Schwannomas (neurilemmomas) are benign tumours of peripheral nerves arising from Schwann cells. These tumours along with neurofibromas form the two most common primary peripheral nerve tumours. Solitary lesions can occur sporadically in the general population but multiple neurofibromas are distinctive feature of neurofibromatosis type 1 and bilateral acoustic schwannomas are a feature of neurofibromatosis type 2. Schwannomas of ophthalmic interest are rare although they have been reported in relation to the orbit, and infrequently uveal tract and conjunctiva. Isolated eyelid schwannomas appear infrequent; only four cases in adults and one in a child in the published literature have been found. Herein, a case of eyelid schwannoma in a 53-year-old man is described.
Aim To examine residual debris within sterilised instruments prior to cataract surgery. Methods (i) Flushings from 32 sets of phacoemulsification instruments, sterilised according to hospital routine protocols, were taken preoperatively and analysed by scanning electron microscopy (SEM).(ii) A total of 16 sets of flushings from a different institute were collectedFwith separation of samples collected from phacoemulsification and those from irrigation-aspiration (IA) instrumentsFand analysed in the same way.(iii) A total of 15 sets of flushings were collected from instruments where an automated flushing system was used prior to sterilisation.
Results(i) In the first study, 62% were clean, 16% were moderately contaminated and 22% were severely contaminated. Various contaminants were identified including lens capsule and cells, man-made fibres, squamous cells, bacteria, fungal elements, diatoms, red blood cells and proteinaceous material.(ii) In the second study, the results were similar and contamination of both phacoemulsification and IA instruments was shown.(iii) The third study showed that although a decrease in contamination followed automated flushing, contamination was not completely eliminated. Conclusions Although all equipment had been sterilised, pyrogenic material was still present. These findings emphasise the importance of meticulous cleaning of all surgical equipment in which biological debris can remain.
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