ABSTRACT
PURPOSE: To report the outcome of a retrospective study of the Pintucci Biointegrable Keratoprosthesis (PBIKP) in Asian eyes. MATERIALS AND METHODS: This was a retrospective analysis of 31 eyes of 31 consecutive patients, who underwent surgery with implantation of the PBIKP. The age ranged from 7 years to 65 years, with a mean age of 34 years. The indications for the PBIKP were chemical burns (11 cases); highly vascularized failed grafts (11 cases); severe dry eyes with total vascularized cornea (6 cases); miscellaneous (3 cases). Twenty eight bilaterally blind Asian patients, with vision not exceeding hand motion close to face in the better eye, underwent the classical two-stage procedure to implant the PBIKP. In another three patients, the PBIKP was implanted as a one-stage procedure. All 31 eyes were unsuitable for keratoplasty or had repeated failed keratoplasties. All patients were followed up for periods ranging from 6 months to 7 years, with a mean of 3.2 years. RESULTS: No eye had infection or retro prosthetic membrane, which were common complications in other Keratoprostheses designs. Twenty-four of 31 eyes improved to greater than finger counting at 1.5 metres, enabling the patients to function independently. Four of 31 eyes (13%) improved to 20/200 or better. Twelve of 31 eyes had significant complications. However only a few were vision- threatening. CONCLUSION: With careful patient selection, the PBIKP could prove to be a useful modality of treatment for bilaterally corneally blind Asian patients, whose vision cannot be improved with conventional medical or surgical treatments.
Subject(s)
Absorbable Implants , Burns, Chemical/surgery , Corneal Transplantation , Eye Burns/surgery , Prosthesis Implantation/instrumentation , Adolescent , Adult , Aged , Child , Eye Burns/chemically induced , Female , Follow-Up Studies , Humans , India , Male , Middle Aged , Prosthesis Design , Retrospective Studies , Treatment OutcomeABSTRACT
The extreme morbidity that a severe chemical burn produces makes it imperative that immediate treatment be instituted for the purpose of restoration of the integrity and transparency of the cornea. The evolution of cicatrisation in severe chemical injuries especially alkali, takes an unfavourable course. Release of collagenase from the newly formed epithelium and fibroblasts of the stroma and lack of required levels of ascorbate in the aqueous humour causes fibroblasts to develop a denatured weak collagen.
Subject(s)
Burns, Chemical/therapy , Eye Burns/chemically induced , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle AgedABSTRACT
Four consecutive menstrual cycles were studied in six healthy parous women. A solvent mixture comprising propylene glycol:ethanol:water (3:3:4) was sprayed intranasally daily using a glass atomizer between days 5 and 24 of the first (control) menstrual cycle. NET was dissolved in the solvent and similarly administered at a daily dose of 100 mcg during the second and third menstrual cycles. Nasal sprays were not administered during the fourth post-treatment cycle. Blood samples were taken during four consecutive cycles between days 8 and 15 and again between days 20 and 24 of the cycle to estimate levels of estradiol (E2), FSH, LH and progesterone (P). These studies revealed that nasal sprays of NET were well accepted and that no adverse clinical effects or menstrual disturbances occurred. NET inhibited ovulation in one cycle. The E2-induced mid-cycle rise in FSH and LH was either suppressed or inhibited in nine out of the 12 treated cycles. P levels in three treated cycles were indicative of luteal inadequacy. These endocrine effects of NET persisted into the post-treatment cycle in two cases.
Subject(s)
Estradiol/blood , Follicle Stimulating Hormone/blood , Luteinizing Hormone/blood , Norethindrone/administration & dosage , Progesterone/blood , Administration, Intranasal , Adult , Drug Evaluation , Female , Humans , Menstruation/drug effects , Norethindrone/adverse effects , Norethindrone/pharmacology , Ovulation/drug effects , PeriodicitySubject(s)
Macula Lutea/physiopathology , Retinal Diseases/physiopathology , Aged , Female , Humans , Male , Middle AgedABSTRACT
Diminution of vision arising from head injuries involving the optic foramen can be treated by transethmoidal decompression of the optic nerve. Early surgery is associated with good recovery of function. In this paper, the surgical procedure is discussed, with the results in 10 cases.
Subject(s)
Blindness/surgery , Craniocerebral Trauma/surgery , Optic Nerve/surgery , Adolescent , Adult , Blindness/etiology , Child , Craniocerebral Trauma/complications , Ethmoid Bone , Humans , Male , Methods , Middle AgedABSTRACT
Two patients with galactorrhea-amenorrhea and bilateral visual field defects were studied. Routine radiologic examination of each patient revealed a normal sella turcica and no demineralization of the posterior clinoid process. Serum prolactin levels were elevated (patient V. G., 80 ng/ml; patient S. R., 204 ng/ml). Within 2 months of bromocriptine therapy, the serum prolactin levels were normal (patient V. G., 12.21 ng/ml; patient S. R., 8.25 ng/ml) and the bilateral visual field defects were corrected. Bromocriptine has been shown to control prolactin secretion in patients with prolactin-secreting pituitary tumors. Normalization of restricted visual fields following bromocriptine therapy indicates the possibility of an anatomical regression of pituitary hyperplasia or an underlying prolactin-producing microadenoma. It is speculated that the modality of functional galactorrhea reflects hyperplasia of the lactotrophs preceding a nodular and ultimately an adenomatous change. The continuous and prolonged administration of bromocriptine may prevent such a progressive sequence. Further experience is required to validate this possibility.
