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PubMed2006

Comparison of the effects of LASIK retreatment techniques on epithelial ingrowth rates.

PURPOSE: To compare the incidence of postoperative epithelial ingrowth using 3 different surgical LASIK retreatment techniques. DESIGN: Retrospective consecutive case series. PARTICIPANTS AND CONTROLS: Thirty consecutive eyes that underwent LASIK retreatments by a single surgeon. METHODS: The first 10 eyes underwent LASIK retreatment using the surgeon's routine surgical technique (forceps lift group), the next 10 retreated eyes had a bandage contact lens placed after surgery and removed the following day (contact lens group), and the next 10 patients had retreatment performed using a Pinelli spatula to cleave the circumference of the flap edge before lifting the flap and no contact lens placed after surgery (spatula cleaving group). The retreatment technique did not vary apart from these modifications. MAIN OUTCOME MEASURES: Incidence of postoperative epithelial ingrowth. RESULTS: The incidence of epithelial ingrowth was 40% in the contact lens group, 20% in the forceps lift group, and 10% in the spatula cleaving group. There was a trend toward a significant difference between the contact lens and spatula cleaving groups (P = 0.12). The patients with epithelial ingrowth showed a trend toward being older, with a mean age of 53+/-8.5 years compared with a mean age of 44+/-13 years for the patients without epithelial ingrowth (P = 0.07). Incidence of ingrowth was not related to the preoperative spherical equivalent. CONCLUSIONS: There was an increased incidence of epithelial ingrowth with use of an overnight bandage contact lens in our series. The Pinelli spatula may reduce trauma to the epithelium at the flap edge. The incidence of epithelial ingrowth was not related to the preoperative spherical equivalent. Increasing age may be a risk factor for epithelial ingrowth, but further study is warranted.

Adult↗
PubMed2006

Therapeutic options for the management of early neurotrophic keratopathy: a case report and review.

BACKGROUND: Neurotrophic keratopathy is caused by the loss of corneal sensation secondary to impaired trigeminal nerve function. Timely and appropriate action is required in the management of this condition to prevent serious complications such as corneal ulceration, perforation, and loss of vision. The role of immunomodulating agents such as cyclosporine as a therapeutic option and a review of several future treatment modalities are discussed. CASE REPORT: A 46-year-old black woman with a noted history of recurrent herpes simplex virus-1 keratitis and secondary neurotrophic keratopathy in the left eye was examined. She reported that another physician had treated her for this condition over the last 6 months. Her treatment regimen consisted of a bandage contact lens, antibiotic solution, and artificial tears. Best-corrected visual acuities were 20/20 in the right eye and 20/25 in the left eye. Biomicroscopy evaluation found punctate keratitis in both eyes and neurotrophic keratopathy with an area of pinpoint epithelial defect in the left eye. Restasis (0.05% cyclosporine ophthalmic emulsion; Allergan, Irvine, California) bid was added to her medical regimen. Within 4 weeks of starting Restasis therapy, the epithelial defect had resolved, and she was advised to discontinue both the bandage lens and antibiotic solution. She was ultimately discharged on a continued regimen of Restasis twice a day and lubricating drops as needed with scheduled follow-up every 3 months. CONCLUSION: Management of neurotrophic keratopathy requires decisive action. Early treatment intervention is important to help avoid severe complications. The use of immunomodulating agents (topical cyclosporine) in the early stage of management should be considered.

Anti-Bacterial Agents↗
PubMed1985

The effects of hypotonic and hypertonic solutions on the fluid content of hydrophilic contact lenses.

Twenty healthy volunteers were fitted with a Bausch & Lomb plano O4 bandage contact lens (center thickness, 0.06 mm; water content, 38.6%) in one eye and a CooperVision therapeutic bandage Permalens (center thickness, 0.24 mm; water content, 70%) in the other eye. Ten received eyedrops every hour for six hours of a solution of 224 ml Osmol and the other ten received a solution of 670 ml Osmol. At the end of the examination period water loss was 21.05% and 20.36% in the Permalens group with the hypertonic and hypotonic solutions, respectively, and 8.86% and 10.74% in the Bausch & Lomb lens groups with the hypertonic and hypotonic solutions, respectively. These values were not significant when compared to those for five control patients (13.75% water loss for the Permalens and 7.28% for the Bausch & Lomb contact lens), suggesting that other factors may be more significant in controlling hydrogel contact lens dehydration.

Adult↗
PubMed1996

Effectiveness of modified Complex Physical Therapy for lymphoedema treatment.

A conservative management technique for lymphoedema, known as Complex Physical Therapy, which comprises massage, compression bandaging, skin care and exercises, appears to be effective in the management of this chronic condition. However, it is extremely time consuming, requiring daily treatments of more than one hour in duration for a period of four weeks. A modified program, which combines all the elements of the treatment technique, was designed. This program requires treatments only twice weekly and uses pressure garments instead of compression bandaging. In this clinical trial on 25 patients, the results of the two treatment programs were found to be similar.

Journal Article↗
PubMed2006

Successful conservative management of hydrops with perforation in pellucid marginal degeneration.

CASE REPORT: Hydrops with perforation in the setting of pellucid marginal degeneration is a rare complication that is generally treated surgically. We report the first case of successful nonsurgical management using only a bandage contact lens. COMMENTS: Hydrops with perforation in one eye is a risk factor for a similar event occurring in the other eye. Initial conservative management with a bandage contact lens should be considered to avoid the risk of surgery. After resolution of hydrops, flattening of the cornea and reduced astigmatism is also a potential benefit.

Adult↗
PubMedDate not supplied

Unusual neutrophil infiltration under the soft contact lens in a patient with Behçet's disease.

BACKGROUND: Behçet's disease (BD) characterized by multisystemic disorders has many kinds of ocular involvement. We report one case of BD with unusual neutrophil infiltration under a soft contact lens (SCL). CASE: A 31-year-old woman diagnosed as having BD exhibited bilateral recurrent phlyctenular keratitis and finally developed corneal perforation in the cornea of her right eye. OBSERVATIONS: A therapeutic SCL was immediately fitted on the right cornea as a bandage and another SCL on the left, as prophylaxis. White gelatinous membrane suddenly appeared between the bandage SCL and the cornea in the left eye. After peeling off this gelatinous membrane from the cornea, we examined it after hematoxylin-eosin staining. We also measured the levels of interleukin-8 (IL-8) both in the tears of the patient and on the surface of the SCL. A great amount of neutrophils had infiltrated into this gelatinous membrane. Laboratory data showed a marked increase of IL-8 levels both on the SCL and in the reflex tears (right SCL, 4980 pg/mL; left SCL, 6810 pg/mL. Reflex tears: right, 2080 pg/mL; left, 2170 pg/mL). CONCLUSION: This case emphasizes the association between the IL-8 level and the disease activity in BD, and provides additional evidence that a BD attack can be induced on the ocular surface under certain conditions.

Adult↗
PubMed2003

Lymphedema, lipedema, and the open wound: the role of compression therapy.

As the science of wound healing has evolved over the past two decades, so has awareness of the "hidden epidemic" of lymphedema. Substantial information has been accumulated regarding the pathophysiology and therapy of lymphedema. Until recently, the relationship between wound healing and the negative effects of associated peri-wound lymphedema has received little attention. Identifying wound-related lymph stasis and safe mobilization of the fluid are fundamentals that must be addressed for proper therapy. Experience gained from the successful treatment of primary and secondary lymphedema has proven very useful in the applications to wound-related lymphedema. The mobilization of lymph fluid from the peri-wound area with the use of reasoned compression is essential for proper therapy of the open wound, as are appropriate bandage selection and safeguards for bandage application.

Adipocytes↗
PubMed1987

A controlled trial of weekly ultrasound therapy in chronic leg ulceration.

In a controlled trial to ascertain whether ultrasound given weekly in conjunction with a standard treatment for chronic leg ulcers improves the rate of healing 56 patients were randomised to standard treatment (paste impregnated bandage and a self-adhesive elastic bandage) and 52 to standard treatment plus pulsed ultrasound given weekly. After 12 weeks the proportion of ulcers healed was 20% greater in the ultrasound than in the control group.

Aged↗
PubMed2003

[Auguste Lumière, pioneer of the modern cicatrization].

At the "Grand Café" in Paris, on december 28, 1895 Louis and Auguste Lumiere displayed the cinematograph, a technical innovation that revolutionized the nascent motion picture. It was the first public projection of a film. While Louis continues his work on pictures and invents autochrome plates for colour photography, Auguste focused his interests on biology and medicine. Since Ambroise Paré, few doctors have been interested in the healing process. Although Carrel and Lecomte Du Nouy published the first studies in the early twentieth century, Auguste Lumière was a pioneer in the modern research and treatment of wounds. He applied the principles of experimental medicine. In his research he used 44 dogs to study the healing speed and the scar quality in certain areas and under general conditions. In the winter of 1914-1915 he studied in Lyon several hundred wounds of war casualties. In 1922 he established and published in a marvellous book the principles of normal healing. In the department of Pr Leon Bérard he was shocked by the fetidness of the wards where the dried bandages were changed once a week. In 1915 he perfected a revolutionary sterilized "treatment-bandage" consisting of 2 mm stitched gauze saturated with Vaseline and Perou's balsam: the "Tulle Gras. In order to disinfect wounds, he used an iodized solution, sprayed in little droplets. The lives of Auguste and Louis Lumière were full of projects and inventions. When Auguste died in 1954 he had registered more than one hundred patents.

Cicatrix↗
PubMed1986

Masseter muscle hypertrophy. Aetiology and therapy.

Masseter muscle hypertrophy (MMH) is most probably a congenital, genetically determined anomaly. Thus we should refer to it as hyperplasia rather than hypertrophy of the masseteric muscle. Excision of the internal layer of the masseter muscle and reduction of the thickened bone in the region of the mandibular angle, via an intraoral approach, is the treatment of choice. Immediately after surgery it is necessary to apply a fixed compression bandage to the masseteric region in order to obliterate dead space which would otherwise be filled by a haematoma which in turn leads to prolonged postoperative trismus. After removal of the bandage it is necessary to institute mouth opening exercises. Very good esthetic and functional results were achieved.

Adult↗
PubMed2005

[Interest of cutaneous resection after reduction of volume by decongestive physiotherapy in huge primary lymphedema of lower limb].

Treatment of lymphedema is based upon decongestive physiotherapy including low stretch bandages. We reported 3 cases of huge primary lymphedema of lower limb treated with cutaneous resection after decongestive physiotherapy. Two men and a woman (47, 48, 48 years old) had unilateral right lymphedema which appeared at the age of 38, 38 and 37 years. Patients were hospitalized and treated during 3 to 5 weeks with decongestive physiotherapy and then followed by one (n=2) or two cutaneous (n=1) resections. Lymphedema volume calculated with the method of truncated cones decreased of 32, 38 and 59%. Largest differences between the two calves were 54, 38 and 57 cm before treatment and 17, 9 and 12 cm after treatment. Cutaneous resections on external side of the calf were longitudinal without complications. Lymphedema volume remained stable after 24, 6 and 12 months with two superposed elastic stockings and regular self bandaging.

Female↗
PubMed2001

Functional and corrective claw trimming.

Foot care and claw trimming require proper systems for restraint, sharp knives and trimming equipment, and an understanding of the biomechanics of weight bearing and hoof overgrowth in cattle. The objective of functional claw trimming is to correct hoof overgrowth, thereby re-establishing appropriate weight bearing within and between the claws of each foot. Traditional trimming methods fail to achieve these objectives. Corrective trimming procedures are applied to horn lesions affecting the claw capsule. Primary objectives of corrective trimming are to adjust weight bearing to provide rest for diseased claws and to remove loose horn and hard ridges that may cause further injury to the corium. The application of a foot block to the healthy claw is a valuable aid in foot care when corrective trimming alone is insufficient to provide needed relief from weight bearing. Finally, the use of topical treatments under a bandage is controversial. It is recommended that caustic treatments be avoided and that the use of a bandage be limited to conditions requiring hemostasis or when operators are committed to their removal within a period of 2 to 5 days depending on the level of environmental contamination.

Animal Husbandry↗
PubMed1999

Keratitis with loss of useful vision after photorefractive keratectomy.

A 30-year-old man was referred as an acute case for keratitis. Two days earlier he had had photorefractive keratectomy for myopia at another clinic; a bandage contact lens was placed over the eye, but prophylactic antibiotics were not prescribed. The keratitis was treated with gentamicin sulfate (Garamycin) and chloramphenicol eyedrops. Scrapings from the cornea showed nonhemolytic streptococci. Two and a half months later, visual acuity was finger counting because of gross distortion of the corneal contour. The combination of a bandage contact lens and the lack of prophylactic antibiotics may have been the source of bacterial keratitis.

Adult↗
PubMed1997

Changes in canine cortical and cancellous bone mechanical properties following immobilization and remobilization with exercise.

The purpose of this study was to assess cortical and cancellous bone responses to unilateral limb immobilization and, subsequently, to remobilization with exercise, in a young adult canine model. Right forelimbs of 14 1-2-year old mongrel dogs were immobilized in a non-weight-bearing position by a bandage for 16 weeks. Six control dogs were untreated. At 16 weeks, seven immobilized and three control dogs were euthanized. The remaining seven immobilized dogs began a recovery protocol consisting of 16 weeks of kennel confinement (without the right forelimb bandaged) followed by 16 weeks of treadmill exercise conducted three times per week. These seven dogs and three control dogs were euthanized at 48 weeks. Bone mineral density of the proximal radii was determined with dual-energy X-ray absorptiometry and humeral middiaphyseal cross-sectional areas were determined with computed tomography. Humeri were tested in cranio-caudal three-point bending to failure. Cancellous bone cores from the lateral humeral condyles had wet apparent density determined and were tested to failure in compression. Mechanical properties, bone density, and cross-sectional areas were compared between immobilized (right forelimb), contralateral weight bearing (left forelimb), and control forelimbs with Kruskal-Wallis and post hoc tests. At 16 weeks, bone mineral density, cortical load, yield, and stiffness as well as cancellous bone failure stress, yield stress, and modulus were significantly lower (p < 0.02) for immobilized limbs than control limbs. Immobilized limb cancellous bone mechanical properties were 28%-74% of control values, and cortical bone mechanical properties were 71%-98% of control values. After 32 weeks of remobilization, cortical and cancellous bone mechanical properties were not different from control values except that cortical bone failure stress and modulus were significantly higher (p < 0.01) between remobilized and control limbs. In summary, 16 weeks of forelimb immobilization was associated with significantly lower mechanical properties, and with greater differences in cancellous than cortical bone properties. Mechanical properties were not different from control values after 32 weeks of recovery that included 16 weeks of treadmill exercise.

Absorptiometry, Photon↗
PubMed1993

Knot to be condemned.

It is common practice following mastoid and middle ear surgery to apply a pressure bandage to the ear for a short post-operative period to reduce local swelling. The bandage is usually secured in such a way as to lift it away from the eye, sometimes with a length of ribbon gauze tied in a knot over the temporal region. Pressure from the knot may cause injury to the underlying tissues leading to post-operative complications which hitherto have not been described.

Adult↗
PubMed1998

Excimer laser for various degrees of myopia. A new model estimating the immediate response, the regression, the final response and the time relationship.

PURPOSE: To demonstrate a unified model for various degrees of myopia, characterizing the response-time relationship and its influence of topical corticosteroids. METHODS: 84 eyes were treated with excimer laser for myopia (median -7.1 D). 50 eyes received topical NSAID for 4 days (group 1), and 34 eyes (group 2) were further treated postoperatively with bandage lens and topical corticosteroids for three months. The response-time relationship was expressed as P(t)=a+b*exp(k*t), where P(t) is the response expressed as the percent change in dioptric power to the postoperative time t, a is the final percent response, b is the total percent regression and k the time constant. a+b express the percent immediate response and T1/2=0.69/k denote the time within which half of the total regression has occurred. RESULTS: The immediate and final responses were significantly larger in group 2 (128.9% and 70.5%) compared with group 1 (110.5% and 59.8%). T1/2 was significantly longer in group 2 (2.1 month) compared with group 1 (0.8 month) CONCLUSION: Use of bandage lens together with steroids significantly influences the response-time relationship after excimer laser treatment for myopia.

Administration, Topical↗
PubMed2004

Complex organic chemical balms of Pharaonic animal mummies.

Millions of votive mummies of mammals, birds and reptiles were produced throughout ancient Egypt, with their popularity increasing during the reign of Amenhotep III (1400 bc) and thereafter. The scale of production has been taken to indicate that relatively little care and expense was involved in their preparation compared with human mummies. The accepted view is that animals were merely wrapped in coarse linen bandages and/or dipped in 'resin' before death. However, as with human mummification there was a range of qualities of treatments, and visual inspection of animal mummies suggests that the procedures used were often as complex as those used in humans (for example, evisceration and elaborate bandaging). Moreover, the ancient Egyptians treated animals with great respect, regarding them both as domestic pets and representatives of the gods; for example, the cat symbolized the goddess Bastet; the hawk, Horus; the ibis, Thoth, and so on. We report here the results of chemical investigations of tissues and wrappings from Pharaonic cat, hawk and ibis mummies using gas chromatography, gas chromatography-mass spectrometry, thermal desorption-gas chromatography-mass spectrometry and pyrolysis-gas chromatography-mass spectrometry. The analyses reveal the presence of highly complex mixtures of n-alkyl and cyclic biomarker components characteristic of fats, oils, beeswax, sugar gum, petroleum bitumen, and coniferous, Pistacia and possibly cedar resins. The mixture of balms is of comparable complexity to those used to mummify humans from the same period.

Animals↗
PubMed2006

Pseudodentritic keratitis associated with meibomitis in young healthy males.

PURPOSE: To report unusual corneal manifestations of pseudodendritic keratitis in cases of coexisting meibomian gland dysfunction (MGD). METHODS: Retrospective chart review of five cases of MGD with associated atypical corneal lesions was carried out. Information including patient's age, symptoms and their duration, clinical features, methods of diagnosis, treatment, and outcome were abstracted from the medical records. Pseudodendritic keratitis and MGD was defined before the data collection. RESULTS: All five patients were males within the age range of 6-24 years. Common symptoms were irritation and watering. MGD, which was defined as stenosis of meibomian gland orifices and/or turbid meibomian secretions, was seen in all the patients. Corneal lesions were epithelial, raised and dendritic in morphology. Blood investigations carried out to rule out tyrosinemia in three of the patients were negative. Bandage contact lens facilitated disappearance of these lesions in five eyes. CONCLUSIONS: Corneal involvement in the form of pseudodendritic keratitis may be associated with MGD. Application of bandage contact lens facilitated prompt resolution, suggesting mechanical factor with or without other etiological factors may be at interplay in producing these innocuous corneal lesions.

Adolescent↗