Sensation Loss of Auricle Following Ear Surgery by Post-auricular Incision: Our Experience.

Post-auricular incisions used for ear surgeries have their distinct advantages and disadvantages. Numbness in post-auricular region or over pinna is a symptom encountered in many patients following surgery via post-auricular incision. We performed this study to investigate this phenomenon of aural numbness in terms of frequency and severity. Design: Prospective study. Setting: This study was conducted in our hospital from 1st December 2015 to 30th November 2016 for a period of 1 year. The period of analysis was 1 month. Subjects: All patients undergoing surgery via post-auricular incision were included in the study. Methods: All the subjects were subjected to touch and pain sensory testing and also symptoms were recorded with the help of visual analog scale. The mean subjective Visual analog scale (VAS) value had significantly reduced after the surgery and it gradually improved over a period of about 6 months when it became near normal. Sensory testing revealed loss of touch and pain sensation in about 67% of patients following the surgery. The sensation recovered over a variable period of time, with about 95% of patients having normal touch and pain sensation 6 months after the surgery. Majority of patients treated with postaural incision develop sensory loss which is likely to recover in 3-6 months. Till that time patients should be counselled properly and appropriate measures should be taken to avoid any complications of sensory loss.

Idiopathic lymphoplasmacellular mucositis-dermatitis of the eyelid.

Idiopathic lymphoplasmacellular mucositis-dermatitis is a rare mucosal or cutaneous disorder characterized clinically by papules or plaques with variable erosion and microscopically by dense dermal inflammatory cell infiltrates with numerous plasma cells. It has been described in the oral and upper aerodigestive tracts, male and female genitalia, and other mucosal surfaces. In this article, the authors describe a case of idiopathic lymphoplasmacellular mucositis-dermatitis occurring in the skin of the eyelid that was removed by excisional biopsy and has not recurred in the 19-month follow-up period.

The use of vascular endothelial growth factor inhibitor for choroidal neovascularization complicating posterior uveitis in eyes with fluocinolone acetonide implants.

PURPOSE: To present a series of eyes with multifocal choroiditis and panuveitis (MFC) treated with fluocinolone acetonide intravitreal implants. All eyes developed recurrent choroidal neovascularization (CNV) and were treated with intravitreal bevacizumab or ranibizumab. METHODS: Retrospective chart review. Data collected included demographics, details of previous immunosuppressive therapy, preinjection Snellen visual acuity, and central macular thickness measured by optical coherence tomography, total injections administered, and postinjection central macular thickness and visual acuity. Patients were followed up for a minimum of 25 months from the first fluocinolone acetonide implant. Duration from implantation to first injection and complications, including development of cataracts, glaucoma, and recurrent inflammation, were followed. PATIENTS: Three patients treated for MFC at the Casey Eye Institute, a tertiary care referral center at Oregon Health & Science University, from 2005-2008 were studied. All three received fluocinolone acetonide implants and later underwent intravitreal anti-vascular endothelial growth factor (VEGF) therapy for CNV. RESULTS: Preinjection visual acuity in 3 patients was 1.2, 0.54, and 0.48 logarithm of minimal angle of resolution (mean 0.74). Postinjection visual acuity in 3 patients was 1.0, 0.40, and 0.0 logarithm of minimal angle of resolution (mean 0.47). Preinjection central macular thicknesses were 855 µm, 215 µm, and 276 µm (mean 449 µm). Postinjection central macular thicknesses were 220 µm, 190 µm, and 223 µm (mean 211 µm). Anti-VEGF injections did not reactivate inflammation. Advancing cataracts contributed to worsening visual acuity postinjection. The total number of anti-VEGF injections until resolution of intraretinal and subretinal fluid associated with CNV was 6 injections for case 1, 1 for case 2, and 8 for case 3 (mean 5, range 1-8). CONCLUSION: Intravitreal anti-VEGF therapy was successful in treating recurrent CNV in MFC patients with well-controlled inflammation after insertion of fluocinolone acetonide implants. Anti-VEGF therapy should be considered in treating active CNV in eyes with MFC and quiescent inflammatory disease.

The use of a vascular endothelial growth factor inhibitor (ranibizumab) in macular edema due to eales disease.

PURPOSE: To report the results of intravitreal use of ranibizumab in a patient with macular edema due to Eales disease. METHOD: This was an open-label, Phase 1, 6-month study of the safety and efficacy of intravitreally administered ranibizumab in patients with macular edema due to Eales disease. A single patient was eligible for the study during the 2 years of recruitment. She received 3 monthly intravitreal injections of 0.5 mg of ranibizumab for 3 months. At each of her monthly visits during the 6-month study, she was evaluated with a full ocular examination and optical coherence tomography imaging of the macula. Primary outcome measure was change in optical coherence tomography central subfield thickness at 6 months. RESULTS: The central macular thickness as measured on optical coherence tomography reduced from 269 µm at baseline to 186 µm at 3 months. This reduction was transient with subsequent increase to 262 µm at the conclusion of the study at 6 months. CONCLUSION: Ranibizumab use led to transient resolution of macular edema at 3 months; however, this reduction in edema was not sustained.