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2.
J Vis Exp ; (170)2021 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-33999033

RESUMO

The Drosophila optic lobe, comprised of four neuropils: the lamina, medulla, lobula and lobula plate, is an excellent model system for exploring the developmental mechanisms that generate neural diversity and drive circuit assembly. Given its complex three-dimensional organization, analysis of the optic lobe requires that one understand how its adult neuropils and larval progenitors are positioned relative to each other and the central brain. Here, we describe a protocol for the dissection, immunostaining and mounting of larval and adult brains for optic lobe imaging. Special emphasis is placed on the relationship between mounting orientation and the spatial organization of the optic lobe. We describe three mounting strategies in the larva (anterior, posterior and lateral) and three in the adult (anterior, posterior and horizontal), each of which provide an ideal imaging angle for a distinct optic lobe structure.


Assuntos
Encéfalo/cirurgia , Lobo Óptico de Animais não Mamíferos/cirurgia , Envelhecimento , Animais , Drosophila melanogaster , Olho , Imuno-Histoquímica , Larva , Procedimentos Cirúrgicos Oftalmológicos
3.
BMC Ophthalmol ; 21(1): 235, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044792

RESUMO

PURPOSE AND BACKGROUND: Recently, we found that maximal medial rectus recession and lateral rectus resection in patients with complete lateral rectus paralysis resulted in a partial restoration of abduction. In an attempt to understand some of the mechanisms involved with this effect we examined gene expression profiles of lateral recti from these patients, with our focus being directed to genes related to myogenesis. MATERIALS AND METHODS: Lateral recti resected from patients with complete lateral rectus paralysis and those from concomitant esotropia (controls) were collected. Differences in gene expression profiles between these two groups were examined using microarray analysis and quantitative Reverse-transcription PCR (qRT-PCR). RESULTS: A total of 3056 differentially expressed genes (DEGs) were identified between these two groups. Within the paralytic esotropia group, 2081 genes were up-regulated and 975 down-regulated. The results of RT-PCR revealed that PAX7, MYOG, PITX1, SIX1 and SIX4 showed higher levels of expression, while that of MYOD a lower level of expression within the paralytic esotropia group as compared with that in the control group (p < 0.05). CONCLUSION: The decreased expression of MYOD in the paralytic esotropia group suggested that extraocular muscle satellite cell (EOMSCs) differentiation processes were inhibited. Whereas the high expression levels of PAX7, SIX1/4 and MYOG, suggested that the EOMSCs were showing an effective potential for differentiation. The stimulation resulting from muscle surgery may induce EOMSCs to differentiate and thus restore abduction function.


Assuntos
Doenças do Nervo Abducente , Esotropia , Diferenciação Celular , Esotropia/cirurgia , Proteínas de Homeodomínio , Humanos , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos
6.
Medicine (Baltimore) ; 100(18): e25717, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950954

RESUMO

BACKGROUND: Intravenous dexmedetomidine (DEX) has been used to prevent emergence agitation (EA) in children. The aim of this meta-analysis was to evaluate whether DEX decreases EA incidence without augmenting oculocardiac reflex (OCR) in pediatric patients undergoing strabismus surgery. METHODS: We searched PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library to collect the randomized controlled trials (RCTs) investigating the effects of intraoperative DEX in children undergoing strabismus surgery from inception to October 2019. Postoperative Pediatric Agitation and Emergence Delirium (PAED) score, postoperative EA, extubation or laryngeal mask airway (LMA) removal time, postanesthetic care unit (PACU) stay time, OCR, and postoperative vomiting (POV) were evaluated. RESULTS: 11 RCTs including 801 patients were included in this study. Compared with control group, intravenous DEX significantly reduced postoperative PAED score (WMD, 3.05; 95% CI: -3.82 to -2.27, P = .017) and incidences of postoperative EA 69% (RR, 0.31; 95% CI: 0.17 to 0.55, P < .00) and POV (RR, 0.28; 95% CI: 0.13 to 0.61, P = .001). Furthermore, the use of DEX significantly delayed extubation or LMA removal time (WMD, 2.11; 95% CI: 0.25 to 3.97, P < .001). No significant difference was found in the incidence of ORC and PACU stay time. CONCLUSION: Intravenous DEX reduced the incidences of EA without increasing OCR in pediatric patients undergoing strabismus surgery. Meanwhile, DEX infusion decreased the incidence of POV in children.


Assuntos
Anestesia Geral/efeitos adversos , Dexmedetomidina/administração & dosagem , Delírio do Despertar/prevenção & controle , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Reflexo Oculocardíaco/efeitos dos fármacos , Dexmedetomidina/efeitos adversos , Delírio do Despertar/epidemiologia , Delírio do Despertar/etiologia , Humanos , Incidência , Injeções Intravenosas , Período Perioperatório , Ensaios Clínicos Controlados Aleatórios como Assunto , Estrabismo/cirurgia , Resultado do Tratamento
7.
Klin Monbl Augenheilkd ; 238(4): 478-481, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33930922

RESUMO

BACKGROUND: In toddlers with esotropia, early alignment of the visual axes either with extraocular muscle surgery (EOMS) or botulinum toxin injections (BTIs) into both medial rectus muscles may result in improved depth perception. We compared the outcome of BTIs with EOMS in toddlers in order to gain further insight into the advantages and disadvantages of either method. PATIENTS AND METHODS: In this retrospective study, our encrypted database was searched for toddlers with esotropia aged 35 months or younger at the time of initial treatment with either BTIs or EOMS and who had a follow-up of at least 2 years. We analyzed the angle of deviation, dose effect (DE), and binocularity as well as the number of interventions. RESULTS: We identified 26 toddlers who received their first treatment for esotropia within the first 35 months of life: 16 with BTIs (9 males, 7 females) and 10 with EOMS (3 males, 7 females). Mean follow-up was considerably longer in the EOMS (87.7 months) than in the BTI group (35.7 months). Age at first intervention was 22.8 months in the BTI and 24.1 months in the EOMS group, and each toddler wore its full cycloplegic refraction. Mean angle at treatment was 41.25 prism diopters (PD) in the BTI compared to 52.9 PD in the EOMS group. The BTI group received an average of 1.68 BTIs, with a mean dosage of 14.5 IU Botox and a mean DE (mDE) of 1.8 PD/IU. In the EOMS group, the average number of surgeries was 1.4, with a mean dosage of 16.85 mm and a mDE of 3.14 PD/mm surgery. Some degree of binocularity could be observed in 9 (56%) of the BTI (5 × Bagolini positive, 2 × 550″, 2 × 220″) and in 4 (40%) of the EOMS group (2 × 3600″, 1 × 550″, 1 × 300″). By the end of the BTI group follow-up, four toddlers electively underwent EOMS rather than a 3rd BTI (followed by a 3rd BTI in 1), which resulted in the appearance of measurable binocularity in all four (1 × Bagolini positive, 1 × 220″, 1 × 200″, 1 × 60″). CONCLUSIONS: Our results show that BTIs are a viable treatment alternative in early esotropia. Even if EOMS is ultimately required, some binocularity may develop as the visual axes are aligned for some time in the sensitive phase owing to the effects of Botox. Moreover, less surgical dosage is needed than would have otherwise been necessary to treat the original angle of deviation. BTIs are faster, less invasive, and present as an effective alternative when patient compliance is too low to reliably measure the angle of deviation, which is essential for the planning of EOMS.


Assuntos
Esotropia , Pré-Escolar , Esotropia/tratamento farmacológico , Esotropia/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , Resultado do Tratamento , Visão Binocular
8.
Klin Monbl Augenheilkd ; 238(4): 493-498, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33930924

RESUMO

BACKGROUND: Surgical treatment of abducens nerve palsy depends on the remaining function of the lateral rectus muscle. Vertical rectus transposition surgery is indicated if the attempted maximal abduction effort does not rotate the eye beyond the midline. After the first description more than 100 years ago, a variety of muscle transposition modifications have been suggested. Nishida's minimally-invasive adaptation has attracted a great deal of attention in recent years. PATIENTS AND METHODS: Retrospective case series of four patients with abducens nerve palsy who were treated with Nishida muscle transposition surgery. Patients' characteristics with special emphasis on comparison between pre- and postoperative angle of deviation and ocular motility are reported. RESULTS: Four patients (2 females, 2 males) were included in this study. Unilateral transposition surgery was performed in a 7-year-old girl and a 37-year-old woman with a left abducens nerve palsy. In a 56-year-old male with a left sixth nerve palsy and in an 82-year-old male with a right sixth nerve palsy the transposition maneuver was combined with a recession of the medial rectus muscle in the same eye. In all patients, ocular motility was improved and the angle of deviation was reduced. CONCLUSIONS: Transposition of vertical rectus muscles is well established in the surgical treatment of abducens nerve palsy. Nishida's adaptation is a safe, effective and minimally-invasive treatment option. This vessel-sparing technique also allows for equilateral weakening of the medial rectus muscle.


Assuntos
Doenças do Nervo Abducente , Esotropia , Doenças do Nervo Abducente/cirurgia , Adulto , Idoso de 80 Anos ou mais , Criança , Esotropia/cirurgia , Movimentos Oculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Período Pós-Operatório , Estudos Retrospectivos
9.
Klin Monbl Augenheilkd ; 238(4): 499-503, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33930925

RESUMO

PURPOSE: The rectus inferior myopexy is often used in vertical incomitant deviations without significant deviation in primary position. We analysed the long-term results in different pathologies. METHODS: Retrospective study of patients operated on rectus inferior myopexy between 1984 and 2018. Vertical and torsional deviations were measured in primary position (PP) and 25° downgaze and the field of binocular single vision (FBSV) was evaluated with the Harms tangent screen, establishing a functional score. Postoperative follow-ups took place at 1 month, 6 months and long term (1 - 24 years). RESULTS: 62 patients were included (mean age 41 years, 28 women and 34 men). 47 presented a fourth nerve palsy (group 1) and 15 a reduced depression of other origins (group 2). 31 patients had undergone previous operations and 34 contemporaneous operations with the myopexy. In group 1, preoperative mean vertical deviation was 6.4° in PP and 12.3° on downgaze, postoperative 4° and 7.2°. In group 2, the value decreased from 3.3° in PP and 11.5° on downgaze to 1.2° and 6.6°. Over the years, there has been a decrease in the effect, particularly in group 1. The torsion was hardly influenced in both groups. The median functional score of FBSV improved in group 1 from 10% preoperatively to 39% postoperatively and in group 2 from 25 to 69%. CONCLUSION: The inferior rectus myopexy shows an effective way to reduce the incomitance of vertical deviation without significant influence on torsion. Over the years, there has been a decrease in the effect, particularly in patients with superior oblique paresis. We do not consider inferior rectus myopexy as a classic surgical treatment of superior oblique paresis. We have only used it in special cases.


Assuntos
Estrabismo , Doenças do Nervo Troclear , Adulto , Feminino , Humanos , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Período Pós-Operatório , Estudos Retrospectivos , Estrabismo/cirurgia , Resultado do Tratamento , Doenças do Nervo Troclear/cirurgia , Visão Binocular
10.
Klin Monbl Augenheilkd ; 238(4): 504-509, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33930926

RESUMO

BACKGROUND: Acute acquired comitant esotropia (AACE) is an uncommon form of strabismus. The main characteristics of AACE Type 2 in childhood are: acute onset of strabismus around 3 years of age, large and comitant angle of strabismus, absence of accommodative component, hyperopia of not more than 3 dpt, and measurable stereopsis. Strabismus surgery is urgently indicated in AACE Type 2 in order to avoid maldevelopment or loss of stereopsis. Therefore, in order to better describe the characteristics of AACE Type 2, we performed a retrospective analysis of patients previously seen in our clinic. PATIENTS AND METHODS: Retrospective analysis of data from patients who underwent strabismus surgery between October 2011 and September 2019 due to suspected AACE Type 2 could be confirmed during postoperative visits by evaluating ocular alignment and stereopsis at our hospital. Analysed data included: age and symptoms at first visit, visual acuity, refractive status, correction by glasses, age at surgery, period of time between first symptoms and surgery, surgical procedure, stereopsis and angle of strabismus (before surgery and 1 day, 3 months, and 12 months after surgery). Ethical approval was obtained from the Cantonal Ethics Committee of Zurich. RESULTS: 18 patients (12 male, 6 female) with mean hyperopia of 1.4 ± 0.6 dpt were identified as meeting the inclusion criteria during the defined time period. Amblyopia was present at first assessment in two patients. Strabismus surgery was performed at 2.0 to 11.1 years of age and between 0.4 and 24.6 months after onset of symptoms. Surgery was performed within 6 months after onset of symptoms in 12/18 children. Before surgery, angle of strabismus at near was measured as 38 ± 10 prism diopters (PD) and was reduced after surgery to 3 ± 3 PD at 3 months and 2 ± 2 PD at 12 months. Stereopsis was confirmed in 5/18 patients one day after surgery and in 18/18 patients 12 months after surgery. CONCLUSION: Our analysis showed that our patients with diagnosis of AACE Type 2 had mild hyperopia and large comitant non-accommodative esotropia; prognosis for recovery of stereopsis is excellent. Preoperative amblyopia does not exclude the diagnosis of AACE Type 2. Therapeutic intervention is advisable within a short period of time after first symptoms and the diagnosis of AACE Type 2.


Assuntos
Diabetes Mellitus Tipo 2 , Esotropia , Criança , Pré-Escolar , Esotropia/diagnóstico , Esotropia/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos
11.
Medicine (Baltimore) ; 100(14): e25348, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832111

RESUMO

INTRODUCTION: Pterygium is a common chronic ocular surface condition in ophthalmology.At present, the main treatment modality is surgical resection. Although the recurrence rate can be controlled to varying degrees, some patients can still develop serious complications, such as scleral melting, corneal melting, and even corneal perforation.We report a case of severe corneal and scleral melting after pterygium surgery treated with a bandage lens. PATIENT INFORMATION: A 60-year-old male who developed corneoscleral melting after pterygium surgery. DIAGNOSIS: This patient was diagnosed with corneoscleral melting. INTERVENTIONS: This patient was treated with a bandage lens and eye drops. OUTCOMES: He was treated with a bandage lens, and the tear break-up time (BUT) was prolonged. After 12 days the cornea and sclera were completely cured and the bandage lens was removed after one month. CONCLUSION: After pterygium surgery, various factors affect the occurrence of serious complications of autolysis. Mainly on ocular parts, such as the cornea and sclera, a bandage lens can stabilize the ocular surface tear film and prolong the tear break-up time (BUT), effectively prevent corneoscleral melting and promote corneoscleral cure.


Assuntos
Doenças da Córnea/etiologia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Pterígio/cirurgia , Doenças da Esclera/etiologia , Doenças da Córnea/cirurgia , Humanos , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Doenças da Esclera/cirurgia
12.
Zhonghua Yan Ke Za Zhi ; 57(5): 348-352, 2021 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-33915637

RESUMO

Objective: To investigate the clinical characteristics, possible etiology and surgical efficacy of acute acquired concomitant esotropia (AACE) with atypical etiology. Methods: Case-control study. Twelve patients, including 7 males and 5 females, who complained of diplopia and were diagnosed with AACE in Tianjin Eye Hospital from January to December 2019 and underwent surgical treatment were included. The duration of the disease was (8.83±3.71) months. All patients underwent routine ocular examination except amblyopia and ocular organic lesions. MRI examination of the orbits and the brain was performed in all the patients in order to screen orbital and craniocerebral diseases, and patients denied that the existence of common causes of AACE (such as occlusion of one eye, mental or psychological factors, medium to high myopia, etc. during medical examination). The characteristics of the disease, the difference of deviation angle at 33 cm and 5 m, and the changes of deviation angle and stereopsis before and after surgery were analyzed. The forced duction test was performed before operation, and the distance between the sclera margin and the midpoint of the medial rectus muscle attachment was measured and compared with the patients with intermittent exotropia (10 cases) and comitant esotropia (10 cases). Paired sample t-test and one-way analysis of variance were used for statistical analysis. Results: The mean spherical equivalent was (1.70±0.88) D in all AACE patients, and the deviation angle was (22.42±5.82) prism diopter (PD) at 33 cm and (20.00±4.86) PD at 5 m in primary gaze, which were not statistically significant (P=0.371). The force duction test showed no obvious tension or contracture of the medial rectus and no paralysis. In patients with AACE, the horizontal distance from the midpoint of the medial rectus to the limbus was (5.20±0.27) mm, versus (5.30±0.25) mm in intermittent exotropia patients and (5.30±0.31) mm in concomitant esotropia patients. All the differences were not statistically significant (P=0.618). All the patients with AACE had residual esotropia (mean, 3.42 to 6.33 PD) at 6 weeks, 3 months, and 6 months postoperatively, and their stereopsis improved more than before, with no stereopsis in 2 patients before surgery and stereopsis in all 12 patients after surgery. Conclusions: AACE patients with atypical etiology do not have high myopia and hyperopia. There is no significant difference between the distance and near angles. The occurrence of esotropia is related to decompensation of esophoria, which may result in clinical symptoms of diplopia. Conventional surgery can reduce esotropia and restore stereoscopic vision, but there is still a small amount of esophoria after surgery. There is no abnormality in the attachment point of the medial rectus muscle. (Chin J Ophthalmol, 2021, 57: 348-352).


Assuntos
Esotropia , Exotropia , Estudos de Casos e Controles , Esotropia/cirurgia , Exotropia/cirurgia , Feminino , Humanos , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , Resultado do Tratamento
13.
Med Clin North Am ; 105(3): 445-454, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926640

RESUMO

Cataract surgery is one of the most common surgical procedures performed in the United States. The decision to remove a cataract is determined by the patient's ability to perform activities of daily living, such as reading, driving, and watching television. Cataract surgery also offers the potential of spectacle independence with a wide array of premium intraocular lens options. In addition, with the continuing advances in ophthalmology, patients now also have the option of selecting between traditional approaches and femtosecond laser-assisted procedures. Cataract surgery continues to be an effective and ever-improving procedure for vision restoration.


Assuntos
Extração de Catarata , Cirurgia da Córnea a Laser/métodos , Hiperopia/cirurgia , Miopia/cirurgia , Presbiopia/cirurgia , Catarata/diagnóstico , Extração de Catarata/efeitos adversos , Extração de Catarata/métodos , Cirurgia da Córnea a Laser/efeitos adversos , Humanos , Lentes Intraoculares , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Procedimentos Cirúrgicos Oftalmológicos/métodos
15.
BMC Ophthalmol ; 21(1): 184, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33882877

RESUMO

BACKGROUND: To evaluate the effect of modified superior oblique intrasheath tenectomy (MSOIT) on superior oblique overaction (SOOA) with A-pattern. METHODS: We retrospectively reviewed the data of 66 patients (130 eyes) with SOOA and A-pattern underwent MSOIT at the nasal border of the superior rectus under an operating microscope between January 1, 2004 and December 31, 2018. The superior oblique (SO) tendon fibres were resected, and the sheath was preserved in all patients. The preoperative and postoperative SOOA, objective torsion, ocular motility, and A-pattern deviation findings were compared. The correlation between the preoperative A-pattern deviation and the corrected deviation was analysed. The average follow-up period was 33.45 ± 29.88 (range: 12-122) months. RESULTS: The mean SOOA deviation improved from 2.95 ± 0.54 to 0.34 ± 0.55 (P < 0.001), while the A-pattern deviation difference between upgaze and downgaze improved from 23.15 ± 7.59 prism diopters (PD) to 3.50 ± 2.90 PD (P < 0.001). The average objective fundus intorsion value improved from + 2.96 ± 0.58 to + 0.38 ± 0.60 (P < 0.001). The magnitude of correction in A-pattern was significantly correlated with the preoperative severity of A-pattern (r = 0.812, P < 0.001). CONCLUSIONS: MSOIT at the nasal border of the superior rectus (SR) under an operating microscope is safe and yields beneficial outcomes in patients with SOOA and A-pattern.


Assuntos
Estrabismo , Humanos , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , Estrabismo/cirurgia , Tendões/cirurgia
16.
Int J Mol Sci ; 22(7)2021 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-33805326

RESUMO

Despite decades of experience with hematopoietic stem cell transplantation, we are still faced with the delicate equipoise of achieving stable ocular health post-transplantation. This is because ocular graft-versus-host disease (oGvHD) following hematopoietic stem cell transplantation frequently occurs (≥50%) among transplant patients. To date, our understanding of the pathophysiology of oGvHD especially the involvement of the meibomian gland is still limited as a result of a lack of suitable preclinical models among other. Herein, the current state of the etiology and, pathophysiology of oGvHD based on existing pre-clinical models are reviewed. The need for additional pre-clinical models and knowledge about the involvement of the meibomian glands in oGvHD are emphasized.


Assuntos
Olho/transplante , Disfunção da Glândula Tarsal/etiologia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Animais , Humanos , Inflamação
17.
J Vis Exp ; (169)2021 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-33779596

RESUMO

Neuronal and vascular structures of the retina in physiologic and pathologic conditions can be better visualized and characterized by using intact whole retina imaging techniques compared to conventional retinal flat mount preparations and sections. However, immunofluorescent imaging of intact whole retina is hindered by the opaque coatings of the eyeball, i.e., sclera, choroid, and retinal pigment epithelium (RPE) and the light scattering properties of retinal layers that prevent full thickness high resolution optical imaging. Chemical bleaching of the pigmented layers and tissue clearing protocols have been described to address these obstacles; however, currently described methods are not suitable for imaging endogenous fluorescent molecules such as green fluorescent protein (GFP) in intact whole retina. Other approaches bypassed this limitation by surgical removal of pigmented layers and the anterior segment of the eyeball allowing intact eye imaging, though the peripheral retina and hyaloid structures were disrupted. Presented here is an intact whole retina and vitreous immunofluorescent imaging protocol that combines surgical dissection of the sclera/choroid/retina pigment epithelium (RPE) layers with a modified tissue clearing method and light sheet fluorescent microscopy (LSFM). The new approach offers an unprecedented view of unperturbed vascular and neuronal elements of the retina as well as the vitreous and hyaloid vascular system in pathologic conditions.


Assuntos
Corioide/cirurgia , Dissecação/métodos , Microscopia de Fluorescência/métodos , Procedimentos Cirúrgicos Oftalmológicos/métodos , Retina/cirurgia , Esclera/cirurgia , Animais , Receptor 1 de Quimiocina CX3C/metabolismo , Corioide/diagnóstico por imagem , Corioide/metabolismo , Camundongos , Retina/diagnóstico por imagem , Retina/metabolismo , Esclera/diagnóstico por imagem , Esclera/metabolismo
19.
BMC Ophthalmol ; 21(1): 131, 2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33750344

RESUMO

BACKGROUND: Conjunctival autograft transplantation from superior conjunctiva is often chosen to lower the postoperative recurrence rate for pterygium treatment. However, inferior conjunctival autograft (ICA) might be taken as an alternative surgery method, especially under certain conditions. Consequently, we designed this research to estimate and contrast the result of inferior conjunctival autograft and superior conjunctival autograft (SCA) on the postoperative recurrence rate. METHODS: We searched through network database (PubMed, Embase and Cochrane Central Register of Controlled Trials) to choose suitable randomized controlled trials (RCTs). Based on Cochrane review methods, we evaluated eligibility and risk of bias of included studies. The primary measures included postoperative recurrence rate. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were assessed. RevMan 5.3 software was utilized to conduct statistical analysis. RESULTS: Four RCTs composed of a total of 438 eyes were included in this meta-analysis, with 234 eyes in the inferior conjunctival autograft group and 204 eyes in the superior conjunctival autograft group. Statistical meta-analysis revealed that the postoperative recurrence rate was similar between the two groups (RR = 0.77, 95% CI: 0.36 to 1.62, P = 0.49). Only two RCTs applied the postoperative pain scale and one of them did not provided adequate numbers. CONCLUSIONS: Our meta-analysis indicated that inferior autograft transplantation and superior autograft transplantation had a similar effect on postoperative recurrence rate. The inferior autograft group might have a less postoperative pain. Subsequent RCTs which have more patients participated and more outcomes are needed to confirm our conclusions in years to come.


Assuntos
Túnica Conjuntiva , Pterígio , Autoenxertos , Humanos , Procedimentos Cirúrgicos Oftalmológicos , Pterígio/cirurgia , Recidiva , Transplante Autólogo
20.
Indian J Ophthalmol ; 69(4): 910-917, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33727458

RESUMO

Purpose: Our study aimed to evaluate the outcome of contralateral eye (CE) fixation duress squint surgery (FDSS) in third nerve palsy (3rd NP) with aberrant regeneration and compare the postoperative ptosis correction with preoperative ptosis improvement on adduction. Methods: Patients of 3rd NP with aberrant regeneration who underwent CE FDSS between December 2012-July 2015 in a tertiary-care eye hospital with a follow-up period of 1-year were retrospectively studied to analyze preoperative and postoperative details. Surgical success was defined as the correction of ptosis within 1 mm of preoperative ptosis improvement during maximal adduction of the affected eye, postoperative alignment ≤10Δ, and resolution of subjective diplopia in primary position. Results: A total of 14 eyes in 14 patients (mean age 23.6 ± 13.6 years) were included. Mean preoperative exotropia and ptosis in primary position in 14 patients was 53.4 ± 20pd and 4.89 ± 2.9 mm, respectively, and mean hypotropia in 6 patients was 23.67 ± 5.89pd. The mean improvement of ptosis on adduction and supraduction in all patients was 4.07 ± 2.64 mm and 2.89 ± 2.22 mm, respectively (P = 0.213). All patients underwent large recession of CE lateral rectus (mean 12.4 ± 2.7 mm), 9 patients underwent CE medial rectus resection/plication (mean 6.0 ± 0.9 mm) and 6 patients underwent CE superior rectus recession (mean 6.6 ± 0.67 mm). Postoperatively, mean ptosis and exotropia correction was 3.7 ± 2.4 mm (P = 0.000) and 15 ± 9.6pd (P = 0.000), respectively, and mean hypotropia was 2.17 ± 4.02pd (P = 0.000). Surgical success was achieved in 6 patients. Postoperative ptosis correction showed strong positive correlation with preoperative improvement of ptosis on adduction (r = 0.87; P = 0.00). Conclusion: Preoperative lid excursion on adduction in 3rd NP can be regarded as a prognostic sign of the success of CE FDSS which can simultaneously correct both ptosis and squint.


Assuntos
Exotropia , Doenças do Nervo Oculomotor , Adolescente , Adulto , Criança , Exotropia/cirurgia , Humanos , Músculos Oculomotores/cirurgia , Doenças do Nervo Oculomotor/complicações , Doenças do Nervo Oculomotor/diagnóstico , Doenças do Nervo Oculomotor/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , Resultado do Tratamento , Visão Binocular , Adulto Jovem
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