[Reconstruction of anophthalmic socket by adipocyte grafting using the Coleman technique, after extrusion of an orbital implant: a case study]. / Comblement d'une cavité orbitaire éviscérée par greffe d'adipocytes selon la technique de Coleman, après expulsion d'implant.

INTRODUCTION: Since the end of the 19th century, autologous fat grafting has often been used in plastic surgery. The first use was described in 1893 by Neurer and consisted in transferring a piece of fat tissue for facial reconstruction. Since then, this technique has evolved somewhat thanks to Coleman, who developed lipostructure. This technique is used in plastic surgery in the filling of orbital cul-de-sacs and unsightly scars. We report a clinical case where this technique was used to fill an anophthalmic socket after extrusion of an orbital implant. OBSERVATION: A 52-year-old man had evisceration of the right eye for ocular phthisis bulbi after injury to the eye. Two weeks later, he presented an expulsion of the hydroxyapatite eyeball with significant secretions. The bacteriological samples showed Staphylococcus aureus and Streptococcus anginous infection. Despite local and general antibiotic treatment and anti-inflammatory drugs, the secretions persisted. The implant material was initially ablated. Twenty days later, adipocyte was grafted in the residual scleral stump using the Coleman technique. Follow-up showed no complications; the adipocyte grafting made it possible to restore orbital volume so that the prosthesis could be adapted. After 6 months, secondary atrophy is moderate and a good esthetic result was obtained. DISCUSSION: The Coleman technique consists in taking adipocytes in abdominal or buttocks fat with nontraumatic liposuction. This is purified after centrifugation, then reinjected into the scars or the orbital cul-de-sacs to be filled. In general, these indications relate to small volumes. In our case, the procedure involved an anophthalmic socket with residual septated scleral tissue. This can explain the good esthetic result obtained. Indeed, the fat atrophy after surgery is more significant when there is no supporting tissue. CONCLUSION: This technique seems simpler and avoids an unsightly scar on the harvest site (contrary to the traditional dermis-fat graft). On the other hand, it is more expensive and requires a minimum of training.

[New treatment for orbital non-Hodgkin's lymphoma: 2 cases treated with rituximab]. / Nouvelle approche thérapeutique du lymphome malin non hodgkinien orbitaire. A propos de deux cas traités par rituximab.

INTRODUCTION: Orbital non-Hodgkin's lymphoma is a rare tumor whose diagnosis is often difficult. Treatment of latent lymphoma have been changing because of progress in immunotherapy. OBSERVATION: We report two patients treated with rituximab (antibody anti-CD20). Two women, 50 and 59 years old, presented low-grade, IE-stage lymphoma. One was conjunctival MALToma, the other was orbitopalpebral, type A, of WFC classification, follicular, with small cells. Immunohistochemistry showed a diffused marking for Ac anti-CD20. Both patients received intravenous rituximab as a first treatment in December 2000, 375 mg/m2, four injections per week. We did not note any major undesirable effects. Both have been in complete remission for 4 years. These patients continue to be followed up. DISCUSSION: Rituximab's efficacy has been proved mainly in follicular LMNH or in recurrent forms. The recurrence may be more frequent in MALT lymphoma. This medical treatment has low hematologic toxicity. CONCLUSION: Rituximab offers an alternative for low-grade lymphoma treatment that is well tolerated by the patient.