Recovery of orbital fat pad prolapsus and deepening of the lid sulcus from topical bimatoprost therapy: 2 case reports and review of the literature.

OBJECTIVES: To report 2 cases of resolution of orbital fat pad prolapsus and deepening of the lid sulcus caused by topical bimatoprost therapy, and to review the literature. METHODS: This was a retrospective, observational chart review. RESULTS: A 54-year-old man with normotensive glaucoma presented with recovery of left lower lid orbital fat pad prolapsus, deepening of the lid sulcus, and iris color and eyelash changes 8 months after initiation of bimatoprost therapy in his left eye (OS). After stopping bimatoprost, his eyelashes and the lower lid orbital fat pad partially regained their natural appearance at 2 months and 4 months, respectively. However, there was no improvement of the left upper eyelid deepening and the iris hyperpigmentation, even after 30 months. A 75-year-old man with unilateral pseudoexfoliative glaucoma had been treated with bimatoprost OS. Three months after initiation of the therapy, his examination showed recovery of the inferior and superomedial orbital fat pad prolapsus, a deep and prominent upper lid sulcus with eyelash changes, and iris hyperpigmentation OS. Five months after discontinuation of bimatoprost, the eyelashes and superomedial orbital fat pad improved. Twenty-four months later, the inferior orbital fat pad partially got its natural appearance back, but the upper lid sulcus was slightly more deep and prominent than the fellow right eye. There was no alteration in iris hyperpigmentation. CONCLUSION: Clinicians and patients should be aware of these possible effects of topical bimatoprost therapy. These adverse effects may not be completely reversible after discontinuation of the medication.

Does long-term talc exposure have a carcinogenic effect on the female genital system of rats? An experimental pilot study.

OBJECTIVE: In several studies, the prolonged exposure to talc has been associated with development of ovarian cancer. However, some studies have advocated contrary views. The present study aims to investigate histopathological changes and whether long-term talc exposure is associated with potential carcinogenic effects on the female genital organs of rats. MATERIALS AND METHODS: The present study was conducted at Dumlupinar University Medical Faculty and a total of 28 Sprague-Dawley rats were included. The experimental animals were allocated into four groups having seven rats each. Groups 1 and 2 served as controls, where the rats in Group 1 did not receive any intervention and Group 2 received intravaginal saline. Groups 3 and 4 received intravaginal or perineal talc application, respectively. Talc was applied for 3 months on a daily basis. Histopathological changes in the peritoneum and female genital system were evaluated. For statistical analyses, Fisher's exact test was carried out using SPSS. FINDINGS: In both the groups exposed to talc (Groups 3 and 4), evidence of foreign body reaction and infection, along with an increase in inflammatory cells, were found in all the genital tissues. Genital infection was observed in 12 rats in the study group and 2 rats in the control group. Neoplastic change was not found. However, there was an increase in the number of follicles in animals exposed to talc. No peritoneal change was observed. In the groups not exposed to talc, similar infectious findings were found, but there was a statistically significant difference between the groups (Groups 1 and 2 vs. Groups 3 and 4, P > 0.05). Neoplastic change was also not observed in these groups. Four groups were compared in terms of neoplastic effects and infections. In Groups 1, 5 rats were normal, two developed vulvovaginitis and endometritis with overinfection (in both ovaries), and one developed salpingitis (in both fallopian tubes), that is, infection was found in a total of two rats. In Group 2, only one experimental animal had endometritis. All the animals in Groups 3 and 4 developed infections. CONCLUSIONS: Talc has unfavorable effects on the female genital system. However, this effect is in the form of foreign body reaction and infection, rather than being neoplastic.