ABSTRACT
PURPOSE: To compare the influence of seven currently available spherical orbital implant wraps on host fibrovascularization of a hydroxyapatite (HA) orbital implant. METHODS: Five groups of 3 (15 total) adult male New Zealand albino rabbits underwent enucleation with placement of a 12-mm HA implant wrapped in high-porosity expanded polytetrafluoroethylene (e-PTFE), processed bovine pericardium, or processed human pericardium, sclera, or fascia lata. Magnetic resonance imaging before and after the intravenous administration of gadolinium-diethylenetriamine pentaacetic acid (DTPA, 0.1 mol/kg) was performed immediately before exenteration. Five rabbits (one with each of the different implant wraps) were killed at 4, 8, and 12 weeks, and the operated socket was exenterated. Histopathologic sections of the implants were then compared with the results of our previous study using polyglactin 910 mesh and autologous sclera as HA orbital implant wraps. RESULTS: Complete fibrovascularization of all the implants occurred by 12 weeks; however, HA implants wrapped with sclera, polyglactin mesh, and e-PTFE appeared to undergo more rapid fibrovascularization than spheres wrapped with other materials. CONCLUSIONS: Although all of the implant wraps studied may be suitable substitutes for donor sclera, we prefer polyglactin mesh because it is readily available, inexpensive, and without risk of transmissible diseases.
Subject(s)
Coated Materials, Biocompatible , Durapatite , Neovascularization, Physiologic/physiology , Orbital Implants , Animals , Fascia Lata/blood supply , Fascia Lata/transplantation , Magnetic Resonance Imaging , Male , Pericardium/transplantation , Polytetrafluoroethylene , Prosthesis Design , Rabbits , Sclera/blood supply , Sclera/transplantationSubject(s)
Corneal Diseases/etiology , Epithelium, Corneal/diagnostic imaging , Epithelium, Corneal/pathology , Keratoplasty, Penetrating/adverse effects , Aged , Cell Division , Corneal Diseases/diagnostic imaging , Corneal Diseases/surgery , Cryotherapy , Diagnosis, Differential , Epithelium, Corneal/surgery , Female , Humans , Laser Therapy , Reoperation , Ultrasonography , VitrectomySubject(s)
Abscess/microbiology , Durapatite , Eye Infections, Bacterial/microbiology , Orbital Implants/microbiology , Prosthesis-Related Infections/microbiology , Staphylococcal Infections/microbiology , Abscess/diagnosis , Abscess/drug therapy , Adult , Anti-Bacterial Agents , Choroid Neoplasms/surgery , Drug Therapy, Combination/therapeutic use , Eye Enucleation , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Melanoma/surgery , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/drug therapy , Reoperation , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/isolation & purificationABSTRACT
PURPOSE: To report a case of chronic, progressive unilateral blepharoptosis in a 73-year-old woman with Waldenström's macroglobulinemia. METHOD: Case report. A biopsy was performed on a thickened and indurated tarsal plate that we believed had resulted in mechanical blepharoptosis. RESULTS: Histologic and immunohistochemistry studies of the biopsy specimen demonstrated a lymphoplasmacytoid cell infiltrate with monoclonal antibodies consistent with Waldenström's macroglobulinemia. CONCLUSION: Involvement of the tarsal conjunctiva and tarsus in Waldenstrom's macroglobulinemia is a newly recognized cause of eyelid thickening and ptosis.
Subject(s)
Blepharoptosis/etiology , Waldenstrom Macroglobulinemia/complications , Aged , Blepharoptosis/pathology , Blepharoptosis/physiopathology , Chronic Disease , Disease Progression , Eyelids/pathology , Eyelids/physiopathology , Female , Humans , Waldenstrom Macroglobulinemia/diagnosisABSTRACT
After frostbite injury, the phases of rewarming and progressive injury may cause intense pain for the patient. Although parenteral narcotic agents are the usual method of pain relief, they have well-described adverse effects such as heavy sedation, respiratory depression, and nausea and vomiting. In frostbite injury of the lower extremities, epidural blockade has the potential to provide good pain relief with fewer of those complications. However, the associated sympathetic blockade is believed by many clinicians to be of no benefit and by some to be potentially harmful. Epidural narcotics have the selective advantage of providing analgesia without sympathetic blockade. In this case report, the use of continuous epidural morphine during the first 24 hours after severe bilateral frostbite injury to the feet is described. The technique provided effective pain control, and no complications occurred. To our knowledge, use of continuous epidural morphine after frostbite injury has not been reported previously. Further use of this technique will be required to clarify its efficacy.
