Dellen corneal secundario a carcinoma epidermoide de conjuntiva / Corneal dellen secondary to epidermoid carcinoma of the conjunctiva

El dellen corneal es un área de adelgazamiento corneal localizado como consecuencia de la deshidratación provocada por la falta de humectación relacionada con una zona adyacente de abultamiento conjuntival. Se presenta una paciente femenina de 72 años, blanca, con antecedentes de hipertensión arterial, quien refirió lagrimeo y sensación de cuerpo extraño en el ojo izquierdo, de una semana de evolución. Al examen biomicroscópico se observó tejido fibrovascular en conjuntiva bulbar nasal que infiltraba la córnea, sobreelevado, de superficie lisa, no queratinizada, acompañada de inyección conjuntival y múltiples neovasos. En la córnea periférica y adyacente a esta se observó depresión de base limpia, redondeada, de 6 mm de extensión y profundidad hasta estroma anterior. Teniendo en cuenta las características de la lesión, se planteó como diagnóstico presuntivo dellen corneal secundario a pterigium grado II sintomático. La biopsia informó carcinoma de células escamosas, moderadamente diferenciado, asociado con un extenso infiltrado inflamatorio a predominio de linfocitos(AU)

Corneal dellen is an area of localized corneal thinning as a result of dehydration caused by lack of humectation associated to an adjoining conjunctival bulging. Here is a 72-years old Caucasian woman with a history of hypertension, who presented continuous tearing and feeling of a foreign body in her left eye during a week. The biomicroscopic exam showed fibrovascular tissue in nasal bulb conjunctiva, which infiltrated into the cornea, it was raised of flat surface, unkeratinized, accompanied with conjunctival injection and multiple neovessels. In the peripheral cornea and adjacent to it, there was a clean, rounded depression measuring 6 mm of extension and depth up to the anterior stroma. The presumptive diagnosis was corneal dellen secondary to symptomatic grade II pterygium. The biopsy yielded the presence of squamous cell carcinoma, moderately differentiated, and associated with extensive inflammatory infiltrate with predominance of lymphocytes(AU)

Mucocele con expansión orbitaria / Mucocele with orbital expansion

El mucocele es una lesión quística benigna, que se desarrolla en el interior de los senos perinasales por la obstrucción de su drenaje natural en el curso de los procesos inflamatorios, traumas y cirugías. Se presentan tres casos con mucocele frontoetmoidal y expansión intraorbitaria, los cuales fueron atendidos en el Hospital Hermanos Ameijeiras entre los meses de febrero a diciembre del año 2013. El propósito del presente estudio es el análisis de los resultados terapéuticos obtenidos y determinar la posible influencia de la vía de abordaje utilizada sobre la efectividad terapéutica y la recidiva tumoral en cada uno de estos pacientes(AU)

Mucocele is a benign cystic lesion that emerges inside the perinasal sinuses due to the obstruction of their natural drainage in inflammatory processes, traumas and surgeries. Here are three cases with frontoethmoidal mucocele and intraorbital expansion, which were treated at Hermanos Ameijeiras hospital from February to December, 2013. The objective of this study was to analyze the therapeutic results and to determine the possible influence of the approach path on the therapeutic effectiveness and the tumor recurrence in each of the patients(AU)

Outcomes of retreatment after aborted laser In Situ keratomileusis due to flap complications

To determine the refractive outcomes and complications of retreatment after aborted primary laser in situ keratomileusis [LASIK] due to flap complications. This retrospective study evaluated 50 retreated eyes that had flap complications during primary LASIK at the Eye Consultants Center in Riyadh, Saudi Arabia. Data were analyzed for patients with at least 3 months follow-up post retreatment. Thirty-three eyes of 31 consecutive patients with 3 months follow-up or later post retreatment were included. The primary LASIK was aborted due to incomplete flaps in 22 eyes [66.7%], buttonhole flaps in 7 eyes [21.2%], free partial flaps in 3 eyes [9.1%], and a free complete flap in 1 eye [3.0%]. Twenty-two eyes [66.7%] were retreated with LASIK, and 11 eyes [33.3%] were retreated with surface ablation. The mean spherical equivalent [SE] was ?0.23 +/- 0.72 D, the mean astigmatism was ?0.65 +/- 0.89 D, and the mean loss of the best corrected visual acuity [BCVA] was 0.78 lines at the final postoperative visit. At the last postoperative visit, 20/30 or better BCVA was achieved in 90.1% of eyes that underwent retreatment with LASIK and in 91% of eyes that were retreated with surface ablation. There was no statistical difference in postoperative SE between eyes retreated with LASIK and eyes retreated with surface ablation [P=0.610]. There was no statistical difference in postoperative BCVA between eyes retreated with LASIK and those retreated with surface ablation [P=0.756]. There were no intraoperative complications and no eyes required a second retreatment. Creation of a flap after a previous intraoperative flap complication was not associated with any complications. The refractive outcomes of retreatment with LASIK or surface ablation were comparable and reasonably favorable

Late dislocation of LASIK flap following fingernail injury.

A case of traumatic flap displacement with a fingernail injury four years after LASIK is reported.

Cambios en el estroma corneal in vivo secundarios a quemadura por álcali / In vivo corneal stroma changes secondary to alkali burn

Objetivo: Observar y describir, mediante microscopía confocal, los cambios asociados al proceso de cicatrización de quemadura por álcali, en córneas sanas de conejo. Método: Se realizó microscopía confocal (ConfoScan 2.0, Fortune Technologies Srl.,Italy) para el análisis morfológico del proceso de cicatrización corneal secundaria a quemadura por álcali, previo a la quemadura, a la semana, al mes y a los tres meses. Resultados: Se observó una cicatriz subepitelial cuya densidad aumenta al profundizar al estroma anterior, desde la primer semana hasta 3 meses después. El epitelio se encontró re-epitelizado desde la primer semana a la quemadura por álcali. Conclusiones: La microscopía confocal demuestra la pronta recuperación del epitelio corneal de los conejos, no obstante se requiere de un estudio a mayor largo plazo para determinar si existen cambios en el proceso de cicatrización del estroma corneal.