A case of traumatic eyeball extrusion with complex, comminuted fractures

PURPOSE: Traumatic extrusion of the eyeball is rare. We experienced and successfully reconstructed a case of the eyeball extrusion with complete avulsion of the optic nerve, and complex, comminuted fractures of medial and inferior orbital walls. METHODS: A 27-year-old man presented with the ocular pain and eyeball extrusion of the right eye after the trauma. There were multiple lacerations of the eyelid and the conjunctiva of the right eye, the complete avulsion of the optic nerve and the avulsion of extraocular muscles except the lateral rectus muscle, and the eyeball extrusion of the right eye. We performed the enucleation with Medpor(R) sphere implantation and the reconstruction of the inferior and medial walls with Medpor(R) one channel and sheet implant. RESULTS: At one-year follow-up, there were no implant exposure and infection, and good cosmetic result was seen without enophthalmos. CONCLUSIONS: In a case of eyeball extrusion with complex, comminuted fractures after trauma, we could reconstruct these successfully with enucleation with Medpor(R) sphere implantation, and repair of fractures with Medpor(R) channel and sheet implant.

A Case of Acute Lymphoblastic Leukemia with Orbital Relapse

PURPOSE: Acute lympholastic leukemia is common in children but, rare in adults. Authors experienced a case of acute lympholastic leukemia with orbital relapse in adult, and we report this case with literature review. METHODS: A fifty-year-old woman complained of left eye pain and proptosis for 7 days. The superio-lateral subconjunctival mass excision and biopsy were performed and evisceration was done. The pathologic findings showed the lymphoblastic leukemia. Immunohistochemistry showed the original precursor T-lineage acute lymphoblastic leukemia. RESULTS: The mass was enlarged 40 days after surgery with pain, and subsided after radiation therapy. We recommended systemic chemotherapy, but she refused the therapy. She died 6months after surgery with systemic relapse.

Long-term Results of Laser in Situ Keratomileusis for High Myopia Above-15D

PURPOSE: We have evaluated the results of laser in situ keratomileuresis (LASIK) for high myopia above -15D over the follow-up periods of three years. METHODS: Twenty-two eyes from 15 LASIK patients were analyzed (10 eyes from 6 males and 12 eyes from 9 females). The average age was 30+/-6.7 years (20~42 years). The follow-up evaluations were performed at 6 months, 1 year and 3 years. RESULTS: The preoperative spherical equivalent ranged from -15.00D to -37.00D (average: -20.38+/-5.06D) and the mean postoperative spherical equivalents -2.07+/-3.43D at 6 months, -3.01+/-2.88D at 1 year, -3.05+/-2.86D at 3 years. Myopic regression continued during three-year follow-up, but, was not statistically significant (p>0.05). The incidence of increased BCVA 2 lines or more was 64% at 3 years and the case of decreased BCVA 2 lines or more was not found. The mean preoperative astigmatism was -2.93+/-2.11D and the mean postoperative astigmatisms were -0.81+/-0.81D at 6 months, -1.06+/-1.07D at 1 year and -1.16+/-1.44D at 3 years. It was significantly decreased (p<0.05). The intraoperative complications were not found. The postoperative complications after 3 years were myopic regression in 8 eyes, night glare in 8 eyes, decentration in 7 eyes and the foreign bodies in the border of the flap in 1 eye and there was no corneal haze. CONCLUSIONS: LASIK for high myopia above -15D is relatively safe. Howerver it needs further longterm evaluation.