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1.
Nanotechnology ; 31(4): 045304, 2020 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-31593938

RESUMEN

Polarized ultraviolet (UV) emitters are essential for various applications, such as photoalignment devices for liquid crystals, high-resolution imaging devices, highly sensitive sensors, and steppers. To increase the high polarization ratio (PR) of a UV emitter, the grating period should be decreased than that of the visible emitter. However, the fabrication of the short period grating directly on UV emitters is still limited. In this study, we demonstrate that 200, 100, and 50 nm period aluminum (Al)-based wire-grid polarizers (WGPs) can be fabricated directly on UV emitters by a solvent-assisted nanotransfer process. The UV emitter with a grating period of 100 nm shows a PR of 84%, and an electroluminescence efficiency that is 22.5% and 48% higher than those of UV emitters with 50 nm and 200 nm period WGPs, respectively, due to the increased photon extraction efficiency (PEE). The higher PEE is attributed to the optical cavity property of the Al metal reflector with low light loss and the surface plasmon effect of the Al grating layer.

2.
J Craniofac Surg ; 29(3): 712-716, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29381625

RESUMEN

Cavernous hemangiomas are the most common benign orbital tumors in the orbit, but radiological differentiation from other solitary orbital masses can still be challenging at times. While there have been previous studies describing the radiological characteristics of cavernous hemangiomas on computed tomography (CT) and magnetic resonance imaging (MRI), there have not been any studies comparing the 2 imaging modalities. The purpose of our study was to evaluate CT and MRI findings of orbital cavernous hemangiomas and compare both modalities.We performed a cross-sectional study of patients with a histopathological diagnosis of cavernous hemangioma over a 20-year period from January 1997 to December 2016 in a single tertiary institution.Our study included 77 patients; mean age was 46.6 ±â€Š11.2 years, and females comprised 68.8%. The lateral orbit (23.4%) was the most common location. The masses were well-defined, with 55.8% being ovoid, 27.3% round, and 16.9% lobulated. The most common enhancement pattern on CT was a small point starting in the periphery, progressing to heterogeneous filling in the late phase. The most common enhancement pattern on MRI was multiple patchy starting points, widespread across the tumor, with a final homogeneous filling in the late phase.Significant differences between CT and MRI were found in terms of area, location, and number of starting points of contrast enhancement in the early phase. We also found that the use of MRI is limited in differentiating fast-filling cavernous hemangiomas from other orbital tumors and in such cases, contrast-enhanced CT would be helpful.


Asunto(s)
Hemangioma Cavernoso/diagnóstico por imagen , Imagen por Resonancia Magnética , Neoplasias Orbitales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Femenino , Hemangioma Cavernoso/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Órbita/diagnóstico por imagen , Neoplasias Orbitales/epidemiología
3.
J Craniofac Surg ; 29(5): 1208-1211, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29554075

RESUMEN

PURPOSE: To assess the ophthalmologic complications after oculofacial plastic and esthetic surgeries, including their incidence and management. METHODS: A retrospective study was performed on 110 patients who presented with ocular complications followed by oculofacial plastic and esthetic surgeries from January 2014 to December 2015. The incidence and management of complications after each surgery or procedure were analyzed. RESULTS: For lower eyelid blepharoplasty, the common complications were chemosis and lower eyelid ectropion. There was also a case of canalicular laceration. Exposure keratitis and corneal abrasion were the most common complications after upper eyelid blepharoplasty. Chemosis frequently occurred after lateral cathoplasty, but other complications, such as ectropion, trichiasis, and lacrimal fistula, were also seen. Nasolacrimal duct obstruction occurred in some cases of orthognathic surgery, and was managed with endonasal dacryocystorhinostomy. Inflammatory lipogranuloma was a common complication after autologous fat transplantation. CONCLUSION: Complications after oculofacial plastic and esthetic surgeries are not rare. Ophthalmologists must be aware of not only common complications but also rare and possibly serious conditions that may occur after such surgeries.


Asunto(s)
Blefaroplastia/efectos adversos , Enfermedades de la Conjuntiva/etiología , Técnicas Cosméticas/efectos adversos , Edema/etiología , Aparato Lagrimal/cirugía , Adulto , Anciano , Lesiones de la Cornea/etiología , Ectropión/etiología , Ectropión/cirugía , Femenino , Humanos , Queratitis/etiología , Enfermedades del Aparato Lagrimal/etiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos
4.
J Craniofac Surg ; 29(5): 1327-1331, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29521763

RESUMEN

PURPOSE: To report the long-term outcomes of using acellular dermal allograft (ADA) as a tarsal substitute for reconstruction of large full-thickness eyelid defects where ipsilateral or contralateral eyelid donor tissue was either not available or tarsoconjunctival transfer was insufficient to cover the full extent of the defect. METHODS: A retrospective review of a consecutive series of 10 patients between May 2003 and April 2012. Main outcome measures were anatomical and functional outcomes and complications. RESULTS: The study cohort included 4 males and 6 females with a mean age of 48.1 years (range 31-64 years). Indications for reconstruction were extensive full-thickness eyelid defects (upper or lower or both) resulting from tumor excision (n = 6), traumatic eyelid defect (n = 2), electrical burn (n = 1), and eyelid necrosis (n = 1). The mean postoperative follow-up was 84.3 months (range 33-164 months). The reconstructive procedure included a variety of techniques using ADA as the posterior lamellar graft. Overall, 7 patients achieved excellent anatomical, cosmetic, and functional results. Reoperation was required in 3 patients (for postoperative upper lid retraction, upper lid entropion, and lower fornix reconstruction) despite acceptable initial results. There were no intraoperative complications, postoperative allergic or immunologic rejection associated with the use of allograft, nor any long-term sequelae. CONCLUSION: The extensive upper and lower eyelid defects with large vertical component can be successfully repaired using ADA as a tarsal substitute. The results of our study with long-term follow-up indicate excellent functional and cosmetic outcomes with minimal morbidity.


Asunto(s)
Dermis Acelular , Párpados/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Reoperación , Estudios Retrospectivos , Resultado del Tratamiento
5.
J Craniofac Surg ; 27(1): 198-200, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26703055

RESUMEN

PURPOSE: To evaluate the surgical outcome between Quickert suture and Quickert suture with modified lateral tarsal strip in involutional lower eyelid entropion. METHODS: A retrospective study was performed on 76 patients (94 eyes) who had undergone Quickert suture (Group 1) and on 38 patients (44 eyes) who had undergone Quickert suture with modified lateral tarsal strip (Group 2) for correction of involutional lower eyelid entropion from January 2011 to December 2013. RESULTS: In Group 1, recurrence rate is 25.5% (24 eyes) and mean duration to recurrence is 11.9 months in Group 1. For correction of recurrence, Quickert suture is performed in 50% (12 eyes), Quickert suture with lateral tarsal strip is performed in 37.5% (9 eyes), and lateral tarsal strip is performed in 12.5% (3 eyes). In Group 2, recurrence rate is 9.1% (4 eyes). For correction of recurrence, lower eyelid retractor reinsertion is performed in 50% (2 eyes), Quickert suture with lateral tarsal strip is performed in 25% (1 eye), and Quickert suture is performed in 25% (1 eye). CONCLUSIONS: Recurrence rate is lower in patients who had undergone Quickert suture with modified lateral tarsal strip than in a patient who had undergone Quickert suture for correction of involutional lower eyelid entropion.


Asunto(s)
Entropión/cirugía , Párpados/cirugía , Técnicas de Sutura , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Resultado del Tratamiento
6.
Ophthalmic Plast Reconstr Surg ; 29(1): e12-4, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-22955341

RESUMEN

Orbital amyloidosis is uncommon and difficult to diagnose due to their variable clinical presentations. The authors report a case of a patient who presents with chronic eyelid swelling as an initial manifestation of myeloma-associated amyloidosis. This patient was also found to have retrobulbar infiltration with no visual impairment. The authors also describe the first documentation of the atypical necrotic appearance of amyloidosis in the involved eyelid tissues. Myeloma-associated amyloidosis can present as chronic, nonspecific periorbital swelling, hence a biopsy of the affected tissues is important in preventing a delay in the correct diagnosis.


Asunto(s)
Amiloidosis/diagnóstico , Edema/diagnóstico , Enfermedades de los Párpados/diagnóstico , Mieloma Múltiple/diagnóstico , Amiloidosis/terapia , Biopsia , Blefaroplastia , Terapia Combinada , Ciclofosfamida , Quimioterapia Combinada , Edema/terapia , Enfermedades de los Párpados/terapia , Glucocorticoides/uso terapéutico , Humanos , Inmunosupresores/uso terapéutico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mieloma Múltiple/terapia , Prednisolona/uso terapéutico , Trasplante de Células Madre , Talidomida/uso terapéutico , Tomografía Computarizada por Rayos X , Trasplante Autólogo
7.
Ophthalmic Plast Reconstr Surg ; 29(2): e40-2, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23250330

RESUMEN

A 28-year-old woman with a history of an hydroxyapatite implantation performed 2 years earlier, presented with complaints of a poorly fitting prosthesis, and fullness of the left upper eyelid accompanied by eyelid erythema. Computed tomography scan showed a mass adjacent to the implant medially. Surgical removal of the implant and mass was performed. Histological examination of the implant revealed degradation on the medial side of the implant while the mass consisted of fibrous tissue with chronic inflammation and lymphoid follicle formation around a foreign material.


Asunto(s)
Durapatita , Reacción a Cuerpo Extraño/etiología , Celulitis Orbitaria/etiología , Implantes Orbitales/efectos adversos , Adulto , Remoción de Dispositivos , Eritema/etiología , Evisceración del Ojo , Enfermedades de los Párpados/etiología , Femenino , Fibrosis , Reacción a Cuerpo Extraño/diagnóstico , Reacción a Cuerpo Extraño/cirugía , Humanos , Tejido Linfoide/patología , Órbita/diagnóstico por imagen , Órbita/cirugía , Celulitis Orbitaria/diagnóstico , Celulitis Orbitaria/cirugía , Ajuste de Prótesis , Reoperación , Tomografía Computarizada por Rayos X
8.
Ophthalmology ; 119(11): 2402-7, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22835816

RESUMEN

PURPOSE: To describe a medial epicanthoplasty technique using the skin redraping method and review the surgical outcome in patients with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). DESIGN: Retrospective, noncomparative, interventional case series with the description of a new surgical technique. PARTICIPANTS: Sixteen consecutive Asian patients with BPES. METHODS: The charts of patients with BPES who underwent medial epicanthoplasty using the skin redraping method were reviewed retrospectively. Preoperative and postoperative inner intercanthal distance (IICD), interpupillary distance (IPD), horizontal palpebral fissure length (HPFL), and visibility of the scar were measured. The ratio of the IICD to IPD (IICD ratio) was calculated. MAIN OUTCOME MEASURES: Postoperative improvement in IICD ratio and the visibility of the surgical scar. RESULTS: The preoperative median IICD ratio was 1.65 (range, 1.49-1.83) and decreased to 1.27 (range, 1.02-1.48) postoperatively. The median reduction in IICD ratio was 21.7% (range, 16.7%-38.2%) (P<0.001, Wilcoxon signed-rank test). Fourteen patients (87.5%) had no visible scarring or scarring only visible under close inspection. Two patients (12.5%) had a more apparent scar, but no patient had severe scarring that required revision. CONCLUSIONS: Medial epicanthoplasty using the skin redraping method is an effective technique in the treatment of epicanthus inversus and telecanthus in patients with BPES, with excellent cosmetic outcomes.


Asunto(s)
Blefarofimosis/cirugía , Blefaroplastia/métodos , Párpados/cirugía , Anomalías Cutáneas/cirugía , Pueblo Asiatico/etnología , Blefarofimosis/etnología , Niño , Preescolar , Fascia Lata/trasplante , Femenino , Humanos , Lactante , Masculino , República de Corea/epidemiología , Estudios Retrospectivos , Anomalías Cutáneas/etnología , Resultado del Tratamiento , Anomalías Urogenitales
9.
Ophthalmic Plast Reconstr Surg ; 28(5): e111-2, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22366665

RESUMEN

A 48-year-old man presented with an enlarging mass of the right upper eyelid over a 1-month period. Nine years prior, the patient was diagnosed with adenoid cystic carcinoma (ACC) of the right maxillary sinus and underwent a total maxillectomy followed by local radiotherapy. Over the previous year, the patient had been treated with chemotherapy and radiotherapy for multiple organ metastases, including the spine, chest, and oral cavity. Ophthalmic examination revealed a white, round mass on the tarsal conjunctiva of the right upper eyelid, measuring approximately 1 × 1 cm, and 2 palpable subcutaneous masses near the inferior orbital rim. Excisional biopsies of the masses were performed, and the histopathological findings were consistent with ACC with solid and cribriform patterns. Herein, the authors describe a case of metastatic ACC of the eyelid, which has not been described in the literature to their knowledge.


Asunto(s)
Carcinoma Adenoide Quístico/secundario , Neoplasias de los Párpados/secundario , Neoplasias del Seno Maxilar/patología , Neoplasias Óseas/patología , Neoplasias Óseas/cirugía , Carcinoma Adenoide Quístico/diagnóstico por imagen , Carcinoma Adenoide Quístico/cirugía , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/cirugía , Humanos , Escisión del Ganglio Linfático , Masculino , Neoplasias del Seno Maxilar/cirugía , Persona de Mediana Edad , Invasividad Neoplásica , Procedimientos de Cirugía Plástica , Tomografía Computarizada por Rayos X
10.
Ophthalmology ; 118(5): 840-5, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21211846

RESUMEN

PURPOSE: To compare choroidal thickness between eyes with polypoidal choroidal vasculopathy (PCV) and eyes with age-related macular degeneration (AMD). DESIGN: Observational, comparative case series. PARTICIPANTS: Twenty-five eyes with PCV, 14 uninvolved fellow eyes with PCV, 30 eyes with exudative AMD, 17 eyes with early AMD, and 20 eyes of age-matched normal subjects. METHODS: Choroidal thickness was measured using enhanced-depth imaging optical coherence tomography. Subfoveal choroidal thickness in each eye was analyzed by measurement of the vertical distance from the Bruch's membrane to the innermost scleral layer. Nasal, superior, temporal, and inferior choroidal thicknesses, 1500 µm apart from the foveal center, were also evaluated in all eyes. MAIN OUTCOME MEASURES: Choroidal thickness in each group. RESULTS: Mean (± standard deviation) subfoveal choroidal thickness in eyes with PCV and in their uninvolved fellow eyes was 438.3±87.8 µm and 372.9±112.0 µm, respectively, which was significantly greater than in eyes of age-matched normal subjects (224.8±52.9 µm) (P<0.001 and P = 0.003, respectively). Subfoveal choroidal thickness of eyes with exudative AMD (171.2±38.5 µm) and eyes with early AMD (177.4±49.7 µm) was thinner than that of age-matched normal subjects (P = 0.004 and P = 0.078, respectively). Choroidal thickness at each of the other 4 points showed a similar tendency. CONCLUSIONS: This study demonstrates thickening of choroid in the eyes with PCV, in contrast with choroidal thinning observed in eyes with AMD. These findings suggest involvement of different pathogenic mechanisms in PCV from those in exudative AMD.


Asunto(s)
Coroides/patología , Neovascularización Coroidal/diagnóstico , Degeneración Macular/diagnóstico , Enfermedades Vasculares Periféricas/diagnóstico , Anciano , Antropometría , Coroides/irrigación sanguínea , Colorantes , Exudados y Transudados , Femenino , Angiografía con Fluoresceína , Humanos , Verde de Indocianina , Masculino , Tomografía de Coherencia Óptica , Agudeza Visual/fisiología
11.
Ophthalmic Plast Reconstr Surg ; 27(4): e103-6, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-20966797

RESUMEN

A 12-year-old boy who had severe burns in the right eye from a firecracker injury 2 years previously was referred to our hospital with severe and recurrent symblepharon. The patient had received conjunctival sac reconstruction with amniotic membrane grafts twice at another hospital. A symblepharon lysis and conjunctival sac reconstruction with a mouth mucosal graft was performed. Eight months after surgery, he could not wear a prosthesis due to the recurrence of symblepharon. A prepuce mucosal graft obtained from circumcision was applied for forniceal and conjunctival sac reconstruction. One year postoperatively, the patient showed no recurrence of symblepharon and could comfortably wear a prosthesis. The prepuce is a useful alternative donor tissue in a male patient with no other available donor sites for conjunctival sac reconstruction.


Asunto(s)
Circuncisión Masculina , Enfermedades de la Conjuntiva/cirugía , Enfermedades de la Córnea/cirugía , Quemaduras Oculares/cirugía , Enfermedades de los Párpados/cirugía , Procedimientos de Cirugía Plástica , Trasplante de Piel , Amnios/trasplante , Niño , Enfermedades de la Conjuntiva/etiología , Enfermedades de la Córnea/etiología , Quemaduras Oculares/etiología , Enfermedades de los Párpados/etiología , Humanos , Masculino , Mucosa Bucal/trasplante , Membrana Mucosa/trasplante
12.
Mol Biol Rep ; 37(7): 3455-63, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19967454

RESUMEN

Glutamate decarboxylase (GAD) catalyzes the conversion of L-glutamate to γ-aminobutyric acid (GABA). A full-length cDNA encoding GAD (designated as PgGAD) was isolated and characterized from the root of Panax ginseng C. A. Meyer. The length cDNA of PgGAD was 1881 bp and contained a 1491 bp open reading frame (ORF) encoding a glutamate decarboxylase protein of 496 amino acids, possessing a Ser-X-X-Lys active site, which belongs to the GAD group. The deduced amino acid sequence of the PgGAD was classified in the plant GAD family and has 76-85% high similarity with other plants as like petunia, Arabidopsis, tomato. Secondary structure of PgGAD was predicted by using SOPMA software program. Southern blot analysis of genomic DNA suggests that, there is more than one copy of the PgGAD gene. The organ specific gene expression pattern also studied in P. ginseng seedlings, in which the stem showed elevated expression than root, leaf, bud and rhizomes. Along with this, we also confirmed the gene expression of PgGAD under various abiotic stresses like temperature stress, osmotic stress, anoxia, oxidative stress, and mechanical damage. Temporal analysis of gene expression except exposure of oxidative stress revealed an enhanced expression after each stresses. The enzyme activity of PgGAD was stimulated to 2-fold under cold stress.


Asunto(s)
Regulación de la Expresión Génica de las Plantas , Genes de Plantas/genética , Glutamato Descarboxilasa/genética , Glutamato Descarboxilasa/aislamiento & purificación , Panax/enzimología , Panax/genética , Estrés Fisiológico/genética , Southern Blotting , Clonación Molecular , Frío , ADN Complementario/genética , Pruebas de Enzimas , Perfilación de la Expresión Génica , Regulación Enzimológica de la Expresión Génica , Glutamato Descarboxilasa/metabolismo , Panax/metabolismo , Estructura Secundaria de Proteína , ARN Mensajero/genética , ARN Mensajero/metabolismo , Secuencias Reguladoras de Ácidos Nucleicos/genética , Análisis de Secuencia de ADN , Homología de Secuencia de Aminoácido
14.
Physiol Mol Biol Plants ; 15(3): 267-75, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23572936

RESUMEN

A cDNA clone containing a S-adenosyl-L-methionine synthetase (SAMS) gene, named as PgSAM, was isolated from a commercial medicinal plant Panax ginseng. PgSAM is predicted to encode a precursor protein of 307 amino acid residues, and its sequence shares high homology with a number of other plant SAMS. PgSAM is expressed at different levels in various organs of ginseng. The expression of PgSAM in adventitious roots and hairy roots of P. ginseng were analyzed using reverse transcriptase (RT)-PCR and real-time PCR under various abiotic stresses. Salt, salicylic acid, abscisic acid and chilling stresses induced PgSAM significantly at different time points within 2-72 h post-treatment. This study revealed that PgSAM may help to protect the plants against various abiotic stresses.

15.
Health Promot Perspect ; 8(1): 15-24, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29423358

RESUMEN

Background: Suicide rates are high among African American students because they are at a greater risk of depression. A commonly used suicide prevention approach is the gatekeeper training. However, gatekeeper training is neither evidence-based nor has it been identified as culturally-appropriate for African American college students. Therefore, the purpose of this study was to develop and evaluate an online peer-to-peer PRECEDE-PROCEED model based depression awareness and suicide prevention program that was culturally appropriate for African American college students. Methods: The setting was a predominantly Black institution in southern USA. A pre-experimental repeated measures one group design was used to measure changes in peer educators' (n = 29) predisposing factors regarding knowledge, skills and attitudes pertaining to depression, reinforcing factors or receiving support from peers, healthcare professionals and teachers to help someone with depression, enabling factors or sureness of finding organizations to help someone with depression, and behavior for helping someone with depression at pretest, posttest and 1-month follow-up. A posttest only one group design was also used to measure effect on predisposing factors and behavior of students (n = 300) trained by peer educators. Results: There were statistically significant improvements in attitudes related to depression as disease (P = 0.003; η2 = 0.39), attitudes about managing depression (P = 0.0001; η2 = 0.30), skills(P = 0.0001; η2 = 0.41), reinforcing factors (P = 0.018; η2 = 0.13), enabling factors (P = 0.0001;η2 = 0.31), and behavior (P = 0.016; η2 = 0.14). Changes in knowledge about depression and attitudes about helping people with depression were not statistically significant over time for peer educators. The peer-to-peer training was not completely effective in transferring corresponding changes for students trained by peers. Conclusion: The program was effective for peer educators but peers could not significantly influence other students in all domains. This study provides a starting point toward evidencebased approaches for health promotion interventionists addressing depression awareness and suicide prevention among African American college students.

16.
ACS Nano ; 12(8): 8224-8233, 2018 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-30067895

RESUMEN

For low-cost and facile fabrication of innovative nanoscale devices with outstanding functionality and performance, it is critical to develop more practical patterning solutions that are applicable to a wide range of materials and feature sizes while minimizing detrimental effects by processing conditions. In this study, we report that area-selective sub-10 nm pattern formation can be realized by temperature-controlled spin-casting of block copolymers (BCPs) combined with submicron-scale-patterned chemical surfaces. Compared to conventional room-temperature spin-casting, the low temperature ( e.g., -5 °C) casting of the BCP solution on the patterned self-assembled monolayer achieved substantially improved area selectivity and uniformity, which can be explained by optimized solvent evaporation kinetics during the last stage of film formation. Moreover, the application of cold spin-casting can also provide high-yield in situ patterning of light-emitting CdSe/ZnS quantum dot thin films, indicating that this temperature-optimized spin-casting strategy would be highly effective for tailored patterning of diverse organic and hybrid materials in solution phase.

17.
Am J Ophthalmol ; 181: 134-139, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28705661

RESUMEN

PURPOSE: To report the surgical results of canaliculorhinostomy for patients with distal canalicular obstruction and lacking a structurally functional lacrimal sac who would otherwise require a conjunctivodacryocystorhinostomy (CDCR) with Jones tube placement. DESIGN: Retrospective observational case series. METHODS: Setting: Single tertiary institution. PERIOD: November 1994 to June 2011. PATIENT POPULATION: Sixteen patients with canalicular obstruction at or beyond 8 mm from the punctum, with an absent or unidentifiable lacrimal sac. INTERVENTION: Patients underwent canaliculorhinostomy, whereby direct anastomosis of the canaliculi or common canaliculus to the nasal mucosa was performed. MAIN OUTCOME MEASURES: Anatomic and functional success. RESULTS: Our study comprised 16 patients with a mean age of 44.9 ± 21.9 years. Ten (62.5%) were female and 6 (37.5%) male. Mean duration of follow-up was 7.8 years. Causes of an absent or unidentifiable lacrimal sac included previous trauma (n = 8, 50.0%), previous dacryocystorhinostomy (n = 4, 25.0%), chronic dacryocystitis (n = 3, 18.8%), and previous dacryocystectomy (n = 1, 6.2%). Anastomoses between the upper and lower canaliculi and the nasal mucosa was performed in 6 patients, while that between the common canaliculus and nasal mucosa was performed in 10. Anatomic and functional success rates were 87.5% (n = 14) and 81.3% (n = 13), respectively. CONCLUSION: Canaliculorhinostomy has reasonable success rates and provides an effective surgical alternative for a group of patients in whom CDCR with Jones tube placement would otherwise have been indicated.


Asunto(s)
Dacriocistorrinostomía/métodos , Obstrucción del Conducto Lagrimal/terapia , Conducto Nasolagrimal/cirugía , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Intubación , Obstrucción del Conducto Lagrimal/diagnóstico , Masculino , Persona de Mediana Edad , Conducto Nasolagrimal/patología , Estudios Retrospectivos , Elastómeros de Silicona
18.
Korean J Ophthalmol ; 31(1): 1-8, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28243017

RESUMEN

PURPOSE: To compare the clinical effects of the single wide-diameter bicanalicular silicone tube and the double bicanalicular silicone tube in endonasal dacryocystorhinostomy (DCR) with canalicular trephinization for canalicular obstruction. METHODS: We retrospectively reviewed the records of 121 patients with monocanalicular or common canalicular obstruction who had undergone endonasal DCR with random bicanalicular insertion of either double silicone tubes (insertion of two tubes into each canaliculus) or a single wide-diameter (0.94 mm) silicone tube. The tubes were removed at around 3 months after surgery. RESULTS: This study included 79 eyes of 61 patients in the double-tube intubation group and 68 eyes of 60 patients in the single wide-diameter tube intubation group. Anatomical success, evaluated by syringing, was achieved in 72 of the 79 eyes (91.1%) in the double-tube intubation group and 60 of the 68 eyes (88.2%) in the single wide-diameter tube intubation group. Functional success was achieved in 65 of the 79 eyes (82.3%) in the double-tube intubation group and 61 of the 68 (89.7%) eyes in the single wide-diameter tube intubation group. There were no significant differences in the success rates of surgery between the two groups. One patient in the double-tube intubation group underwent conjunctivodacryocystorhinostomy (CDCR) and two in the wide-diameter tube intubation group underwent CDCR or reintubation to treat recurrence. CONCLUSIONS: Intubation using a single wide-diameter tube during endonasal DCR is as effective as double-tube intubation for the treatment of canalicular obstruction, with a lower rate of complications such as inflammation or patient discomfort.


Asunto(s)
Dacriocistorrinostomía/métodos , Intubación/instrumentación , Obstrucción del Conducto Lagrimal/diagnóstico , Conducto Nasolagrimal/cirugía , Siliconas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Conducto Nasolagrimal/diagnóstico por imagen , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
19.
Clin Exp Otorhinolaryngol ; 10(1): 85-90, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27384034

RESUMEN

OBJECTIVES: Endonasal dacryocystorhinostomy (DCR) is a well-established treatment method in patients with nasolacrimal duct obstruction. However, there are a few reports about the overall management of failed endonasal DCR. We investigated the causes and management strategies of failed endonasal DCR. METHODS: This retrospective review included 61 patients (61 eyes) who had undergone revision surgery by the same surgeon after failed endonasal DCR between January 2008 and December 2012. The appropriate revision method was determined after analysis of the etiology of failure by the fluorescein dye disappearance test, nasal endoscopy, lacrimal irrigation, and probing. The criteria for success of the revision surgery were defined by the passage of fluid without resistance upon lacrimal irrigation and normalization of the tear meniscus height. RESULTS: The mean duration between the primary endonasal DCR and revision surgery was 15.3 months. The average follow-up period after revision surgery was 12.2 months. The most common cause of endoscopic revision surgery was membranous obstruction. Endoscopic revision surgery was performed in 48 patients, while lacrimal silicone tube intubation under endoscopy was performed in 13 patients. The most common indication for lacrimal silicone tube intubation was functional epiphora. The overall success rate of the revision surgery was 89%. CONCLUSION: The most common cause of failed endonasal DCR was membranous obstruction. When patients with failed endonasal DCR presented at the clinic, it is important to identify the cause of the failure. Revision surgery could increase the final success rate of endonasal DCR.

20.
Korean J Ophthalmol ; 31(4): 290-298, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28682021

RESUMEN

PURPOSE: To investigate the causes of lower eyelid retraction and evaluate the outcomes of various surgical procedures. METHODS: We conducted a retrospective medical record review of patients who underwent lower eyelid retraction surgery performed by a single surgeon at Kim's Eye Hospital between 2006 and 2013. We investigated the causes of lower eyelid retraction, clinical history, characteristics, treatment, and surgical outcomes. Preoperative and postoperative margin reflex distance 2 and inferior scleral show were measured for each eyelid. Success was defined as a positive eyelid elevation and a decrease in inferior scleral show. RESULTS: A total of 19 lower eyelids were treated in 14 patients with lower eyelid retraction. For cosmetic reasons, surgical correction for congenital lower eyelid retraction was performed on seven eyelids (36.8%). Ten eyelids (52.6%) exhibited secondary lower eyelid retraction after surgery. One eyelid (5.3%) was affected by facial palsy and one eyelid (5.3%) exhibited exophthalmos of an unknown origin. We adopted a selective approach based on lower eyelid retraction severity. Spacer grafting via a subconjunctival approach was the most commonly performed surgical technique (13 eyelids, 68.4%). The lateral tarsal strip procedure was used to horizontally tighten three eyelids (15.8%). At the time of the procedure, one of these eyelids (5.3%) also received an adjuvant suborbicularis oculi fat lift. Autogenous dermis fat grafting was performed on two lower eyelids (10.5%), whose retraction was caused by fat and soft tissue loss. Cosmetic outcomes were satisfactory in all cases. CONCLUSIONS: To achieve satisfactory surgical outcomes, surgeons should adopt an approach based on the severity of lower eyelid retraction. Mild lower eyelid retraction can be corrected without grafts. When retraction is severe and exceeds 2 mm, spacer grafts that push the lower eyelid margin upwards and support it from below are required.


Asunto(s)
Blefaroplastia/métodos , Enfermedades de los Párpados/cirugía , Párpados/cirugía , Trasplante de Piel/métodos , Dermis Acelular , Adolescente , Adulto , Niño , Enfermedades de los Párpados/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
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