The outcomes of surgical treatment in fistulous dacryocystitis.

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the outcomes of surgical management in fistulous dacryocystitis cases associated with nasolacrimal duct (NLD) obstruction. MATERIALS AND METHODS: Twenty-two patients (14 female, 8 male) with fistulous dacryocystitis were included. The patients were divided into two groups as congenital (Group I) and acquired (Group II) groups. Fistula excision (FE) together with external dacryocystorhinostomy (DCR) and bicanalicular silicon tube (FCI Ophthalmics, Marshfield Hills, MA, USA) intubation (BSTI) were performed following medical therapy (Ofloxacin 0.3 % four times a day,intravenous cefazolin (50 mg/kg/day in children and 2 g/day in adults and gentamicin (5 mg/kg/day in children and 3 mg/kg/day in adults). The groups were compared with each other in terms of preoperative medical therapy duration, time of silicone tube extubation, follow-up time, and surgical outcomes. RESULTS: Group I included five patients with acute dacryocystitis and seven patients with recurrent dacryocystitis following probing, whereas Group II was comprised of 8 acute dacryocystitis and two recurrent fistulous dacryocystitis. Mean length of preoperative medical therapy was 14.1±6.5 days for Group I and 11.9±2.5 days for Group II. Extubation of the silicone tube was performed after 4.5±1.2 months in Group I and after 4.6± 1.1 months in Group II. The patients were followed up for 13.5±4.8 months in Group I and 14.3±3.7 months in Group II. There was no significant difference between the two groups in length of preoperative medical therapy, time of extubation of the silicone tube, and follow-up time (p > 0.05). Postoperatively, patency of the nasolacrimal drainage system was verified by irrigation of the lacrimal ducts and use of fluorescein eye stain. In both groups, all patients underwent surgical treatment were treated successfully. CONCLUSIONS: In fistulous dacryocystitis cases associated with the obstruction of NLD application of FE, external DCR treatment and BSTI appears as a valid surgical treatment option.  

Conjunctival deposits as the first sign of systemic sarcoidosis in a pediatric patient.

PURPOSE: Sarcoidosis is an inflammatory disease of unknown cause, characterized by noncaseating granulomas. In this study, the authors present a sarcoidosis patient without systemic signs diagnosed by histopathologic analysis of conjunctival deposits. METHODS: A 10-year-old girl had bilateral, focal, multilobular, multiple pale yellow deposits in bulbar conjunctiva for a year. In the patient's biomicroscopic examination, numerous 0.50- to 2-mm diameter pale yellow deposits were determined in both bulbar conjunctivas. The patient had no other systemic or ocular complaints. A conjunctival biopsy was performed. RESULTS: The biopsy specimens showed noncaseating granulomas with prominent asteroid bodies. Serum angiotensin-converting enzyme levels were increased in the patient. Conjunctival deposits were the first manifestation of sarcoidosis in the patient and the diagnosis of sarcoidosis was confirmed with a conjunctival biopsy. CONCLUSIONS: To the authors' knowledge, this is the second study that reports a sarcoidosis patient with non-systemic involvement diagnosed after histopathologic analysis of conjunctival deposits.

Conjunctival deposits as the first sign of systemic sarcoidosis in a pediatric patient.

PURPOSE: Sarcoidosis is an inflammatory disease of unknown cause, characterized by noncaseating granulomas. In this study, the authors present a sarcoidosis patient without systemic signs diagnosed by histopathologic analysis of conjunctival deposits. METHODS: A 10-year-old girl had bilateral, focal, multilobular, multiple pale yellow deposits in bulbar conjunctiva for a year. In the patient's biomicroscopic examination, numerous 0.50- to 2-mm diameter pale yellow deposits were determined in both bulbar conjunctivas. The patient had no other systemic or ocular complaints. A conjunctival biopsy was performed. RESULTS: The biopsy specimens showed noncaseating granulomas with prominent asteroid bodies. Serum angiotensin-converting enzyme levels were increased in the patient. Conjunctival deposits were the first manifestation of sarcoidosis in the patient and the diagnosis of sarcoidosis was confirmed with a conjunctival biopsy. CONCLUSIONS: To the authors' knowledge, this is the second study that reports a sarcoidosis patient with non-systemic involvement diagnosed after histopathologic analysis of conjunctival deposits. (Eur J Ophthalmol 2006; 16: 168-70).

Spontaneous fracture of an implanted posterior chamber intraocular lens.

PURPOSE: Spontaneous fracture of an intraocular lens (IOL) haptic is a rare complication of cataract surgery. The authors report a case of spontaneous fracture of an implanted posterior chamber IOL. CASE: Five years ago, a 12-year-old patient underwent linear lens extraction, posterior capsulotomy, and anterior vitrectomy due to traumatic cataract and received a polymethyl methacrylate (PMMA) biconvex posterior chamber IOL implanted in ciliary sulcus. Five years later, IOL optic was found in anterior chamber with its haptics broken from the optic-haptic junction. DISCUSSION: The broken haptic was examined with scanning electron microscopy. The fracture site of the haptic was on the optic-haptic junction. The fractured surface had a regular appearance. CONCLUSIONS: To our knowledge, this is the fourth report of spontaneous fracture of an implanted posterior chamber IOL.

Spontaneous fracture of an implanted posterior chamber intraocular lens.

PURPOSE: Spontaneous fracture of an intraocular lens (IOL) haptic is a rare complication of cataract surgery. The authors report a case of spontaneous fracture of an implanted posterior chamber IOL. CASE: Five years ago, a 12-year-old patient underwent linear lens extraction, posterior capsulotomy, and anterior vitrectomy due to traumatic cataract and received a polymethyl methacrylate (PMMA) biconvex posterior chamber IOL implanted in ciliary sulcus. Five years later, IOL optic was found in anterior chamber with its haptics broken from the optic-haptic junction. DISCUSSION: The broken haptic was examined with scanning electron microscopy. The fracture site of the haptic was on the optic-haptic junction. The fractured surface had a regular appearance. CONCLUSIONS: To our knowledge, this is the fourth report of spontaneous fracture of an implanted posterior chamber IOL.

Penetrating eye injuries from southeastern Anatolia region of Turkey.

OBJECTIVES: This study analysed 420 patients with penetrating eye injuries who presented for treatment at the Eye Clinic of Dicle University Hospital in Turkey. The aim of the study was to identify preventable risk factors. METHODS: A retrospective evaluation of patients who presented between January 1995 and December 2000 was undertaken. Cases were examined with regard to age, sex, profession, which eye was traumatized, reason for the trauma, nature of the trauma, time between injury and operation, and accompanying pathologies. RESULTS: This study found that most penetrating eye injuries occurred in children aged 0-15 years, and these were mainly caused by accidents during play. For patients aged 16-60 years, penetrating eye injuries were mainly caused by work-related accidents. CONCLUSION: Most penetrating eye injuries were caused by preventable accidents. Many accidents and their resulting injuries could have been prevented by education, greater intensive care and workplace safety.