Factors affecting anophthalmic socket reconstruction outcomes using autologous oral mucosal graft.

BACKGROUND: Limited studies have reported surgical outcomes that are defined by strict criteria following grade 2 or 3 socket reconstruction using an oral mucosal graft (OMG). We aimed to determine factors influencing surgical outcomes of anophthalmic socket reconstruction using OMG in patients with grade 2 or 3 socket contractures. METHODS: Thirty-seven patients who underwent socket reconstruction with autologous OMG between January 2007 and December 2017 were retrospectively analyzed. The successful outcome was defined as an eye prosthesis wearing without experiencing displacement and the absence of any re-operations or additional surgeries following socket reconstruction. Factors affecting surgical outcomes were identified using multivariate analysis. RESULTS: A total of 15 male and 22 female patients (mean age: 40.2 ± 17.2 years) were included. The median duration of socket contracture was 21.5 years. Grade 2 and 3 socket contractures, based on Tawfik's classification, were reported in 20 and 17 patients, respectively. Twenty-eight and eight patients underwent socket reconstruction using OMG alone and OMG combined with a hard palate graft, respectively. The success rates of grades 2 and 3 socket contracture reconstruction were 80.0% and 52.9%, respectively. Multivariate analysis demonstrated that only grade 3 contractures were predictive of worse outcomes. At the final visit (mean follow-up: 6.3 years), 34 patients (91.9%) could wear their eye prostheses. CONCLUSIONS: Socket reconstruction using autologous OMG can provide acceptable results in grade 2 and 3 contractures; however, satisfactory results were more significantly reported in grade 2 than in grade 3 contractures.

Risk factors for globe removal after open-globe injury in agricultural regions.

This study aimed to identify the prevalence and risk factors for globe removal among patients with open-globe injuries (OGIs) in agricultural regions. A retrospective chart review of patients with OGIs was performed between January 2010 and December 2019. Univariable and multivariable logistic regression models were used to identify the factors associated with globe removal in OGI. This study included 422 patients (422 eyes). The highest prevalence of OGI was observed in the middle age group (> 20 to 40 years). The most common cause of OGIs was agriculture-related injury (54.7%), followed by industry or workplace-related injury (20.4%), and assault (5.0%). Intraocular foreign bodies, endophthalmitis, and panophthalmitis were reported in 57.6%, 28.4%, and 5.7% of cases, respectively. Eight eviscerations and 43 enucleations were performed, accounting for 12.1% of OGIs. The most common indication for globe removal was panophthalmitis. Multivariable analysis revealed that the predictive factors significantly associated with globe removal were assault injuries (adjusted odds ratio (aOR) = 5.53; p = 0.026), presenting logarithm of the minimum angle of resolution visual acuity (aOR = 311.79; p < 0.001), and endophthalmitis and panophthalmitis (aOR = 3.58 and 734.94, respectively; p < 0.001). This knowledge would aid in patient counseling and encourage health promotion.

Efficacy of baby shampoo and commercial eyelid cleanser in patients with meibomian gland dysfunction: A randomized controlled trial.

BACKGROUND: To compare the efficacy between Johnson's baby shampoo top-to-toe (No More Tears formula) and OCuSOFT Lid Scrub Original Foaming Eyelid Cleanser (OSO) in patients with grade 2 meibomian gland dysfunction (MGD). METHODS: Sixty participants with grade 2 MGD were enrolled and analyzed based on intention to treat basis in a prospective, randomized, single-blind trial for eye scrub using either diluted baby shampoo or OSO. The data collection included the Ocular Surface Disease Index (OSDI) questionnaire, compliance, and complications. The eye examinations were according to the Tear Film and Ocular Surface Society at baseline and at post-treatment weeks 4 and 12. RESULTS: The mean (±SD) age of the 60 patients who presented with grade 2 MGD was 48.0 ±â€Š13.8 years and 75.0% were females. The OSDI scores of these participants between pre-treatment and post-treatment weeks 4 and 12 improved significantly in both groups (all P < .001). The mean (±SD) differences of the improvement of OSDI score from baseline were not statistically significantly different between the baby shampoo and OSO groups at post-treatment weeks 4 and 12 (P = .57 and P = .54, respectively). The compliance and complications were also not statistically significant between the 2 groups. CONCLUSIONS: Eyelid scrub using either baby shampoo or OSO and warm compresses could significantly reduce eye irritability and uncomfortable symptoms in grade 2 MGD patients. In this study, the efficacy, compliance, and complications between the 2 groups were not statistically significantly different.

Factors related to survival outcomes following orbital exenteration: a retrospective, comparative, case series.

BACKGROUND: Orbital exenteration is a disfiguring procedure that aims to achieve local control. It is commonly a part of the management of malignant orbital tumor which is a life-threatening condition. It is necessary to determine predictive factors associated with overall survival (OS) following orbital exenteration. METHODS: This was a retrospective, comparative, case series of 39 patients with malignant tumors who underwent orbital exenteration. Patient records were reviewed for age, clinical presentation, preoperative visual acuity (VA), tumor size, surgical margin, tumor invasiveness, recurrent disease, and status of distant metastasis. Kaplan-Meier curves were used to assess OS and event-free survival (EFS). The predictive factors related to OS were identified using multivariate analysis. RESULTS: The mean age was 62.9 years (range, 5.5 to 89.7 years), 68.4% presented with VA < 20/400. The mean size of all tumors was 32 ± 18 mm. Distant metastasis at diagnosis was reported in 11 patients (28.2%). Twenty-two patients died during follow-up. The median OS and EFS were 3.89 years and 3.01 years, respectively. The predictive factors for worse OS on multivariate analysis were preoperative VA < 20/400 (adjusted hazard ratio [aHR] 4.67, P = 0.003), tumor size larger than 20 mm (aHR 3.14, P = 0.022,) and positive distant metastasis at diagnosis (aHR 15.31, P <  0.001). CONCLUSIONS: The prognostic factors for poor survival outcome following orbital exenteration were a preoperative VA < 20/400, tumor size > 20 mm, and distant metastasis at diagnosis mostly due to patient negligence.

Ocular Malformations with Presumable Intraocular Calcification.

This is a case of ocular malformations with presumable intraocular calcification based on computed tomography (CT) imaging, magnetic resonance imaging (MRI) and ocular ultrasound (US) findings. The authors presented the clinical, imaging and pathological findings of this case. Intraocular calcification is the most important finding in retinoblastoma, which requires aggressive management. It is important to distinguish it from other intraocular lesions, especially intraocular calcified hematoma.

Success of probing for congenital nasolacrimal duct obstruction in children under 10 years of age.

OBJECTIVE: To determine the success of probing for congenital nasolacrimal duct obstruction in children aged under 10 years. DESIGN: A retrospective study. MATERIAL AND METHOD: The medical records of all children aged under 10 years diagnosed with congenital nasolacrimal duct obstruction between 1997 and 2007 who underwent probing and irrigation under general anesthesia were reviewed. Successful probing was defined as absence of tearing and eye discharge in the affected eye at one month or more after treatment. Data obtained included age at first visit, gender laterality of the eyes, history of previous probing, age at probing time, number of probing, and treatment outcomes. Patients were categorized into four groups according to age at treatment (0-1 year, 1-2 years, 2-3 years and 3-10 years). RESULTS: Forty-four patients were seen during the study period, 19 males and 25females, with 29 right eyes and 30 left eyes undergoing treatments of 29 unilateral probing and 15 bilateral probing. The age at probing ranged from 10 months to 9.6 years (mean +/- SD, 2.51 +/- 1.82 years). Successful probing were identified in 47 out of 59 eyes (80%, 95% CI = 67 to 89%). Most successful eyes required only one probing and only two eyes needed a second probing. The success rates were 80% (8/10 eyes) in patients 0-1 year of age, 86% (18/21 eyes) in patients 1-2 years of age, 75% (12/16 eyes) in patients 2-3 years of age, and 75% (9/12 eyes) in patients 3-10 years of age. CONCLUSION: The success rate of probing for treatment of congenital nasolacrimal duct obstruction varies, depending on the age of the child at treatment. It was higher in children under 2 years than in older children.

Prevalence of abnormal vision in one-year-old Thai children, based on a prospective cohort study of Thai children (PCTC).

OBJECTIVES: To collect preliminary data on the prevalence of abnormal vision in one-year-old Thai children. MATERIAL AND METHOD: A retrospective study was conducted using data collected from a prospective cohort study of Thai children (PCTC) carried out during 2000-2002, to examine the prevalence of abnormal vision in one-year-olds. Data from five districts in five provinces were examined. One-year-old children in the present study underwent vision screening and eye examination performed by non-medical research assistants. RESULTS: There were records from 3,898 children in five districts, 49.7% females and 50.2% males. Their eye examinations showed very good vision in 77.8% (9.8 cy/cm at 38 cm), good vision in 21.5% (6.5 cy/cm at 38 cm), and fair vision in 0.7% (< or = 1.6 cy/cm at 38 cm). Normal ocular motility was found in 99.7% and 99.9% had normal anterior segment and lens. No strabismus was found in 99.4%, 99.9% had normal pupil light reflex, 99.8% had normal red reflex, 93.6% could fix and follow at 3 months of age, 85.7% could detect a falling object at 6 months, and 78.5% of mothers and 46.5% of fathers regularly played with the children. Logistic regression analysis indicated that some factors had statistical significance, such as "fix and follow" by 1 month of age, and lack of father-child interaction, but these were not clinically significant. Using Kappa analysis, the authors combined groups 1 (very good vision) and 2 (good vision) to create a "normal vision" category. If children had 2 abnormal eye examinations (eye exam for strabismus, cornea, anterior chamber, lens, pupil and red reflex), the authors recommended sending them to a specialist. The sensitivity and specificity of the visual screening and eye examination instruments were 19.23% and 99.38%, respectively. The Kappa statistic was 0.17. These instruments are not appropriate for eye screening in one-year-old children. CONCLUSION: More than 99% of the children examined had normal results. The majority of children could fix and follow from 2-3 months of age. The early fix and follow development may be related to better visual acuity. The interaction between father and child may be associated with eye development. However, eye screening of one-year-old children by assistant researchers may be inappropriate due to lack of expertise and experience.