Endoscopic Intranasal Reconstruction of Medial Orbital Wall Fracture with Muco-periosteal Flap

Surgical method for blow out fracture of medial orbital wall is performed by medial canthotomy and subciliary incision or transconjunctival incision. However, these approaches can leave cosmetic problem due to skin incision and have a risk of infection and absorption of prosthetic implant for a large medial wall fracture. The authors performed endoscopic intranasal reconstruction of the isolated medial wall fracture in a case with significant functional impairment of extraocular muscle. After the incision of the middle turbinate, medial wall fracture was reconstructed with muco-periosteal flap under endoscopic control. We had a good result without intraoperative or postoperative complications caused by prosthetic implant. There was no disadvantage seen with the traditional approaches by medial canthotomy. Endoscopic intranasal reconstruction with muco-periosteal flap appears to be a new safe method for especially large defect.

Usefulness of Two-dimensioanl CT & Three-dimensional CT in Blow-out Fracture

The purpose of this study is to compare the diagnostic accuracy and usefulness of three-dimensional CT, two-dimensional CT in case of blow-out fracture. Two-dimensional CT, three-dimensional CT images of twenty-four blow-out fracture and soft tissue incarceration. Two dimensional CT was superior to three-dimensional CT in evaluating orbital bone fracture and soft tissue incarceration. But, three-dimensional CT was more useful to identify of orbital bone fracture than two-dimensional CT in associated facial bone fracture. Coexamination with two-dimensional axial & three-dimensonal CT was useful not only in the detection of fracture but in the evaluation of soft tissue incarcerated blow-out fracture.

Vitrectomy Combined with Lensectomy for Complications of Proliferative Diabetic Retinopathy

We retrospectively analyzed a consecutive series of 36 eyes that underwent vitrectomy for complications of proliferative diabetic retinopathy after classifying according to the preservationof their lenses to determine the postoperative incidence of neovascular glaucoma and final visual outcome. Eyes in which the lens was removed had better visual results than eyes in which the lens was not removed even though they were not statistically significant. There was statistically no difference in the postoperative incidence of neovascular glaucoma between both groups. But, eyes treated with preoperative panretinal photocoagulation had a statistcally significant increase in the incidence of postoperative glaucoma compared to eyes treated with operative one of add laser. This study showed that the eyes undergone vitrectomy combined with lensectomy as well as the eyes undergone only vitrectomy had improved visual outcomes.