This report describes a case of pleomorphic adenoma of an ectopic lacrimal gland arising subconjunctivally in the lateral fornix in a 13-year-old girl. The tumor was removed surgically in toto with the capsule. This is probably the first reported case.

The next care to be taken, in respect of the Senses, is a supplying of their infirmities with instruments, and as it were, the adding of artificial organs to the natural...and as glasses have promoted our seeing, so 'tis not improbable, but that there may be found many mechanical inventions to improve our other senses of hearing, smelling, tasting and touching. " Robert Hooke English natural philosopher (1665) [1] Nothing could demonstrate more than this concept of Hooke with regards to replacement of all the senses by artificial means. Hooke was enthralled by spectacle correction itself and felt that the other senses could also be improved. No doubt the medical world has caught up with hearing aids and cochlear implants but in the real sense the restoration of sight to a blind is still in an experimental stage and the most daunting challenge in ophthalmic research.

No abstract

Background: Vitreous substitutes presently in use for intraoperative tamponade are perfluorocarbon liquids (PFCL) and for post operative tamponade are silicon oil (SO), sulphur hexafluoride (SF 6 ) and perfluorocarbon gas (PFC). Several factors are important for a thorough understanding of each of these vitreous substitutes. The absorption or necessity for removal, indications for use (including clinical studies and special surgical methods), additives and complications of use have to be considered. Methods: Three port standard pars plana vitrectomy was performed in 60 consecutive cases requiring intra-vitreal intervention. PFCL was used intra-operatively in 30 cases (PFCL group and X group). The eyes were implanted with SO (silicon oil subgroup), PFC (C 3 F 8 sub-group) and SF 6 (SF 6 sub-group) in twenty cases each. Apart from best corrected visual acuity (BCVA), the retinal status and the longevity of gas when used, changes and reaction in both the anterior and posterior segments were noted. Result: The difference of postoperative BCVA in the PFCL and non-PFCL groups was statistically significant with p < 0.001. In both the PFCL and non-PFCL groups the difference between preoperative and postoperative BCVA was statistically significant with p < 0.0001. All three vitreous substitutes studied are effective given the case where they had been utilised. Conclusion: PFCL is invaluable in the management of complicated retinal detachment (RD). Where a vitreous microsurgery is indicated, the visual outcome is good. SF 6 is useful for short-term tamponade. Silicon oil and C 3 F 8 are useful for longer tamponade. MJAFI 2010; 66 : 125-128

Original ArticleIntroduction P haco-emulsification has become the procedure of P Pchoi ce for cataract surgery all over the world [1].However, it has also resulted in the increased incidence of drop of lens nucleus into the vitreous and posterior dislocation of intra-ocular lens (IOL) [2]. Eyes with loss of nucleus and or lens fragments develop chronic uveitis, elevated intra-ocular pressure, cystoid macular oedema, corneal oedema and retinal detachment, leading to significant visual loss. IOLs dislocated posteriorly rarely produce these manifestations but they produce visual symptoms [3]. Material and MethodsThirty six patients of nucleus drop and 43 of posterior dislocation of IOL were managed at two tertiary eye centres over the past six years. Of 36 cases of lens drop, seven (19.5%) were managed at the time of the accident itself. The remaining 29 (80.5%) patients of lens drop and the 43 of IOL dislocations were referred from other centres. The 29 cases of nucleus drop were operated within 14 days of the initial surgery. Two (4.6%) patients having posterior dislocations of IOL were less than a year old and they were operated under general anaesthesia, while the rest were operated under peribulbar anaesthesia. Patients with a drop of the nucleus were managed with topical and systemic steroids and ocular anti-hypertensives from the time of admission to postoperative period.The surgical procedure for dropped nuclei involved the exposure of the sclera after surface diathermy and making a 6 mm port infero-temporally for infusion canula. The side port for the phacoemulsification procedure was used for passing the endo-illuminator and the main entry site for the vitrectomy probe. After clearing the section and the anterior chamber (AC) of vitreous, the lens fragments were cleared of vitreous adhesions and were impaled by the micro vitreo retinal (MVR) blade with the aid of the endo-illuminator. The viewing system used was either the irrigating lens or the EIBOS of Moller-Wedel. The lens was brought into the AC and then taken out. Thereafter vitreous was cleared of retained lens particles. Any left over cortical matter was removed by vitrectome or the flute needle. A 6.5 mm optic sized hard posterior chamber IOL (PC IOL) was then implanted in the sulcus, if the capsular support was good. Otherwise, an anterior chamber IOL (AC IOL) was placed over a constricted pupil followed by a peripheral iridectomy. Of these 36 cases, AC IOL was implanted in 30 (83.34%) cases and PC IOL in the remaining six (16.64%).The surgical procedure for dropped IOL involved making an infero-temporal port at 2 mm for infusion with a 6 mm canula. There was a limbal section with interrupted 10-0 sutures in all the 43 cases. In 39 (90.7%) cases the initial limbal entry for a phaco-emulsification procedure was visible. A posterior capsular rent was discernable in all the cases. The ends of the limbal incision were used for introducing the endo-illuminator and the vitrectomy probe if necessary by cutting the end sutures. The AC and the section we...