No abstract

etrospective analysis of surgical outcomes for enucleation in pediatric retinoblastoma stage 5B using the snare wire loop (n=55) and standard curved enucleation scissors (n=22) revealed that a statistically significant longer mean optic nerve length was obtained with the snare (13.35 mm) compared with scissors (11.05 mm; P=.005). Four scissor cases had prolonged bleeding and required thrombin (18.2%), but no snare cases had difficulty with hemostasis (P=.005). More crush artifact was seen with the snare than with scissors (PϽ.001), but this did not affect the ability to determine tumor involvement at the surgical margin. The enucleation snare should be considered a valuable surgical instrument in the small pediatric orbit since obtaining the longest optic nerve segment has prognostic implications in retinoblastoma.

Orbital apex lesions can often be effectively and relatively safely treated by endoscopic decompression alone.

No abstract

Background Prostaglandin analogues (PGAs; a first-line anti-glaucoma treatment) have been re-marketed as popular eyelash lengthening serums due to their lash lengthening and thickening side-effects. Periorbital volume loss is now a well-established side-effect of topical PGAs used to treated glaucoma (prostaglandin-associated periorbitopathy [PAP]) but has not, to date, been listed as a potential side-effect of lash lengthening serums containing PGA. Objectives To identify whether periorbital fat/volume loss is seen in users of prostaglandin analogue lash lengtheners. Methods A case report and informal randomised controlled study comparing “before-and-after” colour photos displayed on the websites of PGA-containing lash lengtheners (PGALL) (i.e., containing bimatoprost, norbimatoprost, isopropyl cloprostenate, dechloro-dihydroxy-difluoro-ethylcloprostenolamide, or methylamido-dihydro-noralfaprostal), compared with two control groups: non-PGALL (NPGALL); false eyelashes (FL). Expert and layperson blinded graders used a purpose-designed grading system to identify subtle signs of periorbital fat/volume loss over time. Results A 35-year-old female developed thin, wrinkled, darker skin and periorbital hollowing within 10-months of using Lash Boost (Rodan & Fields, San Francisco, CA), containing isopropyl cloprostenate, which reversed six months after discontinuation. Fifteen “before-and-after” image pairs (PGALL, n=10; NPGALL, n=3; FL, n=2) were graded by five graders (three expert, two layperson). Mean grading score was 8.2 (of 19) in the PGALL group: NPGALL, 2.3; FL, 3.2. PGALL scores were significantly higher than NPGALL (p<0.001) and FL (p=0.017) groups. Conclusions Review of commercial “before-and-after” photos suggests PGALL users develop changes compatible with PAP. Consumers must be aware of the possibility of periorbital volume loss prior to commencing PGALLs. Often the customer-facing product ingredient list contains no mention of PGA