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At least 955 records · Page 53Linked to original sources
PubMed1993

Risk factors for trichiasis in women in Kongwa, Tanzania: a case-control study.

Women are at a greater risk compared to men for blinding complications from trachoma. In order to evaluate risk factors in women, 205 cases of trichiasis (TT) were selected from 11 villages in rural Tanzania. Each case of trichiasis was matched to two women of the same age and from the same village, who had no clinical signs of trachoma. Factors associated with trichiasis in a conditional logistic regression included history of trichiasis in the women's mother (odds ratio [OR] = 3.6; 95% confidence interval [CI]: 2.0-6.5); sleeping in a room with a cooking fire during childbearing years (OR = 1.8; 95% CI: 1.2-2.8); a home of wood and earth during childbearing years (OR = 2.1; 95% CI: 1.3-3.3); no adult education classes (OR = 2.2; 95% CI: 1.4-3.4); and five or more deaths among her children (OR = 2.6; 95% CI: 1.3-5.1). Detailed measures of prolonged exposure to child care as a young girl and as a mother showed no significant difference between cases and controls. Results from this study characterize women at high risk for severe disease and eventual blindness in a trachoma endemic area.

Adolescent↗
PubMed1999

Incidence of trichiasis in a cohort of women with and without scarring.

BACKGROUND: Blindness from trachoma is a significant problem for many underdeveloped countries. While active trachoma is common in children, trichiasis, the potentially blinding sequella, develops in adulthood and affects mainly women. Little is known about factors associated with the development of trichiasis. METHODS: The 7-year incidence of trichiasis and its association with ocular chlamydia infection was examined in a cohort of women from a hyperendemic area. A total of 4,932 women 18 years and older, living in 11 villages in Central Tanzania, were examined in 1989. A follow-up examination in 1996 was performed on all women with scars living in six of the 11 villages and on a random sample of women without scars from the same villages. Trachoma was graded clinically, chlamydia infection was ascertained at follow-up using polymerase chain reaction-enzyme immunoassay (PCR-EIA). RESULTS: A total 523 of the women with scars and 503 of the women without scars were re-examined. Forty-eight of the women with scars (incidence, 9.2%) and three of the women without scars (0.6%) developed trichiasis in the 7-year period. Prevalence of chlamydia infection was significantly higher in the group with scars (11.7% versus 7.1%). Trichiasis cases were more likely to be older, and to have chlamydia infection at follow-up odds ratio (95% confidence interval) 2.5 (1.1-5.7). CONCLUSION: The 7-year incidence rate in the population with scars was high, over 1% per year. Ocular chlamydia infection was more common in the group with scars at baseline and was also associated with being a trichiasis case, suggesting the importance of potentially long-term chlamydia infection in the progression to trichiasis. Antibiotic distribution programmes for trachoma control should include women with scars.

Adult↗
PubMed1985

Hemodynamic and anesthetic effects of sufentanil as the sole anesthetic for pediatric cardiovascular surgery.

The efficacy, safety, and hemodynamic response to 5 micrograms/kg, 10 micrograms/kg, or 20 micrograms/kg of sufentanil and 0.1 mg/kg pancuronium was evaluated in children between 4 and 12 years of age scheduled for open heart surgery. Systolic time intervals, 2-D echocardiograms, systolic blood pressures (SBP), diastolic blood pressures (DBP), and heart rates (HR) were recorded before and after induction of anesthesia. Significant changes 10 min following induction of anesthesia but before intubation included increases in SBP in the 5 micrograms/kg group (P less than 0.01) and in the ratio of preejection period to left ventricular ejection time in the 20 micrograms/kg group (P less than 0.05). Instances of myoclonic jerking and coughing episodes were observed in all three study groups. Following intubation there were significant (P less than 0.05) increases in SBP in all groups, in DBP in the 5 micrograms/kg group, and in HR in the 5 micrograms/kg and 10 micrograms/kg groups. Smaller increases in SBP, DBP, and HR were seen in all groups after skin incision and sternotomy. Mean plasma catecholamine levels showed nonsignificant increases following periods of intraoperative stimulation with wide patient variations. Recovery of responsiveness to command occurred in all groups within one hour from the end of surgery but extubation was impeded by shallow periodic breathing and hypercapnea. The authors conclude that for children undergoing open heart surgery use of sufentanil as a sole anesthetic in bolus form did not provide a reliable depth of anesthesia with any of the induction doses studied.

Anesthesia, Intravenous↗
PubMed1992

Treatment of the paradoxic inversion of the lashes in ectropion.

Ectropion leads to chronic inflammation of the exposed conjunctiva. This inflammation can lead to shrinkage and to a cicatricial paradoxic inversion of the lashes. When the lid margin is surgically brought into its correct position, these lashes may become trichiatic. The surgical eversion of the lid margin at the time of the ectropion operation can prevent this complication.

Aged↗
PubMed1993

Treatment of localized trichiasis with radiosurgery.

Several treatments exist for trichiasis, a condition in which misdirected lashes come in contact with the globe. The treatments can be considered in two groups, those that destroy the lash follicle and those that redirect the lashes. No technique is without potential complications, and none is 100% effective. The Ellman Surgitron FFPF offers a new treatment for trichiasis directed at destroying the lash follicle. This instrument utilizes energy at 3.8 MHz in the radiofrequency band of the electromagnetic spectrum, hence the term radiosurgery. This report presents a prospective, non-masked study of 30 eyelids in 26 patients with localized trichiasis treated with the Ellman Surgitron FFPF. Single treatment success rate in patient cure was 67%. Complications included lash recurrence in 8 patients, eyelid notching in 2, granuloma formation in 1, and persistent erythema and tenderness for 1 month in 1 patient. This series demonstrates that the instrument can be effectively used to treat localized trichiasis. A review of the literature reveals that this technique offers potential advantages over some others in use. Further study must determine its efficacy in the treatment of diffuse trichiasis and distichiasis.

Aged↗
PubMed1994

Argon laser treatment of trichiasis: a clinical and histopathologic evaluation.

Trichiasis is a common condition of multiple etiologies. Cryosurgery has been advocated as an effective means of treatment but may be associated with serious complications, including scar, skin depigmentation, and lid notching. We treated eight consecutive eyelids with the argon laser. At the end of a 3-month follow-up period, no recurrence was noted. The only observed complication was mild eyelid notching in one eyelid. Histopathologic evaluation of two specimens obtained 10 days and 5 weeks after laser treatment confirmed the highly localized coagulative effect of the laser with minimum destruction of adjacent tissues. Orientation of the eyelid so that the laser beam and the lash follicle are coaxial and careful measurement of the depth of vaporization of the lash follicle are important in confirming complete treatment and minimizing recurrence.

Adult↗
PubMed1995

Congenital shortening of the anterior lamella of all eyelids: the so-called ablepharon macrostomia syndrome.

The so-called ablepharon macrostomia syndrome is an extremely rate congenital condition that includes abnormal ears, an enlarged, fishlike mouth, absence of lanugo, redundant skin, and vertical shortening of all eyelids. Only four cases have been described so far. In these cases the nature of the eyelid anomalies has not been clearly defined. We report one more case showing that the condition is better described as a severe microblepharon because only the anterior lamella of the eyelids is shortened. The literature about this condition is reviewed, and oculoplastic treatment is discussed.

Adolescent↗
PubMed1996

Unusual skin depigmentation following eyelid cryosurgery.

A 71-year-old African-American man was treated with cryosurgery of the left lower lid for trichiasis. Dramatic depigmentation of the lid skin followed, including substantial pigment loss on the untreated upper lid. Pigmentation returned to nearly normal over a 9-year period. Depigmentation of the skin following cryosurgery is a well-known complication. The clinical course of the depigmentation, however, is not well demonstrated in the literature. This case documents, with clinical photographs, the spontaneous return to nearly normal pigmentation 9 years following the cryosurgery. In addition, the extensive depigmentation seen in this patient cannot be explained by cryoinjury alone. We speculate that the depigmentation was due, in part, to segmental vitiligo initiated at the site treated with cryosurgery.

Aged↗
PubMed2003

Localized amyloidosis of the cornea secondary to trichiasis: clinical course and pathogenesis.

PURPOSE: To present four cases of localized corneal amyloidosis secondary to trichiasis and to discuss its pathogenesis. METHODS: Medical and pathologic records of four patients with corneal amyloidosis secondary to trichiasis were reviewed retrospectively. Two patients underwent trichiasis surgery and then lamellar keratectomy. One patient underwent trichiasis surgery only, and one patient received keratectomy only. The excised specimens were examined by light and electron microscopy. In two cases, they were stained with antibodies against kappa and lambda immunoglobulin light chains. All patients were followed for evidence of progression or recurrence of the lesions. RESULTS: Three cases presented with blurring of vision and a progressively enlarging vascularized unilateral corneal mass. One case had normal vision and a smaller, nonvascularized mass. All four cases had a history of trichiasis. After trichiasis surgery but before corneal surgery, two patients were followed for 24 and 18 months, respectively, and showed no progression of the corneal lesions. The patient who did not undergo trichiasis surgery had a recurrence of the corneal lesion after lamellar keratectomy. Pathologic examination confirmed amyloid deposition in all three excised specimens with almost no inflammatory cells. Immunohistochemical stains were negative. CONCLUSION: The close correlation between trichiasis surgery and the clinical course of corneal amyloidosis provides further evidence for their association. The pathologic findings in this study do not confirm that the amyloid deposits are light chain proteins (AL).

Adolescent↗
PubMed2001

Absent lacrimal ducts, distichiasis, dysmorphic features, and brachydactyly: a case report.

We report a male patient presenting with the association of absent lacrimal ducts, distichiasis, dysmorphic facial features and limb abnormalities. Extensive chromosomal studies showed normal chromosomes. We discuss differential diagnoses such as Setleis, Char and Lacrimo-Auriculo-Dento-Digital (LADD) syndromes. This may represent a novel entity for which parental consanguinity would support an autosomal recessive mode of inheritance.

Abnormalities, Multiple↗
PubMed1995

Lasers in oculoplastic surgery.

Applications of laser-assisted surgery in oculoplastics are varied because the enormous scope of the specialty overlaps with ear, nose and throat, dermatology, plastic surgery, and ophthalmology, for example. All of these specialties have applications for lasers that in one fashion or another find their way into our armamentarium. In this article we present the last year's advances in laser applications in oculoplastics. By far, endonasal dacryocystorhinostomies are the most controversial and interest producing. Several articles address different approaches and conclusions. No final determination is available yet as to the effectiveness and ultimate success of this procedure. Dermatologic surgery for lesion removal and for cosmetic surgery also features in this year's review. The use of lasers for tattoo removal was reported in detail in a superb article. Overall there were no major breakthroughs in laser surgery, however, several well-thought-out articles have added to our understanding of this surgical modality.

Dacryocystorhinostomy↗