[Faden operations - indications beyond esotropia and surgical results]

BACKGROUND

Faden operations is a well-known surgical option for the treatment of esotropia. To the best of our knowledge there are only a few reports available dealing with this particular topic.

PATIENTS AND METHOD

Retrospective series of patients in whom between 2000 and 2011 a faden operation was performed under all indications except esotropia. 23 patients (9 Graves' disease, 9 third nerve palsy, 3 sixth nerve palsy, 1 muscle dystrophy, 2 orbital trauma) were included.

RESULTS

5 out of 7 horizontally disturbed patients were operated unilaterally and the remaining 2 bilaterally. The field of binocular single vision increased from 15-70° preoperatively by 10-25° (unilateral) and 20-35° (bilateral) to 30-80° postoperatively. Out of the 16 vertically disturbed patients only one was operated on superior and inferior rectus simultaneously and all the other on only one muscle. The field of binocular single vision increased from 5-55° preoperatively by 5-45° to 10-80° postoperatively. There were no complications so far and none of the patients worsened with the surgery.

CONCLUSION

A faden operation might help to increase the field of binocular single vision in cases of restrictive squint like Graves' disease or in paralytic strabismus.

[Amyloidosis--a rare differential diagnosis of an orbital tumour]

BACKGROUND

Amyloidosis is a disorder caused by a misfoulding of proteins. The deposition of these proteins in tissues and organs can affect the normal function of those tissues and organs.

MATERIALS AND METHODS

Two patients are presented and an overview over the so far published cases with a localised orbital amyloidosis is given.

RESULTS

The first case is a 50-year-old woman with progressive ptosis since half a year, progressive proptosis since three months and deterioration of motility and deviation of the left globe. The second case is a 68-year-old man with progressive ptosis since four years and with affection of the subtarsal conjunctiva of the right eye. Macroscopically a yellow-brown, gelatinous, easily crumbled material was seen during operation.

CONCLUSION

the histological proof of amyloidosis can be made visually in intense unidirectional polarised light after congo red staining. This should be done in suspected cases every time. The orbita can also be involved in systemic forms of amyloidosis, so a systemic form should be excluded. The localised amyloidosis has no effect on the survival time in contrast to the systemic forms does have an effect. An untreated systemic form may be associuated with a prognosis of only 9 to 13 months.