Table of Contents - WOC 2012

WOC2012 Abstract Book
VI-OCP-04
A case report of massive orbital myiasis
Aftab Muhammad (1) , Ahmed Waqar (1) , Karamat M. Irfan (1) , Kamal Zahid (2)
1. Lahore General Hospital
2. Post-graduate medical Institute
Purpose To show a case of massive orbital myiasis, in which both the lids and
all ocular tissues were destroyed by maggots, its presentation and management
Summary We received a 90 years old lady, who had dementia. presenting
complain was pain, loss of volume and presence of maggots in left eye. On
examination, the left orbit was full of maggots, both eye lids were absent and
no ocular tissue could be seen. We removed the maggots on the surface with
forceps. The maggots inside the orbit were removed after they were sedated
with halothane soaked eye pad. About 150 maggots were isolated. A CT-scan
of brain, orbit and sinuses was performed. It showed complete destruction of
left orbit, with erosion of frontal bone, but no extension to sinuses or brain.
After one day, the orbit was examined again. It was found to be full of maggots
again. This time turpentine oil was used to make maggots immobile, and then
removal was carried out. About 60 more maggots were isolated. Orbit was
washed with hydrogen peroxide. Patient was examined daily for ten days, in
which no maggots reappeared in orbit. After that the patient didn›t come back
for follow-up.
VI-OCP-05
Case of large benign orbital mass in a young female patient
Khan Valeed (1) , Kamal Zahid (2) , Kamal Fahad (1) , Randhawa Adeel (1)
1. Lahore General Hospital
2. Post-graduate Medical Institute
Purpose To give awareness that a large orbital mass may present with minimal
proptosis Summary A 27 years old female presented to us with left proptosis,
decreased vision off and on associated with headache which radiated to the
left temple. On examination Snellen visual acuity in left eye was 6/9, colour
vision was 7/13 on Ishihara chart. Pupil reaction was normal. Anterior segment
and fundus examination was normal. There was 3 mm of proptosis. The eye
ball was displaced infronasally. CT scan showed suprotemporal orbital mass,
well-circumscribed and homogenous. She underwent lateral orbitotomy where
bone segment of 15x10mm was removed from lateral orbital wall. The mass
was identified behind the eye ball and it was a bit adherent to optic nerve.
Mass was gradually separated by blunt dissection, taking care to stop as
soon as the pupil started dilating. Finally, 20x25mm bright red coloured firm
mass was removed. A drain was put in and visual observation was done postoperatively
for 24 hours. Histopathology showed a benign fibrovascular tissue.
The recovery of the patient was good. Her visual acuity returned to 6/6, colour
vision to 13/13, and it remained stable throughout the six months follow-up.
VI-OCP-06
Canalicular Laceration Repair with a Monocanalicular Stent -
Simplified!
Desai Savari (1, 2) , Naik Milind (1, 2) , Honavar Santosh (1, 2) , Shahnand Dhwani (1,
2) (1, 2)
, Jalli Gangadhar
1. All India Ophthalmological Society
2. Bombay Ophthalmologists Association
OBJECTIVE :The goal of any canalicular laceration repair is to choose a
method which will prevent post traumatic epiphora as well as provide cosmesis
to the patient.SUMMARY OF CONTENT: Though there are various surgical
techniques for the repair of canalicular injuries, the important principles
to consider for a successful surgery are, an accurate apposition of the
severed eyelid margins, pericanalicular or canalicular anastomosis and an
endocanalicular support with a silicone tubing. Monocanalicular silicone stents
are known to achieve excellent anatomical (70% to 90%) and functional (80%
to 100%) results.In this video we demonstrate how to identify the medial
lacerated canalicular end, without the aid of injections or probes, the method
of monocanalicular stent placement and fixation and precise canalicular
apposition, in a step by step manner, for a successful canalicular repair.
VI-OCP-07
Excision of intraconal prolapsed fat
Alsuhaibani Adel (1)
1. King Saud University
This video will demonstrate step by step the surgical removal of prolapsed
intraconal fat with properative and postoperative photos. Surgical steps will
include: 1. clinical signs confirming the diagnosis along withpreparation of
the patient for surgery. 2. Making the conjunctival incision followed by tenon
capsule incision to reach the prolapsed fat. 3. Excision of the prolapsed fat. 4.
Closure of the conjunctiva with absorbable sutures.
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VI-OCP-08
Atypical presentation of a conjunctival mass
Karamat Muhammad Irfan (1) , Kamal Zahid (2) , Aftab Muhammad (1)
1. Lahore General Hospital
2. Post-graduate Medical Institute
Objective: To present a benign lesion of conjunctiva apperantly seems to be a
malignant lesion.
Summery: A 16 years old labrouer presented to us with a painless slowly
progressive conjunctival mass in his left eye since birth. On examination
right eye was normal. Left eye had a vision perception of light. There was
a raised , pigmented, irregular , nonulcerative , vascularised conjunctival
mass in interpalpebral region nasaly. Its size was 9mm horizantly and 6mm
vertically (6-11 o clock). In anterior chamber there was an amber coloured cyst
3*4 mm. on b-scan vitreous was clear, retina was flat and there was no intraorbital
extension . for this apparently malignant looking lesion we suspected
malignant melanoma , lymphoma , uveal herniation through an old traumatic
tear in sclera or a pigmented nevus. His excisional biopsy was done and
specimen was sent for biopsy. Report confirmed it a pigmented nevus.
VI-OCP-09
NEW MODIFICATION IN REPAIR OF TRAUMATIC CANALICULAR
LACERATION
Rashad Mohamed Saad (1)
1. Ain Shams University Hospitals
Purpose: New modification in technique of ring or circular intubation helping in
decreasing incidence of canalicular injury or infection after repair of traumatic
canalicular laceration.
Summary Of Content: Canalicular laceration is one of the most challenging eye
lid injuries. Early repair is essential in preventing canalicular scaring and
permanent epiphora. Identifying the medial cut end of canaliculus is made
easy by pigtail probe under general anaesthesia with high magnification.
Ring or Circular intubation is an effective way of repair although it needs long
learning curve. Burying the knot inside the canaliculus may be associated with
injury to canaliculus or Infections. The New modification is leaving long ends of
the knot and bury it in the tube with the knot outside the canaliculus. No injury
to both canalicular or ocular surface. This method can be used in management
of punctal stenosis.
VI-OCP-10
Fat and Facts: Dermis Fat Graft, an Autologous Orbital Implant
Fairooz PM (1) , G Honavar Santosh (1) , Naik Milind (1) , Javed Ali Mohammed,
Jalli Gangadhar
1. LV Prasad Eye Iinstitute
The management of severe anophthalmic contracted socket with volume and
surface deficit is challenging. Optimal socket reconstruction can be achieved
by concurrent replacement of both the volume and the surface. Autologous
dermis-fat graft (DFG) provides this unique advantage. DFG is also a practical
solution to replace migrated, exposed or extruded integrated implants, to
reconstruct post-radiation contracted sockets, and expand sockets with
congenital anophthalmos. Vascularization of the graft and its integration with
native orbital tissue and conjunctivalization of the dermis together provide a
healthy and stable socket and excellent cosmesis. This well-illustrated video
details the indications, technical considerations and step-by-step surgery of
DFG, and its outcome.