[Lacrimal drainage obstruction as an early presentation of lacrimal sac lymphoma]

To report a case of lacrimal sac lymphoma presenting with nasolacrimal obstruction. A 35-year-old women presented with epiphora and swelling of the left lacrimal sac area and cervical lymphadenopathy. She had undergone dacryocystorhinostomy [DCR] 6 months before. Computed tomography demonstrated a lacrimal sac mass involving the nasal cavity. Histopathologic examination revealed diffuse large cell lymphoma. According to immunohistologic staining, the tumor was B-cell type. The patient was treated with irradiation and chemotherapy. Lacrimal sac tumors may present with epiphora and dacryocystits masquerading as nasolacrimal canal obstruction

[Outcomes of keratoprosthesis at Labbafinejad medical center]

To evaluate the results of keratoprosthesis [KPS] at Labbafinejad Medical Center. In this case-series 29 eyes of 27 patients who underwent KPS between 1995-2002 were evaluated for results and complications. Patients included 22 male and five female subjects. Diagnoses included chemical burn [17 cases], Stevens-Johnson syndrome [three cases], ocular cicatricial pemphigoid [seven cases], corneal retransplantation [one case] and old corneal scar [one case]. Preoperative visual acuity was hand motion or light perception [no light perception, hand motion, or light perception in the fellow eyes],. Prostheses were Girard in 20 cases, tibiakeratoprosthesis in 3 cases, and Dohlman type 1, Dohlman type 2 and Pintucci, each in two cases. Postoperative visual acuity improved in 21 patients [72.4%] of which 66.7% experienced major complications including bacterial endophthalmitis [42.9%], retinal detachment [28.6%], uncontrolled glaucoma [21.4%], and spontaneous extrusion [7.1%]. Although KPS is hopeful in the short term with acceptable initial results, the long-term complication rate is high and the prognosis is poor. So it is better that KPS be preceded with safer procedures such as keratolimbal graft especially in young patients

[Prevalence of different types of ptosis at a referral hospital in Tehran, Iran]

To assess etiology, demography, surgical management and postoperative complications of ptosis in a referral ophthalmologic center. We reviewed records of 233 ptosis patients managed at Labbafinejad Hospital during 1998-2003. Etiology, age, sex, laterality, family history, amblyopia, past medical history, margin reflex distance and levator function, type of surgery, and postoperative complications were evaluated. The study included 117 female and 116 male subjects with mean age of 18.7 +/- 12.8 years. There was past ocular surgery in 85%, female history of ptosis in 3.4% amblyopia in 19.2% and strabismus in 6.9%. Ptosis was unilateral in 85% and bilateral in 15% and was congenital in 79%. The most prevalent type of ptosis is congenital therefore early ditection and referral of affected children is necessary to prevent amblyopi

[Amniotic membrane transplantation for congenital distichiasis]

To evaluate the use of amniotic membrane transplantation [AMT] for management of congenital distichiasis. This interventional case series was performed on 16 eyelids of 5 patients with congenital distichiasis treated with posterior lamella resection and AMT. All patients were men aged 2 to 42 years. Mean follow up was 17 months [6-29months]. Post-operative symptoms of dry eye were controlled by medical treatment in all patients. Misdirected eyelashes recurred in 3 eyelids [18.8%] outside the AMT area and in 2 eyelids within the AMT area which were treated by gentle laser epilation. AMT is a useful option in management of distichiasis with a low rate of complications and acceptable eyelid contour

[Comparing two methods of fascia lata use for frontalis suspension]

To compare the results of two different methods of frontalis suspension using fascia lata in congenital ptosis. In randomized clinical trial, double triangle sling was compared with single triangle sling using fascia lata. Eight patients with unilateral and 11 patients with bilateral congenital ptosis were randomly assigned for each procedure. There was no statistically significant difference between the two groups in terms of age and sex. Mean increase in interpalpebral fissure was 4.35 +/- 2.32 mm in the double triangle group and 4.36 +/- 1.89 mm in the single triangle group. Increase in palpebral fissure was statistically significant in both groups [P=0.00] but there was no difference between the two groups regarding functions during [lid fissure height] and cosmetic [lid margin contour] results and early or late complications during follow up. Single triangle sling method using fascia lata is safe, easy, and fast with acceptable results and can be used instead of conventional double triangle fascia lata sling for treatment of low function ptosis

Traumatic dislocation of the globe into the Maxillary Sinus

To report a case of enophthalmos secondary to complete globe dislocation into the maxillary sinus due to orbital fracture. An 18-year-old man was referred to Labafinejad hospital, one week after a car accident. At initial examination, the globe was not seen within the right orbit. A large floor fracture and globe luxation into the right maxillary sinus were confirmed on CT scan. Repair of fracture using Medpore implant and globe repositioning were performed. Visual acuity following' surgery was no light perception without improvement during follow-up. Visual impairment in this case was most probably due to traumatic optic neuropathy and delayed surgical intervention and medical therapy with systemic corticosteroid