Program Book

36), 6 (46%) reported previous surgery. In the exenteration group the
mean age at diagnosis was 67,8 years-old (ranging from 31 to 88), 11
(64,7) patients were male, the mean duration of symptoms was of 28,5
months (ranging from 3 to 94), 6 (35%) reported previous surgery.
Conclusions. Mutilating surgery due to orbital or intraocular invasion
by SNOS is uncommon (14%). History of previous surgery was detected
in 40% of the cases. Duration of symptoms was 1.9 higher in cases
undergoing exenteration, a factor that may be considered important for
the occurrence of orbital invasion.
Financial disclosure. None
1150 ECp105
A PROPOSAL FOR A NEW TREATMENT OF ORBITAL
LOW GRADE MALIGNANT LYMPHOMA
Akihiro Kaneko (akikaneko@jcom.home.ne.jp)
Department of Ophthalmology, Teikyo University Hospital, Tokyo, Japan
Purpose. TO propose a new treatment for orbital low grade lymphoma to
avoid complications of radiotherapy
Methods. A selective ophthalmic arterial injection with 3-5mg of
melphalan (SOAI) is performed to eradicate orbital low grade malignant
lymphoma.
Results. The author has no chance to try this therapy until now.
Conclusions. Melphalan is an old alkylating agent which has
radiomimetic activity which means to work as radiotherapy.SOAI is
developed by our group for eye-preservation therapy of retinoblastoma.
It is performed more than 20 countries over the world, because very
slight complications are recognized.
Therefore good response is able to be expected for the treatment of
localized orbital lymphoma. in addition to that ,many complications of
radiotherapy must be avoidable.
Financial disclosure. None
59 ECp106
ORBITAL EXENTERATION RECONSTRUCTION WITH
RADIAL FOREARM AND ANTEROLATERAL THIGH FREE
FLAP: A MULTIDISCIPLINARY APPROACH
Sara E. Lally, M.D., Carol L. Shields, M.D., Joseph Curry, M.D., Ryan
Heffelfinger, M.D., David Cognetti, M.D., Howard Krein, M.D., Jerry A.
Shields, M.D. (saralally1@yahoo.com)
Wills Eye Institute, Philadelphia PA
Purpose.Orbital exenteration is a radical procedure to remove the eye
and orbital contents, usually for invasive malignancies. When possible,
eyelid skin and muscle are spared to aid in closure and healing. If tumor
infiltrates the eyelid, then this tissue must be removed. Reconstruction
of the socket with radial forearm and anterolateral thigh free flaps is
performed.
Methods. Review of technique and outcomes.
Results. Over the past 5 years, exenteration was performed in 44
cases for diagnoses of invasive eyelid squamous cell carcinoma (n=11),
invasive eyelid basal cell carcinoma (n=1), eyelid sebaceous carcinoma
(n=7), conjunctival melanoma (n=8), extraocular extension of uveal
melanoma (n=5), lacrimal gland adenoid cystic carcinoma (n=3),
primary orbital malignancies (n=7), and other extraocular extension of
intraocular tumors (n=2). In 33 cases, eyelid sparing exenteration and
EYELID, CONJUNTIVA & ORBIT
Abstract Posters
84
reconstruction with primary closure was achieved. In 11 cases, eyelid
sacrificing exenteration was performed and reconstruction with radial
forearm (n=4) or anterolateral thigh (n=7) myocutaneous free flap was
performed with anastomosis of large vessels with the temporal artery.
In all cases (100%), reconstruction was successful and the graft survived,
providing skin coverage over orbital bone.
Conclusion. Radical exenteration for extensive orbital malignancies can
lead to large open defects that require free myocutaneous flaps from the
arm or leg with microvascular anastamosis.
Financial disclosure. None
243 ECp107
A HUGE OCULAR ADNEXAL MALT LYMPHOMA WHICH
AROSE FROM IGG4 RELATED ORBITAL LESION
Koh-ichi Ohshima (koh-1125@po6.oninet.ne.jp)
Section of Ophthalmology, Okayama Medical Center, Japan
Purpose. For the treatment of the IgG4 related orbital disorders, steroid
therapy is the first choice. On the other hand, ocular adnexal MALT
lymphoma responds well to the radiation therapy. We should discuss
how to treat MALT lymphoma which arose from IgG4 related orbital
lesion.
Methods. A 71-year-old woman visited our department for the treatment
of eyelid swelling of the left eye which had been aggravating for two
years. The left upper and lower eyelids were very swollen and the left
eyeball had atrophied. The abnormal mass of left eyelid, the swelling of
extra ocular muscle and the enlargement of major lacrimal gland were
shown by orbital MRI. Auto-antibodies related to the thyroid gland were
negative, and serum IgG4/IgG was 450/1844. The incisional biopsy of
eyelid tumor revealed it to be MALT lymphoma with many IgG4 positive
plasma cell infiltration.
Results. The eyelid tumor was surgically removed and the deformity
of the eyelid decreased. To prevent re-growth of the tumor, radiation
therapy of 30Gy was added to the left orbit. The patient has been
carefully followed up for one year.
Conclusions. Excision and radiation therapy performed to treat a huge
ocular adnexal MALT lymphoma which arose from an IgG4 related orbital
lesion, with a good result.
Financial disclosure. None
223 ECp108
HIGH-RESOLUTION ULTRASONOGRAPHY IN THE
DIAGNOSIS OF ORBITAL MALIGNANT LYMPHOMA
S.V. Saakyan, A.G. Amiryan, V.R. Alikhanova (svsaakyan@yandex.ru)
Moscow Helmholtz Research Institute of Eye Diseases
Purpose. To characterize the diagnostic criteria of orbital malignant
lymphoma through the use of complex ultrasonography techniques.
Methods. 21 patients with orbital lymphoma (mean age 55.2±16 years)
were surveyed. The examination was performed on an ultrasonic system
with volume-scanning, Voluson® 730 PRO (Kretztechnik’’s – GE Medical
System, Austria). The Duplex scanning included B-mode examination,
color Doppler Imaging (CDI), spectral Doppler analysis, and threedimensional
reconstruction. In all cases, the diagnosis of lymphoma
was morphologically verified.
Results. The lymphoma was localized in the lacrimal glands in 11