Surgical Outcome of Esotropia Considering the Functional Equator

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.

Surgical Outcome of Esotropia Considering the Functional Equator

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.

The Clinical Effect of Endonasal Dacryocystorhinostomy in the Treatment of Acute Dacryocystitis

PURPOSE: To evaluate the clinical effect of endonasal dacryocystorhinostomy as a primary treatment of acute dacryocystitis with lacrimal sac abscess formation. METHODS: The study comprised 14 patients with acute dacryocystitis and lacrimal sac abscess formation who underwent endonasal dacryocystorhinostomy as a primary treatment. Postoperative evaluations included symptoms of acute dacryocystitis, physical examination, and lacrimal irrigation. Success was defined as the absence of epiphora and good lacrimal irrigation at the last follow-up. RESULTS Of the patients, two were male and twelve were female. The mean age was 54.7 years and mean follow-up period was 8.3 months. Resolution of symptoms and signs of acute dacryocystitis occurred in all patients. In one patient, recurrence of acute dacryocystitis occurred 6 months after surgery. At last follow-up, epiphora and failure of lacrimal irrigation had developed in two patients. CONCLUSIONS: Endonasal dacryocystorhinostomy is considered a safe and effective primary treatment of acute dacryocystitis with lacrimal sac abscess formation.

A Case of Candida Infection after Porous Polyethylene (Medpor(R)) Orbital Implantation

PURPOSE: To report a case of candida infection after Medpor(R) orbital implantation. METHODS: A 51-year-old man was admitted complaining of painful swelling and discharge about 3 years after orbital Medpor(R) implantation. External examination revealed signs of infection and exposure of the implant. Medpor(R) was surgically removed. In laboratory studies, white colony was detected in blood agar, potato dextrose agar, and CHROMagar. Automatic identification with yeast standard test revealed Candida parapsilosis. RESULTS: Six months after surgery, the wound had healed well. In addition, cosmesis was acceptable with the artificial eye, except mild superior sulcus deformity. CONCLUSIONS: Although rare, fungal infection of the implant should be suspected when there are the long standing signs of infection and exposure after orbital Medpor(R) implantation.

Amniotic Membrane Transplantation and Use of Adjunctive Mitomycin C in the Treatment of Symblepharon

PURPOSE: To evaluate the effectiveness of amniotic membrane transplantation and adjunctive mitomycin C in the treatment of symblepharon. METHODS: Amniotic membrane transplantation was performed and adjunctive mitomycin C was applied in 7 patients with symblepharon, resulting from various causes. Mitomycin C soaking (0.02%, 5 minutes) was used intraoperatively followed by meticulous dissection of adherent tissue. Next, amniotic membrane transplantation was done with 2 layers of removed conjunctival tissue and a silicone band bolster was applied to the reconstructed fornix. Evaluating factors were the depth of reconstructed fornix, limitation of eyeball movement, recurrence and presence of complication. These factors were checked at the last visit. RESULTS: Mean follow-up period was 9.0 x +/-A 4.54 months and all patients showed reconstructed fornix. Six patients showed successful outcome (depth of fornix >or=8 mm) and one patient showed 6 mm of forniceal depth and mild limitation of gaze. CONCLUSIONS: Treatment of symblepharon by amniotic membrane transplantation and adjunctive mitomycin C administration can reduce the recurrence rate of symblepharon without complication.