Orbital giant conjunctival epithelial primary cyst.

CASE REPORT: A 15-year-old male, with no previous traumatic o surgical ocular injury, presented with a right eye proptosis and inferior displacement which began 4 months earlier. Ultrasound and CT showed a cystic lesion of 3.5 × 2 cm in the superior orbit. Surgical resection was performed by transconjunctival orbitotomy. The histopathology examination showed a cyst with nonkeratinized epithelium, and without goblet cells. After 10 years of follow-up, there have been no new lesions. DISCUSSION: Conjunctival primary orbital cysts are very uncommon. They are usually of small-moderate size; giant cysts are exceptional. Diagnosis by imaging is essential to establish the differential diagnosis and surgical treatment.

Quiste conjuntival epitelial gigante primario orbitario / Orbital giant conjunctival epithelial primary cyst

Caso clínico: Varón de 15 años de edad, sin antecedente traumático o quirúrgico, que presenta proptosis con desplazamiento inferior del globo ocular derecho de cuatro meses de evolución. La ecografia y la TAC muestran una lesión quística de 3,5 × 2cm. Se reseca mediante orbitotomía transconjuntival. La histopatología muestra un quiste con un epitelio no queratinizado sin células caliciformes. Después de 10 años de evolución no ha recidivado . Discusión: Los quistes epiteliales conjuntivales primarios son muy infrecuentes. Suelen ser de pequeño-moderado tamaño; los gigantes son excepcionales. El diagnóstico por imagen es fundamental para el diagnóstico diferencial y el tratamiento quirúrgico(AU)

Case report: A 15-year-old male, with no previous traumatic o surgical ocular injury, presented with a right eye proptosis and inferior displacement which began 4 months earlier. Ultrasound and CT showed a cystic lesion of 3.5 × 2cm in the superior orbit. Surgical resection was performed by transconjunctival orbitotomy. The histopathology examination showed a cyst with nonkeratinized epithelium, and without goblet cells. After 10 years of follow-up, there have been no new lesions. Discussion: Conjunctival primary orbital cysts are very uncommon. They are usually of small-moderate size; giant cysts are exceptional. Diagnosis by imaging is essential to establish the differential diagnosis and surgical treatment(AU)

Prospective study of cooperation and satisfaction in glaucoma surgery under sub-Tenon's anesthesia.

OBJECTIVES: To evaluate the analgesic effect as well as patient cooperation and satisfaction with sub-tenon's anesthesia in glaucoma surgery. MATERIAL AND METHODS: Prospective uncontrolled study. Fifty-three patients who underwent glaucoma surgery, with or without cataract extraction, with sub-Tenon's anesthesia have been studied. Satisfaction and cooperation were evaluated on a qualitative scale. The pain level was quantified using a numerical scale from 1 (no pain) to 10 (unsupportable pain). RESULTS: The mean pain score at the different periods was: 2.13 (standard deviation [SD] 1.47) on administering anesthesia, 1.74 (SD 1.27) during the surgery, 1.63 SD (1.23) immediately after the procedure, 1.38 (SD 0.38) 30 min later, and 1.38 (SD 0.63) when leaving the recovery unit. The postoperative satisfaction was "fairly or very satisfied" in 92.6% of the cases for both the surgeons and the patients. Twenty-four patients complained during the surgery, 15 of them at the conjunctival suture; in these cases additional anesthesia was administered, and, in 4 cases, intravenous paracetamol was given. Pain scores were significatively higher during the surgery (P=.033), and immediately after the procedure (P=.027) in trabeculectomy than in deep sclerectomy patients. CONCLUSIONS: The good analgesic level reached led to a high level of patient and surgeon satisfaction, even in longer procedures such as deep sclerectomy combined with cataract extraction, or implantation of drainage devices. Pain scores were significatively higher in trabeculectomy than in deep sclerectomy patients.

Estudio prospectivo sobre colaboración y satisfacción en cirugía de glaucoma con anestesia subtenoniana / Prospective study of cooperation and satisfaction in glaucoma surgery under sub-Tenon's anesthesia

Objetivos: Valorar el efecto analgésico así como la colaboración y satisfacción de los pacientes en la cirugía de glaucoma con anestesia subtenoniana. Material y métodos: Estudio prospectivo no controlado. Se estudiaron datos de 53 pacientes operados de glaucoma, asociado o no a cirugía de catarata, bajo anestesia subtenoniana, valorándose de manera cualitativa la satisfacción y colaboración, así como el grado de analgesia mediante una escala numérica de 1 (no dolor) a 10 (máximo). Resultados: La calificación media del dolor ha sido: 2,13 desviación estándar (DE): 1,47 al administrar la anestesia, 1,74 DE: 1,27 durante la intervención, 1,63 DE: 1,23 en el postoperatorio inmediato, 1,38 DE: 0,38 a los 30min y 1,38 DE: 0,63 al alta. El grado de satisfacción fue «bastante o muy satisfecho» en el 92,6% de los casos, tanto para pacientes como para cirujanos. En 24 casos el paciente refirió molestias, 15 de ellos durante la sutura conjuntival, requiriendo anestesia adicional y en cuatro casos, paracetamol sistémico. La puntuación del dolor fue significativamente mayor durante la cirugía (p=0,033) y en el postoperatorio inmediato (p=0,027) en los pacientes operados de trabeculectomía que en la esclerectomía profunda no penetrante (EPNP). Conclusiones: El buen nivel analgésico conseguido favoreció un alto grado de satisfacción por parte de cirujanos y pacientes, incluso en procedimientos de larga duración como esclerectomía profunda no penetrante combinada con facoemulsificación e implantes de dispositivos de drenaje. El dolor percibido por los pacientes durante la cirugía y postoperatorio inmediato fue mayor en la trabeculectomía que en la EPNP(AU)

Objectives: To evaluate the analgesic effect as well as patient cooperation and satisfaction with sub-tenon's anesthesia in glaucoma surgery. Material and methods: Prospective uncontrolled study. Fifty-three patients who underwent glaucoma surgery, with or without cataract extraction, with sub-Tenon's anesthesia have been studied. Satisfaction and cooperation were evaluated on a qualitative scale. The pain level was quantified using a numerical scale from 1 (no pain) to 10 (unsupportable pain). Results: The mean pain score at the different periods was: 2.13 (standard deviation [SD] 1.47) on administering anesthesia, 1.74 (SD 1.27) during the surgery, 1.63 SD (1.23) immediately after the procedure, 1.38 (SD 0.38) 30min later, and 1.38 (SD 0.63) when leaving the recovery unit. The postoperative satisfaction was “fairly or very satisfied” in 92.6% of the cases for both the surgeons and the patients. Twenty-four patients complained during the surgery, 15 of them at the conjunctival suture; in these cases additional anesthesia was administered, and, in 4 cases, intravenous paracetamol was given. Pain scores were significatively higher during the surgery (P=.033), and immediately after the procedure (P=0.027) in trabeculectomy than in deep sclerectomy patients. Conclusions: The good analgesic level reached led to a high level of patient and surgeon satisfaction, even in longer procedures such as deep sclerectomy combined with cataract extraction, or implantation of drainage devices. Pain scores were significatively higher in trabeculectomy than in deep sclerectomy patients(AU)