ABSTRACT
PURPOSE: Either autogenous or allograft fascia lata frontal sling procedures can be used for the treatment of severe ptosis. We retrospectively evaluated the late outcomes of both approaches. METHODS: Medical records of patients who underwent frontal sling ptosis surgery between 1978 and 2000, with a follow-up of one year or more were included in the study. Success rates and the complications of the surgery for autogenous and allograft fascia lata were recorded. The results were compared statistically. RESULTS: Surgeries were performed with 82 autogenous or 43 allograft fascia lata. At last follow-up there were 71 eyes (86.6%) with good, 8 eyes (9.7%) with moderate, 3 eyes (3.7%) with poor results after autogenous fascia lata and 35 (81.4%), 3 (7%) and 5 (11.6%) after the allograft fascia lata frontal sling procedure. There was no significant difference between the two groups. Repeat surgery was carried out on three patients after autogenous and five after allograft fascia lata surgery. Two cases of preseptal cellulitis were observed, one abscess after autogenous and one lagophthalmus after allograft fascia lata sling surgery. All patients had slight edema early after surgery which resolved in a few days. Only one patient developed a hematoma at the site of the leg incision. CONCLUSIONS: Although the long-term success rate with the autogenous fascia lata is slightly higher and this remains the first choice, allograft fascia lata is a good alternative in patients in whom fascia could not be harvested.
Subject(s)
Blepharoplasty/methods , Blepharoptosis/surgery , Fascia Lata/transplantation , Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Intraoperative Complications , Middle Aged , Postoperative Complications , Reoperation , Retrospective Studies , Transplantation, Autologous , Transplantation, Homologous , Treatment OutcomeABSTRACT
PURPOSE: The aim of the study is to investigate whether tear ferning patterns change during different phases of the menstrual cycle. METHODS: The tear ferning test was performed on twelve normal women of childbearing age at three day intervals throughout one complete menstrual cycle. Serum hormone levels (progesterone, estrogen, testosterone) were measured. RESULTS: Eight women showed type I ferning, and the other four had type II ferning initially. These patterns did not change during the menstrual cycle. Serum hormone levels were all in the normal range. Since no change in ferning pattern was detected during the menstrual cycle, the ferning test can be done at any time in women. CONCLUSIONS: This study showed no effect of different menstrual cycle phases on tear ferning patterns.
Subject(s)
Eye Proteins/metabolism , Menstrual Cycle/physiology , Tears/metabolism , Adult , Diagnostic Techniques, Ophthalmological , Estrogens/blood , Eye Proteins/chemistry , Female , Humans , Menstrual Cycle/blood , Mucus/chemistry , Progesterone/blood , Tears/chemistry , Testosterone/bloodABSTRACT
This study was conducted to determine abnormalities of the GDx Glaucoma Scanning System parameters in patients with tilted discs, in order to set guidelines for the evaluation of glaucomatous damage in this situation. The objective was to determine which GDx parameters displayed the highest level of variation, and which remained unchanged in tilted disc syndrome. RNFA was polarimetrically conducted on 45 eyes from 26 subjects with tilted discs, and 43 normal eyes with Nerve Fiber Analyzer II (Laser Diagnostic Technologies). All parameters except inferior maximum, average thickness, ellipse average, and inferior average displayed a significant difference between the two groups (p < 0.05). Although NFA is useful in glaucoma diagnosis, the majority of the GDx parameters, as shown in our study, are unreliable in tilted disc syndrome in this respect.
Subject(s)
Eye Abnormalities/complications , Glaucoma/diagnosis , Nerve Fibers/pathology , Optic Disk/abnormalities , Optic Nerve Diseases/diagnosis , Retinal Ganglion Cells/pathology , Adult , Aged , Female , Humans , Male , Microscopy, Confocal , Middle Aged , Ophthalmoscopy/standards , Practice Guidelines as Topic , Reproducibility of Results , SyndromeABSTRACT
BACKGROUND: The primary site of pathology in Moebius syndrome is still unknown, although several studies have variably localized the lesion in the extraocular muscles, cranial nerves, or central nervous system. CASE: A 24-year-old man with Poland-Moebius syndrome and acquired progressive bilateral paralytic lower eyelid ectropion is described. OBSERVATIONS: In this patient, magnetic resonance imaging studies revealed a barely detectable pontine hypoplasia and normal recti muscles. Nerve conduction studies of the facial nerves showed a severe demyelinating or dysmyelinating type of neuropathy. Bilateral lower eyelid ectropium of the patient was successfully corrected by canthal tightening procedures. CONCLUSION: Contrary to many reported cases, this patient serves as a rare example of a progressive type of Poland-Moebius syndrome presumably resulting from a combination of a brainstem abnormality and a peripheral neural degenerative process.
Subject(s)
Mobius Syndrome/diagnosis , Poland Syndrome/diagnosis , Adult , Demyelinating Diseases/diagnosis , Ectropion/diagnosis , Ectropion/surgery , Electromyography , Facial Nerve Diseases/diagnosis , Humans , Magnetic Resonance Imaging , Male , Nervous System Malformations/diagnosis , Neural Conduction , Oculomotor Muscles/pathology , Oculomotor Muscles/surgery , Pons/abnormalitiesABSTRACT
Contact lens-associated giant papillary conjunctivitis (CL-GPC) caused by mechanical and immune mechanisms is a significant problem resulting in contact lens intolerance and discontinuation of contact lens wear. In the present study, tear fluid leukotriene C4 (LTC4) level was evaluated in soft contact lens wearers with and without CL-GPC using ELISA. Statistical analysis showed no significant difference in tear fluid LTC4 between contact lens wearers without GPC and normal controls (p>0.05), but a significant increase in tear LTC4 level in CL-GPC patients (p<0.05). On the basis of this finding, it might be possible to explain redness, conjunctival edema, increased mucoid secretion, and papillary changes by the effect of LTC4 on eye tissues. Effective treatment of CL-GPC might be possible in the future by employing inhibitors of leukotriene synthesis and action.
Subject(s)
Conjunctivitis, Allergic/metabolism , Contact Lenses, Hydrophilic/adverse effects , Leukotriene C4/metabolism , Tears/metabolism , Adult , Conjunctivitis, Allergic/etiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , MaleABSTRACT
Leukotrienes have been shown to play a role in the pathogenesis of ocular inflammatory and allergic reactions like vernal keratoconjunctivitis and contact lens-associated giant papillary conjunctivitis. This study was designed to determine leukotriene B4 (LTB4) and leukotriene C4 (LTC4) levels in the tears of patients with ocular prosthesis-associated giant papillary conjunctivitis (OP-GPC) and to evaluate the effects of lodoxamide 0.1% on tear LTB4 and LTC4 levels of OP-GPC patients. Tear LTB4 and LTC4 levels were determined by an ELISA technique in the tears of ten OP-GPC patients before and after treatment with lodoxamide 0.1% for one month. The results were compared with that of ten healthy control subjects. The mean tear LTB4 and LTC4 levels of the OP-GPC patients were significantly higher than those of the control group. After treatment with lodoxamide 0.1%, tear LTB4 and LTC4 levels of the OP-GPC patients decreased significantly. This is the first report of elevated LTB4 and LTC4 levels in tears of OP-GPC patients and it points to the possible role of leukotrienes in the immunopathogenesis of OP-GPC. The results also indicate that lodoxamide 0.1%, a mast cell membrane stabilizer, is effective in significantly reducing tear LTB4 and LTC4 levels in OP-GPC patients.
