ABSTRACT
This is a clinco-histopathological study of different varieties of conjunctival cysts where modification of surgical technique was done as per requirement for intact removal of cysts to minimise recurrence rate. Retrospective study of 40 cases of conjunctival cysts. A thorough ocular examination and basic haematological work up was done for all patients. B-scan USG and MRI was done wherever required to see the posterior extent. All patients underwent surgical excision of cyst followed by histo-pathological examination. The various types of conjunctival cysts found in our study were primary inclusion cyst 12 [30%], secondary inclusion cyst 6 [15%], pterygium with cysts 15 [37.5%], parasitic cyst 4 [10%], lymphatic cyst 2 [5%], and orbital cyst with rudimentary eye 1 [2.5%]. The common symptoms noted were progressive increase in size of cyst [39.45%], cosmetic disfigurement [26.23%], foreign body sensations [27.86%], proptosis [1.6%], ocular motility restrictions [3.2%] and decreased visual acuity [1.6%]. The patients were followed till one year after surgical excision for any recurrence and complications and no recurrence was seen. Careful and intact removal of conjunctival cyst is important to prevent recurrence. Minor modifications in surgical technique according to the size, site and nature of cyst help in intact removal and prevent recurrence
Subject(s)
Humans , Male , Female , Conjunctival Diseases/pathology , Conjunctiva , RecurrenceABSTRACT
A case of surgically induced necrotizing scleritis [SINS] after manual small incision cataract surgery that was associated with peripheral ulcerative keratitis [PUK] at a different site. Neither pathology responded to systemic steroids and progressed to become sight threatening, which is unusual. Progression of SINS was aggressive enough to cause a limbal wound gape, similarly PUK extended up to Descemet's membrane and emergency amniotic membrane transplantation [AMT] was required to save the globe. AMT may regress the scleral and corneal melting successfully. It is not common to observe SINS with PUK at a different site that is unresponsive to systemic steroids. AMT, though palliative treatment, was effective at treating this condition successfully
ABSTRACT
Ocular surface disorders [OSD] are challenging to treat. They can introduce serious morbidity and might even lead to visual loss. In such situations, keratoplasty remains the last option. Amniotic membrane transplantation [AMT] has been shown to be effective in the management of ocular surface pathologies. The aim of the study was to assess the efficacy of AMT for various indications of OSD. Experience of AMT in 65 patients with different OSD was evaluated. The aim of AMT was to achieve symptomatic relief, reduced inflammation, stromal healing and visual acuity; and delay keratoplasty. Fresh amniotic membrane was used in all cases by a single surgeon. Follow-up and observations were done to evaluate success of achieving the goal. Indications for AMT included primary and recurrent pterygium, various types of corneal ulcers [non-healing ulcer, descemetocele, corneal thinning and perforation], sphroidal degenerations, chemical burn and bullous keratopathy. The aim of AMT was different etiology indications. Postoperative follow-up was between 6 and 18 months. Success and complication rate were observed. Symptomatic relief [reduce pain and redness] was seen in patients with various corneal ulcers, chemical burn and bullous keratopathy. Improved epithelialization and stromal healing was noted in corneal ulcer cases. In spheroidal degenerations, keratectomy with AMT improved vision. Recurrence of pterygium was low [4.61%]; graft failure in the form of graft rejection was seen in only 3.07% cases of acute keratitis. Corneal vascularization [4.61%] was present but not severe enough to hamper vision. Success in gaining intended effect was the most significant result with AMT. AMT in various ocular surface pathologies shows success in achieving the goal of symptomatic relief, improved epithelialization, stromal healing and vision. Reduction in inflammation, corneal haze and recurrence of original disease is achieved with minimum complications