Subciliary incision for external dacryocystorhinostomy.

PURPOSE: To report the cosmetic and functional outcomes of subciliary incision for external dacryocystorhinostomy (DCR). METHODS: Prospective interventional study reporting subciliary incision to perform external DCR for primary acquired nasolacrimal duct obstruction. Successful functional outcome was defined as relief from epiphora, and patent lacrimal irrigation. Final cosmetic outcome of the scar was evaluated by subjective grading of the scar by the patient, and objective grading by the physician using high-resolution digital photographs. RESULTS: Seventeen eyes of 16 patients (4 males) with a mean age of 41.75 years (range, 26-71) underwent subciliary approach external DCR over a period of 22 months (March 2010 to December 2011). Pre-operative diagnosis was primary acquired nasolacrimal duct obstruction in all cases. Anatomic and functional success was noted in all 17 (100%) eyes. At the final follow up, objective grading of the scar by the physician reported 47% scars to be invisible (grade 0), and 88.2% scars to be invisible or minimally visible (grade 0-1). At the final follow up, subjective scar grading by the patient reported 88% scars to be invisible (grade 0), and 100% scars to be invisible or minimally visible (grade 0-1). In 2 (11.7%) cases, the physician reported the final scar as moderately visible (grade 2). Average follow up after surgery was 29 weeks (range, 6-72 weeks). In 2 eyes (first 2 cases), the incision extended medially by 2 mm. No other surgery related complications were noted. CONCLUSIONS: Subciliary DCR provides an excellent functional cosmetic scar outcome while retaining the access and advantages of external DCR procedure.

Determination of oxidative stress in vitiligo by measuring superoxide dismutase and catalase levels in vitiliginous and non-vitiliginous skin.

BACKGROUND: Vitiligo is an acquired disorder characterized by circumscribed depigmented macules devoid of identifiable melanocytes. Complex genetic, immunological, neural and self destructive mechanisms interplay in its pathogenesis. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. AIMS: The aim of our investigation was to evaluate the role of oxidative stress by measuring levels of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in lesional and normal skin of patients with vitiligo and in the skin of normal controls. METHODS: We determined the activity of SOD in lesional and non-lesional skin and CAT in lesional skin only of 25 vitiligo patients and 25 controls by using the spectrophotometric assay and Aebi's method, respectively. RESULTS: There was statistically significant increase in the levels of SOD in vitiliginous and non vitiliginous skin of patient group compared to the control group (P < 0.001). No significant difference was found between the levels of SOD in lesional skin and non-lesional skin of vitiligo patients. The levels of CAT in the skin of patients were found to be significantly lower than those of controls (P < 0.001). CONCLUSIONS: There is increased oxidative stress in vitiligo as is indicated by high levels of SOD and low levels of CAT in the skin of vitiligo patients.