Bilateral Visual Loss after Lower Lid Blepharoplasty

Blindness following blepharoplasty is a rare but disastrous complication. We present a patient who was referred to us following blepharoplasty by an unauthorized erson, including orbital fat removal in lower lids with subsequent onset of permanent bilateral visual loss. Clinical and radiographic evidence suggested orbital hemorrhage was the cause of visual loss in both eyes. In particular, electrophysiologic tests indicated that optic nerve dysfunction was responsible for loss of vision.Visual acuity in both eyes has not improved following bilateral orbital decompression. Blindness following blepharoplasty can be avoided with prompt decompression in one or two hours after inappro- priate blood supply to optic nerve. Cautious hemostasis during operation and timely orbital decompression is the cornerstone to prevent this catastrophic complication.

Results of Endoscopic Dacryo cystorhinostomy

The success rate of endoscopic dacryocystorhinostomy in epiphopa patients was evaluated. We anaylzed 57 patients, 62 cases from February 1997 to March 1998. Mean follow-up period was 7.17 months. There were 51 cases(82.3%) of female Causes of the disease were idiopathic(52 cases), trauma(3 cases) and congenital(3 cases). Primary success rate was 67.8% while total success rate was 80.6%. We used mitomycin C in 20 cases. Primary success rate in mitomycin C used group was 70.6% while total success rate was 95.0%. The success rate in mitomycin C used group was higher than that without mitomycin C. Endoscopic darcryocystorhinostomy has advantages such as less scar and short postoperarive recovery time but low success rate limits its use. However the success rate in endoscopic dacryocystorhinostomy is incresasing due to surgical improvement and instrument development.

Comparison of Transconjunctival Releasable Sutures and Transcorneal Releasable Sutures in Trabeculectomy

Releasable suture was used to control anterior chamber depth and intraocular pressure during early postoperative period following trabeculectomy. Failure of releasable suture removal was due to entrapping of the tissue into suture knot or fibrosis between suture and surrounding tissues. Hence, the authors compared the failure rate of transconjunctival releasable suture and transcorneal releasable suture in trabeculectomy. The authors evaulated the 60 eyes of 60 patients undergoing trabeculectomy. Of these eyes, 30 eyes did not use Mitomycin C and transconjuctival releasable suture(15eyes) and transcorneal releasable suture(15eyes) at 2weeks after trabeculectomy, and the other 30 eyes used Mitomycin C and were removed transconjuctival releasable suture(15eyes) and transcorneal releasable suture(15eyes) removed at 4 weeks after trabeculectomy. With Mitomycin C, failure rate of releasable suture removal was 87% in transconjunctival releasable suture and 33% in transcorneal releasable suture. Without Mitomycin C, failure rate of releasable suture removal was 73% in transconjunctival releasable suture and 7% in transcorneal releasable suture. Recently, we have commonly used thin suture material such as 10-0 nylon and with use of antimetabolite let releasable suture was removed at late time. We suggest that transcorneal releasable suture can reduce the fibrosis of subconjunctival tissue and reaction between suture material and subconjunctival tissue.

Malignant Change of Pleomorphic Adenoma

A 54-year-old man had complained of proptosis on his right eye. Computed tomography showedlarge mass on superotemporal portion of right orbit. Surgical removal was done through the lateral orbitotomy. The histopathological diagnosis demonstrated pleomophic adenoma. Seven Years later, the patient revisited complaing of proptosis on his right eye. Magnetic resonance image demonstrated ill defined mass on the same iste. We excised mass including psuedocapsule and surrounding tissue.