ABSTRACT
PURPOSE: To report the location of the inferior oblique muscle after enucleation without primary attachment of the muscle to the orbital implant and after evisceration. METHODS: Interventional case series. Retrospectively, eight orbital magnetic resonance imaging (MRI) studies were analyzed, four after enucleation and four after evisceration, to assess the position of the inferior oblique muscle relative to the orbital implant and the point of insertion. RESULTS: In the enucleation patients, the inferior oblique muscle was anteriorly displaced and the muscle appeared to insert into an inferior subconjunctival scar mass in three of the four patients. In all four of the evisceration patients, the inferior oblique muscle appeared normally positioned and inserted onto the implant in the normal location. CONCLUSION: Enucleation without suturing of the inferior oblique muscle to the implant is associated with healing in an abnormal anterior location and into an inferior subconjunctival scar mass. Evisceration does not appear to disrupt the normal position or insertion of the inferior oblique muscle.
Subject(s)
Eye Enucleation , Eye Evisceration , Oculomotor Muscles/anatomy & histology , Humans , Magnetic Resonance Imaging , Orbital Implants , Retrospective Studies , Suture Techniques , Wound HealingABSTRACT
PURPOSE: To compare pain on injection and the efficacy of anesthesia of three modified lidocaine solutions for use in eyelid surgery: 1) 2% lidocaine with 1:100,000 epinephrine, 2) 2% lidocaine with 1:100,000 epinephrine buffered 9:1 with 8.4% sodium bicarbonate, and 3) 2% lidocaine with 1:100,000 epinephrine diluted 1:9 with 0.9% bacteriostatic saline solution (with benzyl alcohol). METHODS: In this prospective, randomized, double-masked, controlled clinical trial, 30 consecutive patients undergoing bilateral identical eyelid surgery were randomized to one of three treatment groups. Group 1 received buffered solution on one side and stock solution on the other, group 2 received bacteriostatic saline diluted solution on one side and stock solution on the other, and group 3 received buffered solution on one side and bacteriostatic saline diluted solution on the other. Patients used a 5-point scale to rate the perceived pain on injection and the pain felt during the operative procedure. RESULTS: Comparison of mean injection pain scores showed that buffered solution was significantly less painful than unmodified solution (2.2 versus 3.1, p < 0.05), bacteriostatic saline modified solution was significantly less painful than unmodified solution (0.9 versus 3.3, p < 0.05), bacteriostatic saline modified solution was significantly less painful than buffered solution (1.2 versus 2.3, p < 0.05). Comparison of mean intraoperative pain scores demonstrated no significant difference between the solutions in any of the treatment groups. CONCLUSIONS: For local anesthesia in eyelid surgery, bacteriostatic saline modified solution provides more comfort on injection than either buffered or unmodified lidocaine-epinephrine solution and provides an adequate level of anesthesia that does not differ significantly from either the buffered or unmodified solutions.
Subject(s)
Anesthesia, Local/methods , Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Benzyl Alcohol/administration & dosage , Epinephrine/administration & dosage , Lidocaine/administration & dosage , Sodium Bicarbonate/administration & dosage , Vasoconstrictor Agents/administration & dosage , Double-Blind Method , Eyelid Diseases/surgery , Eyelids , Humans , Injections , Pain Measurement , Prospective Studies , Treatment OutcomeSubject(s)
Fibrinolytic Agents/adverse effects , Myocardial Infarction/drug therapy , Postoperative Hemorrhage/chemically induced , Retrobulbar Hemorrhage/chemically induced , Thrombolytic Therapy/adverse effects , Tissue Plasminogen Activator/adverse effects , Aged , Blepharoplasty , Blepharoptosis/complications , Blepharoptosis/surgery , Drug Therapy, Combination , Female , Follow-Up Studies , Heparin/adverse effects , Humans , Myocardial Infarction/complications , Postoperative Hemorrhage/surgery , Retrobulbar Hemorrhage/surgery , Suction , Visual AcuitySubject(s)
Eye Infections, Parasitic/surgery , Laser Therapy , Nematode Infections/surgery , Optic Neuritis/surgery , Retinitis/surgery , Acute Disease , Aged , Aged, 80 and over , Canada/epidemiology , Child , Eye Infections, Parasitic/epidemiology , Eye Infections, Parasitic/pathology , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Nematode Infections/epidemiology , Nematode Infections/pathology , Optic Neuritis/epidemiology , Optic Neuritis/parasitology , Retinitis/epidemiology , Retinitis/parasitology , SyndromeABSTRACT
Oxygen-free radicals may injure the epithelium of corneas in storage awaiting transplantation. This study compared the cytoprotective effects of several antioxidants against oxygen-free radical injury to rabbit corneal epithelial cells in vitro. Cultured rabbit corneal epithelial cells were exposed to oxygen-free radicals generated by xanthine oxidase and hypoxanthine. The cytoprotective activities of various antioxidants on this system were compared using established morphologic criteria. The results demonstrated that purpurogallin at 1.0 mM delayed cell necrosis to 9.98 +/- 1.16 min compared with 2.96 +/- 0.67 min without antioxidant protection. This degree of protection was significantly different from that provided by ascorbate (1.0 mM), trolox (1.0 mM), superoxide dismutase + catalase, catalase (92,000 IU/L), mannitol (1.0 mM), and superoxide dismutase (24,200 IU/L) (p < 0.01). We concluded that purpurogallin effectively protects corneal epithelium from oxygen-free radical injury and may help prevent such injury in corneal preservation solutions.
