A Case of Orbital Mucocele Lined With Two Types of Epithelial Cells After Orbital Wall Fracture Repair

PURPOSE: The authors report a case of orbital mucocele lined with two types of histological epithelial cells developed after repair of the orbital wall fractures. CASE SUMMARY: A 53-year-old man presented with proptosis of the left eye for two years. The patient had a history of left orbital inferomedial wall fracture repair ten years earlier at a different hospital. Examination revealed 4 mm proptosis and superior globe displacement of the left eye. Restriction of left ocular movements on elevation, depression and adduction were observed. A computed tomography scan demonstrated a large, non-enhancing, cystic tumor in the left inferior orbit with the inferior and medial wall displaced toward the paranasal sinus. An orbital cystic tumor was excised with the removal of previously-inserted orbital implant via a transconjunctival and transcaruncular approach. The inferior, and medial orbital walls were reconstructed using a MEDPOR(R) TITAN(TM) implant. The initial pathologic diagnosis was epidermal cyst. Histopathologic re-review revealed an orbital cyst lined with both stratified squamous epithelium and pseudostratified ciliated columnar epithelium, thus diagnosis was changed to orbital mucocele. Proptosis and restriction in ocular motility improved postoperatively. CONCLUSIONS: Mucocele formation should be considered in patients in whom a cyst developed after orbital fracture repair.

Corneal Endothelial Cell Change with Different Phacoemulsification Time in Diabetic Patients

PURPOSE: To investigate the difference in corneal endothelial cell loss between diabetic and non-diabetic patients who were divided by the degree of phacoemulsification time after phacoemulsification with intraocular lens implantation. METHODS: Forty eyes of 30 patients with diabetes and 47 eyes of 36 patients without diabetes were divided by phacoemulsification time into 3 groups: less than 40 seconds, from 40 to 80 seconds and over 80 seconds. The corneal endothelial cell density was compared before and 1, 4 and 16 weeks after phacoemulsification by one-way ANOVA. Bivariate correlation analysis was used to identify the correlation between phacoemulsification time and the endothelial density before and 1, 4 and 16 weeks after phcoemulsification. RESULTS: The endothelial cell densities in diabetic and non-diabetic patients with different phacoemulsification time were not significantly different when compared before and 1, 4 and 16 weeks after phacoemulsification (P>0.05). Phacoemulsificaiton time and endothelial cell loss at 1, 4 and 16 weeks also showed no significant correlation. CONCLUSIONS: Diabetes and differences in phacoemulsification time had no significant influence on corneal endothelial cell loss. This result suggests uncomplicated phacoemulsificaion is a safe method for cataract extraction in patients with or without diabetes.

Analysis of Aqueous Humor Calcium and Phosphate from Cataract Eyes with and without Diabetes Mellitus

PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.

Analysis of Aqueous Humor Calcium and Phosphate from Cataract Eyes with and without Diabetes Mellitus

PURPOSE: To compare the levels of calcium and phosphorus in the aqueous humor and serum of diabetics and non-diabetics. METHODS: We divided patients into two groups: seventy-six non-diabetic cataract patients and fifty-two diabetic cataract patients. The diabetic group was divided again into three subgroups: twenty-six patients with no diabetic retinopathy, thirteen patients with non-proliferative diabetic retinopathy, and thirteen patients with proliferative diabetic retinopathy. The authors compared the levels of calcium and phosphorus in the serum and aqueous humor of cataract patients. Statistic analysis was performed to form two comparisons: 1) a comparison between non-diabetics and diabetics and 2) a comparison among non-diabetics and the three subgroups of diabetics. RESULTS: In serum, calcium levels did not statistically differ between non-diabetics and diabetics. The phosphorus level was also not significantly different. In the aqueous humor, however, while calcium levels did not differ significantly, the phosphorus levels in diabetics were considerably higher than those in non-diabetics. When non-diabetics were compared to the three diabetic subgroups, calcium levels did not differ in serum or aqueous humor, but the phosphorus levels in diabetics with proliferative diabetic retinopathy were significantly higher than those in non-diabetics, diabetics without diabetic retinopathy, and diabetics with non-proliferative diabetic retinopathy. CONCLUSIONS: The level of phosphorus in the aqueous humor and serum of diabetics was significantly increased, especially in diabetics with proliferative diabetic retinopathy. This result may be related to hydrophilic acrylic IOL opacification. Future studies regarding the pathogenic role of a high concentration of aqueous humor and serum phosphorus are required.