Enucleation in a patient with neurofibromatosis type 1 with buphthalmos and ocular deformity

In infants with neurofibromatosis type 1, plexiform neurofibroma with altering anterior segment outflow system may result in raised intraocular pressure. Here we report a case of buphthalmos with neurofibromatosis [NF-1] who suffered with blindness suffered enucleation. Physical examination and histopathology were performed. Physical examination revealed Buphthalmos and vascularized cornea with lower lid ectropion and orbital deformity. Histopathologic findings showed plexiform neurofibroma in orbital tissue with scleral wall involvement. And hamartomatous proliferation in choroid and cilliary bodies with melanocytic elements. Few NF-1 cases with buphthalmos have been reported. But cases with complicationg buphthalmos [retinal detachment and optic nerve atrophy] suffering enucleation are very rare

[Congenital nasolacrimal duct obstruction and its risk factors in premature neonates]

To determine the frequency of congenital nasolacrimal duct obstruction [CNLDO] in premature newborns and its correlation with gestational age [GA], sex, family history and chronological age. This study was performed on infants who were referred for retinopathy of prematurity from 2002 to 2003. Cases of CNLDO were visited again three and six months later. This study was conducted on 60 preterm infants [26 male, 34 female] with gestational age of 33.2 +/- 1.3 weeks [range 25-36] and age of 3.8 +/- 0.9 months [range 1.5-6] at first presentation, of which 13 had CNLDO [9 unilateral and 4 bilateral]. Overall, 17 out of 120 ducts [14.1%] were obstructed. There was no correlation between CNLDO and sex, family history or gestational age. Three months later 58.4% of the obstructions were cleared and at the 6 month visit, 25% of residual obstructions were cleared, such that the total remission rate at 6 months was 83.4%. In premature newborns with CNLDO, the rate of spontaneous clearing of the obstruction is greater than 80% during the first 6 months

Mersilene Mesh versus Sclera as a wrapping material for orbital implant

To evaluate exposure rate following wrapping hydroxyapatite implant in mersilene mesh and donor sclera. In a prospective comparative interventional case-series 60 consecutive patients underwent primary hydroxyapatite orbital implant wrapped in mersilene mesh or donor sclera. Thirty patients [21 male and 10 female] underwent implantation with mersilene mesh and 30 patients [20 males and 10 females] with donor sclera. Average age at the time of surgery was 36.4 years [range, 10-77] in the mersilene mesh group and 28_5 years [range, 8-85] in the sclera group. The most frequent cause of enucleation in both groups was trauma [53.3% in mersilene mesh and%56.6 in sclera' group, respectively]. After 10.4 months [range, 6-18] follow up there was no exposure in the mersilene mesh group; however after 9.4 months [range, 6-15] follow up in the sclera group one exposure was observed. There was no significant diference in exposure rate between the two groups. Mersilene mesh should be considered as an alternative for donor sclera. It is readily available and avoids risk of disease transmission