[Pterygium surgery: comparative study of conjunctival autograft with suture versus fibrin adhesive]. / Cirugía del pterigión: estudio comparativo entre autoinjerto conjuntival con sutura y con adhesivo tisular.

PURPOSE: To compare recurrence rate, complications, and biomicroscopical findings after conjunctival autograft pterygium surgery with the use of a fibrin glue (Tissucol Duo, Baxter AG, Vienna, Austria) or suture (7-0 silk). METHODS: Patients with nasal pterygium were included in two groups of conjunctival autograft surgery. In 9 of them the graft was sutured to the surrounding conjunctiva and in 8 of them the graft was fixed to the conjunctiva using fibrin glue. RESULTS: 17 patients (17 eyes) 41.2% women and 58.8% men were surgically treated. Mean patient age was 59.8 years. Five of the patients presented recurrence for simple excision and 12 presented primary pterygium. The extent of corneal invasion was 2 to 4 mm. In the suture group, 33.3% of the patients experienced pain after surgery compared to none in the fibrin glue group. In the suture group, 44.4% of the patients presented inflammation after surgery compared to none in the glue group. One patient from the glue group lost the graft and presented a recurrence one month later. CONCLUSIONS: The use of fibrin glue in pterygium surgery reduces patient symptoms, inflammation and discomfort. The rate of recurrence seems to be similar in both procedures.

[Trans-scleral sutureless vitrectomy with a 25-G system for rhegmatogenous retinal detachment treatment]. / Cirugía del desprendimiento de retina regmatógeno mediante vitrectomía transescleral sin sutura con sistema 25-G.

PURPOSE: The evaluation of the trans-scleral sutureless vitrectomy (TSV) efficiency using a 25G system as an alternative in rhegmatogenous retinal detachment (RRD) treatment. METHODS: Patients treated for RRD with TSV have been reviewed taking into account their age, phakic or pseudophakic state, RRD localization and extension, surgical technique and post-operative resolution. RESULTS: Twenty two eyes of 22 patients have been treated for RRD with TSV. The average age was 54.3 years. 50% of the eyes were phakic. Eight of the detachments were "macula-off" at the time of diagnosis. SF6 was used in 5 cases and air in the remainder. Retinopexia of the breaks was done with trans-scleral cryocoagulation in 13 cases, with laser endophotocoagulation in 6 cases, and with both methods in 3 cases. The average follow-up time was 6.8 months, and the main complications were cataracts in 7 of 11 phakic eyes (63.6%) and a new retinal detachment in 4 eyes (18.2%). The intraocular pressures were similar to those before surgery and in 18 cases (81.8%) the visual acuity was better. CONCLUSION: TSV is effective in the treatment of RRD but with some limitations like the need for a learning period and a high incidence of cataracts.

[An orbital metastasis as the presentation of lung adenocarcinoma]. / Metástasis orbitaria como primera manifestación de adenocarcinoma pulmonar.

INTRODUCTION: Metastasis of primary tumours can involve the orbit via the blood stream. In 19% of cases this type of metastasis is the first oncologic symptom. CASE REPORT: A 42-year-old woman with a hard, well-defined nodule situated anteriorly in the right orbit and with mild associated inflammation. MR showed an oval image with homogeneous gadolinium uptake. On excision-biopsy a ductal cancer was found and determined on CAT scan to be of pulmonary origin. Chemotherapy was given and no recurrence occurred in the orbit. CONCLUSION: Ophthalmologic examination was the first step in the diagnosis of a metastasis of adenocarcinoma of the lung.