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PubMedDate not supplied

Medial canthoplasty for epiphora in dogs: a retrospective study of 23 cases.

The medical records of 23 dogs that underwent medial canthoplasty for treatment of epiphora were reviewed. The most prevalent breed encountered was the shih tzu. Other affected breeds included the Pekingese, Maltese, toy poodle, and pug. All dogs had epiphora associated with medial canthal trichiasis and/or entropion. Other ocular abnormalities included conjunctivitis, keratitis, pigmentary keratitis, corneal ulceration, globe prolapse, and nasal fold trichiasis. After medial canthoplasty, the epiphora resolved in all dogs.

Animals↗

PubMed1999

[Complications of transpalpebral osseous orbital decompressions in thyroid orbitopathies].

INTRODUCTION: Complications of bony orbital decompression (BOD) are rather unreported and often neglected. The aim of this study was to assess the risks of this surgery. MATERIAL AND METHODS: 44 patients (76 orbits) were studied. There were 19 malignant orbitopathies and 57 cosmetic rehabilitations. All side-effects and true complications were reported. A questionnaire was send to the patient and to his ophthalmologist. RESULTS: Infra-orbital hypoesthesia, oculomotor disorders, entropion, changes of lid position were the most frequent complications. A case of hypoglobus, a case of lacrimal stenosis, a case of decreased visual acuity were reported. DISCUSSION: Side-effects of BOD are frequent. Higher rates are even found in the literature. These effects tend to decrease spontaneously or can be treated by adequate medical or surgical care. Some measures are proposed to perform surgery safer. CONCLUSION: More precise information should be given to the patients before surgery and a better prevention can be afforded.

Adult↗

PubMedDate not supplied

Penetrating keratoplasty in patients with corneal scarring due to trachoma.

BACKGROUND AND OBJECTIVE: Trachoma remains the leading cause of preventable corneal blindness. The outcome of penetrating keratoplasty (PK) in these patients is usually poor because of the extensive corneal vascularization, adnexal and ocular surface problems. We evaluated the long-term results of PK in patients with corneal scarring due to trachoma. PATIENTS AND METHODS: The fiels of 16 eyes of 13 patients who underwent PK due to late sequel of trachoma were reviewed. RESULTS: Preoperative visual acuity ranged from light perception to finger counting levels. Preoperatively, dry-eyes, meibomian gland dysfunction, trichiasis and cicatricial entropion were treated. Over a mean postoperative follow-up of 26.1 +/- 15.6 months (range of 14-61 months), eyes required redrafting due to graft rejection and failure, and corneal ulceration (12.5%). Fourteen eyes remained clear grafts (87.5%), and 13 eyes (81.3%) achieved 0.1 or better visual acuity. CONCLUSIONS: These results suggest that although patients with corneal scarring due to trachoma are at high risk, PK may be helpful for visual rehabilitation.

Aged↗

PubMed1999

A new case of neonatal progeroid syndrome with agenesis of corpus callosum.

We report on a female infant with a history of severe intrauterine and postnatal growth retardation, pseudohydrocephaloid cranium, frontal bossing, widened fontanelles, prominent scalp veins, progeroid face, entropion, beaked nose, small mouth, generalized lipodystrophy, camptodactyly and hypoplasia of lower limb muscles, suggesting the diagnosis of neonatal progeroid syndrome (NPS). In addition, she had congenital hip dysplasia and agenesis of corpus callosum. It is the first Hungarian case with neonatal progeroid syndrome.

Abnormalities, Multiple↗

PubMed1975

Blinding and non-blinding trachoma: assessment of intensity of upper tarsal inflammatory disease and disabling lesions.

A simplified method of evaluating both the intensity of active inflammatory disease and the visually disabling lesions of trachoma is presented. Evaluation of the active disease is based on the scoring of clinical signs, lymphoid follicles, and papillary hypertrophy. The irreversible lesions of trachoma are classified as conjunctival scarring, trichiasis and/or entropion, and corneal scarring.

Blindness↗

PubMed2001

[Evaluation of the conjunctiva of leprosy patients using impression cytology].

OBJECTIVE: To evaluate ocular surface disorders (OSD) similar to cicatricial pemphigoid in leprosy patients. SUBJECT AND METHOD: Sixteen leprosy patients were examined. They were under treatment as inpatients at the Tama Zenshoen National Sanatorium, an institution for the treatment of leprosy. In addition to routine ophthalmological examinations, the patients conjunctival goblet cells were examined using impression cytology. OSD similar to ocular cicatricial pemphigoid were defined as the presence of at least two items of the following: symblepharon, cicatricial contraction of the conjunctival sac, corneal neovascularization, and palpebral entropion. RESULTS: OSD was present in 8 of the 16 patients (50%). Goblet cells were either decreased in number or absent in 7 cases(44%), and included 4 cases with OSD. Six of the 7 cases(86%) with reduced or absent goblet cells had been diagnosed as leprosy prior to 1944. CONCLUSION: Reduction or absence of goblet cells is a frequent feature in leprosy patients, particularly in longstanding ones of 56 years or more. Insufficient initial treatment appears to be a major cause of this finding.

Aged↗

PubMed2001

[A clinical observation of preserved donor tarsal plate transplantation for repair of tarsus defect].

OBJECTIVE: To investigate the effect of preserved donor tarsal plate transplantation on the repair of the tarsus defect at the time of eye lid tumor removal. METHODS: Donor tarsal plates preserved in pure glycerin were used for the repair of tarsus defects of 58 cases after the complete removal of the eye lid tumors. The grafts were covered with rotated or slid myocutaneous and conjunctival flaps. The associations of the effect with the blood supply, with the size and the preserved time of the donor tarsal plates, as well as with the follow-up time were analyzed by chi(2) test. RESULTS: Of the 43 cases whose plates were fully covered with conjunctival flaps, new blood vessels began growing into the donor tarsal plates one week after the operation. The grafts were vascularized one month later. The donor tarsal plates of 15 cases were only partly covered with conjunctival flaps. As a result, the grafts were vascularized in 2 -- 3 months, and there was dissolution to varying degrees at the surface of the exposed parts of the plates. The effects of the 43 cases with good blood supply were significantly better than the effects of 15 cases with poor blood supply (chi(2) = 5.81, P < 0.05). The sizes of the donor tarsal plates ranged from 5 x 10 mm(2) to 8 x 29 mm(2). Eleven cases were equal or shorter than half of the original sizes of donor tarsal plates, 34 cases were subtotal and 13 cases were total plates. The differences of the sizes led to different results (chi(2) = 6.28, P < 0.05). The preserved times of donor tarsal plates were from 1 week to 2.5 years. However, the results were similar in all cases (chi(2) = 0.99, P > 0.05). All the patients were followed up for 6 months to 10 and half years (mean, 1.8 years). The effects had no statistical significance (chi(2) = 0.85, P > 0.05). The cilia of the donor tarsal plates were preserved in 3 cases, but all of them were totally lost during post-operative one month. After operation slight entropion occurred in 8 cases, slight ectropion in 3 cases, lagophthalmos for 2 -- 3 mm in 7 cases, notch of the palpebral margin in 5 cases and thinness of the donor tarsal plates in 4 cases, but the functional and aesthetic results were normal. Thirty-one cases were cured, 11 cases acquired tangible results and 12 cases were improved. The total effective rate was 93.1%. CONCLUSIONS: The more blood supplies of the donor tarsal plates, the better the effects. So we must make all our efforts to improve the blood supplies of the donor tarsal plates. The effects were associated with the sizes of the plates, but not associated with the preserved times of the grafts and the follow-up times. Preserved donor tarsal plate transplantation for the repair of tarsus defect is a relatively simple operation, the rejection is slight and the result satisfactory, thus it is an ideal plastic material.

Adult↗

PubMed1975

Modification of the Mustardé and Hughes methods of reconstructing the lower lid.

Reconstruction of the lower lid often is a greater task than originally anticipated in preoperative evaluations. The Mustardé and Hughes methods are commonly used for extensive lower lid reconstruction. Certain difficulties encountered in these methods may be minimized by variations in the basic techniques. Structural support for a Mustardé flap may be provided by a free tarsal conjunctival graft rather than a nasal septal cartilage mucosa graft. Late complications following the Hughes procedure include upper lid retraction and entropion. These may be minimized by removing Mueller's muscle from the flap at the time of the original dissection. The Hughes flap may be lysed in 3 to 4 weeks. Lid margin abnormalities, which occur occasionally, are corrected with minor modifications.

Conjunctiva↗

PubMed2003

Retrospective case series of therapeutic applications of a lotrafilcon A silicone hydrogel soft contact lens.

PURPOSE: To report a series of consecutive cases for which a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications. METHODS: Three practitioners in Spain, Denmark, and Germany supplied 41 consecutive case reports on 39 patients for whom a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications for erosion or recurrent erosion, bullous keratopathy, corneal edema, corneal dystrophy, neurotrophic corneal ulcer, entropion, and after corneal surgeries. Practitioners reported their judgements of pain relief, change in corneal signs by slitlamp evaluation, additional complications, and success of therapeutic lens treatment. Twenty cases that had completed treatment and 21 that remained under ongoing treatment were reported. RESULTS: Complete pain relief was reported for 78% of cases with 94% reporting pain relief of 50% or more. Corneal signs were restored to normal for 74% of cases with 100% showing at least partial improvement. No additional complications were reported in 83% of cases. Therapeutic contact lens application was judged fully successful for 71% of cases with 93% showing at least partial success. CONCLUSION: The high-Dk lotrafilcon A lens met or exceeded the outcomes reported from historic reports of therapeutic applications of low-Dk soft contact lenses. Whereas the case reporting conditions may vary among the historic studies and from the current study, there is the indication that success may be improved with the lotrafilcon A high-Dk lens.

Biocompatible Materials↗

PubMed2003

[Applications of the botulinum A toxin].

The botulinum A toxin inhibits the release of acethylcoline from the vesicles of presynaptic neuronal end plates. Its effect is a transient pharmacological neurectomy. The toxin is used more and more widespreadingly. It selectively inhibits certain muscles or groups of muscles. Its use is of outstanding importance in the treatment of blepharospasm, a disease possibly causing transient functional blindness. This blindness develops randomly, with undetermined duration, therefore it may even threaten the life of the patient. There is no alternative treatment. In ophthalmology, the toxin is used in the therapy of strabismus and nystagmus, as well as replacing entropion operations. Most often its use is suggested in the treatment of focal dystonies, dysphonia, tremor palatinus, dysphagia, spasm of the oesophagus sphincter muscle, nasal hypersecretion, hemifacial spasm, headaches, focal hyperhydrosis, proctalgia fugax, diabetic gastroparesis and difficulties in urination. In the past few years, the toxin has been used for esthetic reasons as well. By relaxing the muscles causing wrinkles, non-permanent result may be reached with its use. The botulinum A toxin does not have general side effects. As local side effects, haematomas and unwanted, transient paresis of the neighboring muscles can be mentioned.

Blepharospasm↗

PubMedDate not supplied

[Trachoma in Chad: results of an epidemiological survey].

A regional survey was carried out in Chad in 2000 and 2001 to estimate the prevalence and severity of trachoma. The main objectives were to describe the epidemiological pattern in terms of prevalence of inflammatory trachoma and blinding complications in two sub-samples of the population: children under 10 years of age and women over 14. Two strata were identified based on geographical criteria: two regions [Ouaddaï-Biltine, North-East] and [Lac-Kanem-Chari Baguirmi, North-West]. Random samples of thirty clusters were selected in each stratum with probability proportional to size. The simplified grading system proposed by the World Health Organisation (WHO) was used. A total of 3,952 children and 2,492 women were examined. The participation in the survey was 95% for the children sample, 92% for the women sample and the representativity of the samples was fairly good. In children under 10 years of age, the prevalence of follicular trachoma (TF) was estimated at 31.5% (IC(95%): 28.6-34.5) and that of intense inflammatory trachoma (TI) at 16.7% (IC(95%) : 14.4-19.2). The severity of the disease is high, as shown by the prevalence of trichiasis-entropion of 1.5% (IC(95%): 0.9-2.2), of central corneal opacity of 1% (IC(95%) :0.6-1.6) and of trachoma-related blindness of 0.5% (IC(95%) : 0.2-1) in women over 14. The epidemiological pattern of trachoma deserves particular attention in the field of public health in Northern Chad, where all indicators are consistently high. The national program for prevention of blindness has prepared a 3-year work plan to implement the SAFE strategy as soon as possible in these areas.

Adolescent↗

PubMed1976

[Chronic mucosynechial pemphigoid: so-called ocular pemphigus].

The so-called ocular pemphigus is an oculocutaneomucosal disease, the clinical manifestations of which have been recognized for over a century while its recognition as a nosological and histopathological unit is quite recent. The clinical picture in the eye consists essentially of progressive scar contraction which, preceded by a transient bullous phase, leads to symblepharon, entropion and trichiasis. Corneal complications, such as bullous eruption, erosions, proliferation of vasculoconnective tissue, supervene later. The final appearance is that of complete xerosis with total symblepharon producing a typical 'statute eye'. This local process may be accompanied by bullous lesions of the skin and mucous membranes but the general condition of the patient invariably remains good. In the advanced stages of the disease the appearance is described as 'pemphigoid facies'. The nosological place of ocular pemphigus has been a matter of debate. At various times it has been identified with pemphigus vulgaris, dermatitis herpetiformis of Duhring-Brocq, erythema multiforme of Hebra, Stevens-Johnson syndrome, syphilitic dermatitis bullosa and other bullous dermatoses. At present the condition is universally recognized as a clinical entity, referred to as chronic mucosynechial pemphigoid (CMSP). The anatomopathological picture is quite peculiar. The elementary lesion is a sub-epidermic bulla, hence easily distinguished from that of pemphigus vulgaris, which is situated in the Malpighian layer. This difference applies to the lesions of the skin as well as to those of the mucous membranes including the conjuctiva. In the conjunctiva, epithelial changes suggestive of its epidermization were demonstrated. The Malpighian layer shows a high glycogen and DNA content with overall reduction in enzyme activity. The dermis shows infiltration by lymphocytes, histiocytes and plasma cells, and a considerable increase in hyaluronic acid content. There are many areas of dermoepidermal separation with formation of bullae and the basal membrane is often missing. In some cases, in the centre of the bullae, we were able to demonstrate one or more lumps, consisting almost exclusively of hyaluronic acid, probably filtered in from the dermis across the altered basal membrane. Similar changes are met with also in other mucous membranes, that of buccal cavity in particular, even in ostensibly healthy areas. The histological and histochemical findings are sufficiently typical to justify early diagnostic biopsy in all suspected cases. The aetiology of the CMSP still remains debated. Two theories are under consideration at the moment, viral and autoimmune. The main argument in favour of the viral theory is that a cytopathogenic agent can be isolated from the blood of patients with different dermatoses of the pemphigus group, including the CMSP, whose cytotoxic activity can be passed through and potentiated by passage in cell cultures...

Adrenal Cortex Hormones↗

PubMed1992

Orbito-palpebral reconstruction in anophthalmos and severe congenital microphthalmos.

In patients with congenital anophthalmos and severe microphthalmos, a tiny orbit and socket exist with little eyelids, frequently preventing retention of a standard conformer or prosthesis. Socket expansion is sometimes impossible with microorbitism; the retention of a prosthesis is also difficult when malformations of the eyelids exist. The treatment of these difficult cases includes three stages. The first stage is orbital expansion that depends on the cephalometric studies of the patient: transverse osteotomy on the maxilla and the zygomatic bone with lateral bar by extracranial route, vertical osteotomy on the roof of the orbit by intracranial route. In some cases, the osteotomy includes expansion in the transverse and vertical diameter with bone grafts in the defects and on the lateral and superior rims. Simultaneously, socket expansion is performed by incision of the conjunctival sac circumferentially, with mucosal or split skin grafts on a conformer. The second stage includes eyelid reconstruction by different flaps. A third stage is frequently needed for correction of eyelid malposition on the prosthesis: ptosis, entropion surgery. Two cases of congenital anophthalmos are reported. Methods and indications of treatment are discussed.

Adolescent↗

PubMed2004

Elevated free tear lactoferrin levels in leprosy are associated with Type 2 reactions.

PURPOSE: To determine the association of demographics, leprosy and ocular characteristics with altered levels of lactoferrin in the tears of normal subjects and leprosy patients, and to detect the presence of antibodies to lactoferrin in these tear samples. METHOD: We collected light-stimulated tears from 298 leprosy patients and an equal number of normal subjects using the glass capillary method. Free lactoferrin levels were estimated using ELISA and the presence of antibodies to lactoferrin was detected using the immuno-blotting method. Significant associations were looked for between tear lactoferrin levels and demographic characteristics, leprosy characteristics such as type of disease, duration of disease, reactions, deformity and bacterial load, and ocular complications, using chi-square and regression analysis. RESULTS: Tear lactoferrin levels with a mean (SD) of 2.55 (2.83)mg/ml in the control group were significantly different (P<0.000) from leprosy patients with a smean (SD) of 5.66 (7.21)mg/ml. Age showed an inverse correlation with tear lactoferrin levels in controls. Increased bacterial load, grade 2 leg deformity and Type 2 reactions were significantly associated (P<0.05) with increased tear lactoferrin levels. Type 2 reactions remained significantly associated (P=0.01) on multiple regression analysis. Tear lactoferrin levels were not associated with gender, serum lactoferrin levels, Type 1 reactions, face patches, treatment status, orbicularis oculi weakness, lagophthalmos, ectropion, entropion, corneal opacity, cataract and iridocyclitis. CONCLUSION: Age is inversely related to tear lactoferrin levels in normal subjects. Free lactoferrin levels in tears are significantly higher in leprosy patients compared with normal controls. Type 2 reactions in leprosy are significantly associated with elevated tear lactoferrin levels.

Adolescent↗

PubMed2004

Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures.

OBJECTIVE: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures. METHODS: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation. RESULTS: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation. CONCLUSIONS: The subciliary incision and lateral cantholysis have many advantages such as invisible scar, sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

Adolescent↗

PubMed2006

Folliculectomy: management in segmental trichiasis and distichiasis.

OBJECTIVE: To propose a new surgical technique as an alternative method for the correction of segmental trichiasis and distichiasis. MATERIAL AND METHOD: An interventional case series reviewed the segmental trichiasis and distichiasis patients who were treated with folliculectomy in the Ophthalmology Department, King Chulalongkorn Memorial Hospital. The data was collected from January 1997 to December 2002. The history, clinical features and treatments were reviewed. Patients with the initial diagnosis of entropion were excluded. RESULTS: Nine segmental trichiasis and distichiasis patients (13 eyes) were reviewed. Eight eyes underwent folliculectomy and one had folliculectomy with anterior lamellar recession. The follow-up time was 1-24 months. Nine of thirteen eyes (69.2%) were successfully treated with folliculectomy or folliculectomy with anterior lamellar recession. Four eyes needed second operations due to the recurrence of the eyelashes. CONCLUSION: Folliculectomy revealed good results in trichiasis and distichiasis. It should be considered as an alternative technique because it is a simple and fast procedure.

Adult↗

PubMed2005

[Diagnostics and pharmacological treatment of ocular cicatrical pemphigoid].

Ocular cicatricial pemphigoid (OCP) is an autoimmune disease characterize by mucous membrane fibrosis and skin changes resulting with scarring. The pathogenic mechanisms of ocular cicatricial pemphigoid are incompletely understood. Antibasement membrane antibodies which lead to subepithelial blistering, granulation tissue and inflammatory infiltrate formation in the substantia propria are thought to be the main pathophysiological mechanisms in cicatricial pemphigoid. It has been found eosinophils and increased collagen type I and III. Human leukocyte antigen HLA-DR2, HLA-DR4 and DQw7 genotypes have been identified as conferring increased susceptibility to the development of this disease. Ocular cicatrical pemphigoid (OCP) is one of the forms of bullous pemphigoid. Initial symptoms of ocular pemfigoid are not characteristic. Conjunctival fibrosis may cause severe entropion, trichiasis, symblepharon, dry eye syndrome, corneal epithelial erosions or ulceration. Secondary glaucoma is one of the most frequent complications. Ocular cicatricial pemphigoid may be chronic, acute, or subacute disease with periodic exacerbation of conjunctival inflammation. The treatment in this disease are topical drops or ointment (lubricants, corticosteroids, antibiotics, antiglaucomatous). Oral dapsone and corticosteroids may control the activity of the disease. In other progressive cases immunosuppressive drugs must be used (azathioprine, cyclophosphamide, methotrexate, mycophenolan mofetil, daclizumab, intravenous immunoglobulin therapy). To make an early diagnosis of ocular cicatricial pemphigoid, biopsy and immunohistochemical analysis of conjunctiva should be performed in every case of persistent conjunctival inflammation.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2006

[Reconstruction of eyelid with hard palate mucosa autograft after resection of Malignant tumor of eyelid].

OBJECTIVE: To evaluate the clinical effect of the eyelid reconstruction using hard palate mucosa graft after resection of malignant tumor of eyelid. METHODS: From January 1998 to October 2003, 18 cases of malignant tumor of eyelid underwent the eyelid reconstruction with local flap grafting and hard palate mucosa autotransplantation. Of 18 cases, there were 10 males and 8 females, aging from 35 to 67 years. The defect was caused by basal cell carcinoma of eyelid in 10 cases, by carcinoma of meibomian glands in 6 cases and by squamous cell carcinoma of eyelid in 2 cases, including 12 cases of complete eyelid defect and 6 cases of 2/3 eyelid defect. RESULTS: The appearance and function of the eyelid in all cases were almost normal after the eyelid reconstruction with hard palate mucosa autotransplantation in replacing posterior layer of eyelid. The complete eyelid closure and no entropion were observed in all cases. The infection and contracture of the graft, immunologic rejection were not observed in all cases during the follow-up period of 6 to 48 months. CONCLUSION: The eyelid reconstruction using autotransplantation with hard palate mucosa in replacing posterior layer of eyelid was easy-to-operate and has satisfactory clinical effect. The hard palate mucosa as substitute of tarsus is superior to the traditional substitute.

Adult↗