Assuntos
Neoplasias da Íris , Melanoma , Humanos , Neoplasias da Íris/diagnóstico , Melanoma/diagnóstico , IrisAssuntos
Glaucoma de Ângulo Fechado , Glaucoma , Glaucoma/diagnóstico , Glaucoma/etiologia , HumanosAssuntos
Humanos , Masculino , Feminino , Dacriocistorinostomia , Ansiedade , Dor Pós-Operatória , Período PerioperatórioAssuntos
Dacriocistorinostomia , Ansiedade , Transtornos de Ansiedade , Humanos , Dor Pós-OperatóriaAssuntos
Neoplasias da Mama/patologia , COVID-19/epidemiologia , Neoplasias da Íris/secundário , Neoplasias da Íris/terapia , Tempo para o Tratamento , Adulto , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/terapia , Terapia Combinada , Feminino , Humanos , Neoplasias da Íris/patologia , Pandemias , Quarentena , Radioterapia/métodos , Resultado do Tratamento , Carga Tumoral/efeitos dos fármacos , Carga Tumoral/efeitos da radiação , Suspensão de TratamentoRESUMO
INTRODUCTION: The treatment of conjunctival melanoma is most often conservative, but exenteration is sometimes necessary in order to achieve local control of the disease. It can be performed as a primary procedure in cases of locally advanced disease or as a secondary procedure after one or more recurrences. No benefit to secondary exenteration on patient survival has been demonstrated to date for conjunctival melanoma, and it is generally considered a palliative procedure. PATIENTS AND METHODS: Single-center retrospective study performed in the ocular oncology department of the Institut Curie (Paris, France). We included all patients who underwent secondary orbital exenteration for conjunctival melanoma between January 2008 and January 2016. RESULTS: Twenty-five patients underwent secondary exenteration for conjunctival melanoma. The maximum number of local recurrences prior to exenteration was six. Metastases occurred in 11 patients after exenteration and were more common when there was a greater tumor thickness on histology, if the tumor had not been treated initially in an ocular oncology center, or if there had been a greater number of local recurrences before the secondary exenteration was performed. Seventy-five percent of patients developed metastases when the exenteration was performed after 5 or 6 local recurrences. CONCLUSION: This study suggests that early secondary exenteration (i.e. after a number of local recurrences less than or equal to 4) may reduce the occurrence of metastases (and therefore improve patient survival) in conjunctival melanoma. Thus, secondary exenteration might be a curative surgery in some patients with recurrent disease.
Assuntos
Neoplasias da Túnica Conjuntiva , Melanoma , Neoplasias da Túnica Conjuntiva/cirurgia , Humanos , Melanoma/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Exenteração Orbitária , Estudos RetrospectivosRESUMO
INTRODUCTION: The goal of this study was to assess the efficacy of transcanalicular diode laser assisted dacryocystorhinostomy (TDL-DCR) for the treatment of primary acquired nasolacrimal duct obstruction. MATERIAL AND METHODS: This was a single center retrospective study. We included all patients who underwent TDL-DCR between July 2015 and October 2017 for chronic epiphora or chronic dacryocystitis. All procedures were performed under local anesthesia with sedation. The anatomical and functional success rates were studied as a function of each operative indication. RESULTS: Thirty-seven patients were included (18 had chronic epiphora and 19 had chronic dacryocystitis). All but one patient had bicanalicular silicone stent intubation. Irrigation of the lacrimal system demonstrated postoperative patency in 78% of patients operated for chronic epiphora and 76% of those with chronic dacryocystitis. The functional success of the surgery (as defined by the Munk score) was higher if the operative indication was chronic dacryocystitis (62%) (whereas it was only 41% for the indication of chronic epiphora). CONCLUSION: TDL-DCR has a lower anatomical and functional success rate than those reported in the literature for external or endonasal dacryocystorhinostomy. However, it retains a place in the treatment of primary acquired nasolacrimal duct obstruction (in particular when it is complicated by chronic dacryocystitis), especially if there is an absolute or relative contraindication to the two other dacryocystorhinostomy techniques.
Assuntos
Dacriocistorinostomia , Obstrução dos Ductos Lacrimais , Terapia a Laser , Ducto Nasolacrimal , Anestesia Local , Humanos , Obstrução dos Ductos Lacrimais/terapia , Lasers Semicondutores/uso terapêutico , Ducto Nasolacrimal/cirurgia , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Neoplasias da Retina , Retinoblastoma , Enucleação Ocular , Humanos , Inflamação/complicações , Inflamação/diagnóstico , Neoplasias da Retina/complicações , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/cirurgia , Retinoblastoma/complicações , Retinoblastoma/diagnóstico , Retinoblastoma/cirurgiaRESUMO
Kabuki syndrome (KS) is a rare congenital disorder characterized by multiple systemic anomalies and facial characteristics. Here, the authors present the first case, to the best of the authors' knowledge, of bilateral lacrimal puncta agenesis in a patient with KS.#8232;The proband patient was a 29-year-old woman diagnosed with this syndrome, brought to our office due to recurrent conjunctivitis where agenesia of lacrimal puncta was observed. Therapeutic options were exposed but, as the concomitant medication (topiramate) produced ocular dryness, conservative treatment was decided. Diagnosis of KS is challenging because it is a complex syndrome with many associated findings. The authors recommend taking into account the agenesis of lacrimal points in the differential diagnosis of KS if it is associated with other phenotypic alterations as well as including lacrimal examination in patients with KS diagnosis. The authors emphasize the importance of individualizing treatment since drugs used for the systematic management of these patients can influence tear symptoms.