Orbital infarction syndrome after transcanalicular dacryocystorhinostomy with diode laser.

Orbital infarction syndrome is a rare but devastating disorder resulting in sudden visual loss. A patient with orbital infarction syndrome due to orbital cellulitis after transcanalicular dacryocystorhinostomy with diode laser is described. A 55-year-old woman presented 3 days after transcanalicular dacryocystorhinostomy. Initial examination revealed significant eyelid swelling, marked proptosis, total ophthalmoplegia, and no light perception in the right eye. Fundus examination revealed ophthalmic artery occlusion. The clinical findings of the patient were consistent with orbital infarction syndrome. Clinical findings improved with antibiotic therapy, but visual acuity did not change.

A rare complication after transcanalicular dacryocystorhinostomy: tissue necrosis and nasal-cutaneous fistula.

Transcanalicular dacryocystorhinostomy (TCDCR) with diode laser is a minimally invasive technique with good cosmetic results. The reported complication rate is low. In this brief report, the authors describe a patient with tissue necrosis and nasal-cutaneous fistula after TCDCR. A 65-year-old woman attended the authors' clinic 1 month after TCDCR. Examination revealed a large tissue defect and nasal-cutaneous fistula in the medial canthal region. Aspergillus growth was noted in culture specimens taken from the nasal cavity. The patient was treated with intravenous amphotericin B. The treatment resulted in granulation and closure of the defect.

Evaluation of the microstructure of cornea by in vivo confocal microscopy in contact lens wearing and non-contact lens wearing keratoconus patients.

PURPOSE: To compare the microstructure of the central keratoconic cornea in contact lens wearing and non-contact lens wearing keratoconus subjects. METHODS: One hundred and one eyes of 56 keratoconic subjects were compared with control patients who wear contact lenses (22 subjects) and controls who do not wear contact lenses (40 subjects). The keratoconic subjects were assessed in 2 groups: the contact lens wearing keratoconus group (37 patients, 64 eyes, 20 female and 17 male; Group 1) and the keratoconus group comprising subjects who do not wear contact lenses (19 patients, 37 eyes, 9 female, 10 male; Group 2). RESULTS: The mean age was 33 +/- 12 years in the contact lens wearer keratoconus group, 31 +/- 12 years in the non-contact lens wearer keratoconus group, 34 +/- 12 years in the non-contact lens wearing control group and 29 +/- 10 years in the contact lens wearing control group. Mean basal epithelial cell density was significantly lower in the contact lens wearer keratoconus group (p < 0.001) and in the non-contact lens wearer keratoconus group (p < 0.001) in comparison with controls. The anterior, intermediate and posterior keratocyte densities were significantly lower in both contact lens wearer keratoconic subjects (p < 0.001, p < 0.001, p < 0.001) and non-contact lens wearer keratoconic subjects (p < 0.001, p < 0.001, p=0.004) as compared to controls. Endothelial cell density was not altered in keratoconic patients. DISCUSSION: The decrease in basal epithelial cell density and in keratocyte density may highlight the role of apoptosis in keratoconus. Endothelial cell density does not change in keratoconus, but extensive variability in endothelial cell size and shape may be encountered.

The Long-Term Results of Frontalis Suspension Using Autogenous Fascia Lata in Children with Congenital Ptosis under 3 Years Old.

Purpose. To describe the long-term results of frontalis suspension using autogenous fascia lata in children with congenital ptosis under 3 years old. Methods. Forty three-eyes of 35 patients were enrolled in the study. Frontalis suspension using autogenous fascia lata was performed in all patients. The postoperative eyelid level, ptosis recurrence, visual acuity, and cosmetic results were evaluated. Results. The mean age of the patients was 16.8 ± 9 months (7-36 months). The mean follow-up time was 52.8 ± 15 months (14-95 months). All patients had good (ptosis <2 mm) or moderate (2-3 mm ptosis) eyelid level after the operation. All patients achieved satisfactory cosmetic results. Succesfull harvesting was performed in all cases and no additional materials or surgical manipulation were needed during the surgery. Conclusion. Frontalis suspension using autogenous fascia lata can be used in children under 3 years old without harvesting problems. Surgical experience and good knowledge of anatomy are important factors for successful results after the surgery.

Efficiency of olopatadine hydrochloride 0.1% in the treatment of vernal keratoconjunctivitis and goblet cell density.

PURPOSE: The aim of this study was to investigate the effect of topical 0.1% olopatadine hydrochloride on goblet cell density, clinical signs, and symptoms of patients with vernal keratoconjunctivitis. METHODS: Between December 2002 and April 2003, 40 eyes of 20 patients with vernal keratoconjunctivitis and 10 healthy eyes of 5 control patients were evaluated prospectively and treated with 0.1% olopatadine hydrochloride. Both groups were observed clinically, subjective complaints were recorded, and changes in goblet cell density were obtained with brush cytology. RESULTS: After the 2-month therapy, subjective complaints and clinical signs improved with therapy. Also, the clinical signs were improved with the therapy. As the severity of the signs and symptoms were reduced, goblet cell numbers in the brush cytologic specimens were reduced. CONCLUSION: Olopatadine hydrochloride 0.1% is an effective agent for relieving the signs and symptoms of vernal keratoconjunctivitis. Also, it reduces the number of goblet cells, which, in turn, decreases the amount of mucus discharge in vernal keratoconjunctivitis during treatment.

Effect of 30-day continuous wear of silicone hydrogel contact lenses on corneal thickness.

PURPOSE: To investigate the effect of 30-day continuous-wear contact lenses (Focus Night & Day) on corneal thickness and physiology. METHODS: Twenty-six myopic eyes with no history of contact lens wear were fitted with silicone hydrogel contact lenses. Complete ophthalmologic examinations, corneal topography, and corneal thickness measurements at the center and eight peripheral areas were performed before fitting and at each visit, namely on day 1, day 10, and 1 month. Mean corneal thicknesses were statistically compared by using one-way repeated-measures analysis of variance. RESULTS: All patients maintained their 20/20 vision with correction. Limbal vascularization was noted in one patient at the end of the study. No patient had subjective complaints. In another patient, a punctate corneal epithelial defect was noted on the 15th day, but it healed when the contact lens was removed for a day. The mean corneal thicknesses in different regions were significantly increased by approximately 14 to 38 microm compared with baseline measurements. There were no significant differences between the corneal topography taken on the first day and the one taken at the end of the first month. CONCLUSIONS: All patients maintained their visual acuity. Apart from the limbal vascularization and punctate epithelial corneal defects, which resolved when the contact lens was removed for 1 day, no serious complications were noted. Despite the high oxygen permeability of the monthly Night & Day contact lenses, the mean central and peripheral corneal thicknesses increased. These increases indicate that these lenses may have an effect on corneal metabolism.