9 month history of acute acquired comitant esotropia. On first presentation, the patient's angle of esodeviation was 50 prism-diopters (PD) at distance and near fixation without any lateral incomitance. The cycloplegic refraction revealed +0.75 diopters in both eyes. Very mild bilateral papilledema was found on the fundus examination, but the neurological examination did not reveal any other pathological findings. Brain MRI showed a 5 cm mass located in the midline of the cerebellum as well as hydrocephalus. The mass was completely excised and histological examination confirmed the diagnosis of pilocytic astrocytoma. Despite neurosurgery, the patient's strabismus remained unresolved. One year after neurosurgery, both medial rectus muscles were surgically recessed by 6 mm, resulting in esotropia of 8PD at distant and near fixation without restoration of bifoveal fusion at follow-up 2 years after the eye muscle surgery. Therefore, acute onset comitant esotropia in a child can be the first sign of a cerebellar tumor, even without any other neurological signs and symptoms.

Hydatid Cyst of the Orbit

PURPOSE: Most hydatid cysts affecting humans grow in the liver and the lung, but orbital involvement is very rare. To our knowledge, this is the first report of a hydatid cyst of the orbit in Korea. METHODS: A 33-year-old woman came to the hospital with a 2-month history of slowly progressive proptosis and ocular pain of the right eye. The right eye showed proptosis, visual impairment and mild limitation of abduction. Orbital CT and MRI revealed a 32X20X24-mm well-defined unilocular cyst in the retrobulbar, intraconal area of the right orbit. RESULTS: The cyst was surgically removed with lateral orbitotomy and it ruptured just prior to the end of the operation. Complete aspiration of the cystic fluid and in situ irrigation with gentamicin-normal saline mixture were performed. Histopathological examination revealed a hydatid cyst. After surgery, the visual acuity and primary position of the right eye were recovered, but its abduction was mildly limited.