Goldenhar syndrome: the importance of an ophthalmological approach.

The article describes a case of Goldenhar syndrome that had been diagnosed by an ophthalmologist in a medical consultation by school bullying due to a choristoma. A 15-year-old male patient, who had a nodular lesion with hair in the inferior temporal corneal-limbo-conjunctival of the left eye, was reported. He also had a facial asymmetry, with mild mandibular hypoplasia and malformation of the left external ear, where only an auricular appendage was formed. He denied similar family history and the history of genetic diseases, but revealed that his mother had used ibuprofen during the first 3 months of pregnancy and had gestational diabetes mellitus. Excisional biopsy of the eye lesion was performed and revealed a dermoid cyst. After the exegesis and with adequate multidisciplinary monitoring, the patient reported being very satisfied with the aesthetic result, returning with more confidence to his daily activities. That was a typical case of Goldenhar syndrome that has remained undiagnosed and untreated for more than a decade due to a lack of diagnosis despite its classic presentation. The delay in the approach resulted in social stigma and profound psychosocial damage. The importance of disseminating the correct knowledge of this pathology and of having an early multidisciplinary approach in these patients is emphasized, since the impact on the quality of life is significantly high.

Colonic pseudotumor caused by abdominal actinomycosis: A case report.

We report a case of abdominal actinomycosis, a chronic suppurative infection caused by bacteria of the genus Actinomyces, simulating colon cancer, and presenting with abdominal pain and leukocytosis. Computed tomography revealed a mass lesion with irregular contours, infiltrative aspect, with extension to omental fat and abdominal wall, in the transverse colon. A surgical intervention was performed due to the suspicious of a colonic tumor. In the post-operative period, anatomopathological examination showed suppurative nodules associated with actinomycetes colonies, confirming the diagnosis of abdominal actinomycosis. After surgery, the patient was submitted to antibiotic treatment and no relapse was observed.

Reportamos un caso de actinomicosis abdominal, una infección supurativa crónica causada por bacterias del genero Actinomyces, que simula el cáncer de colon y se manifiesta con dolor abdominal y leucocitosis. La tomografía computada reveló una lesión sólida con contornos irregulares y aspecto infiltrativo en el colon transverso, con extensión al epiplón y la pared abdominal. La intervención quirúrgica fue realizada debido a la sospecha de un tumor de colon. En el posoperatorio, el examen anatomopatológico mostró la presencia de nódulos supurativos asociados con colonias de actinomicetos, lo que confirma el diagnóstico de actinomicosis abdominal. Posteriormente a la cirugía el paciente recibió antibioticoterapia y no presentó Recidivas.

Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes.

AIM: The aim of this study is to compare the outcomes, success rates, complications, and number of interventions of the trabeculectomy surgery with mitomycin C (MMC) in two different techniques: conventional soaked sponges and sub-Tenon injection. MATERIALS AND METHODS: An observational retrospective study was performed with 79 eyes of 64 participants who underwent a glaucoma surgery with MMC. The conventional sponge soaked with MMC 0.03% for 3 minutes over the scleral flap (group I) and the subtenon injection of 0.1 mL of MMC 0.03% (group II) techniques were used to deliver the MMC. The data collected were patient demographics, preoperative intraocular pressure (IOP), central corneal thickness (CCT), number of pre- and postoperative ocular hypotensive drugs, postoperative complications, number of interventions, and need of further glaucoma surgery. RESULTS: Seventy-nine eyes were divided into two: 39 eyes (49.37%) in group I and 40 eyes (50.63%) in group II. Trabeculectomy was performed in 53.17% and phacotrabeculectomy in 46.83%. The IOP decreased from 18.0 ± 11.0 mm Hg at the baseline to 10.0 ± 3.0 mm Hg at the last visit in group I and, in group II, from 16.0 ± 10.0-13.0 ± 6.0 mm Hg (median ± ID), p < 0.001. There were no significant differences between the groups regarding demographics, median follow-up, IOP in baseline, CCT, drugs reduction, success criteria adopted, postsurgical interventions, surgical complications, and need for new procedures (p > 0.05). CONCLUSION: Sub-Tenon injection of MMC is a safe and as effective as the conventional soaked sponge method in trabeculectomies. This method reduces surgical time and sponge-related risks with equivalent surgical efficacy. CLINICAL SIGNIFICANCE: As trabeculectomy is still the most common surgical procedure to reduce IOP and scar formation is one of the main causes of surgical failure, it is important to develop surgical techniques to improve its outcomes. HOW TO CITE THIS ARTICLE: Guimarães MEV, de Pádua Soares Bezerra B, et al. Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes. J Curr Glaucoma Pract 2019;13(2):50-54.

Sclerokeratoplasty for the early management of acquired anterior staphyloma.

Objective: To report a case of acquired anterior staphyloma after trauma and its first surgical management. Methods: This is a case report of a 17-year-old man who had a history of trauma by insect on the right eye, without a previous history of eye conditions, and evolved with local pain and low visual acuity. The ophthalmological exam showed light perception visual acuity in right eye and 1,0 in left eye, anterior staphyloma and impossibility to blink. The first surgical procedure proposed was sclerokeratoplasty and the second one an optical transplantation but, after step one, the patient did not return to the service and missed the follow-up. Results: Sclerokeratoplasty was proposed once the posterior segment and the crystalline were preserved in topical position. The anterior tumor was excised in free-cut and corneal-scleral graft sutured in single points with 10-0 mononylon. Gatifloxacin 0.3% with Prednisolone Acetate 1%, Epitezan® and Atropine 1% were prescribed immediately postoperative. After 60 postoperative days, he maintained the use of Dexamethasone 0.1% and Atropine 1% and the patient had visual acuity of perception of hand movement in the affected eye. Conclusion: Few treatment options are alternatives to evisceration. In this case report, the sclerokeratoplasty was the chosen technique for the initial management. The second step was not possible due to loss of follow-up. Despite the uncomplicated procedure, we need greater compliance by the patient to conclude the treatment.