RESUMO
PURPOSE: To compare the efficacy of topical cyclosporine, punctal occlusion, and a combination for the treatment of dry eye. METHODS: Patients with dry eye (N = 30) seen in a university-affiliated private practice were randomized to 1 of 3 treatments: cyclosporine 0.05% ophthalmic emulsion (RESTASIS) twice daily, lower-lid punctal plugs (PARASOL), or a plugs-cyclosporine combination. Tear volume, ocular surface staining, and artificial tear use were assessed at baseline and 1, 3, and 6 months. RESULTS: All treatments improved Schirmer scores by 6 months (P < or = 0.005 vs. baseline), with plug-containing regimens favored at 1 and 3 months (P < 0.001 vs. cyclosporine alone). Cyclosporine-containing regimens, but not plugs alone, improved rose bengal staining at 3 and 6 months (P < or = 0.010 vs. baseline). Artificial tear use decreased with plug-containing regimens at 1 month and with all treatments at 3 and 6 months (P < or = 0.005 vs. baseline). Combination therapy produced the greatest overall improvements and was superior to plugs alone in decreasing artificial tear use at 6 months (P = 0.012). CONCLUSIONS: All 3 regimens effectively treated dry eye. Plug-containing regimens increased wetness initially; cyclosporine appeared to promote long-term ocular surface health. The effects may be additive. Patients with punctal occlusion may benefit from adjunctive cyclosporine.
Assuntos
Ciclosporina/administração & dosagem , Síndromes do Olho Seco/tratamento farmacológico , Síndromes do Olho Seco/cirurgia , Pálpebras/cirurgia , Aparelho Lacrimal/cirurgia , Próteses e Implantes , Administração Tópica , Adulto , Terapia Combinada , Síndromes do Olho Seco/metabolismo , Feminino , Corantes Fluorescentes/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rosa Bengala/metabolismo , Lágrimas/metabolismo , Resultado do TratamentoRESUMO
A multitude of techniques exists for facelift surgery (rhytidectomy). These techniques range from simple skin undermining to complex procedures involving superficial musculoaponeurotic system (SMAS) manipulation and subperiosteal dissection. Most surgeons agree that some type of modification of the SMAS is necessary to achieve an acceptable result. The technique presented herein involves developing a relatively large skin flap, tightening the SMAS, and redraping the skin.
Assuntos
Ritidoplastia/métodos , Humanos , Envelhecimento da PeleRESUMO
A 60-year-old woman had a slow-growing cutaneous nodule of her left brow. After initial excisional biopsy, the lesion recurred within 1 week. After tissue diagnosis was confirmed, the recurrent mass was excised under frozen section control and the defect was reconstructed with a forehead flap. This unusual tumor involved the brow and eyelid, down to the level of the orbital septum. The patient remains free of disease after 20 months.
