Orbital Dermoid Cysts in Monozygotic Twins.

Two healthy 12-year-old monozygotic twin sisters presented with strikingly similar, painless orbital masses along their frontozygomatic suture line that had been slowly enlarging since birth. The masses were clinically consistent with orbital dermoid cysts and the patients underwent excision of their lesions, with the diagnosis confirmed by histological analysis. There are prior case reports of both nasal and ovarian dermoid cysts in twins, however, no prior case of orbital dermoid cysts in twins have been described. These dermoid cysts are generally thought to be a sporadic disorder of embryogenesis, yet the authors' case suggests genetics may play a role in the underlying etiology of dermoid cysts.

Bilateral Congenital Nasolacrimal Duct Obstruction in Williams-Beuren Syndrome.

A 23-year-old patient with Williams-Beuren syndrome presented with ocular irritation and bilateral persistent tearing. Despite probing as an infant which showed bilateral nasolacrimal duct obstruction, dacryocystorhinostomy had been avoided due to the patient's syndromic supravalvular stenosis and related anesthesia risk. As the known diminished production of elastin in Williams-Beuren syndrome causes an array of associated vascular diseases, this case report hypothesizes that the lacrimal duct becomes obstructed through a similar mechanism. This case presents the unique findings of bilateral congenital nasolacrimal duct stenosis in a Williams-Beuren syndrome patient.

A Novel Study Quantifying Intrinsic Dimensional Variation Among Glaucoma Drainage Devices.

Purpose Variation among aqueous humor outflow from venting slits performed on glaucoma drainage device tubing often occurs even when physician technique and equipment are held constant. Our hypothesis is that there are dimensional differences within the tubing, even among the same make and model of glaucoma drainage device (GDD) implants. Methods Prior to surgical implantation, excess glaucoma drainage tubing was collected for analysis. The tubing samples were sliced horizontally, and the external tube, internal lumen, and wall dimension measurements were collected microscopically. Groups were divided based upon brand and model and then statistically analyzed using an independent t-test. A total of 28 tubes were analyzed, consisting of 7 Molteno and 21 Baerveldt implants. Results The mean external diameter for the Molteno group was 656 ± 20µm, significantly larger than the Baerveldt external diameter of 620 ± 13µm (P<0.05). The mean internal diameter among Molteno lumens was 344 ± 13µm, also statistically larger than the mean internal diameter of 309 ± 18µm for Baerveldt tubes (P<0.05). The Molteno luminal wall width varied significantly less than the Baerveldt wall, 18% versus 28%, respectively (P<0.05). The tubings' wall widths variation translated into highly significant off-centered lumens among both brands. Conclusion Our findings suggest that there are significant variations among glaucoma implant dimensions between and within the multiple makes and models. The discrepancies among tubal wall thickness and off-centered lumens are undetectable to the naked eye. Importantly, this may result in significant aqueous humor outflow variation following the creation of venting slits secondary to the found irregular luminal diameters and tube wall thicknesses.