ABSTRACT
PURPOSE: During the surgical correction of dysthyroid diplopia, the risk of ischemia by transection of the anterior ciliary arteries is well-known. In order to avoid this, we modified the classical surgical technique: (1) through the preservation of the vascular pedicles during muscle recession and (2) if necessary, through a plication (instead of a resection) of the ipsilateral antagonist muscle. The objective to be achieved is thus the resolution of the diplopia without ischemic complications. SUBJECTS AND METHODS: We report a prospective series of 10 patients with dysthyroid ophthalmopathy, causing strabismic diplopia, all operated on by the same surgeon (BR) after at least 12 months of euthyroidism. Data collection included: history of previous decompressive surgery, surgical procedure, and oculomotor status before and after surgery. RESULTS: Ten patients (8 females), aged 51 to 74 years (mean age, 58.00 ± 7.62 years), were collected between 2008 and 2012. All patients had one or more vascular risk factors (diabetes, smoking, obesity, high blood pressure). With a follow-up from 16 to 67 months (mean ± SD 27.7 months ± 14.87), surgical outcomes were excellent: diplopia was cured in all cases, with recovery of stereoscopic vision. We had no operative or postoperative complications. CONCLUSIONS: The technique of preservation of the anterior ciliary vascularization, which is particularly justified for these fragile patients, is compatible with moderate muscle recessions. For larger deviations, in which a larger recession might increase the proptosis, it is possible to add a plication of the ipsilateral antagonist. This surgical technique made possible the suppression of the diplopia in all cases.
Subject(s)
Ciliary Arteries/surgery , Diplopia/surgery , Graves Ophthalmopathy/surgery , Organ Sparing Treatments/methods , Aged , Diplopia/etiology , Female , Graves Ophthalmopathy/complications , Humans , Ischemia/prevention & control , Male , Middle Aged , Postoperative Complications/prevention & control , Retrospective StudiesABSTRACT
We report two personal cases of intra ocular cysticercosis typical by their sub retinal and intra vitreous localization. After a short review of epidemiology and biological diagnostic we propose a treatment which associates a medical part with Praziquantel, killing the larva and a surgical part with pars plana vitrectomy allowing the control of the inflammation, contemporary of the larva's death and the intra-vitreous cysticercosis extraction.
Subject(s)
Cysticercosis/diagnosis , Eye Infections, Parasitic/diagnosis , Adult , Cysticercosis/epidemiology , Cysticercosis/surgery , Eye Infections, Parasitic/epidemiology , Eye Infections, Parasitic/surgery , Female , Humans , MaleABSTRACT
We describe two patients with unusual neuro-ophthalmologic complications during long-term therapy with lithium carbonate given for bipolar affective disorder, "benign" intracranial hypertension in one, and downbeat nystagmus, with oscillopsia in the other. A review of the literature is proposed. Though rare, such neuro-ophthalmologic manifestations are worth being recognised since they usually disappear with cessation--when possible--of lithium therapy.
Subject(s)
Lithium/adverse effects , Nystagmus, Pathologic/chemically induced , Pseudotumor Cerebri/chemically induced , Adult , Female , Humans , Lithium Carbonate , Middle Aged , Papilledema/chemically induced , Time FactorsABSTRACT
135 patients with chronic uveitis were observed and 23 had therapeutic problems by their severity. The corticoid treatment method, always used in a first time, is studied. When there is corticoresistance, corticodependance or absolute contra-indications, the immunosuppressive drugs are used with reduced doses to avoid an AIDS. The corticoid bolus, the plasma exchange and colchicine are adjuvant treatments. Cyclosporin A brings large hopes but its use is now limited by necessity and serious side effects. Serious uveitis does not answer to a unique therapeutic protocol. The treatment must be adaptable and surgery decided in time.