No abstract

Primary combined trabeculotomy-trabeculectomy with mitomycin-C and releasable suture offers a viable surgical option in Northern Indian infants with primary congenital glaucoma. The use of 0.2 mg/ml mitomycin C for 2 minutes improves the overall success while the releasable suture decreases the risk of postoperative complications especially associated with the use of antimetabolites.

A 23-year-old female patient was admitted to the infection unit with high fever (401C) left facial swelling, right proptosis, diplopia, and decreased vision for 2 days. She had been treated with clarithromycin for a sore throat 3 weeks before presentation. Examination revealed visual acuity of 6/24 on the right and 6/5 on the left, proptosis (26 mm OD, 22 mm OS), conjunctival chemosis, and painful limitation of gaze.CT scan revealed a left-sided parapharangeal abscess with a right-sided cavernous sinus thrombosis. Throat examination revealed a parapharyngeal abscess abutting the epiglottis. She underwent emergency left tonsillectomy with drainage of the abscess and was commenced on high-dose intravenous benzyl penicillin with metronidazole.On the third day of admission, she developed left arm weakness and a right facial palsy. The MRI scan revealed diffuse swelling of right hemisphere with swollen right cavernous sinus and enhancement of adjacent sphenoid sinus (Figure 1). Blood and aspirate culture grew F. necrophorum sensitive to penicillin, metranidazole, and clindamycin. She received 4 weeks of the appropriate intravenous antibiotics and had a full recovery.