Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-OCP-43
Congenital Ptosis with Marcus Gunn Jaw Winking Phenomenon -
Cosmetic results of Unilateral Surgery.
Haider Golam (1) , Mitra Mukti (1) , Bhowmik Swapan (1) , Parveen Nishat (1) , Islam
Rajibul (1)
1. National Institute of Ophthalmology & Hospital
Purpose: To see the effect of unilateral surgery in case of congenital ptosis with
Marcus Gunn Jaw Winking phenomenon.
Methods: A total 8 patients (1- 24 years) of MJW phenomenon had been
operated from January 2007 to September 2010. Surgeries were done in
National Institute of Ophthalmology & Hospital and Harun Eye Hospital. At first
levator palpebrae superioris was dissected along with its medial and lateral
horn as far as possible. Then after excision of LPS muscle sling surgery was
done with fascia lata.
Result: Among three female and five male patients MJW phenomenon was
totally abolished in five patients. In one male patient (09 years) there was mild
residual MJW phenomenon because of failure of excision of horns of LPS
muscle. LPS resection was done in one female patient (15 years) with mild
MJW phenomenon. Sling surgery with synthetic material was done in a child
of 1 year.
Conclusion: Congenital ptosis with MJW phenomenon is a major cosmetic
blemish in young patients. Correction of simple congenital ptosis is relatively
easy, but difficult when associated with MJW phenomenon. Though bilateral
surgery is ideal to achieve symmetrical result, sometimes unilateral surgery
may yield satisfactory cosmetic outcome.
PO-OCP-44
Effectiveness for Intralesional Triamcinolone Acetonide Injections
for Chalazia in Pediatiric Patients
Son Junhyuk (1) , Chang Woohyok (1)
1. Department of Ophthalmology, Yeungnam University College of Medicine
Purpose: To evaluate the effectiveness of intralesional triamcinolone acetonide
(TA) injection for chalazia in pediatric patients.
Methods: We performed a retrospective chart review of 58 patients (70 lesions)
under fifteen years of age and 40 patients (50 lesions) aged fifteen and over,
who underwent intralesional TA injections and performed follow-ups for at
least three months. Data regarding age, sex, lesion size, location, number of
injections, treatment success, surgery, and complication were evaluated.
Results: Cummulative treatment success of TA was 64.3% with one injection,
82.9% with two injection, 88.6% with three injection in pediatric patients.
The average number of TA injection was 1.69±1.03 in parimary chalazia
and 1.48±0.87 in recurrent chalazia, while the cumulative treatment success
until third TA injection was 89.8% in primary chalazia and 85.7% in recurrent
chalazia in patients under fifteen years old. The average nember of TA injection
was 1.95±1.18 in primary chalazia and 1.80±1.14 in recurrent chalazia, while
the cumulative treatment success until the third TA injection was 82.5% in
primary chalazia and 70.0% in recurrent chalazia in patients aged fifteen and
over. No complication was noted with TA injections
Conclusions: Intralesional TA injection in chalazia is an effective and safe
treatment in pediatric patients.
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PO-OCP-45
Simultaneous Three-Wall Orbital Decompression, Orbital Fat
Removal and Blepharotomy in Severe Graves Ophthalmopathy
Sembiring Sindy Boru (1) , Irawati Yunia (1) , Soeharko Hernawita (1) , Kersten
Robert C (2)
1. Department of Ophthalmology, Faculty of Medicine University of Indonesia
2. Department of Ophthalmology, University of California
Purpose To demonstrate the management and outcome of severe Graves›
ophthalmopathy by three-wall orbital decompression, orbital fat removal and
blepharotomy in one-stage surgery Methods A 45-years-old Indonesian man
with diagnosis of hyperthyroid presented to Division of Ophthalmic Plastic and
Reconstructive at Cipto Mangunkusumo Hospital with gradual bulging of both
eyes since 2 years ago. On ophthalmological examination bilateral eyelids
retraction, severe exophthalmos, lagophtalmos, and corneal leucoma were
found. There was restriction in upgaze of the right eye. Left eye movement was
restricted to all fields of gaze. The patient underwent orbital floor decompression
of both eyes, lateral wall drilling and medial wall decompression in combination
with removal of inferotemporal and superonasal portion of the orbital fat
and ended with blepharotomy. All procedures were performed in one-stage
surgery. Results Three months after surgery he had significant reduction of
exophthalmos. No lagophthalmos was found on his right eye. However, 1 mm
lagophthalmos with corneal exposure were still present on the left eye. He also
complained of numbness of the cheek and chin Conclusions Simultaneous
three-wall orbital decompression, orbital fat removal and blepharotomy
performed as one-stage surgery is a safe and effective surgical procedure in
managing severe Graves› ophthalmopathy
PO-OCP-46
Outcome of frontalis suspension in cases of severe ptosis
Pai Vijaya (1) , Pai Prathvi (1) , Hazarika Manali
1. Dept of Ophthalmology,Kasturba Medical Colleege
OBJECTIVE: To evaluate the outcome of frontalis suspension in severe ptosis.
Methods: A retrospective analysis of patients with severe ptosis during the
period of one year.
Results: 7 patients were included. 3 had bilateral ptosis . Age of the patients
varied from 3 to 26 years. All the patients presented with complaints of
drooping of the upper lid since childhood. All the patients had severe ptosis
with poor levator palpebrea superioris action [mean 2.1mm]. There was no
associated jaw winking phenomenom. Two patients had restriction of the
elevation. Amblyopia was noted in one patient. All the patients underwent
frontalis suspension with sling (2-fascia lata, 5- silicon rod).During the follow
up period of 1 year, no lagophthalmos or exposure keratitis was noted.
Conclusion: All the patents had good cosmetic out come after frontalis
suspension.
PO-OCP-47
Evaluation of the cosmetic outcome, safety and efficacy of subciliary
incision (a novel technique) for External Dacryocystorhinostomy
(Ex-DCR)
Dave Tarjani (1) , Ali Mohd. Javed (1) , Honavar Santosh (1) , Naik Milind (1)
1. Dept. of Ophthalmic Plastics and Facial Aesthetics, Orbit and Ocular Oncology
Aim: To evaluate the cosmetic outcome, safety and efficacy of subciliary
incision (a novel technique) for External Dacryocystorhinostomy (Ex-DCR).
Methods: A Prospective Interventional Case Series. A novel lower eyelid
subciliary skin incision extending from the medial canthus laterally for 15 mm
was made. Suborbicularis dissection was done to reach the anterior lacrimal
crest. Rest of the steps were similar to standard Ex-DCR. The wound was
closed in a single layer with polyglactin 910 interrupted sutures at the conclusion
of surgery. The scar was graded at 6 weeks by a masked observer as grade
0:no visible scar, grade1:flat scar with good color match, grade2:flat scar with
pigmentary changes, grade3:raised scar and grade4:acquired epicanthus.
Results: 12 patients with a mean age of 49.27 were included. 6(50%) had
grade0, 5(42%) grade1 and 1(8%) grade2 scar at 6 weeks. 4(33%) had mild
punctual eversion. Anatomic and functional success was 100%. Average follow
up was 11.09 weeks.
Conclusions: Subciliary DCR provides excellent wound healing combining the
success rate of standard Ex-DCR and the cosmesis of Endonasal DCR. Mild
punctual eversion is the main disadvantage of this technique.