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1.
Pharmaceutics ; 13(3)2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-33671006

RESUMO

The conjunctiva, an under-researched yet incredibly important tissue, plays key roles in providing protection to the eye and maintaining homeostasis of its ocular surface. Multiple diseases can impair conjunctival function leading to severe consequences that require surgical intervention. Small conjunctival defects can be repaired relatively easily, but larger defects rely on tissue grafts which generally do not provide adequate healing. A tissue engineering approach involving a biomaterial substrate capable of supporting a stratified epithelium with embedded, mucin-secreting goblet cells offers a potential solution. As a first step, this study aimed to induce stratification of human conjunctival epithelial cells cultured on electrospun scaffolds composed from poly(ε-caprolactone) (PCL) and decellularised tissue matrix (small intestinal submucosa (SIS) or urinary bladder matrix (UBM)) and held at the air/liquid interface. Stratification, up to 5 cell layers, occurred more frequently on scaffolds containing PCL + UBM. Incorporation of these decellularised tissue matrices also impacted material properties, with significant changes occurring to their fibre diameter, tensile properties, and chemical composition throughout the scaffold structure compared to PCL alone. These matrix containing scaffolds warrant further long-term investigation as a potential advanced therapy medicinal product for conjunctiva repair and regeneration.

2.
Ophthalmic Plast Reconstr Surg ; 37(4): 385-387, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33315844

RESUMO

PURPOSE: To describe how a vertical lid split helps excision and reconstruction of conjunctival tumors. METHODS: All patients with a limited view of conjunctival tumors involving the fornices underwent a vertical lid split procedure to improve access during resection and reconstruction. RESULTS: There were 11 cases where vertical lid splits were performed to assist excision and reconstruction of conjunctival tumors on patients between 2015 and 2019. There were 4 male and 7 female patients, 50-85 years of age, mean age 67.2 years. Four patients had invasive malignant melanoma, 2 melanoma in situ, 3 invasive squamous cell carcinoma, and 2 squamous cell carcinoma in situ. The authors have had no local reoccurrences in 9 patients (follow-up 8-54 months, mean 18 months). One patient's deep margins were involved and proceeded to exenteration, and 1 patient died from liver metastases. CONCLUSIONS: A vertical lid split incision of either or both eyelids, well away from the visible tumor edge splays the lid open allowing the whole conjunctival surface to be stretched out and viewed as a single flat sheet. This aids excision and reconstruction of the tumor, potentially reducing the risk of seeding and simplifying the reconstruction.


Assuntos
Neoplasias da Túnica Conjuntiva , Melanoma , Neoplasias Cutâneas , Idoso , Túnica Conjuntiva/cirurgia , Neoplasias da Túnica Conjuntiva/cirurgia , Pálpebras , Feminino , Humanos , Masculino
3.
Orbit ; 29(6): 341-2, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20712512

RESUMO

Orbital exenteration is a rare radical procedure used for the treatment of locally invasive or potentially life threatening orbital tumors. The procedure results in significant visual and psychosocial disability. Recently there has been a shift toward a subtotal extenteration with maximum preservation of orbital tissue and globe in appropriate cases. We describe the management dilemma of a patient with orbital extension of a frontal sinus squamous cell carcinoma. The patient underwent combined craniofacial and transnasal macroscopic excision with globe preservation. Traditional approach for a sinus tumor that has invaded the orbit would be an exenteration. The favorable outcome of the case reported here raises the possibility of considering this approach more frequently.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Invasividade Neoplásica/patologia , Exenteração Orbitária/métodos , Neoplasias Orbitárias/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Biópsia por Agulha , Carcinoma de Células Escamosas/patologia , Seguimentos , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neoplasias Orbitárias/patologia , Neoplasias dos Seios Paranasais/patologia , Medição de Risco , Resultado do Tratamento
4.
Orbit ; 27(4): 293-5, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18716967

RESUMO

Orbital involvement in chronic lymphocytic leukemia (CLL) is highly unusual and most commonly involves hemorrhage or soft tissue infiltration in advanced disease. We report a case of rapid onset bilateral orbital muscle infiltration as the presenting feature of early stage CLL. In addition, we demonstrate clinico-pathological correlation with an identical chronic B-cell lymphocytic infiltrate in both orbit and bone marrow, with good response of the orbital disease to local radiotherapy.


Assuntos
Leucemia Linfocítica Crônica de Células B/patologia , Infiltração Leucêmica/patologia , Músculos Oculomotores/patologia , Neoplasias Orbitárias/patologia , Idoso , Antígenos CD/análise , Terapia Combinada , Lateralidade Funcional , Glucocorticoides/uso terapêutico , Humanos , Imunofenotipagem , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Linfocítica Crônica de Células B/radioterapia , Infiltração Leucêmica/tratamento farmacológico , Infiltração Leucêmica/radioterapia , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Músculos Oculomotores/efeitos dos fármacos , Neoplasias Orbitárias/tratamento farmacológico , Neoplasias Orbitárias/radioterapia , Radioterapia
5.
Arch Ophthalmol ; 124(9): 1244-50, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16966618

RESUMO

OBJECTIVE: To perform a multicenter review of the clinical features and treatment of 31 patients with idiopathic sclerosing orbital inflammation. METHODS: We included all patients with histologically confirmed idiopathic sclerosing orbital inflammation from 5 regional orbital centers. We reviewed the case notes to determine the clinical presentation, diagnostic features, and response to treatment. The main outcome measures were duration and nature of symptoms, anatomical location of disease, histopathological findings, treatment modalities, treatment efficacy and adverse effects, and final clinical status. RESULTS: We included 13 male and 18 female patients ranging in age from 7 to 83 years. The average duration of symptoms at presentation was 13.4 months. There was a predilection for the lateral and superior quadrants. Thirteen patients had apical disease, and 4 had extraorbital involvement. Histopathological findings invariably showed sclerosis associated with a sparse mixed cellular infiltrate. Twenty-seven patients were treated with oral prednisolone, response to which was good in 9 patients, partial in 11, and poor in 7. Six patients were treated with a second-line immunosuppressive agent, and 6 received radiotherapy. The response to radiotherapy was generally poor. CONCLUSIONS: Idiopathic sclerosing orbital inflammation is a rare condition that can be difficult to diagnose and manage. Early intervention with immunosuppression in the form of corticosteroids combined with second-line agents can result in control and even regression of the disease.


Assuntos
Órbita/patologia , Pseudotumor Orbitário/diagnóstico , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Técnicas de Diagnóstico Oftalmológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Órbita/efeitos dos fármacos , Órbita/efeitos da radiação , Pseudotumor Orbitário/tratamento farmacológico , Pseudotumor Orbitário/radioterapia , Prednisolona/uso terapêutico , Esclerose , Tomografia Computadorizada por Raios X
6.
J Cataract Refract Surg ; 28(1): 44-9, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11777709

RESUMO

PURPOSE: To assess the role of the Staar Surgical implantable contact lens (ICL) for the correction of pseudophakic anisometropia. SETTING: Oxford Eye Hospital, Oxford, and Rosen Eye Center, Alexandra Hospital, Manchester, United Kingdom. METHODS: Six patients with pseudophakic anisometropia ranging from 2.0 to 7.9 diopters (D) (mean 4.4 D) had ICL implantation as an alternative to intraocular lens (IOL) exchange or conventional piggyback IOLs. RESULTS: All patients had a reduction in anisometropia to asymptomatic levels. The mean reduction was 3.15 D. No patient experienced adverse effects. CONCLUSIONS: The implantable contact lens offers an alternative approach to the management of pseudophakic anisometropia that avoids some of the risks associated with IOL exchange, corneal refractive surgery, and conventional piggyback IOLs.


Assuntos
Anisometropia/cirurgia , Lentes de Contato , Implantação de Prótese , Pseudofacia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refração Ocular , Acuidade Visual
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