Timothy Greenwell, Simon Madge, Paul Cannon, Dinesh Selva, Peter Anderson, David David
To present our experience of the clinical presentation, management, and outcomes of a large cohort of patients with orbitotemporal neurofibroma-tosis (OTNF) followed-up over a long period of time.
The study was a retrospective, longitudinal case series of OTNF patients presenting to the Austra-lian Craniofacial Unit, Adelaide, during a 27-year period. Case notes were reviewed, recording symp-toms and baseline examination, relevant investiga-tions, the number and types of interventions performed, complications and final outcomes.
Thirty-eight patients were followed up for a mean duration of 79 months (range 2–228). Common symptoms were facial swelling (95%), visual impair-ment (36%), diplopia (13%), and headache (5%). Examination and imaging findings included orbital dystopia (92%), sphenoid dysplasia (89%), upper lid ptosis (87%), canthal disinsertion (58%), and propto-sis (53%; 70% pulsatile). Twenty-two percent had an ipsilateral blind eye.Eight-four percent underwent surgery, with a median of 2 surgeries (range 1–7) during follow-up. Seventy-two percent were via transcranial approach. Tumour debulking (97%), orbital bone grafting (75%), and ptosis repair (62%) were the most common proce-dures. Sixteen percent underwent enucleation.Sixty-eight percent had a complication. Residual ptosis (32%), unsatisfactory lid contour (25%), and residual dystopia (22%) were most common. Three (9%) had bone graft resorption with recurrent pulsatile exoph-thalmos. Overall 8% had significant visual loss. Further interventions were planned for 46% of patients.
Treatment of OTNF is challenging, with unstable outcomes necessitating multiple surgeries. The current study is the most comprehensive of its kind detailing the presentation and longitudinal man-agement of this rare condition.
GLISTENINGS IN INTRAOCULAR LENSES IN AUSTRALIA AND NEW ZEALAND- A COLLABORATIVE SURGICAL QUALITY AUDIT OVER THE 24 MONTH PERIOD UP TO FEBRUARY 2017. FINDINGS OF THIS AUDIT OF LENSES IMPLANTED BETWEEN 1995 AND 2016, HIGHLIGHT THE ONGOING PRESENCE AND SEVERITY OF VACUOLES EVEN IN THE MOST RECENTLY IMPLANTED LENSES.