Delayed-Onset Orbital Abscess After Orbital Blowout Fracture Repair Using Porous Polyethylene Implant.

This study aims at documenting a rare case of delayed-onset orbital abscess following the use of a nonabsorbable porous polyethylene implant in orbital fracture repair, highlighting the potential long-term risks associated with non-biodegradable orbital implants. A 44-year-old man presented with diplopia on down gaze, proptosis, and eyelid edema for 2 weeks. He had undergone repair of an inferior orbital wall fracture with a porous polyethylene implant 5 years ago. Computed tomography (CT) evaluation revealed a significant intraorbital abscess related to implant infection. Surgical interventions included abscess drainage and implant replacement, which led to patient recovery. Nonabsorbable implants, which are beneficial for orbital reconstruction, may pose a risk of occurrence of delayed infections several years following surgery. This report highlights the importance of long-term monitoring to mitigate the risks of potential late complications, which necessitate early diagnosis, appropriate intervention, and management strategies.

Torsion and clinical features in patients with acquired fourth cranial nerve palsy.

This retrospective study aimed to compare objective/subjective torsion and other clinical characteristics of patients with acquired trochlear nerve palsy. This study included 82 consecutive patients who were diagnosed with acquired fourth cranial nerve palsy between 2014 and 2021 and who were followed up for ≥ 6 months. The etiologies, ocular deviation, objective and subjective torsions were reviewed. The etiologies were classified as ischemic, traumatic, brain lesion, idiopathic, or other. The patients were classified into two groups according to the recovery state: full recovery and partial/no-recovery. We compared the torsion and clinical features based on the etiology and recovery state. The average age was 59.1 ± 11.1 years, and 58 (71.0%) of the patients were male. The most common cause was ischemic (n = 49, 59.7%) and other common causes included traumatic (n = 16, 19.5%), brain lesion (n = 8, 9.8%), idiopathic (n = 5, 6.1%) and others (n = 4, 4.9%). Of the 82 patients, 56 (68.3%) were assigned to the full recovery group, and 26 (31.7%) were assigned to the partial/no-recovery group. The average age and number of patients with ischemic causes of palsy were greater in the full recovery group (p = 0.026 and p < 0.000, respectively). The vertical deviation angle, tilted angle on the Lancaster red-green test (LRGT), proportion of patients who experienced subjective torsion on the LRGT, and head tilt were smaller in the full recovery group (p = 0.037, 0.042, 0.045, and 0.006, respectively). Ischemic trochlear nerve palsy, advanced age, a small deviation angle at the primary position, and few cases of excyclotorsion on LRGT were characteristic of the full recovery group of acquired unilateral trochlear nerve palsy patients.

Factors Associated with Surgical Outcomes after Bilateral Lateral Rectus Recession in Children with Intermittent Exotropia.

Backgroud: To analyze the factors associated with surgical outcomes after bilateral rectus recession (BLR) in children with intermittent exotropia (IXT). Methods: A retrospective study was performed on 125 patients who had all received preoperative patch treatment with a ≥1 year follow-up. The surgical outcomes were grouped as success (esodeviation ≤5 PD to exodeviation ≤10 PD) or failure (esodeviation >5 PD or exodeviation >10 PD) according to the angle of deviation at 1 year postoperatively. The patients' magnitude of exodeviation, near and distant stereoacuity, and 3-mo patch responses were assessed. The factors associated with the surgical outcomes were determined using univariate and multivariate analyses. Results: Of the 125 patients, 102 (81.6%) and 23 (18.4%) were assigned to the success and failure groups, respectively. According to the univariate analysis, the absence of anisometropia, a smaller preoperative near exodeviation, a better near stereopsis, a smaller magnitude of deviation on day 1 postoperatively, and response to patching were significantly associated with surgical success for IXT after 1 year. In the multivariate analysis, distant esotropic deviation on day 1 postoperatively and response to patching were the factors affecting successful surgical outcomes. Conclusions: Esotropic distant deviation on day 1 postoperatively is a prognostic factor for favorable surgical outcomes. Preoperative patching could be a factor influencing surgical success in children with IXT.

Comparative Evaluation of Visual Performance and Patient Satisfaction following Cataract Surgery: A Retrospective Analysis of an Extended Depth-of-Focus Intraocular Lens and a Diffractive Multifocal Lens with Extended Depth of Focus.

(1) Background: Cataract surgery has evolved significantly with the development of multifocal and extended depth-of-focus intraocular lenses (IOLs), driven by increasing patient desire for spectacle independence. (2) Methods: This retrospective, single-center study conducted on 86 eyes from 59 patients aged 40-80 years compared the performance and patient satisfaction of Symfony® and Synergy® (Johnson & Johnson Vision) IOLs during a follow-up of 1 year postsurgery. Uncorrected and corrected distance, intermediate, and near visual acuities were assessed (UDVA, CDVA, UIVA, CIVA, UNVA, and CNVA, respectively). (3) Results: Although both IOLs demonstrated a commendable distance VA, Synergy® outperformed in near VA (UNVA, p = 0.040; CNVA, p = 0.014), and Symfony® slightly excelled in intermediate VA (UIVA, p = 0.014; CIVA, p = 0.040). The defocus curve of Synergy® maintained a higher VA even at -4 D with a smoother curve and a broad landing zone. Although the optical quality assessments were similar, Symfony® had a nonsignificant edge. Patients indicated higher satisfaction and reduced reliance on spectacles with Synergy® despite more frequent reports of glare and halos. (4) Conclusions: These findings highlight the importance of personalized IOL selection in cataract surgery, which must be customized to apply the distinctive advantages of each IOL to address the unique visual requirements and lifestyle of patients.

Identification of Free-Living Amoebas in Tap Water of Buildings with Storage Tanks in Korea.

Free-living amoebas (FLAs) can cause severe disease in humans and animals when they become infected. However, there are no accurate survey reports on the prevalence of FLAs in Korea. In this study, we collected 163 tap water samples from buildings, apartments, and restrooms of highway service areas in 7 Korean provinces with high population density. All these buildings and facilities have water storage tanks in common. The survey was separated into categories of buildings, apartments, and highway service areas. Five hundred milliliters of tap water from each building was collected and filtered with 0.2 µm pore filter paper. The filters were incubated in agar plates with heated E. coli at 25°C. After axenization, genomic DNA was collected from each FLA, and species classification was performed using partial 18S-rDNA PCR-sequencing analysis. We found that 12.9% of tap water from buildings with storage tanks in Korea was contaminated with FLAs. The highway service areas had the highest contamination rate at 33.3%. All of the FLAs, except one, were genetically similar to Vermamoeba vermiformis (Hartmannella vermiformis). The remaining FLA (KFA21) was very similar to Acanthamoeba lugdunensis (KA/E26). Although cases of human infection by V. vermiformis are very rare, we must pay attention to the fact that one-third of tap water supplies in highway service areas have been contaminated.