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Biomedical subjects

R G Fante

Publications and source records attributed to R G Fante.

14 recordsLinked to original sources
PubMed2001

Transcaruncular approach to medial canthal tendon plication for lower eyelid laxity.

PURPOSE: A new operation to correct lower eyelid laxity was evaluated. METHODS: A new transcaruncular, orbital approach to posterior medial canthal tendon plication was performed on eight orbits of four cadavers, which were then analyzed with computed tomography or histologic techniques. The procedure was also performed on 23 eyelids of 15 patients with lower eyelid medial canthal tendon laxity, alone or in conjunction with other procedures. These patients were followed up for a mean of 12 months. RESULTS: Improved postoperative eyelid position, epiphora, and superficial punctate keratopathy were found. Radiographic and histologic analysis demonstrated consistency of suture placement without involvement of contiguous anatomical structures. CONCLUSIONS: This procedure appears to be a safe, reproducible, and effective corrective procedure for medial canthal tendon laxity and lagophthalmos. When combined with lateral lower eyelid tightening, it is also an effective treatment for lower eyelid retraction and superficial punctate keratopathy. Other potential advantages and complications of this procedure are described in comparison to other reported surgical methods used to address medial canthal tendon laxity and malpositions of the medial lower eyelid.

Blepharoplasty↗
PubMed2001

Differential section of the seventh nerve as a tertiary procedure for the treatment of benign essential blepharospasm.

PURPOSE: To examine the efficacy of differential section of the seventh nerve in treatment of patients with blepharospasm refractory to botulinum toxin and eyelid protractor myectomy. METHODS: A retrospective noncomparative interventional case series consisting of a cohort of 228 patients with benign essential blepharospasm followed from 1987 to 1997 in a university ophthalmic plastic surgery referral practice. Patients were treated with botulinum toxin injections, eyelid protractor myectomy, and differential section of the seventh nerve in stepwise fashion as needed for symptomatic control. RESULTS: Thirty-four patients (15% of total) underwent eyelid protractor myectomy during this period. Eyelid protractor myectomy failed to control blepharospasm in 7 (21%) of these 34 patients, who then underwent differential section of the seventh nerve an average of 2 years after myectomy. Patients were followed up for an average of 36 months, with a success rate of 42% (3 of 7). The remaining 4 patients had repeat differential section of the seventh nerve with a 50% success rate, which brought the overall success rate from differential section of the seventh nerve to 71%. Lower eyelid ectropion requiring surgical repair complicated 27% of differential section of the seventh nerve procedures. CONCLUSIONS: Differential section of the seventh nerve is a reasonable alternative in the treatment of patients who have persistent disability despite treatment with botulinum toxin injections and eyelid protractor myectomy.

Adult↗
PubMed1992

Incidence of vitreous loss among third-year residents performing phacoemulsification.

The incidence of vitreous loss among third-year residents learning phacoemulsification was retrospectively evaluated. One hundred thirty-six cases of phacoemulsification were performed by six different third-year residents with the same attending physician supervising all cases. The incidence of vitreous loss was 14.7%. This study demonstrates that the rate of vitreous loss among residents learning phacoemulsification is higher than the reported incidence of vitreous loss for residents learning planned extracapsular cataract surgery with expression of the lens nucleus.

Cataract Extraction↗
PubMed1992

Treating dry eye.

Explore the source record for details and available documents.

Dry Eye Syndromes↗
PubMed1992

Recurrent hemorrhagic choroidal detachment associated with disseminated intravascular coagulation.

We report the case of a patient with recurrent hemorrhagic choroidal detachments after combined cataract and filtering surgery associated with exacerbation of chronic disseminated intravascular coagulation (DIC). It was postulated that the formation and drainage of the hemorrhagic choroidal detachments induced thrombin generation and consequently coagulation factor and platelet consumption. Fibrinolysis resulted in the release of fibrin-degradation products (FDP). Consumption of clotting factors and platelets combined with FDP release may result in decompensation of a chronic DIC state and cause a bleeding diathesis. This case shows the need for complete hematologic evaluation of patients with hemostatic abnormalities.

Aged↗
PubMed1990

Relative survival rates after alternative therapies for uveal melanoma.

Survival in a group of 556 patients with uveal melanoma treated by proton beam irradiation with a median follow-up of 5.3 years was compared with that of 238 patients enucleated during the same 10-year period as irradiated patients (July 1975 to December 1984) with a median follow-up of 8.8 years, and 257 patients enucleated during the preceding 10 years (January 1965 to June 1975) with a median follow-up of 17.0 years. Adjustments were made for known prognostic factors including age, tumor location, tumor height, and clinical estimate of tumor diameter (for enucleated patients this was estimated in a regression equation relating histologic to clinical measurement). The overall rate ratio for all cause mortality was 1.2 (95% confidence interval, 0.9-1.6) for the concurrent enucleation series versus proton beam, and 1.6 (95% confidence interval, 1.2-2.1) for the earlier enucleation series versus proton beam. Relative rates of metastatic death, cancer death, and all cause mortality comparing alternative treatments were found to vary with time after treatment. Interval-specific rate ratios were evaluated using proportional hazards models fitted to separate time intervals after treatment. For all three outcomes, rate ratios were over two and statistically significant for the first 2 years after treatment and closer to one and nonsignificant after year 6 comparing the two enucleation groups with proton beam. Results suggest that treatment choice has little overall influence on survival in patients with uveal melanoma.

Adult↗
PubMedDate not supplied

Fat-conserving aesthetic lower blepharoplasty.

OBJECTIVE: To evaluate a variation on lower eyelid fat-conserving blepharoplasty as a treatment for several facets of periorbital aging, especially eyelid fat protrusion and skeletonization of the inferior orbital rim. PATIENTS AND METHODS: Retrospective review of 14 consecutive patients at an academic center who underwent fat-conserving lower blepharoplasty over an 8-month period. Independent evaluation of surgical success was performed by two experienced surgeons. RESULTS: Fat-conserving blepharoplasty corrected skeletonization of the inferior orbital rim in 13 of 14 cases, and was moderately effective at correction of lower eyelid fat protrusion and wrinkles. There were no complications. CONCLUSION: Fat-conserving lower blepharoplasty is a safe and effective surgical technique for reduction of visibility of the bony orbital rim and can complement other procedures used to improve signs of aging in the periorbital region.

Adipose Tissue↗
PubMedDate not supplied

Correlation of ophthalmic findings with carotid artery stenosis.

Patients presenting with symptoms suggestive of amaurosis fugax, or with findings of Hollenhorst plaques on fundoscopy are frequently referred for duplex evaluation to detect possible carotid artery disease. To better determine the reliability of monocular visual loss and the presence of Hollenhorst plaques for predicting the presence or significance of carotid artery stenosis, we prospectively studied 66 patients with these ocular signs and symptoms. After evaluation, the patients were categorized as follows: 34 of 66 (52%) patients had amaurosis fugax, 23 (35%) had asymptomatic Hollenhorst plaques, 7 (11%) had retinal artery occlusion, and 2 (3%) had venous stasis retinopathy. All patients were evaluated ophthalmologically, with carotid duplex scanning and spectral analysis. A stenosis of greater than 60% was regarded as significant. The presence of risk factors including hypertension, diabetes, a history of CVA or TIA's, tobacco use and hyperlipidemia was recorded. There were no statistically significant differences (p greater than 0.05) in the incidence of atherosclerotic risk factors between the four groups. Patients with amaurosis fugax were more likely to have a significant carotid artery stenosis than those with asymptomatic Hollenhorst plaques or retinal artery occlusion (53% vs 9% vs 0% respectively) (p less than 0.006). We conclude that routine carotid duplex scanning is indicated in all patients with amaurosis fugax in view of the frequent association with significant carotid stenosis (53%). However, the presence of Hollenhorst plaques in the absence of visual symptoms appears not to have a significant association with carotid disease and may not necessarily require routine screening unless other risk factors for carotid stenosis are present.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗