A Case of Squamous Cell Carcinoma Originating from the Lacrimal Sac

PURPOSE: The tumor of lacrimal sac is very rare. We report an experience of a 63-year-old female who had a squamous cell carcinoma of the lacrimal sac and discuss its diagnosis and overall management. METHODS: A 63-year-old woman came to our clinic with a 2-month history of a growing mass in the region of the left medial canthus, left eye tearing. Examination revealed left epiphora and swelling on the left medial canthus and the left lacrimal sac, which was firm. Lacrimal irrigation indicated an obstruction. A computed tomographic scan demonstrated a well enhancing soft tissue mass in medial aspect of left orbit and no evidence of invasion of rectus muscles and adjacent bony destruction. The mass was excised by dacryocystectomy and subsequently, required 200 cGy a day, 5 times a week, 6000 cGy of radiotherapy for 6 weeks. RESULTS: The patient was finally diagnosed with keratinizing, squamous cell carcinoma that was proven by histopathologic finding. There was no evidence of recurrence of the tumor in lacrimal sac throughout 24 months of follow-up period.

The Effect of the Changes in Central Corneal Thickness and Curvature on Measurement of Intraocular Pressure after LASIK

The measurement of intraocular pressure (IOP) is influenced by the parameters of corneal thickness, corneal curvature, and corneal astigmatism. LASIK changes these parameters and may influence measurements of IOP. IOPs of 62 eyes were analysed before LASIK and 6 months after LASIK and the correlation coefficient between IOP and corneal thickness & corneal curvature was determined. Preoperative and postoperative IOP after 6months follow-up was 13.03 +/- 3.26 mmHg, 9.26 +/-1.69 mmHg respectively. Postoperative IOP was significantly decreased as compared to preoperative one. There was a tendency that showed the low IOP was related to the decrease of corneal thickness & corneal curvature. Each correlation coefficient was r=0.563, r=0.646 respectively but the coefficient`s influence was not determinable. The decrease of corneal thickness and curvature showed a constant relation to the lowered IOP, therefore it should be taken in account in the patient evaluation.

Diagnosis and Therapy of Canaliculitis

Canaliculitis is an uncommon condition. It is often difficult to diagnose because of its chronicity and its multitude of clinical presentations. We reviewed the nature, the diagnosis and therapy of six patients of chronic lacrimal canaliculitis. Bacteriologic investigation showed one case of E. coli, one case of alpha-hemolytic streptococcus, two of coagulase-negative staphylococcus and no growth to be seen in two cases. On dacryocystography, canalicular diverticulum were found in three cases. Five patients were treated with conservation therapy and one case improved with surgical treatment. Canaliculitis can be diagnosed by clinical features and dacryocystography. Conservative therapy should take priority to surgical treatment.

Surgical Correction of Lower Lid Retraction Using The Scleral Spacer

Lower lid retraction can be caused by many etiologies but few require surgical intervention except for cosmetic reasons and exposure deratitis due to lagophthalmos. We report three lower lid retraction patients who underwent lower lid reconstruction was due to congenital etiology or was secondary to excessive inferior rectus muscle recession or lower lid blepharoplasty due to orbital neurofibroma. All three patients found their results satisfactory and showed no severe side effects during the follow-up period. It is suggested that the use of scleral spacer combined with lateral canthoplasty be an effective surgical procedure for correction of lower lid retraction.