Conservative Management of Giant Pyogenic Granuloma Post Strabismus Surgery: A Case Report and Literature Review

The critical role of primary care clinicians in the early detection of ocular surface squamous neoplasia

Ocular surface squamous neoplasia (OSSN) encompasses a spectrum of conjunctival tumours and, while rare globally, is the most common ocular malignancy in sub-Saharan Africa. Its rising incidence, primarily driven by the human immunodeficiency virus (HIV) epidemic, presents significant challenges in clinical diagnosis, as these lesions often share characteristics with other conjunctival lesions. In South Africa, where risk factors such as HIV, human papillomavirus infection and excessive sun exposure are prevalent, primary care clinicians play a crucial role in identifying and referring cases for early intervention. Ocular surface squamous neoplasia is often the first indication of HIV in patients who are otherwise unaware of their status when they present to healthcare workers, making it essential for healthcare workers to screen for HIV and initiate antiretroviral therapy. Early recognition of at-risk patients and prompt referral of suspicious lesions are imperative to improve patient outcomes and prevent vision loss.

Effect of minimally invasive strabismus surgery under a microscope on tear film function and ocular surface status in strabismus patients

OBJECTIVE

To investigate the effects of minimally invasive strabismus surgery (MISS) on tear film function and ocular surface status in patients with strabismus.

METHODS

We respectively analyzed the clinical data from 173 cases of strabismus patients treated at Xi'an First Hospital from September 2021 to March 2024. The patients were classified into a minimally invasive group (n=91, undergoing MISS) and a conventional group (n=82, undergoing traditional strabismus correction) according to their treatment plans. The general data, treatment efficacy, tear film function, ocular surface status, perioperative indicators, pain, and visual recovery were compared between the two groups. Factors affecting the patients' postoperative recovery were further analyzed according to the treatment effects.

RESULTS

The clinical efficacy of the minimally invasive group (95.6%) was significantly higher than the conventional group (68.3%). Visual recovery of the minimally invasive group was also significantly better than the conventional group (P<0.05). The minimally invasive group showed superior tear film function and ocular surface health (P<0.05). The visual analog scale (VAS) scores for pain were significantly lower in the minimally invasive group at different postoperative time points (all P<0.05). Intraoperative blood loss was significantly lower in the minimally invasive group (P<0.05), but there was no significant difference in surgical time (P>0.05). Logistics analysis identified the tear secretion basal test (Slt), corneal fluorescein staining score (CFS), and treatment regimen as independent factors influencing postoperative recovery status.

CONCLUSION

MISS effectively improves clinical outcomes in strabismus patients, preserves tear film function and ocular surface health, and promotes visual recovery. The Slt, CFS, and treatment regimen are independent factors affecting postoperative recovery in strabismus patients.