Phthisical Eye Research Articles

Klinisch-pathologische Korrelationen: Befunde des hinteren Augenabschnitts und der Orbita

Diseases of the posterior compartment and the orbit are characterised by histological findings, most of which can be reproduced clinically. Examples are the examination of calcifications in retinoblastoma by ultrasonography. In the present review, histological findings of tumour and other diseases of the posterior ocular compartment and the orbit are presented and correlated with the clinical pictures and imaging techniques: uveal melanoma, choroidal nevus, choroidal metastases, choroidal hemangioma, retinoblastoma, Coat's disease, sympathetic ophthalmia, pleomorphic adenoma (benign mixed tumour) of the lacrimal gland, dacryoadenitis, lymphoma, rhabdomyosarcoma, Langerhans cell histiocytosis, orbital metastases, and phthisical eyes. Histopathology is usually the gold standard for a definitive diagnosis. It is very important for residents and those in training to become familiar with clinico-pathological correlations as these provide insight in pathophysiological processes. Regarding ophthalmic surgery, ophthalmic pathology offers the possibility to study wound healing and complications. A close collaboration between clinicians and ocular pathologists allows for an optimised processing of the submitted tissue and diagnosis. Thus, pre- and postoperative care can also be improved. This outstanding knowledge that ophthalmologists have gained over the last decades and beyond, should be preserved and passed on to the next generations in order to maintain a high standard in ophthalmological care.

Scleral erosion, phthisis bulbi, and orbital pseudocyst formation as a late complication of miragel scleral buckle surgery.

The purpose of this study was to report a case of scleral erosion as a late complication of Miragel scleral buckle surgery. The resulting defect in the eye wall was associated with a phthisical eye and an inferior orbital pseudocystic lesion. Case report. An 81-year-old white woman presented with a Miragel scleral buckle 23 years after retinal detachment repair in the right eye. She complained of redness, swelling, and pain in the right eye, which was completely blind from glaucoma. There was evidence of implant extrusion in the inferior cul-de-sac. Orbital computed tomography scan revealed an inferior orbital cystic-appearing lesion. At the time of surgery, a fragmented Miragel implant was removed and 5 mL of clear fluid were drained from the pseudocyst. A 2.5-cm defect in the eye wall was partially repaired. Scleral erosion as a late complication of scleral buckle surgery is relatively well described with the buckle becoming visible in the subretinal space on funduscopic evaluation. Progression to a full-thickness scleral defect is uncommon. We present a unique case of postbuckle scleral necrosis associated with involution of the globe and development of a contiguous orbital pseudocyst.

A Case of Sympathetic Ophthalmia After a Severe Acanthamoeba Keratitis

To report a case of sympathetic ophthalmia (SO) after a severe Acanthamoeba keratitis. Interventional case report. A 59-year-old white woman, wearing contact lenses, developed a severe Acanthamoeba keratitis in the left eye, which involved the limbus, and required 8 months of intensive antiamoeba therapy; the condition resolved leaving a painful, phthisical eye with complete corneal neovascularization. Six months later, the patient presented with pain, blurred vision, and photophobia in the right eye. Slitlamp examination of the right eye revealed granulomatous uveitis. On the suspicion of an SO, treatment with high-dose topical and oral corticosteroids and immunosuppressants was started. After 3 months, the eye is stable, with a visual acuity of 20/50, and the patient is taking prednisolone 7.5 mg per day and cyclophosphamide 50 mg per day. [corrected] Development of SO in the absence of previous trauma or surgery is rare. Our case is the first report of a clinically diagnosed SO after an episode of severe Acanthamoeba keratitis.

Ocular status and functional adaptation of visually challenged children of a special school in Oman

Introduction:We assessed the ocular status and visual adaptation among children studying at a school for visually disabled children in Muscat, Oman.Materials and Methods:This descriptive study was conducted in 2009–2010. We assessed the visual and ocular status of the participants. They were interviewed to elicit the past history of eye problems and management. They also expressed their visual adaptation in their ‘day-to-day’ life, and their ambitions.Result:We examined and interviewed 47 participants (29 male and 18 female). The mean age of the participants was 19.7 years (Standard deviation 5.9 years). Twenty-six of them were blind since birth. Phthisical eyes, disfigured eyes and anophthalmic sockets were noted in 19, 58, and six eyes of participants. Twenty-six (55.5%) participants had visual disabilities due to genetic causes, since birth. In 13 participants, further investigations were needed to confirm diagnosis and determine further management After low vision training, 13 participants with residual vision could be integrated in the school with normal children. One participant was recommended stem cell treatment for visual restoration. Five children were advised reconstructive orbital surgery. The participants were not keen to use a white cane for mobility. Some participants, 16 / 28 (57%), with absolute blindness, were not able to read the Braille language. Singing and playing music were not very well-accepted hobbies among the participants. Nineteen participants were keen to become teachers.Conclusions:Children with visual disabilities need to be periodically assessed. The underlying causes of visual disabilities should be further explored to facilitate prevention and genetic counseling. Participants had visual adaptation for daily living and had ambitions for the future.

Adjunctive Use of Hyaluronic Acid Gel (Restylane Sub-Q) in Anophthalmic Volume Deficient Sockets and Phthisical Eyes

This study aims to present the use of Restylane Sub-Q for orbital volume augmentation in patients with secondary volume deficiency either postenucleation or postevisceration or those with phthisical eyes. This prospective case series reviews clinical, photographic, and radiologic records of 16 patients with anophthalmic or enophthalmic orbits who underwent volume augmentation by injection with hyaluronic acid gel in the intraconal and extraconal posterior orbit. The technique is discussed in detail. The volume of hyaluronic acid gel injected ranged from 2 to 4 ml (mean volume, 2.3 ml) per orbit, with a mean reduction of enophthalmos of 3.7 mm (71.4%) at 1 week, 2.8 mm (59.9%) at 6 months, and 2.5 (51.3%) at 12 months, with follow-up of 94.1%, 68.8%, and 50% of the patient group, respectively. Follow-up after 12 months consisted of subjective feedback from the patient. With the exception of one patient, the mean subjective follow-up period was 14.7 months (maximum, 22.4 months; minimum, 1.6 months). The procedure was well tolerated by 15 of the 16 patients who all experienced an improvement in cosmetic appearance. There was one possible complication of orbital cellulitis (although not examined by our clinic); this patient did not attend further follow-ups. One patient had full correction of her enophthalmos, which was maintained over 12 months. Hyaluronic acid gel injections in patients with enophthalmic sockets appear to be a safe, tolerable, and minimally invasive alternative for orbital volume augmentation in the outpatient setting. However, as predicted, its affects are temporary, and volume does begin to decrease within 12 months of injection.

Cataracta ossea – Ultrastructural and specimen analysis

Although intraocular osseous metaplasia is a well-known phenomenon, ossification of the lens is a rare phenomenon nowadays. An enucleated phthisical eye showed a rock-hard intraocular particle. Lens status after a trauma 36 years ago had been unclear. Differential diagnosis included an intraocular foreign body or ossification of the lens. X-ray diffraction analysis showed microcrystalline apatite indicating a mineralized structure. Histologic specimens revealed a mineralized lens that underwent secondary osseous metaplasia. Due to the small number of cases, the mechanisms and preconditions of osseous metaplasia of the lens are not understood in detail, but injury to the lens capsule and availability of blood supply are being discussed. Both were present in this case, in which the luxated lens ended up in the ciliary body region. The mechanism resembled enchondral ossification rather than intramembranous ossification, which is seen in osseous metaplasia of other intraocular structures.

Prosthetic management of ocular defect: Esthetics for social acceptance

It is quite usual for a person to have a natural eye removed as a result of a severe trauma; congenital abnormality; or disease such as an infection, a tumor or untreatable painful glaucoma. In such situations, the natural eye is removed by an acceptable medical procedure, for example, by enucleation or evisceration. It is also usual for a person to have a smaller than normal or phthisical eye that is blind. An ocular prosthesis is created to restore a more normal anatomical structure and the cosmetic defect created by these conditions in a person. The initial step in creating this prosthesis is the preparation of an impression of the ocular socket. From this impression, an ocular prosthesis is created that simulates a person's natural eye and is inserted into the ocular socket posterior to the lids and anterior to the orbital implant or phthisical globe. With such a procedure, a person's psychological trauma associated with the loss of the eye is reduced, and a more cosmetically acceptable appearance results from the use of these prostheses. Although implant eye prosthesis has a superior outcome, due to economic factors it may not be advisable in all patients. Therefore, a custom-made ocular prosthesis is an excellent alternative. Here, we present a case of a custom- made ocular acrylic prosthesis, which showed excellent fit, retention and esthetics. These prostheses usually comprise a scleral region with veins, an iris, a pupil and a clear corneal layer.

Functioning avascular retinae—a report of two siblings

Introduction: We present two siblings who, despite having complete retinal vessel absence, have functional retinae. Methods: Retrospective case reports Results: Two sisters, aged 3 (SK) and 5 (AK), of consanguineous parents, presented with poorly controlled congenital glaucoma. AK had a right phthisical eye and uncontrolled glaucoma in the left. She demonstrated degraded electroretinograms (ERG) in the right eye but no consistent flash visual-evoked potentials (VEP). SK had uncontrolled glaucoma and dense cataract in the left eye with moderately controlled glaucoma in the right eye. She demonstrated normal ERG in the right eye but no consistent responses in the left eye. Both children had microspherophakia, marked iris hypoplasia, and anomalous dentition. Homocystinuria was excluded serologically. AK had a right vitreolensectomy with subsequent control of glaucoma with topical Cosopt®. SK underwent combined left trabeculectomy and trabeculotomy with mitomycin C, with subsequent lensectomy. The right eye glaucoma was controlled topically as for AK. Clinically SK was able to navigate in familiar surroundings and play with toys close to her face. Both children showed absence of retinal vasculature. Discussion: These are the first reported cases to the best of our knowledge of functioning avascular retinae. AK has little or no vision secondary to glaucoma, although ERG responses are present. SK has functioning vision with normal ERG in the right eye. Conclusions: Physiologically avascular retinae occur in the mammalian world in which the entire metabolic demands are met by the choroidal circulation. These cases may represent a similar entity and in so doing contravene the accepted hypothesis that an avascular retina precludes functional vision in humans.

Diagnostic Surprise in an Evisceration Specimen

Diagnostic surprise in an evisceration specimen. Aims and purpose: To report a rare ocular tumor discovered incidentally after evisceration of a painful blind eye. Methods: Observational case report. Results: A 67-year-old Caucasian lady presented for elective evisceration of chronically irritable phthisical right eye. A history of bilateral retinal detachment surgery 34 years prior followed by phthisis of the right eye was noted. The patient was a smoker but otherwise fit and well. Intra-operatively, the ocular contents were felt to be unusual with hard deeply pigmented lumps being present in the eviscerated tissue. The specimen was sent for histopathology. This was reported as a primary adenocarcinoma of the retinal pigment epithelium after expert histological opinion. The possibilities of a secondary adenocarcinoma with possible primary sites as lung, breast or kidney were ruled out by immuno-histochemical techniques. The patient underwent extensive systemic screening including a whole body CT scan. Exhaustive investigations have not found any other tumor site. Conclusion: In the absence of a recognizable source of metastasis, a diagnosis of primary ocular adenocarcinoma has been made with retinal pigment epithelium being the possible site of origin. Literature review shows that primary ocular adenocarcinoma arising from neuroepithelium is a rare but recognized occurrence especially in longstanding blind eyes. This case highlights the importance of routine histopathological examination of eviscerated ocular contents, especially in long standing blind eyes.

Phthisis Bulbi and Buphthalmos as Presenting Signs of Retinoblastoma: A Report of Two Cases and Literature Review

To report two cases of bilateral retinoblastoma (RB) with unusual presentations. The medical records of 321 patients from the Retinoblastoma Referral Center in Siena were reviewed. A total of 111 patients had bilateral RB, 2 of them presenting with phthisis bulbi and buphthalmos. Both patients underwent bilateral enucleation. Clinical features, imaging studies, and histopathology were reviewed. These 2 cases represent 0.62% (2/321) in our series. Histopathology did not reveal viable tumor cells in the phthisical eyes; in both buphthalmic eyes the tumor was active, infiltrating the choroid and optic nerve. Phthisis bulbi and buphthalmos are unusual presenting signs of RB. This very rare combination of these two signs in different eyes of the same patient is probably due to a delay in diagnosis.

Polycystic Echinococcosis of the Orbit

To report a case of polycystic echinococcosis of the orbit caused by Echinococcus oligarthrus. Interventional case report. A 14-year-old girl presented with a massive proptosis of the right eye of 9 years duration and loss of vision. The eye was phthisic, and a cystic mass was palpable. Computed tomography scan showed closely packed multiple orbital cysts with destruction of the medial orbital wall. Surgical exploration was performed. The phthisic eye was enucleated. Dissection of the outer fibrous capsule yielded approximately 30 intact translucent white cysts of various sizes that were suggestive of polycystic echinococcosis. The diagnosis of echinococcosis was confirmed on histopathologic evaluation. The specific diagnosis of E oligarthrus was made on the basis of the presence of straight-backed hooks and central guards. Polycystic echinococcosis of the orbit caused by E oligarthrus is rare. It may be an entirely new entity or hitherto unrecognized form of orbital echinococcosis.

An unusually longstanding, strictly ocular, limited form of Wegener's granulomatosis

Sir, W egener’s granulomatosis (WG) in its complete form is characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract, vasculitis and glomerulonephritis (Haynes et al. 1977; Bullen et al. 1983). Limited forms of WG, where not all the criteria are simultaneously present, have been well described (Carrington & Liebow 1966; Coutu et al. 1975; Coppeto et al. 1985; Boudes 1990), although such forms of the disease have been questioned by others (Lie 1990). We describe a case of a limited form of WG in a 49-year-old man, with an unusually long course (30years) and a long interval (22years) between attacks on the two eyes, in which manifestations have always been isolated to the eyes, without involving any other organs so far. At the age of 19years the patient experienced relapsing episodes of recurrent sclerokeratitis in the left eye, leading to corneal perforation. At the time he underwent penetrating keratoplasty twice, but both grafts failed, resulting in phthisis in the left eye. During that period, the specific underlying causes of the clinical signs remained unclear, and the condition was described using the general term ‘an autoimmune disease’. Since then, the subject’s medical and ocular history had been unremarkable. In July 1996, at the age of 41 years, the patient presented with painful proptosis, limited eye movements and blurred vision in the right eye. His best corrected visual acuity (BCVA) was 0.5 RE and no light perception LE. Anterior segment and fundus examination were unremarkable. However, a central scotoma was detected on visual field examination of the right eye. The patient was using prosthesis over his phthisic left eye. An orbital computed tomography (CT) scan was performed, showing optic nerve compression by the inflamed extraocular muscles in the right eye and phthisic alterations behind the prosthesis in the left eye. In addition, an episcleral lesion extended around the lateral rectus muscle insertion in the right eye (Fig. 1). On laboratory work-up, cANCAs (cytoplasmic pattern of staining antineutrophil cytoplasmic antibodies) positive titre was the only finding. Thus, considering the previous ocular history, WG was strongly suspected. Biopsy of multiple orbital specimens taken from the episcleral lesion and other granuloma suspected areas on the CT scan confirmed the diagnosis (Figs 2 and 3). In the absence of generalized symptoms, the patient was evaluated for subclinical involvement of other systems. A CT scan of the lungs, contrast magnetic resonance imaging (MRI), renal evaluation and otorhinolaryngological examination including MRI of paranasal sinuses and nasal mucosa biopsy revealed no WG findings. Over the following 8months the patient had two additional relapses of the orbital pseudotumour in the right eye and one attack of sclerokeratitis. Treatment modalities included two repetitive orbital decompressions, i.v. pulse and per os corticosteroids administration and cyclophosphamide prescription (2mg/kg/day) for 20months.

Enucleation with Reverse Replacement of Sclera as an Alternative to Conventional Evisceration

Background and Objective: To objectively review the results of a technique combining enucleation with evisceration in patients listed for traditional evisceration with preservation of the rectus muscles. Materials and Methods: Ten patients who underwent combined enucleation and evisceration with 3 to 36 months of follow-up were identified (average follow-up 14 months). Three eyes were phthisical, 1 microphthalmic, 1 buphthalmic, 1 a secondary implant following conventional evisceration and 4 non-phthisical painful eyes. The technique involved enucleation followed by evisceration of the eye contents. Implants, either coral or acrylic, were wrapped in the eviscerated sclera and replaced in the orbit with the posterior pole of the sclera facing anteriorly. The rectus muscles were then resutured onto the sclera. The patients were subsequently recalled and volume replacement, cosmesis and complications were assessed. Results: Three coral and 7 acrylic implants were placed, 2 of 22 mm, 7 of 20 mm and 1 of 18 mm. No complications were encountered, in particular no implant extrusions. Cosmesis was graded good in 9 out of 10 patients. Conclusion: Combined enucleation and evisceration allows the selection and placement of an appropriately large-sized implant to achieve good volume replacement with no extrusions in our series. This technique is particularly pertinent as an alternative to standard evisceration in phthisical eyes.

Retinal and choroidal biopsies are helpful in unclear uveitis of suspected infectious or malignant origin

Objectives To assess the clinical value of retinal or choroidal biopsy in establishing a definitive diagnosis directing subsequent management and to assess the risk involved in such surgery. Design Retrospective noncomparative interventional case series. Participants Thirteen patients with uveitis of suspected malignant or infectious origin. One patient had 2 consecutive biopsies on the same eye. Methods A retrospective review of a 4-year period was undertaken of all those cases in which the biopsy was taken for diagnostic purposes at a single institution. Main outcome measures Ability of biopsy to establish a pathologic diagnosis and guide treatment and surgical complications. Results A transscleral approach was used in 4 and a pars plana vitrectomy approach in 10 of the biopsies. The only operative complication was a retinal break in 1 case. Postoperative events that might be related to the surgery included 1 localized retinal detachment, 2 cataracts, and 1 phthisical eye. The pathologic diagnosis differed from the initial clinical diagnosis in 5 of the 13 cases. The biopsy result directed specific appropriate treatment in 7 of the 13 cases. In the 6 remaining cases, no specific diagnosis was confirmed, but the results of the biopsy were useful in excluding malignancy and in some cases allowing a therapeutic trial. Conclusions Retinal or choroidal biopsy is a valuable investigation that often changes clinical management when carried out for specific indications in patients with uveitis of suspected malignant or infectious origin. Although it is likely to remain an investigation of last resort, it should be considered at an earlier stage when there is diagnostic uncertainty if severe visual loss is to be prevented.

Pleomorphic adenocarcinomas of the ciliary epithelium: Immunohistochemical and ultrastructural features of 12 cases

Objective To examine the immunohistochemical and ultrastructural features of the rare pleomorphic adenocarcinomas of the ciliary epithelium (CE). Design Retrospective case series. Participants The study materials included 12 cases of adenocarcinoma of the ciliary epithelium: 9 cases of CE hyperplasia and 3 cases of CE adenomas. Intervention Histologic sections were stained with hematoxylin-eosin, alcian blue, periodic acid-Schiff, and occasionally with Masson trichrome. Additionally, the following immunohistochemical markers were used: Kermix (ae1/ae3 + ck1), cytokeratin 7 (CK7), cytokeratin 20 (CK20), epithelial membrane antigen, CAM 5.2, S-100 protein, neuron-specific enolase, glial fibrillary acid protein, smooth muscle actin, and vimentin. Five lesions were studied ultrastructurally. Clinical data were available in all cases, and follow-up was obtained in 9 of the 12 patients. Results Nine tumors occurred in phthisical eyes in adults. The tumor cells were arranged in tubular and solid patterns and surrounded by thick basement membrane (BM) material and fibrous stroma. Immunohistochemistry (IM) of adenocarcinomas showed positivity with kermix (8 of 12 lesions), CAM 5.2 (7 of 12), and CK7 (5 of 12). Ultrastructurally, the tumor cells were surrounded by a thick, homogeneous, and/or multilaminar BM and attached to each other by junctional complexes. Conclusions Clinically, this intraocular neoplasm should be considered in adults with a longstanding blind eye with an epibulbar mass and/or proptosis of recent duration. Fatal cases only occurred in tumors with extraocular extension. Adenocarcinomas of CE should be differentiated from amelanotic melanoma and metastatic lesions by the presence of a thick BM material around the tumor cells and intraocular fibrosis. Immunohistochemistry is helpful in differentiating from melanomas but not helpful in cases of metastatic carcinomas.

Topical treatment of Pseudomonas spinfected corneal ulcers in horses: 70 cases (1977–1994)

Objective To determine which antimicrobial agents. were most effective against Pseudomonas sp-infected ulcerative keratitis, and identify any trends in the various clinical conditions associated with these bacteria that might assist in effective treatment of the disease. Design Retrospective case series Animals 66 horses with 70 Pseudomonas sp-infected corneal ulcers. Procedure We reviewed medical records of horses admitted to the George D. Widener Hospital for Large Animals, University of Pennsylvania between July 1977 and December 1994. Records of horses that had Pseudomonas sp isolated from a corneal ulcer scraping or deep swab were included in the study. Results Aggressive topical medical treatment was successful in 57 ulcers and most likely would have been effective in 5 additional ulcers. Antimicrobial susceptibility testing indicated susceptibilities of 87, 85, and 93% to tobramycin, gentamicin, and amikacin, respectively. Although concurrent fungal infections were identified in only 2 of 35 ulcers examined, almost three fourths of the ulcers were treated with antifungal medications prophylactically. Clinical outcomes of the 70 affected eyes included: excellent vision with minimal leukoma, 73%; enucleation, 19%; blind phthisical eye, 4%; peripheral vision only, 3%; and euthanasia of newborn, 1%. Clinical Implications Aggressive topical medication with microbial agents effective against Pseudomonas sp can result in excellent vision with minimal leukoma in most horses with corneal ulcers. (J Am Vet Med Assoc 1996;209:954-957)

Treatment outcome and dose-response relationship in infants younger than 1 year treated for retinoblastoma with primary irradiation

Thirty-three infants ( < 1 year at diagnosis) were treated for retinoblastoma with primary irradiation at St. Jude Children's Research Hospital (SJCRH) between 1963 and June 1992. Staging of the 44 treated eyes was as follows: Reese-Ellsworth (R-E) Groups I (n = 20), Group II (n = 9), Group III (n = 6), Group IV (n = 2), Group V (n = 7). Irradiation was delivered using either a single anterior field (31 eyes) or lens-sparing techniques (13 eyes). Total doses ranged from 21-45 Gy (median = 36 Gy) in fractions of 150-180 cGy (n = 34) or > 180 cGy (n = 10). One child died of metastatic disease at 42 months. Three patients have developed second malignant neoplasms; two have succumbed at 88 and 125 months post-RB diagnosis; the remaining patients are alive at 6-259 months postdiagnosis (median follow-up = 127 months). Local control with irradiation alone and supplemented cryotherapy given within 2 months (n = 2) was maintained in 29 eyes, with no statistical difference seen for total doses < or = 36 Gy (21/8 eyes) vs. > 36 Gy (8/16). Of 15 eyes that required salvage therapy, tumor control has been maintained in 13. Enucleation was required for four patients, two with recurrent retinoblastoma and one with a phthisical eye. Cataract formation was documented in 23 eyes (87.5%) treated with lens-sparing techniques developed cataract. At last follow-up, 23 of 30 patients tested (77%) had visual acuity of 20/100 or better. This experience confirms early observations in that doses > or = 36 Gy do not appear to improve local control with irradiation alone in infants ( < 365 days) with retinoblastoma.

Treatment outcome and dose‐response relationship in infants younger than 1 year treated for retinoblastoma with primary irradiation

Thirty-three infants (<1 year at diagnosis) were treated for retinoblastoma with primary irradiation at St. Jude Children's Research Hospital (SJCRH) between 1963 and June 1992. Staging of the 44 treated eyes was as follows: Reese-Ellsworth (R-E) Groups I (n = 20), Group II (n = 9), Group III (n = 6), Group IV (n = 2), Group V (n = 7). Irradiation was delivered using either a single anterior field (31 eyes) or lens-sparing techniques (13 eyes). Total doses ranged from 21–45 Gy (median = 36 Gy) in fractions of 150–180 cGy (n = 34) or >180 cGy (n = 10). One child died of metastatic disease at 42 months. Three patients have developed second malignant neoplasms; two have succumbed at 88 and 125 months post-RB diagnosis; the remaining patients are alive at 6–259 months postdiagnosis (median follow-up = 127 months). Local control with irradiation alone and supplemented cryotherapy given within 2 months (n = 2) was maintained in 29 eyes, with no statistical difference seen for total doses ≤36 Gy (21/28 eyes) vs. >36 Gy (8/16). Of 15 eyes that required salvage therapy, tumor control has been maintained in 13. Enucleation was required for four patients, two with recurrent retinoblastoma and one with a massive retinal hemorrhage, one with a phthisical eye. Cataract formation was documented in 23 eyes (87.5%) treated with anterior field. Three patient treated with lens-sparing techniques developed cataract. At last follow-up, 23 of 30 patients tested (77%) had visual acuity of 20/100 or better. This experience confirms early observations in that doses ≥36 Gy do not appear to improve local control with irradiation alone in infants (<365 days) with retinoblastoma. © 1996 Wiley-Liss, Inc.

Panasil light body impression material study

Summary This study was undertaken to confirm that Panasil light body is a suitable replacement impression material for Panasil ‘C’, used for ocular impression procedures, which was withdrawn by the manufacturers in 1993. The damaging effects to the corneal and conjunctival tissues of alginate materials used in the past during impression-taking procedures for artificial eye and cosmetic shell prostheses, is recognized by ocularists and optometrists. Modern silicone impression materials demonstrate: 1. Minimal disruption to tissues. 2. High accuracy. 3. High strength in relation to thin section. 4. Good flow characteristics prior to curing. Panasil light body impression material is polyvinyl siloxane based, low viscosity, addition curing silicone. Our trial investigated the effects of obtaining impressions from five groups of patients presenting with: 1. Anophthalmia with hydroxyapatite implants. 2. Phthisical eyes. 3. Unsighted vascularized eyes. 4. Clear corneas. 5. Exenterated orbits with osseointegrated implants. Total number of patients examined was 30. In all cases where an eye was present, post-procedural examination by Burton/slit-lamp with fluorescein was carried out to determine the level of tissue damage/abrasion. A table of results is presented. We have shown that Panasil light body silicone impression material is accurate and stable when used for the purposes investigated. We would emphasize the minimal adverse effects to the corneal and conjunctival tissues observed during the course of this study.

Panasil light body impression material study

SummaryThis study was undertaken to confirm that Panasil light body is a suitable replacement impression material for Panasil ‘C’, used for ocular impression procedures, which was withdrawn by the manufacturers in 1993. The damaging effects to the corneal and conjunctival tissues of alginate materials used in the past during impression‐taking procedures for artificial eye and cosmetic shell prostheses, is recognized by ocularists and optometrists.Modern silicone impression materials demonstrate:1. Minimal disruption to tissues.2. High accuracy.3. High strength in relation to thin section.4. Good flow characteristics prior to curing.Panasil light body impression material is polyvinyl siloxane based, low viscosity, addition curing silicone.Our trial investigated the effects of obtaining impressions from five groups of patients presenting with:1. Anophthalmia with hydroxyapatite implants.2. Phthisical eyes.3. Unsighted vascularized eyes.4. Clear corneas.5. Exenterated orbits with osseointegrated implants.Total number of patients examined was 30.In all cases where an eye was present, post‐procedural examination by Burton/slit‐lamp with fluorescein was carried out to determine the level of tissue damage/abrasion. A table of results is presented.We have shown that Panasil light body silicone impression material is accurate and stable when used for the purposes investigated. We would emphasize the minimal adverse effects to the corneal and conjunctival tissues observed during the course of this study.