The Clinical Effect of Micro-Multiporous Expanded Polytetrafluoroethylene Insertion for Recurrent Pterygium

PURPOSE: To investigate the clinical effect of micro-multiporous e-PTFE insertion for severe recurrent pterygium with symblepharon. METHODS: The present study included a total of 13 cases of recurrent pterygium associated with symblepharon, motility restriction and diplopia which had undergone micro-multiporous e-PTFE insertion after pterygium excision, 0.02% mitomycin C application, human amniotic membrane transplantation (AMT) and/or conjunctivo-limbal autograft (CLAU) between September 2010 and February 2011. One month after surgery, the inserted e-PTFE was removed. Recurrence of pterygium and symblepharon, motility restriction, diplopia and injection of ocular surface were evaluated for 11.92 +/- 1.32 months of mean follow-up period. RESULTS: Pterygial recurrence was not observed in 12 out of 13 eyes, and the 1 eye which recurred showed conjunctival recurrence. No postoperative symblepharon recurrence was observed in any of the 13 eyes. Diplopia and motility restriction disappeared in 11 out of 13 eyes, and were improved in the other 2 eyes. VAS (Visual Analogue Scale) injection scores in the wound site decreased after surgery in all patients. CONCLUSIONS: Micro-multiporous e-PTFE insertion combined with mitomycin C application, AMT and CLAU can be a useful surgical method to lower the postoperative recurrence rate and to improve the pterygium-related symptoms in severe recurrent pterygium.

Prognosis and Clinical Features of Orbital Wall Fracture in Preschool Children

PURPOSE: To evaluate the clinical aspects associated with the preoperative and postoperative state of blow-out fractures in preschool children. METHODS: The authors of the present study retrospectively reviewed 11 cases of blow-out fracture repaired by orbital reconstruction. RESULTS: The most common cause of fracture was a traffic accident (45%); there were 7 cases (63%) of inferior wall fracture and 7 cases (63%) of trapdoor-type fracture. All patients with trapdoor-type fractures had nausea and vomiting. After the operation, the majority of patients (88%) had mild ocular motility restriction and diplopia. CONCLUSIONS: In preschool children, systemic symptoms such as nausea and vomiting presented frequently. In addition, complications such as restriction in ocular movement and diplopia often developed postoperatively.

Degree of enophthalmos according to the extent of orbital wall fracture and volume of herniated orbital tissue

INTRODUCTION: The enlargement and deformation of the orbit give rise to a visible enophthalmos. As a consequence, a disturbance of eye motility together with double images is likely to occur. This study examined the degree of enophthalmos according to the extent of orbital wall fracture and volume of herniated orbital tissue in blowout fractures of the medial and inferior orbital wall. MATERIALS AND METHODS: This study was performed on patients diagnosed with medial and inferior orbital wall fractures at the Department of Oral and maxillofacial surgery, Chonbuk National University Hospital from 2007 to 2009. The patients' age, gender, etiology of fracture and degree of enophthalmos were investigated. The changes in the degree of enophthalomos, diplopia and ocular motility restriction after operation were examined. RESULTS: The degree of enophthalomos increased with increasing extent of orbital wall fracture and volume of herniated orbital tissue. CONCLUSION: Whether to perform the operation is decided after measuring the extent of the orbital wall fracture and volume of herniated orbital tissue using computed tomography (CT), time for the decision of operation can be shortened. This can cause a decrease in the complications of orbital wall fractures.

Relationship between Preoperative Clinical Features and Postoperative Recovery of Ocular Motility Restriction in Blow-out Fractures

PURPOSE: Diplopia and ocular motility restriction after blow-out fracture repair may often be permanent. We attempted to analyze various factors associated with preoperative and postoperative ocular motility restriction after blow-out fracture. METHODS: We assessed retrospectively the recovery of ocular movement in 60 eyes of 60 patients with blow-out fractures, which were repaired by orbital reconstruction from April 1997 to October 1999. We analyzed the relationship between patient age, fracture size, severity of ocular motility restriction before and after surgery, and CT evidence of muscle entrapment. RESULTS: Fracture size was smaller in the patients aged 18 years or younger than those 19 years or older, and ocular motility restriction before surgery was greater in the patients with small-sized fractures. Postoperatively, ocular motility restriction was remained more frequently in the patients with severe ocular motility restriction before surgery. CONCLUSIONS: In pediatric patients who have severe motility restriction, CT evidence of small-sized fracture and some tissue entrapment, immediate surgical repair would be helpful for recovery of extraocular movement.