PURPOSE: To investigate the possibility of expanded polytetrafluoroethylene (e-PTFE) as a wrapping material for porous polyethylene orbital implant. METHODS: Two groups of 6 female New Zealand albino rabbits underwent enucleation with placement of a 12 mm porous polyethylene orbital implant wrapped in simple e-PTFE in one group (group 1) and macro-porous e-PTFE in the other group (group 2). Histopathologic sections of the implants obtained at 4, 6, 8 weeks were compared on the extent of fibrovascular ingrowth, percentage of the area of proliferated vessel, and grade of fibrosis between the two groups. RESULTS: There was no implant exposure or severe inflammation in group 1 and 2 during the observation. The extent of fibrovascular ingrowth differs only at 4 weeks. Group 1 showed less fibrovascular ingrowth (until outer 1/3) at anterior half compared with posterior one, but there was no difference between anterior and posterior half in group 2 (until middle 1/3). The percentage of the area of the proliferated vessels was higher in group 2 than group 1 at both anterior and posterior half, and the anterior/posterior ratio of the area of vessels was also higher in group 2 than group 1. The grade of fibrosis was higher in group 2 than group 1 at 4, 6, and 8 weeks. CONCLUSIONS: Macro-porous e-PTFE almost didn't disturb fibrovascular ingrowth into the orbital implant, so macro-porous e-PTFE can be used safely as a wrapping material for porous polyethylene orbital implant.
Female ; Fibrosis ; Humans ; Inflammation ; New Zealand ; Orbit* ; Orbital Implants* ; Polyethylene* ; Polytetrafluoroethylene* ; Rabbits

PURPOSE: To report a case of periorbital infantile capillary hemangioma treated with propranolol. CASE SUMMARY: A 6-month-old girl visited our clinic for a mass on the right upper eyelid, which had been present since birth. A dome-shaped, red-purple colored mass occupying almost the entire right upper eyelid was observed, and overlying branch-shaped telangiectases were also detected. The visual axis of the right eye was partially obscured, due to the ptotic eyelid, and her ability to fix and follow was poor in the right eye. The patient was diagnosed with infantile capillary hemagioma. Because amblyopia in her right eye was suspected, treatment with propranolol was initiated. After 2.5 months of propranolol treatment, the hemangioma decreased in size and volume dramatically, changed from red-purple to light red color, and softened. The ptosis of the right upper eyelid improved, as well as the ability of the right eye to fix and follow. No significant adverse effects (e.g. hypotension, bradycardia, hypoglycemia, bronchospasm, or elevated liver enzymes) were observed, except transient QTc prolongation during cotreatment with ibuprofen, due to an upper respiratory infection. CONCLUSIONS: Propranolol should be considered as a treatment option for periorbital infantile capillary hemangioma. Further clinical studies are required to establish the optimal guidelines and long-term outcome.
Amblyopia ; Axis, Cervical Vertebra ; Bradycardia ; Bronchial Spasm ; Capillaries ; Eye ; Eyelids ; Hemangioma ; Hemangioma, Capillary ; Humans ; Hypoglycemia ; Hypotension ; Ibuprofen ; Infant ; Light ; Liver ; Parturition ; Propranolol ; Telangiectasis

PURPOSE: To evaluate the surgical results of lower eyelid retraction using autologous ear cartilage graft. METHODS: Fifty patients (54 eyes) who received surgical correction of lower eyelid retraction by lower eyelid retractors and conjunctiva recession from the tarsal plate with autologous ear cartilage grafts from March 2002 to July 2010 were evaluated. Medical records were reviewed and clinical characteristics, surgical outcomes, and postoperative complications were analyzed retrospectively. RESULTS: The use of prosthesis due to anophthalmos or microphthalmos (22 eyes) was the most common cause of lower eyelid retraction. The mean postoperative follow-up period was 16.6 months (1-98 months). Lower eyelid retraction was successfully corrected in 52 of 54 eyes. Postoperatively, 2 cases of corneal erosions, 1 case of conjunctival erosion, and 2 pyogenic granulomas developed. Corneal and conjunctival erosions resolved with conservative management and granulation tissues were removed by excision. CONCLUSIONS: Correction of lower eyelid retraction using autologous ear cartilage graft is an excellent surgical procedure with low complication rates for eyelid retraction of various etiologies.
Anophthalmos ; Conjunctiva ; Ear ; Ear Cartilage ; Eye ; Eyelids ; Follow-Up Studies ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Medical Records ; Microphthalmos ; Postoperative Complications ; Prostheses and Implants ; Transplants

PURPOSE: To report a rare case of medulloepithelioma originating from the retina. CASE SUMMARY: A nine-year-old boy visited our clinic with conjunctival injection and decreased visual acuity in the left eye, which had developed two month previously. Slit lamp examination revealed a distorted pupil and an anteriorly protruding ciliary body displacing the peripheral iris toward the cornea on the inferonasal side. Funduscopic examination showed total retinal detachment accompanied by an inferior hypervascular mass. The examination of the right eye was unremarkable. On computer tomography imaging, a calcified mass was identified behind the iris of the left globe in the inferomedial aspect, and ultrasound biomicroscopy revealed a medium to high echogenic tumor with an uneven oval cystic cavity in the ciliary body. At the follow-up examination, the size of the mass was increased, so we performed enucleation of the left eye. Pathology demonstrated that the retrolental mass abutting the lens had arisen from the retina. Histological examination revealed that the tumor had originated from the retina and extended into the ciliary body, and most of the tumor was composed of hyaline cartilage with calicification. Tumor cells were identified in the periphery, forming elongated tubules and cord-like structures that were immunohistochemically positive for vimentin, neuron-specific enolase, and CD56 compatible with a teratoid medulloepithelioma. The patient was followed up for eight months without any metastasis in the orbit or elsewhere. CONCLUSIONS: Medulloepithelioma should be considered in the differential diagnosis of pediatric orbital mass accompanied by calcification.
Ciliary Body ; Cornea ; Diagnosis, Differential ; Eye ; Follow-Up Studies ; Humans ; Hyaline Cartilage ; Iris ; Microscopy, Acoustic ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Orbit ; Phosphopyruvate Hydratase ; Pupil ; Retina ; Retinal Detachment ; Vimentin ; Visual Acuity

BACKGROUND: To present our experience on orbital and periorbital tissue changes after proton beam radiation therapy (PBRT) in patients with intraocular tumors, apart from treatment outcomes and disease control. METHODS: Medical records of 6 patients with intraocular tumors who had been treated with PBRT and referred to oculoplasty clinics of two medical centers (Seoul National University Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center) from October 2007 to September 2014 were retrospectively reviewed. The types of adverse effects associated with PBRT, their management, and progression were analyzed. In anophthalmic patients who eventually underwent enucleation after PBRT due to disease progression, orbital volume (OV) was assessed from magnetic resonance (MR) images using the Pinnacle3 program. RESULTS: Among the six patients with PBRT history, three had uveal melanoma, and three children had retinoblastoma. Two eyes were treated with PBRT only, while the other four eyes ultimately underwent enucleation. Two eyes with PBRT only suffered from radiation dermatitis and intractable epiphora due to canaliculitis or punctal obstruction. All four anophthalmic patients showed severe enophthalmic features with periorbital hollowness. OV analysis showed that the difference between both orbits was less than 0.1 cm before enucleation, but increased to more than 2 cm3 after enucleation. CONCLUSION: PBRT for intraocular tumors can induce various orbital and periorbital tissue changes. More specifically, when enucleation is performed after PBRT due to disease progression, significant enophthalmos and OV decrease can develop and can cause poor facial cosmesis as treatment sequelae.
Canaliculitis ; Child ; Dermatitis ; Disease Progression ; Enophthalmos ; Humans ; Lacrimal Apparatus Diseases ; Medical Records ; Melanoma ; Orbit ; Protons* ; Retinoblastoma ; Retrospective Studies ; Seoul

PURPOSE: The incidence and clinical correlation of MALT1 translocation and chromosomal numerical aberrations in Korean patients with ocular adnexal mucosa associated lymphoid tissue (MALT) lymphoma have not yet been reported. We investigated the incidence and clinicopathologic relationship of these chromosomal aberrations in ocular adnexal MALT lymphomas in a Korean population. METHODS: Thirty ocular adnexal MALT lymphomas were investigated for the t(11;18) API2-MALT1, t(14;18) IgH-MALT1 translocations and chromosomes 3 and 18 aneuploidies using fluorescence in situ hybridization. Patient medical records were reviewed retrospectively for information on demographics and clinical characteristics, including treatment response. RESULTS: The MALT1 gene rearrangement was found in one out of 30 cases. The t(14;18) IgH-MALT1 translocation was demonstrated in only one case (3.3%), and the t(11;18) API2-MALT1 translocation was not found in any of the cases. Trisomy 3 was observed in three ocular adnexal MALT lymphomas (10.0%), and five cases showed trisomy 18 (16.7%). Translocation positive cases also showed trisomy 18. One case of tumor relapse showed trisomy 18 only in the recurrent biopsies. There were no statistically significant correlations between chromosomal aberrations and clinical characteristics and treatment responses. CONCLUSIONS: Translocations involving the MALT1 gene are not common in Korean ocular adnexal MALT lymphomas. The t(14;18) translocation was detected in only one out of 30 cases, and the t(11;18) translocation was not found at all. Furthermore, the chromosomal aberrations found in this study had no prognostic implications.
Adult ; Aged ; *Chromosome Aberrations ; *Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 18/*genetics ; Eye Neoplasms/diagnosis/epidemiology/*genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Incidence ; Lymphoma, B-Cell, Marginal Zone/diagnosis/epidemiology/*genetics ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Translocation, Genetic ; Young Adult