ABSTRACT
PURPOSE: To evaluate in vitro adherence of Staphylococcus epidermidis to silicone punctal plugs and collagen implants. SETTING: Loyola University Medical Center, Maywood, Illinois, USA. METHODS: Silicone punctal plugs and collagen implants were exposed to S epidermidis (3 x 10(8) colony forming units/mL) for 0, 5, 30, and 60 minutes, rinsed in sterile saline, and processed for light, scanning (SEM), and transmission (TEM) electron microscopy. Scanning electron microscopy (x2000) was used to quantify bacteria/mm2 adhering to the devices. RESULTS: The mean S epidermidis/mm2 +/- (SD) adhering to each device were as follows: baseline, silicone punctal plug, 1593 +/- 899, and collagen implant, 7168 +/- 2895 (P =.000, paired Student t test); 5 minutes, silicone punctal plug, 3833 +/- 537, and collagen implant, 6571 +/- 2240 (P =.008); 30 minutes, silicone punctal plug, 13 988 +/- 9076, and collagen implant, 10 404 +/- 1731 (P =.2616); and 60 minutes, silicone punctal plug, 12 644 +/- 10 402, and collagen implant, 11 748 +/- 2685 (P =.8056). CONCLUSIONS: Staphylococcus epidermidis adhered significantly more to collagen implants than to silicone punctal plugs at 0 and 5 minutes. No significant difference in bacterial adherence was seen at 30 and 60 minutes. For both devices, bacterial adherence increased with increasing exposure.
Subject(s)
Bacterial Adhesion , Collagen , Prostheses and Implants/microbiology , Silicone Elastomers , Staphylococcus epidermidis/growth & development , Biocompatible Materials , Colony Count, Microbial , Humans , In Vitro Techniques , Lacrimal Apparatus/surgery , Microscopy, Electron, Scanning , Staphylococcus epidermidis/ultrastructureABSTRACT
PURPOSE: To describe a case of orbital Wegener granulomatosis without systemic disease. METHOD: Case report. RESULTS: A 69-year-old patient with bilateral inflammatory lacrimal gland masses underwent multiple biopsies that showed a nonspecific lymphoplasmacytic infiltrate consistent with orbital pseudotumor. After unsuccessful treatment with systemic corticosteroids and radiation, severe orbital disease rapidly progressed and the patient underwent unilateral enucleation. The enucleated specimen showed multifocal vasculitis, tissue necrosis, and granulomas consistent with Wegener granulomatosis (WG). Elevated antineutrophil cytoplasmic antibody titers supported the diagnosis of WG. The patient did not have any extraocular signs of WG and continues to be disease-free systemically. CONCLUSION: The authors believe this is the first report of bilateral lacrimal gland masses presenting as a localized form of WG in the total absence of systemic disease.
