Comparing the outcome of Muller’s muscle conjunctival resection for mild/moderate versus severe involutional aponeurotic ptosis

2020 ◽  
pp. 112067212096345
Author(s):  
Senay Asik Nacaroglu ◽  
Gamze Ozturk Karabulut ◽  
Korhan Fazil ◽  
Kubra Serefoglu Cabuk ◽  
Nilay Kandemir Besek ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Success Rates ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Surgical Success ◽  
Resected Tissue ◽  
Group 2 ◽  
Control Study ◽  
Müller’S Muscle ◽  
Group 1

Aims: To compare predictability of the outcomes of Muller’s muscle conjunctiva resection (MMCR) in patients with severe versus mild/moderate involutional aponeurotic ptosis. Methods: This was a retrospective case-control study. All cases were recruited into the groups in terms of preoperative marginal reflex distance of upper eyelid (MRD-1). Group 1 consisted of patients with mild to moderate blepharoptosis was defined as an MRD-1 equal to 1.1 to 3 mm and Group 2 consisted of patients with severe blepharoptosis defined as MRD-1 ⩽ 1 mm. All patients underwent MMCR based on the response to phenylephrine and the amount of ptosis. MRD-1 obtained both manually and with ImageJ analysis program preoperatively and on the postoperative sixth month was compared. Successful surgical outcome criteria were defined as MRD-1 ⩾ 2.5 mm and inter-eyelid symmetry ⩽ 1 mm. Results: A total of 97 eyes of 83 participants met the inclusion criteria for this study (Group 1 n = 50, Group 2 n = 47). In terms of MRD-1 success rates were 88% in Group 1, and 70.2% in Group 2 ( p = 0.03). Preoperative MRD-1 which was measured by ImageJ, and the amount of resected tissue in mm were the predictive data of surgical outcome by the logistic regression analysis (OR 6.45, 95% CI 1.82–22.78, p = 0.004, OR 2.47, 95% CI 1.05–5.80, p = 0.037, respectively). Conclusion: The surgical success of MMCR can be predicted via tissue resection length and preoperative MRD-1. Higher surgical success rates were obtained in cases with mild-moderate ptosis and clinically acceptable success rates were obtained in cases with severe ptosis.

scholarly journals Outcomes of bicanalicular nasal stent inserted by sheath-guided dacryoendoscope in patients with lacrimal passage obstruction: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoyuki Kamao ◽  
Xiaodong Zheng ◽  
Atsushi Shiraishi
Keyword(s):  
Observational Study ◽  
Nasolacrimal Duct ◽  
Retrospective Observational Study ◽  
Success Rates ◽  
Surgical Success ◽  
Obstruction Group ◽  
Symptom Scores ◽  
Lacrimal Canaliculus ◽  
Group 2 ◽  
Group 1

Abstract Background The dacryoendoscope is the only instrument that can observe the luminal side of the lacrimal passage with minimal invasiveness. It was developed to treat lacrimal passage obstructions by inserting a bicanalicular nasal stent with sheath-guided bicanalicular intubation (SG-BCI). The purpose of this study was to determine the outcomes of SG-BCI to treat lacrimal passage obstructions. In addition, to determine the effects of SG-BCI treatment on the quality of life. Methods This was a retrospective observational study of 128 patients (mean age 70.9 ± 11.0 years, range 28–93 years) diagnosed with a unilateral lacrimal passage obstruction. There were 73 patients with a nasolacrimal duct obstruction, 37 with a lacrimal canaliculus obstruction, 7 with a lacrimal punctum obstruction, and 11 with common lacrimal canaliculus and nasolacrimal duct obstructions. They were all treated with SG-BCI. The postoperative subjective outcomes were assessed by the answers to the Glasgow Benefit Inventory (GBI) questionnaire and to an ocular specific questionnaire on 6 symptoms including tearing, ocular discharges, swelling, pain, irritation, and blurred vision. The objective assessments were the surgical success rates and the patency at 6 months after the bicanalicular nasal stent was removed. The patients were divided into those with a pre-saccal obstruction, Group 1, and with a post-saccal obstruction, Group 2. The subjective and objective outcomes were compared between the two groups. Results One hundred twenty-four sides (96.9%) had a successful probing and intubation of the lacrimal passage obstruction by SG-BCI. Of the 124 sides, 110 sides (88.7%) retained the patency after the stent was removed for at least 6 months. The GBI total, general subscale, social support, and physical health scores were + 37.1 ± 29.0, + 41.5 ± 30.0, + 28.0 ± 39.4, and + 24.1 ± 37.7, respectively, postoperatively. All of the 6 ocular specific symptom scores improved significantly postoperatively. The postoperative score of tearing improved in Group 1 (P < 0.0001), while the postoperative scores of all symptoms improved significantly in Group 2. Conclusions The relatively high surgical success rates and positive GBI scores, and improved ocular symptom scores indicate that SG-BCI is a good minimally invasive method to treat lacrimal passage obstructions.

Viscocanalostomy with Mitomycin-C: A Preliminary Study

2005 ◽  
Vol 15 (2) ◽  
pp. 202-208 ◽  
Author(s):  
A. Yarangümeli ◽  
ö. Gürbüz Köz ◽  
M.N. Alp ◽  
A.H. Elhan ◽  
G. Kural
Keyword(s):  
Mitomycin C ◽  
Long Term Results ◽  
Success Rates ◽  
Surgical Success ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Conjunctival Bleb ◽  
Group 1

Purpose To compare the results of viscocanalostomy with and without mitomycin-C (MMC). Methods Retrospective results of 15 standard viscocanalostomy (VCO) operations (Group 1) were compared with the prospective results of 15 VCO operations performed with intraoperative adjunctive MMC (Group 2). MMC (0.2 mg/mL) was applied over and under the superficial scleral flap for 3 minutes in Group 2 before the deep flap was prepared. Each patient was followed up for at least 1 year, and results of examinations in the first 12 months were used in the statistical comparison of the two groups. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg. Results Pr eoperative mean intraocular pressures (IOP) in Group 1 and Group 2 wer e 35.3±11.0 and 39.1±8.9, respectively. Mean IOP levels at the 12th month were 14.4±2.6 and 11.9±4.0, respectively, showing a significant decrease in both groups (p<0.001). Postoperative IOP course appeared to be lower in the MMC group, however, the difference was not statistically significant (p=0.554). Complete success rates without medications were 40% in Group 1 and 67% in Group 2. No significant difference was found between the two groups in terms of early and late postoperative complications, pre- and postoperative number of antiglaucoma medications, and surgical success rates at the end of the study period (p>0.05 for all). A significant difference was verified between the two groups of eyes considering the conjunctival bleb types, as low-lying, localized blebs were the most frequent type in Group 1 and thin-walled, avascular blebs were more predominant in the MMC group (p=0.004). Conclusions Intraoperative adjunctive MMC use might improve the long-term results of viscocanalostomy by facilitating subconjunctival filtration and might widen the indication range of the technique.

Surgical treatment of consecutive exotropia: Comparison of different surgical methods applied to one eye in one session

2021 ◽  
pp. 112067212110342
Author(s):  
Nazife Sefi-Yurdakul ◽  
Sibel Oto ◽  
Aysel Pelit
Keyword(s):  
Surgical Treatment ◽  
Success Rates ◽  
Single Session ◽  
Surgical Success ◽  
Group 4 ◽  
Additional Surgery ◽  
Surgical Methods ◽  
Consecutive Exotropia ◽  
Group 2 ◽  
Group 1

Purpose: To compare the different surgical methods performed on a single eye in a single session and the factors that affect the success of patients having consecutive exotropia (XT) developed after esotropia surgery. Methods: The medical data of the patients who underwent surgery for consecutive XT were reviewed retrospectively. Patients with followed of 6 months or more were divided into four groups; patients with medial rectus (MR) advancement (Group 1 = 10), MR advancement and MR resection (Group 2 = 12), MR advancement and lateral rectus (LR) recession (Group 3 = 13), MR advancement, MR resection, and LR recession (Group 4 = 14). Success results and possible risk factors were investigated. Results: Forty-nine patients with consecutive XT (21 female, 28 male) were enrolled in the study. The mean age of overall patients was 22.97 years at surgery for consecutive XT. The groups did not display significant differences in terms of surgery ages, gender, refraction values, visual acuity, amblyopia, inferior oblique overaction, limitation of adduction, surgical success rates, and follow-up time ( p > 0.05). Patients of Group 4 had larger preoperative and postoperative deviation, while Group 1 had smaller ( p < 0.05). The surgical success rates of Groups 1, 2, 3, 4 were 90%, 75%, 76.9%, and 50%, respectively ( p = 0.192). Statistically, no factor was found to be effective in surgical success rates ( p > 0.05). Conclusion: Surgical treatment of consecutive XT is successful in most of the patients with numerous surgical options performed on a single eye in a single session. Patients, particularly with a high amount of deviation should be warned about the possibility of additional surgery.

scholarly journals Risk factors of extended-spectrum beta-lactamaseproducing Enterobacteriaceae bacteremia in Thai emergency department: a retrospective case-control study

2011 ◽  
Vol 5 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Khrongwong Musikatavorn ◽  
Chatgaew Chumpengpan ◽  
Chaita Sujinpram
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Enteric Bacteria ◽  
Control Group ◽  
Retrospective Case ◽  
Extended Spectrum ◽  
First Choice ◽  
Group 2 ◽  
Control Study ◽  
Group 1

Abstract Background: Infections caused by resistant extended-spectrum beta-lactamase (ESBL)-producing enteric bacteria and their risk factors are globally recognized. However, such risk factors have not been explored in emergency department (ED) where the first choice of empirical antimicrobials is crucial. Objective: Determine risk factors of ESBL bacteremia in ED, especially in our geographic area. Methods: A retrospective case-double-control study was conducted at King Chulalongkorn Memorial Hospital. All adult ED patients with ESBL-producing E. coli and K. pneumoniae in blood cultures between October 2007 and October 2008 were recruited for this study. The potential risk factors were analyzed and compared with non- ESBL-producing bacteremic patients (control group 1) and matched general ED patients (control group 2). Nonbeta- lactam susceptibility testing among the cohort was also evaluated. Results: Thirty ESBL (cases), 103 group 1 controls, and 100 group 2 controls were assessed. Based on the univariate analysis, age, chronic kidney diseases, malignancy, poor functional status, previous hospitalization within 90 days, and previous antimicrobial exposure especially to cephalosporins, quinolones, and carbapenems within 30 days were the risk factors for ESBL bacteremia compared with both types of control patients. Age > 60 and previous cephalosporin use were consistently identified as the risk factors by multivariate models using both control groups. The susceptibility to non-beta-lactam agents in the ESBL group was significantly lower than the non-ESBL. No carbapenem resistance was found. Conclusion: Elderly ED patients, especially those who had previous cephalosporin exposure within 30 days, were at higher risk of ESBL-producing bacteremic infections. ESBLs tended to have less susceptibility to the non-β-lactam agents.

Does a 3D laparoscopic approach improve surgical outcome of mininvasive right colectomy? A retrospective case–control study

2020 ◽  
Vol 72 (2) ◽  
pp. 445-451 ◽  
Author(s):  
Umberto Bracale ◽  
Giovanni Merola ◽  
Antonia Rizzuto ◽  
Emanuele Pontecorvi ◽  
Vania Silvestri ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Case Control Study ◽  
Laparoscopic Approach ◽  
Case Control ◽  
Right Colectomy ◽  
Retrospective Case ◽  
Control Study

scholarly journals The effects of previous open renal stone surgery types on PNL outcomes

2016 ◽  
Vol 10 (7-8) ◽  
pp. 246 ◽  
Author(s):  
Faruk Ozgor ◽  
Onur Kucuktopcu ◽  
Burak Ucpinar ◽  
Omer Sarilar ◽  
Akif Erbin ◽  
...  
Keyword(s):  
Renal Stone ◽  
Complication Rates ◽  
Success Rates ◽  
Anesthetic Agents ◽  
History Of ◽  
Renal Stone Surgery ◽  
Retrospective Nature ◽  
Group 2 ◽  
Free Status ◽  
Group 1

<p><strong>Introduction:</strong> Our aim was to demonstrate the effect of insicion of renal parenchyma during open renal stone surgery (ORSS) on percutaneous nephrolithotomy (PNL) outcomes.</p><p><strong>Methods:</strong> Patients with history of ORSS who underwent PNL operation between June 2005 and June 2015 were analyzed retrospectively. Patients were divided into two groups according to their type of previous ORSS. Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study.</p><p><strong>Results:</strong> 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%).</p><p><strong>Conclusions:</strong> Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure.</p>

scholarly journals The Results of Trabeculectomy with Antimetabolites in Elderly Patients: A Retrospective Study

Acta Medica ◽  
2021 ◽  
pp. 1-5
Author(s):  
Özlem Dikmetaş ◽  
Sepideh Lotfisadigh, ◽  
Merve Kaşıkçı ◽  
Ali Bülent Çankaya ◽  
Sibel Kocabeyoğlu
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Mitomycin C ◽  
Open Angle Glaucoma ◽  
Success Rates ◽  
Topical Medication ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective: To examine the effectiveness and results of primary trabeculectomy with 5-fluorouracil (group 1) or mitomycin-C (group 2) in elderly patients. Materials and Methods: This was a retrospective study including 67 eyes with primary open-angle glaucoma that underwent primary trabeculectomy with group 1 or group 2. Patients who were followed up for less than 1 year or were under 55 years of age were excluded from the study. Surgical success was evaluated according to a decrease in cup/disk ratio and reduction of intraocular pressure without any topical medication. Results: The mean ages of participants were 65.7 years (range 59–88) and 65.9 years (range 59–74) in groups 1 and 2, respectively. The mean preoperative and postoperative intraocular pressure values were 31.3 ± 5.7 mmHg (range 17–46) and 14.8 ± 0.4 mmHg (range 10–21) in group 1 (p < 0.001) and 31.5 ± 7.4 mmHg (range 18–52) and 14.8 ± 2.9 mmHg (range 10–21) in group 2 (p < 0.001). Conclusion: The use of 5-fluorouracil or mitomycin-C during primary trabeculectomy is associated with high postoperative success rates. There were no significant differences between 5-fluorouracil and mitomycin-C in terms of intraocular pressure reduction.

scholarly journals Unilateral Versus Bilateral Frontalis Suspension Sling Surgery for Correction of Severe Unilateral Congenital Ptosis.

2020 ◽  
Vol 9 (1) ◽  
pp. OT05-OT08
Author(s):  
Jyoti Dhaka ◽  
Ashok Kumar Grover
Keyword(s):  
Comparative Study ◽  
Surgical Outcome ◽  
Fascia Lata ◽  
P Value ◽  
Congenital Ptosis ◽  
Sling Surgery ◽  
Frontalis Suspension ◽  
Cosmetic Outcomes ◽  
Group 2 ◽  
Group 1

Background: To compare the surgical outcome of unilateral silicone sling with bilateral fascia latafrontalis suspension surgery for severe unilateral congenital ptosis.Subjects and Methods:This prospective, interventional and comparative study examined 30 patients of severe unilateral congenital ptosis. 30 patients were divided in to 2 groups, group 1 included 15 patients who underwent unilateral silicone sling frontalis suspension surgery and group 2 included 15 patients who underwent contralateral levator excision with bilateral fascia latafrontalis sling surgery.Results:Mean improvement in MRD1 after surgery in group 1 who underwent unilateral silicone sling surgery was 3.9+1.18 mm and in group 2 who underwent bilateral fascia lata it was 4.9+0.89 mm (p value 0.0001). Excellent results (difference of lid height <1 mm) were seen in 93.3% patients who underwent bilateral fascia latafrontalis sling while in 73.3% patients of unilateral silicone sling. All patients who underwent bilateral fascia lata showed excellent lid crease (symmetric without obliteration) and 80% of the patients who underwent unilateral silicone sling surgery (p value 0.032).Conclusion: Functional and cosmetic outcomes regarding MRD1, symmetry of lid height, lid crease were noted better in group 2 patients who underwent contralateral levator excision with bilateral fascia latafrontalis suspension surgery as compared to group 1 patients who underwent unilateral silicone sling surgery.

scholarly journals Sensor driven-position adaptive versus conventional spinal cord stimulation in failed back surgery syndrome: a retrospective case series

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mert Akbas ◽  
Haitham Hamdy Salem ◽  
Tamer Hussien Emara ◽  
Bora Dinc ◽  
Bilge Karsli
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Case Series ◽  
Failed Back Surgery Syndrome ◽  
Retrospective Case ◽  
Treatment Groups ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Group 2 ◽  
Group 1

Abstract Background Failed back surgery syndrome (FBSS) is a common problem affecting 20–40% of cases undergoing spine surgeries. Spinal cord stimulation (SCS) has been shown to be an efficient and relatively safe treatment in managing many intractable chronic pain syndromes. Objectives This study compares the efficacy and safety of MR-compatible sensor driven-position adaptive SCS and conventional SCS in treating FBSS. Methods This is a retrospective case series of 120 consecutive FBSS patients who underwent SCS between February 2011 and March 2018. Pain levels, analgesic/opioid use, and sleep problems were assessed before and 3 months after the procedure in patients who received either conventional SCS (group 1; n = 62) or sensor-driven position adaptive SCS (group 2; n = 34). The degree of patient satisfaction, the change in the activities of daily living (ADLs) together with the rate of complications were compared in both treatment groups. Results The two treatment groups were homogenous at baseline. Patients in both groups improved significantly regarding pain, opioid consumption, sleep, and ADLs. The magnitude of improvement was statistically higher in group 2. An absolute reduction of 6 points on the VAS in patients who received position adaptive SCS vs a 3.3 point reduction in conventional SCS cases (p < 0.0001). Half of the patients in group 2 (n = 17) showed excellent satisfaction after the procedure versus 14.5% of cases in group 1 (n = 9). Conclusion SCS is an efficient and reliable treatment in FBSS. MR-compatible sensor driven-position adaptive SCS can be a more effective treatment in this patient group.

scholarly journals Ab Interno vs. Ab Externo Microcatheter-Assisted Circumferential Trabeculotomy in Treating Patients With Primary Open-Angle Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Weijia Zhang ◽  
Yiwei Wang ◽  
Chen Xin ◽  
Yang Sun ◽  
Kai Cao ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Success Rates ◽  
Criterion A ◽  
The Mean ◽  
Group 2 ◽  
Ab Interno ◽  
Group 1

Background: Circumferential trabeculotomy have evolved from ab externo to ab interno approach. Both procedures may lower IOP, but it is unclear which maybe a superior approach.Purpose: To compare the outcomes of ab interno and ab externo circumferential trabeculotomy in patients with primary open-angle glaucoma.Design: Retrospective, comparative case series.Participants: Primary open angle glaucoma patients undergoing ab interno (40 patients in Group 1) or ab externo (54 patients in Group 2) circumferential trabeculotomy, with about one half of them having prior incisional glaucoma surgery.Methods: Outcomes including intraocular pressure (IOP), glaucoma medications and surgical complications were analyzed.Main Outcome Measures: IOP, medications and surgical success defined as an IOP of ≤ 21 mmHg and a reduction of IOP ≥20% from baseline (criterion A) or IOP ≤ 18 mmHg and a reduction of IOP 20% from baseline (criterion B) with (qualified success) or without (complete success) medications.Results: At 1 year, IOP decreased by 37.1% (26.0–14.8 mmHg) in Group 1 and 39.5% (28.5–15.1 mmHg) in Group 2. Medications decreased from 3.5 in Group 1 and 3.6 in Group 2 pre-operatively to 0.6 ± 1.0 and 0.3 ± 0.6 post-operatively, respectively. Success rates did not differ significantly between groups based on criterion A (complete and qualified success: 68.7 and 81.9% in Group 1, and 75.3 and 90.4% in Group 2, respectively) or criterion B (complete and qualified success: 58.2 and 79.3%in Group 1, and 69.5 and 88.4% in Group 2, respectively). For eyes with prior filtration surgeries, the mean percent reduction of IOP (41.7 ± 32.7% in Group 1, 39.7 ± 27.8% in Group 2, P = 0.724) and the mean medication reduction (2.9 ± 1.6 in Group 1, 3.4 ± 1.0 in Group 2, P = 0.454) were not significantly different.Conclusions: Ab interno circumferential trabeculotomy achieved comparable outcomes to ab externo trabeculotomy and may be an effective surgical option for patients with primary open-angle glaucoma.

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