RESUMEN
The purpose of this systematic review is to investigate the most common indications, treatment, and outcomes of computer-assisted surgery (CAS) in ophthalmological practice. CAS has evolved over the years from a neurosurgical tool to maxillofacial as well as an instrument to orbitofacial surgeries. A detailed and organized scrutiny in relevant electronic databases, journals, and bibliographies of the cited articles was carried out. Clinical studies with a minimum of two study cases were included. Navigation surgery, posttraumatic orbital reconstruction, computer-assisted orbital surgery, image-guided orbital decompression, and optic canal decompression (OCD) were the areas of interest. The search generated 42 articles describing the use of navigation in facial surgery: 22 on orbital reconstructions, 5 related to lacrimal sac surgery, 4 on orbital decompression, 2 articles each on intraorbital foreign body and intraorbital tumors, 2 on faciomaxillary surgeries, 3 on cranial surgery, and 2 articles on navigation-guided OCD in traumatic optic neuropathy. In general, CAS is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were related to trauma. Treatment of complex orbital fractures was greatly improved by the use of CAS compared with empirically treated control groups. CAS seems to add a favourable potential to the surgical armamentarium. Planning details of the surgical approach in a three-dimensional virtual environment and execution with real-time guidance can help in considerable enhancement of precision. Financial investments and steep learning curve are the main hindrances to its popularity.
Asunto(s)
Descompresión Quirúrgica/métodos , Imagenología Tridimensional , Fracturas Orbitales/cirugía , Procedimientos de Cirugía Plástica/métodos , Cirugía Asistida por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Humanos , Fracturas Orbitales/diagnósticoRESUMEN
Chronic suppurative lacrimal canaliculitis is an important cause of ocular surface discomfort. Treatment with topical antibiotics is often inadequate and surgical treatment by canaliculotomy and canalicular curettage has been the mainstay of treatment in the past. The role of canalicular antibiotic irrigation has been inadequately studied. We report the clinical features, microbiological profile and treatment outcome in a series of 12 patients with suppurative lacrimal canaliculitis. Two patients had Actinomyces infection, five had Nocardia infection and seven patients had polymicrobial infection. Three patients had resolution of canaliculitis on combination broad-spectrum topical antibiotic therapy using ciprofloxacin and fortified cefazolin. In nine patients, topical antibiotic therapy was combined with canalicular irrigation using fortified cefazolin. All patients had excellent resolution of canaliculitis without the need for surgical treatment. Availability of broad-spectrum antibiotics and canalicular irrigation may offer an alternative to surgery in the management of suppurative lacrimal canaliculitis.
Asunto(s)
Antibacterianos/uso terapéutico , Cefazolina/uso terapéutico , Ciprofloxacina/uso terapéutico , Dacriocistitis/tratamiento farmacológico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Adulto , Anciano , Bacterias/aislamiento & purificación , Enfermedad Crónica , Dacriocistitis/microbiología , Quimioterapia Combinada , Infecciones Bacterianas del Ojo/microbiología , Infecciones Fúngicas del Ojo/microbiología , Humanos , Persona de Mediana Edad , Soluciones Oftálmicas/uso terapéutico , Estudios RetrospectivosRESUMEN
We report the case of a 23-day-old boy with unilateral complete cryptophthalmos and congenital cystic eye, who had no associated systemic anomalies. We describe the technique of socket reconstruction with autologous prepucial skin graft used in this patient.
Asunto(s)
Quistes/cirugía , Anomalías del Ojo/cirugía , Párpados/anomalías , Prepucio/trasplante , Órbita/cirugía , Implantes Orbitales , Quistes/congénito , Humanos , Recién Nacido , Masculino , Procedimientos de Cirugía Plástica , Tomografía Computarizada por Rayos X , Trasplante AutólogoRESUMEN
AIM: To study the indications, technique and diagnostic utility of helical computed tomographic dacryocystography (CTDCG). MATERIALS AND METHODS: Retrospective analysis of 13 patients who underwent CTDCG with subsequent surgical intervention, during the period January 2003 to December 2005, was done. Axial plain computed tomography (CT) scan was performed, followed by administration of water-soluble contrast in the conjunctival cul de sac or by cannulation of the lacrimal passages. Thin-slice helical CT with two-dimensional (2D) and three-dimensional (3D) coronal and sagittal reformation was done. RESULTS: Four patients were males and 9 were females. Age range was 5 to 62 years. Seven patients presented with watering and 6 patients with a medial canthal mass. Three patients had history of trauma. CTDCG was performed by instillation technique in 10 patients and by cannulation in 3 patients. CTDCG showed mass lesion displacing the sac in 5 cases, nasolacrimal duct obstruction in 6 cases and mucocele in 2 cases. Based on the findings on CTDCG, 5 patients underwent mass excision, 7 underwent dacryocystorhinostomy and 1 patient underwent primary silicone tube intubation. CONCLUSION: Helical CTDCG is a safe and useful diagnostic tool for the lacrimal surgeon. Instillation technique is a physiological and convenient method, and cannulation is needed only in cases where adequate visualization is not achieved.
Asunto(s)
Aparato Lagrimal/diagnóstico por imagen , Obstrucción del Conducto Lagrimal/diagnóstico por imagen , Tomografía Computarizada Espiral , Adolescente , Adulto , Niño , Preescolar , Medios de Contraste , Femenino , Humanos , Obstrucción del Conducto Lagrimal/etiología , Obstrucción del Conducto Lagrimal/terapia , Masculino , Persona de Mediana EdadRESUMEN
A retrobulbar orbital abscess secondary to congenital dacryocystitis is extremely rare. External abscess drainage, probing, and syringing with broad spectrum intravenous antibiotics was performed in a 22-day-old neonate who was examined for congenital dacryocystitis complicated by retrobulbar orbital abscess formation.