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Purpose To compare the visual outcome of transepithelial photorefractive keratectomy (PRK) against alcohol-assisted PRK in treating low-to-moderate myopia with or without astigmatism. Setting Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. Design This is a retrospective study. Methods Forty eyes of 22 patients with myopia from -0.75 to -6.00 diopters (D) with or without astigmatism from 0 to -3D were included in this study. Preoperative and postoperative data of 20 eyes from 11 patients who underwent transepithelial PRK were compared with 20 eyes from 11 patients who underwent alcohol-assisted PRK were collected and analyzed. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest spherical equivalence (SE), manifest cylinder, vector analysis of astigmatism, and efficacy and safety indices were compared between the groups at a mean follow-up of one year postoperatively. Results Baseline characteristics were similar between groups, except the transepithelial PRK group had lower cylinder values than the alcohol-assisted PRK group by 0.69D. Regression analysis was used to control for the difference in the cylinder in all outcome parameters. Both groups had similar mean UDVA (p=0.73), CDVA (p=0.98), the proportion of eyes in either group achieved (20/20, 20/25, and 20/30) UDVA (p=0.72, 0.68 and 0.31 respectively) and percentage of eyes lost two lines of CDVA (p=1.0). There was no statistically significant difference between the two groups in regard to both efficacy and safety indices (p=0.55 and 0.67, respectively). Both groups had similar residual SE (p=0.72), the proportion of eyes within ±0.5D of SE (p=0.29), and residual refractive astigmatism (p=0.87). Both groups had similar difference vectors, surgically induced astigmatism, and correction index (p=0.82, 0.10, and 0.26, respectively). However, the transepithelial PRK group had lower target-induced astigmatism (TIA; p=0.01), higher magnitude of error (ME; p=0.05), and higher angle of error (AE; p=0.02) than the alcohol-assisted PRK group. Conclusion Transepithelial PRK had similar visual and refractive outcomes as alcohol-assisted PRK. This approach was considered as safe and effective as alcohol-assisted PRK in treating patients with low-to-moderate myopia with or without astigmatism.
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Background: Blowout fracture is defined as an internal orbital fracture that does not involve the orbital rim. This type of fracture results in the loss of tissue and disruption of the structure of the orbital wall. The symptoms and signs include pain, enophthalmos, diplopia, orbital emphysema, and ecchymosis. The surgeon's main goal is to reconstruct the orbit in the best possible manner to achieve optimal anatomy and functionality of the orbit wall postoperatively. There is no consensus regarding the best material for use in surgical orbital reconstruction, despite the commercial availability of several biological and manufactured materials. Moreover, material selection is often based on the practitioner's preferences/experience and patient safety. This study reported two cases of orbital fracture reconstruction using moldable methyl polymethacrylate as a bone surrogate. This material has already been used in dentistry, neurosurgery, and orthopedic surgery and is potentially hazard-free for orbit surgery. Case Presentation: Two victims of motor vehicle collisions presented with blowout orbital fractures. Cross-sectional imaging revealed inferior fractures involving the orbital wall. High-resolution tomographic modeling was used to plan surgical orbital floor reconstruction using moldable polymethyl methacrylate material. The short-term outcome of the implant appeared favorable at the one-year follow-up, based on regular patient monitoring and cross-sectional imaging assessment. Postoperative improvement with positive clinical outcomes was observed during both patients' follow-up visits. Conclusion: Moldable polymethyl methacrylate can be used safely and effectively for reconstructive surgeries for the management of blowout orbital fractures. This new technique ensured a satisfactory short-term postoperative orbital configuration and tolerance and good esthetic and functional results without adverse effects. This customizable product is affordable and easy to fabricate.
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Pediatric-type follicular lymphoma is a disease that affects the lymph nodes of the head and neck in the adult and pediatric patient groups. Ocular involvement is exceedingly rare, especially in the pediatrics age group; therefore, keeping a high clinical suspicion is warranted. Here, we report a rare conjunctival pediatric-type follicular lymphoma in a 15-year-old boy presenting with progressive swelling over the medial aspect of the left bulbar conjunctiva for two months. On examination, the mass was firm, mobile, well encapsulated, wide-based, and had a negative transillumination. An excisional biopsy was performed, and histopathological examination and immunohistochemistry studies revealed lymphoid tissue that was positive for CD20, CD79a, BCL6, and CD10; and negative for BCL2 and MUM1. The CD21 and CD23 positivity highlighted the presence of an expanded follicular dendritic cell meshwork. The patient was diagnosed with conjunctival pediatric-type follicular lymphoma and referred to an oncology center for further examination and treatment. This lymphoma is rare, requiring high clinical suspicion, and thus, reporting the case detail is important and valuable for ophthalmologists and general pediatrics practitioners alike.
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Erythromelanosis follicularis faciei is a rare sporadic condition of unknown etiology characterized by reddish-brownish patches and follicular papules that appear commonly on the face and rarely on the neck. Herein, we report a 16-year-old male who had asymptomatic facial skin lesions since early childhood. His family history revealed a similar case in his younger brother. His parents are not consanguineous. Skin examination revealed diffuse nonscaly brownish patches with erythematous background and multiple skin-colored, hypopigmented follicular papules on both cheeks. A summary of previous reports of erythromelanosis follicularis faciei in the literature is presented in this report.
