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Background: Fungal sinusitis typically occurs in immunocompromised patients. The authors report four cases of fungal sinusitis in immunocompetent young adults, all of whom had proptosis. Methods: The diagnosis in all four patients was determined after orbital imaging and sinus biopsies. Results: All four patients required surgical removal of the fungal source and antifungal chemotherapy postoperatively. Conclusion: Patients with proptosis, ocular pain, or other symptoms suggestive of orbits cellulitis unresponsive to antibiotic treatment should undergo radiographic imaging: ff sinus disease is present, biopsy and culture may lead to the diagnosis of fungal disease. Surgical debridement and the appropriate systemic antifungal therapy usually lead to cure.

Cryptophthalmos is a rare, probably autosomal recessive condition in which the lid folds fail to separate in the embryo resulting in a continuous sheet of skin from the forehead to the cheeks covering the eyes. Cryptophthalmos has many variants and is usually associated with multiple other congenital anomalies. This article reports on an isolated case of "abortive cryptophthalmos" with multiple systemic anomalies. The surgical treatment is described and the general features of the cryptophthalmos syndrome and its variants are reviewed.

We compared the wound strength of 5.1 -millimeter no-stitch incisions with that of 7. 0-millimeter sutured incisions in cadaver eyes. Each incision was performed on seven cadaver eyes. Wound integrity was evaluated by subjecting each globe to increasing intraocular pressure HOP), increasing external pressure, and sudden external pressure. Wound leaks occurred in the 7. 0-mill i meter-incision globes at consistently lower IOPs and with less external pressure than they did in the 5.1 -millimeter-incision globes. We conclude that the 5.1-millimeter no-stitch flap incision has greater wound integrity than the 7.0millimeter sutured incision when subjected to either internal or external pressures.

PURPOSE: To present results of laser in situ keratomileusis (LASIK) enhancement after radial keratotomy (RK). METHODS: Sixteen eyes of 10 patients were treated with LASIK for residual myopia and hyperopia after RK. Mean preoperative spherical equivalent refraction was -3.14 ± 3.04 D (range, -6.675 to +6.00 D). Best spectacle-corrected visual acuity was 20/20 in 9 eyes, 20/25 in 6 eyes, and 20/30 in 1 eye. Uncorrected visual acuity was better than 20/40 in only 2 eyes. Patients were followed at 1 day, 1 week, 1, 3, and 6 months, and 1 year. Mean follow-up was 8.3 months (range, 1 to 17 mo). RESULTS: All eyes received one LASDX enhancement. Mean final spherical equivalent refraction was +0.16 ± 0.68 D (range, -1.00 to +1.75 D). No eyes experienced any visual loss. Five eyes gained 1 line of best spectacle-corrected visual acuity. Uncorrected visual acuity was 20/20 in 9 eyes, 20/25 in 6 eyes, and 20/30 in 1 eye. Two eyes of one patient had the previous RK incisions open. CONCLUSION: LASLK was an effective treatment for correction of residual myopia and hyperopia after RK. [J Refract Surg 2000;16:187-190]

Repair of large full-thickness lower lid defects requires reconstruction of the tarsoligamentous sling. This may necessitate either a tarsus sharing technique or a skin flap with a free cartilage graft. Obtaining tarsus or cartilage in these procedures has the disadvantage of requiring a second surgical site, which may cause further scarring and deformity. Polytetrafluoroethylene (PTFE) is a nonantigenic, inert, highly biocompatible, mechanically strong synthetic material that has been successfully utilized as a vascular and soft tissue patch since the 1970's. PTFE has been used in ophthalmic surgery to wrap orbital implants and as an interpositional graft for the correction of lower lid retraction. We evaluated the usefulness of PTFE in the reconstruction of the tarsoligamentous sling in 24 lids of 12 New Zealand white rabbits. PTFE with internodal spacings of 10 and 30 microns were used initially. Despite a lack of tissue inflammation, the PTFE grafts were uniformly extruded by 2 weeks postoperatively. Four additional lids were reconstructed using PTFE (30 and 60 microns) coated with a biological substrate. This graft material was also extruded. These results suggest that PTFE material may not be satisfactory for reconstruction of the tarsoligamentous sling.