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1.
Orbit ; 41(6): 763-765, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33938345

RESUMEN

Several chemotherapeutic agents are known to induce lacrimal drainage stenosis and obstruction, resulting in epiphora. Pemetrexed is one such drug and is used in the management of mesotheliomas and non-small cell lung carcinomas. Pemetrexed inhibits folate metabolism at multiple levels. The present case is the second report of pemetrexed induced punctal and canalicular stenosis, but the first to document dacryoendoscopy findings and report balloon puncto-canaliculoplasty as a minimally-invasive treatment option.


Asunto(s)
Antineoplásicos , Dacriocistorrinostomía , Obstrucción del Conducto Lagrimal , Humanos , Obstrucción del Conducto Lagrimal/inducido químicamente , Obstrucción del Conducto Lagrimal/terapia , Dacriocistorrinostomía/métodos , Pemetrexed/efectos adversos , Constricción Patológica , Antineoplásicos/efectos adversos
2.
Proc Natl Acad Sci U S A ; 115(3): 537-542, 2018 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-29295928

RESUMEN

The eukaryotic cell's microtubule cytoskeleton is a complex 3D filament network. Microtubules cross at a wide variety of separation distances and angles. Prior studies in vivo and in vitro suggest that cargo transport is affected by intersection geometry. However, geometric complexity is not yet widely appreciated as a regulatory factor in its own right, and mechanisms that underlie this mode of regulation are not well understood. We have used our recently reported 3D microtubule manipulation system to build filament crossings de novo in a purified in vitro environment and used them to assay kinesin-1-driven model cargo navigation. We found that 3D microtubule network geometry indeed significantly influences cargo routing, and in particular that it is possible to bias a cargo to pass or switch just by changing either filament spacing or angle. Furthermore, we captured our experimental results in a model which accounts for full 3D geometry, stochastic motion of the cargo and associated motors, as well as motor force production and force-dependent behavior. We used a combination of experimental and theoretical analysis to establish the detailed mechanisms underlying cargo navigation at microtubule crossings.


Asunto(s)
Microtúbulos/química , Microtúbulos/metabolismo , Transporte Biológico , Citoesqueleto/metabolismo , Humanos , Imagenología Tridimensional , Cinesinas/química , Cinesinas/metabolismo , Cinética , Modelos Biológicos , Modelos Teóricos , Unión Proteica
3.
Orbit ; 40(6): 509-512, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32896195

RESUMEN

PURPOSE: To present first of its kind series on the clinical features and outcomes of lacrimal drainage disorders in Peters anomaly and Peters plus syndrome. METHODS: A retrospective chart review was performed of all consecutive patients who were known cases of Peters anomaly or Peters plus anomaly and were diagnosed with associated congenital lacrimal drainage disorders. The study period was from June 2016 to Dec 2020. All these patients underwent examination under anaesthesia for a detailed assessment of lacrimal drainage anomalies. Where indicated, they were treated with probing, intubation, or in refractory patients with a dacryocystorhinostomy. The anatomical and functional outcomes were assessed. RESULTS: Of the 282 patients with Peters anomaly, 4 (1.4%) patients had associated lacrimal drainage system anomalies while of the 16 Peters plus anomaly children, 3 (18.75%) had associated lacrimal drainage system anomalies. A total of 12 lacrimal drainage systems of 12 eyes of 7 patients of Peters anomaly were found to be involved. Upper or lower punctal agenesis were noted in 3 eyes. Three eyes had complex congenital nasolacrimal duct obstruction (CNLDO), two of which had a bony NLD block and one had a misdirected nasolacrimal duct through the inferior turbinate. One eye had a diffuse NLD stenosis without a CNLDO. Following appropriate management, at a mean follow-up of 25.7 months (range: 3-48 months), all the eyes except one (91%, 10/11) demonstrated anatomical and functional success. CONCLUSION: Lacrimal drainage involvement was more common in Peters plus syndrome. Multiple proximal and distal lacrimal drainage segment anomalies were noted in all the variants of Peters anomaly; however, Peters plus syndrome was noted to usually involve both the segments.


Asunto(s)
Dacriocistorrinostomía , Anomalías del Ojo , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Segmento Anterior del Ojo/anomalías , Niño , Opacidad de la Córnea , Humanos , Lactante , Intubación , Obstrucción del Conducto Lagrimal/diagnóstico , Obstrucción del Conducto Lagrimal/terapia , Conducto Nasolagrimal/diagnóstico por imagen , Conducto Nasolagrimal/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
4.
Biochem Biophys Res Commun ; 529(2): 303-305, 2020 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-32703427

RESUMEN

Microtubules often form sparse networks in eukaryotic cells which simultaneously contribute to shape maintenance and help establish overall cell layout. It is therefore important to quantify not only how these filaments function individually but also as a coupled network. We have developed a straightforward approach to assemble such networks de novo and we now use it to measure microtubule rigidity within small networks under controlled conditions. Our results suggest that microtubule rigidity increases with the contour length of the filament both for single microtubules and within small microtubule networks.


Asunto(s)
Citoesqueleto/química , Microtúbulos/química , Animales , Fenómenos Biomecánicos , Módulo de Elasticidad , Porcinos
5.
Orbit ; 39(6): 408-412, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31900017

RESUMEN

OBJECTIVE: To describe the outcomes of punctal dilatation and non-incisional canalicular curettage in patients with infectious canaliculitis. METHODS: A retrospective analysis of 53 canaliculi of 47 eyes of 46 consecutive patients diagnosed with canaliculitis was performed from November 2015 to December 2018. All patients were treated with punctal dilatation and a non-incisional canalicular curettage. Parameters studied include demographics, clinical presentation, microbiological analysis, management and treatment outcomes. The outcome measures were clinical resolution of canaliculitis and resolution of epiphora. RESULTS: The mean age at presentation was 59.34 years with female preponderance (M:F = 19:28). Left eye was more affected (64%, n = 30) as compared to the right (36%, n = 17). Only one patient presented bilaterally. Lower canaliculus was most commonly involved (68%, n = 32). Six eyes showed involvement of both upper and lower canaliculus. Presenting symptoms include discharge (81%), swelling of the eyelids (64%), watering (55%), redness (51%) and pain (39%). Punctal dilatation and non-incisional canalicular curettage were performed using punctum dilator and a small chalazion scoop (1 mm Meyhoefer chalazion curette). Of the 53 involved canaliculi, 14 canaliculi of 14 eyes underwent a repeat curettage for complete resolution and 1 canaliculus underwent the same procedure thrice. The most common micro-organisms isolated were Streptococci species (28% cases). At a mean follow-up of 6.8 months, resolution of canaliculitis was achieved in all patients; however, epiphora persisted in two eyes (4%). CONCLUSION: Non-incisional canalicular curettage is a minimally invasive technique with good preservation of the punctal and canalicular anatomy. It also facilitates good anatomical and functional outcomes in infectious canaliculitis.


Asunto(s)
Canaliculitis/cirugía , Legrado/métodos , Infecciones Bacterianas del Ojo/cirugía , Párpados/patología , Adulto , Anciano , Anciano de 80 o más Años , Canaliculitis/microbiología , Dilatación Patológica , Infecciones Bacterianas del Ojo/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
6.
AAPS PharmSciTech ; 19(6): 2751, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29380281

RESUMEN

This article has been retracted by the journal because the editors have clear evidence that the scientific findings in this article are unreliable.

7.
Orbit ; : 1, 2021 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-34465273
8.
Infect Disord Drug Targets ; 24(1): e220823220210, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37608615

RESUMEN

BACKGROUND: Genital tuberculosis (GTB) is a common form of extra-pulmonary TB with cervical TB being a rare entity accounting for 0.1-0.65% of all TB cases globally. It is usually asymptomatic but may present with infertility, menstrual irregularities, dyspareunia, dysmenorrhoea, or vaginal discharge. CASE PRESENTATION: The present case report briefs about a 39 years old nulliparous infertile woman who presented with complaints of irregular menstrual cycles and amenorrhea with an erosive papillary growth over the cervix simulating invasive cervical carcinoma. Her Pap smear report revealed the presence of granulomas. On cervical punch biopsy also a large number of granulomas were seen and on Ziehl Nielsen staining the diagnosis of TB was further confirmed by the presence of acid-fast rodlike bacilli. The patient responded well to anti-tubercular drugs. DISCUSSION: GTB in most of the cases remains asymptomatic with infertility being the most common presenting complaint. Other symptoms include menstrual irregularities, amenorrhoea, dysmenorrhoea, dyspareunia, chronic pelvic pain, and occasionally abnormal vaginal discharge. Tuberculous cervicitis is difficult to diagnose clinically and many times mimics cervical malignancy. RESULT AND CONCLUSION: Hence, cervical tuberculosis should be kept in the differential diagnosis of cervical cancer especially in an infertile woman from a developing country.


Asunto(s)
Dispareunia , Infertilidad , Tuberculosis de los Genitales Femeninos , Neoplasias del Cuello Uterino , Excreción Vaginal , Humanos , Femenino , Adulto , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Dismenorrea/diagnóstico , Dismenorrea/tratamiento farmacológico , Dismenorrea/etiología , Tuberculosis de los Genitales Femeninos/diagnóstico , Tuberculosis de los Genitales Femeninos/patología , Granuloma
11.
Indian J Radiol Imaging ; 33(3): 403-408, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37362369

RESUMEN

Achilles tendon xanthoma is a benign and rare disease with a high incidence in patients having familial hypercholesterolemia. Patients present with or without pain and thickened tendons. Gout is seen in patients with hyperuricemia. Coexistence of xanthoma and gout is extremely rare. We searched the PubMed literature with 'Xanthoma' and 'Gout' as keywords and could find only one case report. Imaging modalities such as radiography and ultrasonography, play a vital role in diagnosing this condition early, hence helping the patient to commence the use of potentially lifesaving lipid-lowering therapeutic agents. Magnetic resonance imaging is helpful in delineating the morphological changes, exact measurements, and eventually in treatment planning. It helps to rule out early involvement of other tendons by the same pathology. We present a case of a 25-year-old male patient who presented to our institute with bilateral large symmetrical swelling in the posterior aspects of ankles for 4 years, with normal serum and blood parameters. Bilaterality, enormous size and normal blood and serum parameters make this case unique.

12.
Natl J Maxillofac Surg ; 14(1): 86-92, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37273446

RESUMEN

Aim: The aim of this study was to evaluate the efficacy, stability, and clinical outcomes of a bioresorbable plating system in the treatment of pediatric maxillary fractures. Materials and Methods: Twenty pediatric patients with maxillary fractures (13 males and 7 females) were included in this study. The 1.5- and 2.0-mm resorbable plates were used and secured with monocortical resorbable screws 6 mm and 7 mm in length. All patients were followed up for 6 months. Clinical parameters, such as pain, swelling, soft-tissue infection, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results: Fall from height (50%) was the most common cause of etiology, followed by road traffic accidents (35%). Maxillary alveolar # (40) was the most common fracture site, followed by nasal complex # (25%) and zygomatic complex # (25%). Appropriate fixation and adequate primary bone healing was achieved in 100% of the cases. Few minor complications were observed: (1) soft-tissue infection (5%) and (2) paresthesia (10%). There was a significant increase in bite force in the incisor and molar regions. Observation in clinical parameters shows that there was a significant reduction in postoperative pain and swelling at different follow-up periods. Conclusion: Bioresorbable plating system is used as a load-sharing plate in a semirigid fixation technique after anatomic fracture reduction. Although its high costs limit its feasibility for use low infection rates, minimized second surgery for implant removal attracts its use. 1.5- and 2-mm resorbable plating system along is a good treatment modality for moderately displaced maxillary fractures in pediatric patients. Larger sample size and longer follow-up studies are required for conclusive results.

13.
J Surg Case Rep ; 2023(1): rjac600, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36685122

RESUMEN

Our case uniquely presents a patient with two rare gallbladder disease entities occurring simultaneously. The patient presented to hospital with abdominal pain and was subsequently diagnosed with emphysematous cholecystitis and porcelain gallbladder. After initial conservative management failed, cholecystectomy was performed, and the patient recovered well post-operatively and was discharged home.

14.
Cytojournal ; 20: 20, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37681076

RESUMEN

Objectives: We undertook this study to find out the spectrum of the cervical smear pattern along with the clinical profiles of patients who underwent cervical Papanicolaou (Pap) smear evaluation in our newly started tertiary care center. We also tried to find the possible clinical cause for unsatisfactory smears and factors for epithelial cell abnormality. Material and Methods: The present study was a retrospective observational study. Pap smears cases with their clinical findings mentioned on the requisition form and cytopathology observations were retrieved from the archives of the department of pathology. Fisher's exact test was used for statistical analysis. Results: Five hundred and ninety-four cases were included in the study. The most common age group was 36- 40 years. White discharge per vaginum was the most common clinical presentation. The negative for squamous intraepithelial lesions or malignancy was the most common interpretation (86.87%). Cervical erosion had statistically significant associations with unsatisfactory smears, while bacterial vaginosis had with satisfactory smears. Epithelial cell abnormality was seen in 4.62% patients. We observed a statistically significant association of cervical mucoid discharge, and inflammation with "no epithelial cell abnormality" cases, while postmenopausal bleeding was associated with "epithelial cell abnormality" cases. Conclusion: In the presence of clinical factors like cervical erosion, which may affect the quality of Pap smear, proper sampling techniques are to be used by health-care providers. The careful evaluation of Pap smears, especially in cases of cervical mucoid discharge, postmenopausal bleeding, and inflammatory smears is required to ensure that epithelial cell abnormalities are not overlooked.

15.
Diagnostics (Basel) ; 13(3)2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36766660

RESUMEN

BACKGROUND: The usage of whole-slide images has recently been gaining a foothold in medical education, training, and diagnosis. OBJECTIVES: The first objective of the current study was to compare academic performance on virtual microscopy (VM) and light microscopy (LM) for learning pathology, anatomy, and histology in medical and dental students during the COVID-19 period. The second objective was to gather insight into various applications and usage of such technology for medical education. MATERIALS AND METHODS: Using the keywords "virtual microscopy" or "light microscopy" or "digital microscopy" and "medical" and "dental" students, databases (PubMed, Embase, Scopus, Cochrane, CINAHL, and Google Scholar) were searched. Hand searching and snowballing were also employed for article searching. After extracting the relevant data based on inclusion and execution criteria, the qualitative data were used for the systematic review and quantitative data were used for meta-analysis. The Newcastle Ottawa Scale (NOS) scale was used to assess the quality of the included studies. Additionally, we registered our systematic review protocol in the prospective register of systematic reviews (PROSPERO) with registration number CRD42020205583. RESULTS: A total of 39 studies met the criteria to be included in the systematic review. Overall, results indicated a preference for this technology and better academic scores. Qualitative analyses reported improved academic scores, ease of use, and enhanced collaboration amongst students as the top advantages, whereas technical issues were a disadvantage. The performance comparison of virtual versus light microscopy meta-analysis included 19 studies. Most (10/39) studies were from medical universities in the USA. VM was mainly used for teaching pathology courses (25/39) at medical schools (30/39). Dental schools (10/39) have also reported using VM for teaching microscopy. The COVID-19 pandemic was responsible for the transition to VM use in 17/39 studies. The pooled effect size of 19 studies significantly demonstrated higher exam performance (SMD: 1.36 [95% CI: 0.75, 1.96], p < 0.001) among the students who used VM for their learning. Students in the VM group demonstrated significantly higher exam performance than LM in pathology (SMD: 0.85 [95% CI: 0.26, 1.44], p < 0.01) and histopathology (SMD: 1.25 [95% CI: 0.71, 1.78], p < 0.001). For histology (SMD: 1.67 [95% CI: -0.05, 3.40], p = 0.06), the result was insignificant. The overall analysis of 15 studies assessing exam performance showed significantly higher performance for both medical (SMD: 1.42 [95% CI: 0.59, 2.25], p < 0.001) and dental students (SMD: 0.58 [95% CI: 0.58, 0.79], p < 0.001). CONCLUSIONS: The results of qualitative and quantitative analyses show that VM technology and digitization of glass slides enhance the teaching and learning of microscopic aspects of disease. Additionally, the COVID-19 global health crisis has produced many challenges to overcome from a macroscopic to microscopic scale, for which modern virtual technology is the solution. Therefore, medical educators worldwide should incorporate newer teaching technologies in the curriculum for the success of the coming generation of health-care professionals.

16.
Semin Ophthalmol ; 37(2): 249-252, 2022 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-34606409

RESUMEN

AIM: The purpose of this study was to report the profile and outcomes of children with an earlier failed probing that was performed without endoscopy guidance. METHODS: Retrospective interventional case study was performed on all the patients who were referred with a diagnosis of a single or multiple failed probing from Jan 2016 to June 2019 to a tertiary care Dacryology center. All the patients had a blind probing without an endoscopy assistance before referral. The parameters evaluated were patient demographics, number of earlier probings, prior operative notes, clinical presentation, findings of endoscopy guidance during the repeat procedure, simple vs complex CNLDO, types of complex CNLDO, management, complications and outcomes. RESULTS: One hundred eyes of 82 children had a failed probing experience without endoscopic guidance elsewhere. The mean age of the children was 55.7 months (range: 9-168 months). Of these, 63 eyes underwent repeat probing under endoscopic guidance, 35 eyes being simple CNLDO (35/63, 55.5%), and 28 eyes (28/63, 44.5%) being complex CNLDO. Among the complex subset, balloon dacryoplasty was performed for five cases and monoka-Crawford stents for eight cases under direct endoscopy visualization. Buried probes were managed successfully by standard protocols of probe exteriorization. The two cases of misdirected probes were re-directed under endoscopy guidance for appropriate recanalization and the single case of granuloma at the NLD opening was excised followed by intubation without any recurrence. CONCLUSION: Endoscopy guidance plays a crucial role in the management of CNLDO with an earlier failed probing.


Asunto(s)
Dacriocistorrinostomía , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Niño , Endoscopía , Humanos , Lactante , Obstrucción del Conducto Lagrimal/diagnóstico , Obstrucción del Conducto Lagrimal/terapia , Conducto Nasolagrimal/diagnóstico por imagen , Conducto Nasolagrimal/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
17.
J Pediatr Ophthalmol Strabismus ; 59(3): 172-179, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34928761

RESUMEN

PURPOSE: To evaluate the demographic details, clinical presentation, and surgical outcomes in patients presenting with strabismus following orbital wall fractures. METHODS: A retrospective review was conducted over a 6-year period on 347 consecutive patients with strabismus who presented after orbital wall fractures. The patients were evaluated for their demographic data, clinical presentation, and profiles, management, complications, and outcomes of strabismus. RESULTS: Strabismus following orbital wall fractures was noted in 347 patients: 87.03% were men (n = 302) and 12.97% were women (n = 45). Fracture of the orbital floor in isolation or in combination with other walls was more frequently noted in 72.3% of patients (n = 251). The resultant strabismus included paralytic, restrictive, or both etiologies. Exotropia was noted most frequently in 25.65% of patients (n = 89), followed by exotropia with hypotropia in 20.75% of patients (n = 72). Ten percent of patients with strabismus (n = 34), who were observed for at least 6 months after injury, underwent surgical correction for strabismus. Preoperative diplopia was observed in 79.41% of patients (n = 27) and persisted after strabismus surgery in 15% of patients (n = 6). A successful outcome regarding the postoperative angle of deviation of 10 prism diopters or less horizontal and/or 5 prism diopters or less of vertical deviation with elimination of diplopia was observed in 41.17% of patients. CONCLUSIONS: Strabismus following orbital wall fractures is complex and requires a tailored strategy. The current study found the orbital floor to be more frequently involved in orbital wall fractures. However, the resultant strabismus was a combination of paralytic and restrictive etiologies. [J Pediatr Ophthalmol Strabismus. 2022;59(3):172-179.].


Asunto(s)
Exotropía , Fracturas Orbitales , Estrabismo , Diplopía/diagnóstico , Diplopía/etiología , Exotropía/etiología , Exotropía/cirugía , Femenino , Humanos , Masculino , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/efectos adversos , Fracturas Orbitales/complicaciones , Fracturas Orbitales/diagnóstico , Fracturas Orbitales/cirugía , Estudios Retrospectivos , Estrabismo/complicaciones , Estrabismo/cirugía , Resultado del Tratamiento
18.
Cornea ; 40(2): 142-146, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32355112

RESUMEN

PURPOSE: To study the efficacy of interferon alfa-2b (IFN-a2b) on pigmented ocular surface squamous neoplasia (p-OSSN) and assess the resolution of the pigment to the treatment. METHODS: A retrospective case series of 8 tumors in 7 patients. RESULTS: The mean age at diagnosis of p-OSSN was 65 years (median, 61 years; range, 51-84 years), and all patients were men. The mean duration of symptoms was 2 months (median, 1 month; range, 1-4 months). One patient had 2 distinct lesions in the same eye. Tumor epicenter was located at the limbus (n = 5) or bulbar conjunctiva (n = 2). Complexion-associated melanosis was noted in all eyes. The mean basal dimension of the tumor was 8 mm (median, 7 mm; range, 5-12 mm). The mean % of tumor pigmentation was 47% (median, 30%; range, 10%-100%). The treatment details included topical IFN-a2b (n = 1) or a combination of topical and subconjunctival injection of IFN-a2b (n = 7). All patients with p-OSSN showed excellent response to IFN-a2b with complete tumor regression and resolution of tumor-associated pigment with a mean number of 2 subconjunctival IFN-a2b injections (median, 2; range, 0-3) and topical IFN-a2b for an average of 2 months (median, 2 months; range, 1-3 months). There was no change in the complexion-associated melanosis with IFN-a2b. CONCLUSIONS: IFN-a2b is very effective in the management of p-OSSN. There is a complete resolution of the pigment along with the tumor.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de la Conjuntiva/tratamiento farmacológico , Enfermedades de la Córnea/tratamiento farmacológico , Neoplasias del Ojo/tratamiento farmacológico , Interferón alfa-2/uso terapéutico , Limbo de la Córnea/efectos de los fármacos , Administración Oftálmica , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Neoplasias de la Conjuntiva/patología , Enfermedades de la Córnea/patología , Neoplasias del Ojo/patología , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intraoculares , Limbo de la Córnea/patología , Masculino , Melanosis/patología , Persona de Mediana Edad , Soluciones Oftálmicas , Estudios Retrospectivos , Resultado del Tratamiento
19.
Eye (Lond) ; 35(6): 1600-1604, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32778741

RESUMEN

PURPOSE: To assess the exclusive role and outcomes of Crigler's lacrimal sac compression in the management of congenital nasolacrimal duct obstruction (CNLDO). METHODS: Retrospective interventional case-series was performed on patients diagnosed with CNLDO and who were advised Crigler's lacrimal sac compression (CLSC) at a tertiary care Dacryology Institute from Jan 2016 to June 2019. CNLDO patients who were practicing incorrect techniques of lacrimal sac compression at presentation were separately assessed. All the patients were assigned to four groups (Gr 1: 0-3 months, Gr 2: >3 & <6 months, Gr 3: >6 & <9 months and Gr 4: >9 and <12 months) based on the age at which the CLSC was initiated and followed up quarterly or as needed till at least 1 year of age. The parameters studied include patient demographics, clinical presentation, age of initiation of CLSC, success rate with CLSC, and need for additional interventions. Success was defined as the subjective resolution of epiphora and discharge with objective measures of normal tear meniscus height and dye clearance on fluorescein dye disappearance test. RESULTS: A total number of 1240 patients with CNLDO were assessed. Of these, 1037 patients were advised correct techniques of CLSC from the beginning, and the remaining 203 patients were referred but performing it incorrectly at presentation. Of the 1037 patients, 236 were lost to follow-up; hence, a total of 1004 patients (801 + 203) were included for final analysis. CLSC was found to be an effective conservative strategy in the management of CNLDO. The rate of resolution of CNLDO in Gr 1 to Gr 4 was 87.3%, 78.9%, 77.9%, and 76.8%, respectively. There were no statistically significant differences in the outcomes based on the age of CLSC initiation. The referred patients whose techniques were rectified following the initial incorrect techniques showed a resolution of 61.2% (79/129). The correct techniques of CLSC appeared to influence the outcomes. However, the age of its initiation did not substantially impact the outcomes. Significantly high resolution was noted even beyond nine months of age and encouraging results beyond 12 months of age. CONCLUSIONS: It is crucial to initiate the correct techniques of Crigler's lacrimal sac compression to achieve favourable outcomes. Age of initiation of CLSC in infancy does not appear to influence the outcomes. The resolution rate continued to be significantly high up to 1 year of age. There is a need to assess the role of CLSC beyond 12 months of age.


Asunto(s)
Dacriocistorrinostomía , Aparato Lagrimal , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Humanos , Lactante , Obstrucción del Conducto Lagrimal/diagnóstico , Obstrucción del Conducto Lagrimal/terapia , Estudios Retrospectivos , Resultado del Tratamiento
20.
Eur J Ophthalmol ; 31(2): NP12-NP14, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31771345

RESUMEN

Bilateral Tessier cleft types 3 and 4 are rare and commonly involve the lacrimal drainage system owing to their anatomical location. Such clefts commonly present with associated ocular anomalies and include colobomatous eyelids, hypertelorism, microphthalmia, punctal or canalicular agenesis, and nasolacrimal duct obstruction or exstrophy. The current report presents an 18-month-old baby with bilateral Tessier cleft 3 with a unilateral anophthalmos, symmetrical eyelid colobomas, and lacrimal drainage anomalies. The lacrimal anomalies noted include small lacrimal sac with inferior canaliculus on the right side and upper and lower punctal and canalicular agenesis on the left side. Computed tomographic dacryocystography demonstrated unilateral lacrimal sac and bilateral maldevelopment of the bony nasolacrimal duct.


Asunto(s)
Anoftalmos/complicaciones , Labio Leporino/complicaciones , Coloboma/complicaciones , Párpados/anomalías , Enfermedades del Aparato Lagrimal/congénito , Anomalías Maxilofaciales/complicaciones , Conducto Nasolagrimal/anomalías , Anoftalmos/diagnóstico por imagen , Anoftalmos/cirugía , Labio Leporino/cirugía , Coloboma/diagnóstico por imagen , Coloboma/cirugía , Dacriocistorrinostomía , Párpados/diagnóstico por imagen , Párpados/cirugía , Humanos , Lactante , Enfermedades del Aparato Lagrimal/diagnóstico por imagen , Enfermedades del Aparato Lagrimal/cirugía , Masculino , Anomalías Maxilofaciales/cirugía , Conducto Nasolagrimal/diagnóstico por imagen , Conducto Nasolagrimal/cirugía , Procedimientos de Cirugía Plástica , Tomografía Computarizada por Rayos X
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