Molteno rip-cord suture hypopyon.

Seven of 27 eyes developed hypopyons following removal of a 4-0 chromic suture that had been placed intraoperatively in the lumen of the tube of a Molteno implant as a temporary occlusion device. The hypopyons were sterile to anterior chamber tap and in six of seven cases resolved with only routine antibiotic coverage. Surgeons contemplating using an internal chromic suture occlusion in Molteno implants, however, should be aware of this potential problem and adopt a conservative, noninvasive approach.

Filtering bleb encapsulation increased by steroid injection.

In an attempt to enhance its pressure-lowering and fibroblast inhibiting effects, we administered 0.15 cc of 24 mg/ml dexamethasone, intra-Tenon's, directly over the fistula site following 16 consecutive filtering surgeries. The encapsulation rate in these eyes was 56% (9/15), as compared with 10% (2/20) in a retrospectively matched group of eyes that had undergone filtering surgery with dexamethasone given subconjunctivally 180 degrees away from the filter site.

Orbital cyst formation associated with Gelfilm use.

Two patients developed cystic lesions in the anterior orbit 21 and 26 months after repair of blow-out fracture with orbital floor Gelfilm implants. Both patients had associated motility disturbances. Both lesions were surgically excised and found to be cystic in nature and filled with glistening gelatinous material consistent with partially absorbed, encysted gelatin film (Gelfilm).

Ocular perforation and phthisis bulbi secondary to strabismus surgery.

We present our ocular clinicopathologic findings of a child who suffered bilateral perforation of the globe during medial rectus recession bilaterally for congenital esotropia. The right eye progressed to a painful phthisis bulbi and subsequently required enucleation. Penetration or perforation of the sclera during extraocular muscle surgery is not rare; however, serious sequelae such as visual loss or loss of the eye are unusual.