Deep orbital Sub-Q restylane (nonanimal stabilized hyaluronic acid) for orbital volume enhancement in sighted and anophthalmic orbits.

OBJECTIVE: To describe a new technique of injecting Restylane Sub-Q (Q-Med, Uppsala, Sweden) into the intraconal and extraconal posterior orbit. METHODS: Retrospective review. Eight injections were performed in 5 patients using 2-mL Sub-Q in the intraconal and extraconal posterior orbit for orbital volume enhancement. Four injections were performed in sighted orbits and the remaining in anophthalmic orbits. The age range was 18 to 36 years; the follow-up time was 5 to 12 months. RESULTS: Orbital volume enhancement was achieved in all cases with an improvement in upper eyelid sulcus and skin fold. Enophthalmos reduction was 2 mm per 2-mL injection. The procedure was well tolerated. One patient experienced a vasovagal episode lasting 3 hours and 1 patient had postoperative pain. No such episodes occurred after I began injecting local anesthesia before performing the Sub-Q injection. One patient required hyaluronidase for migrating gel, which caused lower eyelid swelling. CONCLUSION: This small case series suggested the safety and tolerability of deep orbital Sub-Q. Injections are easily performed in the outpatient setting. The expected volume enhancement was achieved in all cases with no long-term adverse effects to date.

Mitomicina C colírio como tratamento para granuloma piogênico em cavidade anoftámica / Mitomicyn C eye drops as alternative treatment for pyogenic granuloma in anophthalmic socket

OBJETIVO: Avaliar a eficácia do uso tópico de colírio de mitomicina C 0,02 por cento (MMC 0,02 por cento) no tratamento de pacientes com granuloma piogênico em cavidade anoftálmica. MÉTODOS: Seis pacientes portadores de granuloma piogênico em cavidade anoftálmica foram submetidos ao tratamento com mitomicina C 0,02 por cento instilada quatro vezes ao dia durante ciclos quinzenais e intervalo de 15 dias entre os ciclos. Os pacientes foram acompanhados semanalmente. RESULTADOS: Foram acompanhados seis pacientes dos quais um apresentou resolução do granuloma piogênico ao final do primeiro ciclo de uso da MMC 0,02 por cento. Em dois pacientes a MMC 0,02 por cento foi eficaz na resolução da lesão após a segunda semana de tratamento (primeiro ciclo). Dois pacientes apresentaram resolução completa do granuloma piogênico na quinta semana de uso da MMC 0,02 por cento (início do segundo ciclo). Este fármaco foi ineficaz em apenas um paciente que persistiu com a lesão após dois ciclos de tratamento. Não foram observadas complicações decorrentes do uso de MMC 0,02 por cento em nenhum dos pacientes. CONCLUSÃO: A MMC 0,02 por cento tópica mostrou-se eficaz no tratamento de granuloma piogênico em cavidade anoftálmica, entretanto, diante de casuística pequena, torna-se necessário estudo mais amplo, comparando a eficácia da MMC 0,02 por cento com drogas já utilizadas no tratamento desta lesão, tais como os esteróides e antimetabólicos.

PURPOSE: To evaluate the efficacy of mitomycin C eye drops 0.02 percent concentration (0.02 percent MMC) in pyogenic granuloma in anophthalmic socket. METHODS: Six patients who presented pyogenic granuloma were treated with 0.02 percent MMC four times a day in fifteen-day cycles with intervals of fifteen days between each cycle. The patients were observed every week. RESULTS: Among the six studied patients, one presented a complete resolution of the pyogenic granuloma after a ten-day treatment with 0.02 percent MMC that is, before the end of the first cycle. In two patients, the treatment was successful after two weeks using 0.02 percent MMC (one complete cycle). In other two patients, the resolution of the lesion occurred after five weeks that is, at the beginning of the second cycle. 0.02 percent MMC was not successful in only one patient whose lesion persisted after two cycles of the treatment. None of the patients presented complications after the use of 0.02 percent MMC. CONCLUSION: The topical use of 0.02 percent MMC proved efficacy in the treatment of anophthalmic socket pyogenic granuloma. A small number of patients took part in this study, therefore another randomized and comparative research is necessary in order to compare the efficacy of 0.02 percent MMC with other drugs such as corticosteroids and antimetabolites.