Intraocular penetration of vancomycin eye drops after application to the medial canthus with closed lids

AIMS: To investigate the intraocular penetration of vancomycin eye drops and to compare the conventional method of drop instillation to the lower cul de sac with applying drops to the medial canthus with closed lids. METHODS: This prospective randomised trial evaluated 53 eyes of 53 patients who had undergone extracapsular cataract extraction (ECCE) with intraocular lens implantation. Vancomycin (50 mg/ml) eye drops were applied to either the lower cul de sac with open lids (conventional method), or to the medial canthus with the patient in a supine position and with closed lids. After paracentesis performed during ECCE, an aqueous humour sample was taken and vancomycin concentration was measured using the TDX vancomycin assay (fluorescence polarisation immunoassay). RESULTS: Vancomycin concentration in the anterior chamber were above the minimal inhibitory concentration for Gram positive bacteria in the two methods of drop instillation examined (2.04 (SD 1.9) microg/ml and 1.49 (1.1) microg/ml in the open and closed methods, respectively (p =0.202)). CONCLUSIONS: Vancomycin (50 mg/ml) reaches therapeutic concentration in the anterior chamber after topical drop application. Comparable concentrations were reached when drops were applied in either the lower cul de sac or to the medial canthus with closed lids. The latter method is proposed as likely to improve patient compliance.     

Tendon sheath fibroma of the medial canthus

Isolated fibromas of the ocular adnexa are rare. Fibromas of the tendon sheath (FTS) are benign, collagenous, spindle cell neoplasms that typically present as an acquired, painless mass in the adult extremities. They infrequently involve the head and neck. We report a case of FTS presenting as a medial canthal mass. Like most FTS, the lesion in our patient was successfully treated by complete surgical excision. While the differential diagnosis contains a variety of mesenchymal tumors, the clinical and radiographic characteristics should lead to the correct diagnosis. To our knowledge, this is the first case of FTS reported to arise at this site.     

Reconstruction of nasal fistulas of the medial canthus

Invasive carcinomas of the medial canthus may require the removal of skin, subcutaneous tissue, and nasal bone, which can result in a nasal fistula of the medial canthus. I applied a nasolabial flap on the inside of the fistula and a forehead flap on the outside to reconstruct such a fistula. This technique was successful in three patients.     

Lateral lid lysis for medial lid and medial canthus lacerations

Techniques are now being used to provide adequate healing time for medial lid and medial canthal full-thickness lacerations. Lateral upper and lower lid lysis allows the needed extended period of healing.     

普拉洛芬滴眼液在LASEK术中的应用

目的：观察普拉洛芬在LASEK术中应用的效果。

方法：选取2011-05/08来我院行LASEK手术患者56例112眼。随机分为实验组(使用普拉洛芬)和对照组。对两组患者术后的刺激症状进行1wk对比研究。

结果：两组在控制术后刺激症状方面有明显差异。实验组未见特殊的不良反应及并发症。

结论：普拉洛芬眼液是控制LASEK术后刺激症状的安全有效的药物。     

The horizontal dynamic of the medial and lateral canthus

PURPOSE: To identify and quantify the horizontal dynamic movement of the medial and lateral canthus in subjects without previous eyelid surgery. METHODS: Prospective, experimental study. RESULTS: Seventy-two eyes in 36 normal subjects were studied. Frontal view lateral canthal movement with abduction of the globe averaged -0.4 mm (negative numbers mean the canthus moves in the opposite direction of the globe), with a range of -3.8 to 2.1. Profile view lateral canthal movement with abduction of the globe averaged 1.6 mm, with a range of -2.2 to 4.7 mm. Frontal view lateral canthal movement with adduction of the globe averaged -0.3 mm, with a range of -3.7 to 3.9 mm. Profile view lateral canthal movement with adduction of the globe averaged 0.5 mm, with a range of -2.4 to 3.9 mm. Frontal view medial canthal movement with abduction of the globe averaged -0.4 mm, with a range of -3.9 to 1.5 mm. Frontal view medial canthal movement with adduction of the globe averaged 0.1 mm, with a range of -5.2 to 4.6 mm. Intrasubject variation was observed for all measurements. CONCLUSIONS: The medial canthus and the lateral canthus are dynamic structures that move with horizontal eye movements in patients who have not undergone canthoplasty. The measured movement of the lateral canthus differed, based on the position from which the measurements were made, and was not always in the direction of the globe. The movement of the lateral canthus and the medial canthus differed on the right and left sides of the same subject.     

Evaluation of the medial canthus blepharoplasty using the lazy-T method

PURPOSE: To evaluate the efficacy of surgical "Lazy-T" method used to correct ectropion of the lower punctum with the inferior lid laxity and the medial canthal tendon. METHOD AND MATERIAL: Between January 2004 and February 2005, four patients of mean age 67 years (+/-12) were operated with this method. In two patients, one eyelid was operated; the other two patients underwent bilateral lid surgery. Preoperative qualifications included: subjective assessment of epiphora (range 0-10 points), where 0 represents loss of epiphora and 10 points maximum intensification with ectropion of the lower punctum, laxity of the inferior eyelid more than 10 mm, and laxity of the medial canthal tendon of 2-nd degree or more. Two subjects, who expressed their consent, underwent lacrimal scintigraphy. Surgical technique included excise of the middle part of the lid at its full thickness, laterally from lower punctum, and correction of the conjunctiva. The follow-up period was 6 months on average. RESULTS: All patients reported reduction of epiphora of 5 points on the average. Eyelid laxity decreased by mean 4.5 mm (+/- 1.0 mm). In two patients epiphora regressed, in two others - decreased. All patients evaluated the cosmetic result as satisfactory. CONCLUSIONS: The "Lazy-T" correction is an effective procedure, which restores the lower punctum into its normal anatomical position. It is a simple surgical technique that can free patients from epiphora.     

玻璃酸钠滴眼液联合鱼腥草滴眼液治疗干眼症的疗效观察

目的:研究单纯玻璃酸钠滴眼液,及其联合鱼腥草滴眼液治疗干眼症的临床疗效。方法:选取确诊的干眼症患者125例198眼,随机分为单纯玻璃酸钠滴眼液组(A组)63例100眼和玻璃酸钠滴眼液联合鱼腥草滴眼液组(B组)62例98眼。A组用1g/L玻璃酸钠滴眼液治疗;B组交替给予1g/L玻璃酸钠滴眼液和鱼腥草滴眼液治疗。连续治疗2mo后,比较两组治疗前后的临床症状、泪液基础分泌试验(SⅠt)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)程度。结果:两种治疗方法均可明显改善干眼症患者的临床症状、SⅠt,BUT和FL程度;但B组的主观症状、SⅠt,BUT和FL的改善程度明显优于A组。结论:玻璃酸钠滴眼液联合鱼腥草滴眼液可明显改善干眼症患者的临床症状,提高疗效。     

辰泽滴眼液在激光虹膜周切术中的应用

目的 评价辰泽滴眼液在激光虹膜周切术中的临床应用价值。方法 选择86例（172眼）双眼进行Nd：YAG激光虹膜周切术的患者,在激光治疗前1h滴2％毛果芸香碱滴眼液两次后,分为两组,一眼加滴辰泽滴眼液1滴,在激光手术完成后即刻再次滴入辰泽滴眼液一滴,另一眼不用辰泽滴眼液。术后1h测量双眼的眼压,第二天复诊时观察虹膜周切口的情况并再次测量眼压,术后一周复诊观察虹膜周切口的情况并再次测量眼压。如眼压升高大于22 mm Hg需进行降眼压治疗。结果 辰泽滴眼液能良好的控制行激光虹膜周切术后患者的眼压,仅有5只眼(5.81％)应用辰泽滴眼液患者的眼压略高于22 mm Hg,未予降眼压治疗;而未应用辰泽滴眼液的患眼眼压升高达48只眼(55.81％),术后1h眼压测量比较,所有应用辰泽滴眼液的术眼的眼压升高远较对侧眼为低,且辰泽滴眼液也能较好地改善滴用毛果芸香碱滴眼液后球结膜充血。结论 辰泽滴眼液在激光虹膜周切术中能明显减轻手术副反应,降眼压效果确切,建议临床中推广应用。     

双氯芬酸钠滴眼液在翼状胬肉术后的应用

目的:评价1g/L双氯芬酸钠滴眼液在角膜缘干细胞移植治疗翼状胬肉术后临床应用价值。方法:收集分析我院2009-01/2012-04行翼状胬肉切除+角膜缘干细胞移植手术的76例104眼患者的数据。分为试验组(术后使用1g/L双氯芬酸钠眼液)和对照组,对两组术后角膜刺激症状、角膜创面愈合时间、角膜瘢痕情况、结膜伤口愈合时间和翼状胬肉复发情况进行对比观察和统计学分析。结果:术后1,3,5d,试验组和对照组角膜刺激症状差异有统计学意义(P<0.05),余观察指标两组间差异无统计学意义(P>0.05)。结论:1g/L双氯芬酸钠滴眼液控制角膜缘干细胞移植治疗翼状胬肉术后引起的眼部刺激症状是安全有效的。     

Malignant hidradenoma of the medial canthus with orbital and intracranial extension

A 70-year-old woman presented with signs and symptoms consistent with nasolacrimal duct obstruction. MRI revealed a medial canthal mass with orbital and intracranial extension. The patient was treated with wide surgical excision, chemotherapy, and radiation. A diagnosis of malignant hidradenoma of the medial canthus was confirmed by histopathology. Despite aggressive therapy, the patient developed metastatic disease and died within 1 year.