ABSTRACT
AIM: This study aimed to compare the outcomes and efficacy of canalicular trephination with monocanalicular stenting and canaliculodacryocystorhinostomy (canaliculoDCR) with silicone intubation. MATERIALS AND METHODS: A prospective comparative study was done in 30 patients (30 eyes) with common canalicular blocks who were randomized into two groups. Fifteen patients underwent canalicular trephination with monocanalicular stenting and 15 patients underwent canaliculoDCR with silicone intubation. Common canalicular obstruction was diagnosed by preoperative syringing and the location of block was confirmed on probing. Stents were kept in both the groups for 3 months and followed up till 6 months postoperatively. Success was defined based on both anatomical and functional outcomes. Anatomical success was defined by the free passage of fluid on syringing with the fluid felt in the throat. Functional success was defined in terms of relief from epiphora based on the subjective opinion and its categorization by Kraft and Crawford's grading and the fluorescein dye disappearance test (FDDT). RESULTS: Eighty percent of eyes in canalicular trephination group and 73.3% of eyes in canaliculoDCR group were anatomically patent on syringing at the final follow-up. Sixty-six percent of eyes in trephination group and 53.3% in canaliculoDCR group were reported to have absent epiphora (complete recovery). Ten eyes in both groups had Grade 0 and 1 FDDT indicating a functional success of 66.6% in both groups. CONCLUSIONS: Canalicular trephination can produce results comparable to canaliculoDCR with silicone intubation in cases of common canalicular blocks. The average duration of surgery is significantly less in canalicular trephination which gives this procedure an added advantage.
ABSTRACT
Dome-shaped macula (DSM) is characterised by a convex anterior bulging of the macular area. It can further get complicated by accumulation of subretinal fluid (SRF). Foveal cysts that are bilateral, in a setting of DSM, are an entity not yet reported. Management options for DSM with SRF showed variable success. Topical carbonic anhydrase inhibitors (CAIs) have been successful in treating certain macular pathologies. The authors report a rare case of bilateral intraretinal foveal cyst in a myopic child with DSM with favourable response to topical dorzolamide. Topical CAIs may be considered a safe and effective option in such cases.
Subject(s)
Carbonic Anhydrase Inhibitors/administration & dosage , Cysts/drug therapy , Fovea Centralis/pathology , Retinal Diseases/drug therapy , Sulfonamides/administration & dosage , Thiophenes/administration & dosage , Administration, Ophthalmic , Child, Preschool , Cysts/diagnosis , Cysts/etiology , Fluorescein Angiography , Fovea Centralis/diagnostic imaging , Fovea Centralis/drug effects , Humans , Male , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Subretinal Fluid/diagnostic imaging , Subretinal Fluid/drug effects , Tomography, Optical Coherence , Treatment Outcome , Visual AcuityABSTRACT
Aggressive posterior retinopathy of prematurity (APROP) is the most severe form of retinopathy of prematurity (ROP), with rapid progression to tractional retinal detachment. Exudative retinal detachment (ERD) has rarely been described as a primary presentation in ROP. We present a case of unlasered zone 1 APROP in a 34-week infant presenting with bilateral ERD, which was treated with intravitreal ranibizumab. After injection, the left eye developed acute endophthalmitis, which was managed by intravitreal antibiotic therapy and early vitrectomy. Subsequent laser photocoagulation of the avascular areas resulted in regression of ROP. This case highlights the role of intravitreal anti-vascular endothelial growth factor in treating ERD in APROP and the need for close observation for endophthalmitis after injection.
