Delayed Periorbital Reconstruction After War Injuries.

Introduction: Syrian patients injured in the war frequently undergo rudimentary primary wound closure in combat zones. These patients are later transferred to Lebanon where their wounds need to be secondarily managed. This often leads to the creation of unorthodox approaches for reconstruction of orbital injuries.

Large Tick Infestation of the Upper Eyelid Presenting as Eyelid Mass and Preseptal Cellulitis.

A child was referred for removal of an eyelid mass. She had preseptal cellulitis and a large tick deeply embedded in the tarsus of the upper eyelid necessitating antibiotic therapy and en-bloc excision of the tick with the attached eyelid portion. Large ticks that are embedded in the eyelid are best treated surgically with en-bloc excision of the tick and its attached lid.

Establishment of a formal program for retinoblastoma: Feasibility of clinical coordination across borders and impact on outcome.

Retinoblastoma is an ocular tumor that occurs in young children, in either heritable or sporadic manner. The relative rarity of retinoblastoma, and the need for expensive equipment, anesthesia, and pediatric ophthalmologic expertise, are barriers for effective treatment in developing countries. Also, with an average age-adjusted incidence of two to five cases per million children, patient number limits development of local expertise in countries with small populations.

Cyst formation associated with porous polyethylene orbital floor implant.

A 28-year-old female presented with hyperglobus and inferior scleral show after the repair of an orbital floor fracture using a porous polyethylene (Medpor) implant. CT revealed a large inferior orbital cystic mass displacing the globe. The cyst was explored and excised and the implant was found to be free from any attachment to surrounding tissues and hence, removed without difficulty.

Treatment of recurrent eyelid margin verruca vulgaris with mitomycin C.

A 62-year-old male presented with multiple bilateral eyelid margin verruca vulgaris. Treatment with surgical excision and cauterization of the bases was done twice, but the lesions recurred rapidly with more extensive involvement of the eyelid margins. Excision and intraoperative application of mitomycin C (0.

Bilateral lower eyelid margin erosion associated with lichen planus.

A 32-year-old woman presented with bilateral lower eyelid margin erosion and erythema of several years' duration. She reported no improvement with the use of topical corticosteroid therapy. A full-thickness excisional biopsy was performed, and the histopathology of the specimens was consistent with lichen planus.

Mucous membrane graft versus Gunderson conjunctival flap for fitting a scleral shell over a sensitive cornea.

Purpose: To assess the efficacy of full-thickness mucous membrane grafts in forming a total and permanent corneal cover.

Methods: The records of all patients with a phthisical globe or microphthalmos who underwent a corneal covering procedure to allow comfortable wearing of a cosmetic scleral shell between March 1999 and July 2004 were reviewed.

Results: Ten eyes underwent a Gunderson conjunctival flap (group A), and 9 eyes underwent a full-thickness mucous membrane graft (group B).

Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion.

Objective: To evaluate the efficacy of intravitreal triamcinolone acetonide in the management of persistent macular edema secondary to nonischemic central retinal vein occlusion (CRVO).

Methods: Twenty consecutive patients were selected with a 3- to 4-month history of nonischemic CRVO and persistent macular edema. These patients received a single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL).

Modified technique for tube fixation in conjunctivodacryocystorhinostomy.

The standard glass tube used with a conjunctivodacryocystorhinostomy is subject to spontaneous displacement or extrusion, especially in the early postoperative period. To anchor the tube in the surrounding tissues, a suture is commonly tied around the collar of the Pyrex tube and externalized to the skin of the medial canthal area where it is fixed. The loop can become loose around the tube, and displacement or extrusion can occur.

Upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C.

Purpose: To describe 3 cases of upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C and to highlight possible causes.

Methods: A report of 3 patients, identified over an 8-year interval period, who had development of upper eyelid retraction a few months after undergoing trabeculectomy with mitomycin C in the ipsilateral eye.

Results: Testing for Graves disease, including second-generation thyrotropin receptor antibodies (TRAb), was negative in all cases.

Anterior canthal tendon release for correction of the centurion syndrome.

Purpose: To investigate the effectiveness of anterior canthal tendon release in the management of centurion syndrome.

Methods: Four patients diagnosed as having the centurion syndrome were treated over a period of 3 years. They all underwent bilateral anterior canthal tendon release under local anesthesia.

The use of viscoelastics during pars plana vitrectomy in eyes with an anterior chamber intraocular lens.

Pars plana vitrectomy in eyes with an anterior chamber intraocular lens poses several challenges. This becomes more obvious during fluid-air exchange. The use of viscoelastics during the surgery to overcome these problems is described.

Orbital osteoma arising adjacent to a foreign body.

A 27-year-old man sustained a blast injury to the face in April 1996, with a resultant foreign body at the right medial orbital wall. He refused to undergo surgical removal of the foreign body at that time and was discharged on oral antibiotics. Five years later, he presented because of recurrent attacks of swelling, redness, and pain at the right medial canthal area.

Scleral fixation of posterior chamber intraocular lenses using fascia lata to cover the knots.

Background And Objective: To describe the use of fascia lata to cover the polypropylene knots of scleral fixated posterior chamber intraocular lenses (PCIOL).

Patients And Methods: Fascia lata was used to cover the knots of scleral fixated PCIOL in 5 eyes with significant scleral thinning. Four of the 5 eyes had the PCIOL insertion and the fascia lata patching in the same setting.

Mitomycin C as adjunct therapy in correcting punctal stenosis.

Purpose: To assess the efficacy of intraoperative mitomycin C in improving the success rate of the posterior punctectomy procedure.

Methods: The charts of all patients who underwent posterior punctectomy between the years 1997 and 2000 were reviewed. The procedure was done without mitomycin C (n = 26 eyes, group A) until the end of 1998 and with mitomycin C (n = 25 eyes, group B) starting in 1999.