Ophthalmic complications after functional endoscopic sinus surgery (FESS).

The purpose of this paper is to inform the ophthalmologist about the occurrence of ophthalmological complications after functional endoscopic sinus surgery (FESS). Due to the close anatomical relationship between the paranasal sinuses and the orbit, involvement and/or injury of the orbit from processes primarily located in the paranasal sinuses, may occur. The orbit, the extra-ocular muscles, the optic nerve and the lacrimal drainage system can be damaged during FESS. The risk of injury is correlated to the anatomical variations, the history of previous surgery, the extent and the gravity of the disease and the skill of the surgeon. We hereby present three cases, each showing a different ophthalmologic complication after FESS.

Multifocal intraocular lens implantation in patients with presenile unilateral primary and secondary cataract.

Multifocal intraocular lens implantation was studied in 6 eyes with a unilateral cataract due to ocular trauma. Two patients had an uncomplicated traumatic cataract, two patients had a complicated traumatic cataract and two patients had a unilateral primary presenile cataract. Postoperative visual acuity for distance and for near vision, with and without additional spectacle correction, as well as the presence of postoperative binocular vision was evaluated. Additionally, we looked for pre- and postoperative parameters, assuming these criteria determine the success ratio of a multifocal intraocular lens implantation: presence of a stereoscopic vision pre-operatively, or absence of a pre-operative strabismus; rather good visual prognosis (no retinal damage in the traumatic cases and no amblyopia in the primary cases); normal functioning of the pupillary sphincter.

Diplopia as an uncommon complication of cataract surgery.

Two patients are presented with diplopia after cataract extraction performed under local anesthesia. Since there was no spontaneous recuperation after several months, strabismus surgery was performed. The first patient presented a restriction of the inferior rectus muscle probably caused by the retrobulbar injection of anesthetics. The second patient had a decompensation of a congenital superior oblique palsy. A survey of the different etiologies of diplopia after cataract surgery is given.

Diagnosis of a masked bilateral congenital superior oblique palsy.

Some patients in whom the diagnosis of a purely unilateral congenital superior oblique palsy was made, developed signs of a palsy in the fellow eye after surgery was done. A review of all diagnostic tests used in discovering the presence of a masked bilateral superior oblique palsy is given. The usefulness of the occlusion-test, which is often forgotten, is illustrated.

Combined fourth and sixth cranial nerve palsy after lumbar puncture: a rare complication. A case report.

Palsies of cranial nerves are well-known complications after lumbar puncture. Sixth nerve palsies are the most common. They normally occur 4 to 14 days after the lumbar puncture and spontaneously recover in a few weeks or months. The occurrence of a fourth nerve palsy following lumbar puncture however is extremely rare. We report on a patient who developed a combined contralateral fourth and sixth nerve palsy after lumbar puncture (Syndrome of Intracranial Hypotension), requiring surgical correction for secondary diplopia.