ABSTRACT
· AIM:To analyze the clinical effect of different surgical approaches for orbital tumors.· METHODS:A total of 52 patients (56 eyes) with orbital tumors who were admitted to the hospital from January 2012 to June 2017 were examined by brain MRI and orbital sectional CT scan to identify the relationship between tumors and surrounding anatomical structures.They were treated by orbitotomy,and the approaches included anterior conjunctival approach,lateral approach and combined medial and lateral approach.The removal of tumors,recovery of visual acuity,postoperative early complications and follow-up recurrence were statistically analyzed.· RESULTS:Among the 52 patients,there were 7 cases 8 eyes (14％) with residual tumors.The rate of residual tumors after anterior conjunctival orbitotomy (23％) was higher than that after lateral orbitotomy or combined medial and lateral orbitotomy (6％,7％;P＜ 0.05).The visual acuity was improved in 28 cases 30 eyes (54％),no change in 18 cases 19 eyes (34％) and decreased in 6 cases 7 eyes (13％).The incidence of early complications was 23％,including 2 cases 2 eyes with accidental loss of vision,2 cases 2 eyes with pupil changes,3 cases 3 eyes with ptosis and 5 cases 6 eyes with eye movement disorders,which mainly occurred in the elderly.The recovery of visual acuity and the incidence rates of complications (23％,19％,29％) of the three kinds of surgical approaches were close (P＞ 0.05).During the follow-up period,there were 3 cases 3 eyes (5％) with recurrence in the 52 patients,and the recurrence rate after combined medial and lateral orbitotomy (14％) was significantly higher than that after anterior conjunctival or lateral orbitotomy (4％,0;P＜0.05).· CONCLUSION:The appropriate surgical approach can successfully remove the orbital tumors,improve or stabilize the visual function,and reduce complications and recurrence.
ABSTRACT
AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.