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Biomedical subjects

Bijan Beigi

Publications and source records attributed to Bijan Beigi.

12 recordsLinked to original sources
PubMed2005

Acquired external punctal stenosis: surgical management and long-term follow-up.

PURPOSE: To introduce and assess the results of a long-term follow-up of a one-snip punctoplasty with monocanalicular stent (Mini Monoka) for acquired external punctal stenosis (AEPS) with and without associated internal punctal and canalicular stenosis. DESIGN: Prospective non-comparative interventional case series. METHODS: Thirty-five eligible patients (53 eyes) with AEPS underwent a horizontal one-snip punctoplasty and Mini Monoka tube insertion by or under supervision of a consultant Oculoplastic surgeon from June 1999 to May 2002. Diagnostic probing and irrigation were performed before operation and after operation at the last follow-up. Patients with canalicular obstruction, nasolacrimal duct stenosis and obstruction, and those with less than 6 months' follow-up were excluded. The Chi-square (X(2)), Fisher's exact, Pearson correlation, and multiple logistic regression analysis tests, with 95% confidence interval when appropriate, were used for statistical analysis. RESULTS: The age range was 39 to 90 years (mean: 67.2, SD: 11.8, SE: 2). Twenty-seven patients (77.1%) were female. There was a normal canalicular system in 21 (39.6%), lower canalicular stenosis in 10 (18.8%), and internal punctal stenosis in 22 (41.5%) eyes. Postoperative follow-up was from 6 to 41 months (mean: 18.5, SD: 9.2, SE: 1.2). There was a 77.4% complete functional success, 7.5% partial functional success, and 96.2% anatomical success at the last follow-up. The success rate was not significantly different between the eyes with and without preoperative internal punctal and canalicular stenosis (p = 0.4). The lower success rate was significantly correlated with a final abnormal probing and irrigation (p < 0.01). CONCLUSION: The use of a monocanalicular Mini Monoka stent together with a one-snip punctoplasty is helpful to prevent the recurrence of punctal stenosis in the healing phase and addresses the associated internal punctal and canalicular stenosis.

Adult↗
PubMed2005

Monocanalicular versus bicanalicular silicone intubation for nasolacrimal duct stenosis in adults.

PURPOSE: To compare the success rate of monocanalicular versus bicanalicular silicone intubation of incomplete nasolacrimal duct obstruction (nasolacrimal duct stenosis) in adults. METHODS: In a retrospective, nonrandomized comparative case series, 48 eyes of 44 adult patients with nasolacrimal duct stenosis underwent endoscopic probing and either bicanalicular (BCI; n=22 eyes) or monocanalicular (MCI; n=26 eyes) nasolacrimal duct intubation under general anesthesia. "Complete success" was defined as complete disappearance of the symptoms, "partial success" as improvement with some residual symptoms, and "failure" as absence of improvement or worsening of symptoms at last follow-up. The last follow-up examination included diagnostic probing and irrigation if there was not complete success. RESULTS: Patient ages ranged from 31 to 90 years (mean, 69; SD, 11.5). Forty-five tubes were removed 6 to 17 weeks (mean, 9.1; SD, 3) after surgery. Premature tube dislocation and removal occurred in one eye with BCI and in two eyes with MCI. Follow-up ranged from 6 to 52 months (mean, 14.9; SD, 8.4). The complete success rate was nearly the same in eyes with MCI (16/26, 61.53%) and BCI (13/22, 59.09%). Partial success (MCI: 8/26, 30.76%; BCI: 1/22, 4.54%) and failure (MCI: 2/26, 7.69%; BCI: 8/22, 36.36%) were, however, significantly different (p=0.010). Complications included 3 slit puncta with BCI and 4 temporary superficial punctuate keratopathy after MCI. CONCLUSIONS: MCI had virtually the same complete success rate as BCI, a higher partial success rate than BCI, and a lower failure rate than BCI in treatment of nasolacrimal duct stenosis in adults.

Adult↗
PubMed2004

Retained anterior chamber cilium causing endophthalmitis after phacoemulsification.

An 81-year-old white man had uneventful cataract surgery by an experienced surgeon. Three days postoperatively, he presented with endophthalmitis and was treated in accordance with the standard departmental protocol. During the recovery, a curvilinear foreign body was identified and subsequently removed from the interior anterior chamber. Histological examination confirmed the foreign body as an eyelash. The patient improved to a final corrected visual acuity of 6/9. The relevant literature is reviewed, and ways to prevent this potentially blinding but avoidable complication of intraocular surgery are presented.

Aged↗
PubMed2003

Acquired external punctal stenosis: etiology and associated findings.

UNLABELLED: PURPOSE; To investigate the underlying causes of acquired external punctal stenosis (AEPS) and assess the associated tear drainage problems. DESIGN: Prospective, noncomparative observational case series. METHODS: Seventy-eight eyes of 52 patients with symptomatic AEPS were prospectively assessed by or under supervision of a consultant oculoplastic surgeon from June 1999 to October 2002. The severity of the stenosis was graded on clinical examination. Associated findings from ophthalmic examination, diagnostic probing, and irrigation were recorded. The chi(2) test with 95% confidence interval (CI) and the Fisher exact test were used for statistical analysis. RESULTS: The age range was 39 to 90 years (mean, 69.4 years). Acquired external punctal stenosis was due to chronic blepharitis in 35 eyes (45%), unknown etiology in 21 eyes (27%), ectropion in 18 eyes (23%), and related to drugs in 4 eyes (5%). Associated canalicular stenosis and common canalicular stenosis with obstruction (at the level of the internal punctum) was found in 36 eyes (46%) with AEPS. Nasolacrimal duct stenosis (5 eyes) or obstruction (2 eyes) was found in 8.5%. The number of patients with associated canalicular and common canalicular stenosis increased with increasing age (95% Confidence Interval [CI] = 0.03-0.04, P =.03) and duration of symptoms (95% CI = 0.02-0.03, P =.02). The number of patients with associated nasolacrimal duct stenosis and obstruction increased with increasing age (95% CI = 0.000- 0.001, P =.001) and in AEPS with unknown etiology (95% CI = 0.004-0.006, P =.003). CONCLUSIONS: Chronic blepharitis is a common cause of AEPS even after treating the blepharitis, but in a significant number of patients there is no apparent etiology. Associated upper and lower tear drainage stenosis should be considered in the preoperative evaluation and surgical plan for AEPS.

Adult↗
PubMed2003

Hertel exophthalmometry: reliability and interobserver variation.

PURPOSE: To quantify and analyze the interobserver variation in Hertel exophthalmomety and to evaluate the impact of experience on it. METHODS: In a population-based epidemiologic study, Hertel exophthalmometry was performed on 1063 randomly selected normal subjects (stratified sampling) by an oculoplastic attending surgeon (A) and a third-year ophthalmology resident (R). Both observers were masked to the reading of the other. The Chi-square test, two-tailed paired sample t-test, and two-tailed paired independent t-test were used to analyze the data (SPSS Release 9.0, Chicago). RESULTS: There were 463 (43.5%) females and 600 (56.5%) males. The age ranged from 6 to 70 years (mean +/- SD = 20.3 +/- 10.9). The mean right eye protrusion was 14.8 mm for both 'A' and 'R'. The mean left eye protrusion was 14.6 mm and 14.7 mm, respectively. There was good correlation (r = 0.80) and no statistically significant difference (0.1 < P < 0.6) for the ocular protrusion values (right, left, and average) measured by 'A' and 'R'. However, the percentage agreement (within +/-1 mm limits of acceptance) was about 60%. Comparison of the first 530 subjects versus the remaining cases showed no improvement in agreement with the senior observer. CONCLUSION: Hertel exophthalmometry is a reliable method for measuring the ocular protrusion. However, as with most clinical measures, there is a negligible interobserver variation that seems to be unavoidable.

Adolescent↗
PubMed2003

Factors affecting the success of external dacryocystorhinostomy.

PURPOSE: To assess the success rate of external dacryocystorhinostomy (Ext-DCR) and factors affecting it in a university hospital. MATERIALS AND METHODS: In a retrospective interventional non-comparative case series, records of 276 Ext-DCRs in 274 patients in a 9-year period were reviewed. 'Complete success' was defined as patent system on irrigation (objective) and absence of symptoms (subjective). Patent system on irrigation with minimal postoperative symptoms was considered as partial success. The chi-square and Fisher's exact tests with 95% confidence interval (CI) were used to analyze the data (SPSS release version 9.0, Chicago). RESULTS: The age range was 3-84 years (mean: 41.5, SD: 17.7). The majority of the patients (66.7%) were female. The most common presumed etiology was primary acquired nasolacrimal duct obstruction (PANLDO) (227/276, 82.2%). A silicone tube was inserted in 111 patients (40.2%). Follow-up was from 6 to 89 months (mean: 11.5, SD: 10.4). Overall complete success rate was 89.1% (246/276). It was 92% (209/227) in PANLDO, 72.7% (16/22) in congenital NLDO (P: 0.01, 95% CI: 0.024-0.030), 71.4% (10/14) in traumatic NLDO (P: 0.001, 95% CI: 0.012-0.017), 90% (9/10) in previous failed DCR (P: 0.6, 95% CI: 1), and two out of three patients with previous nasal/sinus surgery. Gender, type of presenting symptoms, duration of preoperative symptoms, silicone tube insertion in PANLDO, and associated canalicular stenosis did not have a significant effect on the success. CONCLUSION: Ext-DCR is an effective and highly successful procedure for the treatment of NLDO regardless of the etiology.

Adolescent↗
PubMed2002

Effect of Honan balloon compression on peribulbar anesthesia adequacy in cataract surgery.

PURPOSE: To ascertain whether a Honan balloon is necessary to produce effective peribulbar anesthesia in routine cataract surgery by evaluating its effect on intraocular pressure (IOP), surgeon assessment of the anesthesia's effectiveness, and patients' analgesic experience. SETTING: West of England Eye Unit, Royal Devon and Exeter Hospital, England. METHOD: Fifty eyes of 50 patients having routine phacoemulsification cataract extraction and intraocular lens implantation were randomized to have 10-minute ocular compression with the Honan balloon or no compression after peribulbar anesthesia. A single investigator gave all the peribulbar injections using a standard technique. The IOP was measured immediately before and 10 minutes after the injections. Two surgeons who were blinded to the randomization process performed the surgeries and completed an assessment questionnaire on various aspects of the peribulbar block. The patients also scored their level of analgesia during surgery. RESULTS: In the 26 patients who had Honan balloon compression, there was a significant reduction in IOP (mean 6.2 mm Hg; P <.05). In the 24 patients with no balloon compression, there were no significant changes in IOP 10 minutes after the peribulbar injections. There was no statistically significant difference in the surgeons' scores in any aspect of the peribulbar anesthesia (P >.05). All patients experienced a good level of analgesia. CONCLUSIONS: There was a significant reduction in IOP after Honan balloon ocular compression. However, there was no significant increase in IOP without balloon compression. The use of a Honan balloon did not appear to make a significant difference in the effectiveness of the peribulbar anesthesia to the surgeons or patients.

Aged↗
PubMed2001

Orbicularis oculi muscle stripping and tarsal fixation for recurrent entropion.

This prospective study highlights the result of a new technique for correction of recurrent lower lid entropion. The technique was designed to address the aetiological factors involved based on the pre- and per-operative findings. MATERIAL AND METHODS. 37 eyelids of 31 consecutive patients with recurrent entropion were enrolled. Under local anaesthesia, a horizontal incision was made at the lower border of the tarsus, involving the total width of the lower eyelid. Anterior lamellar (skin and orbicularis oculi muscle - OOM) inferior to the incision was dissected towards the orbital rim. An ellipse of the excess overriding OOM and overlying skin inferior to the incision was excised. The OOM was fixed to the lower border of the tarsus with three to four 6/0 Vicryl subcutaneous sutures. Skin was repaired with 6/0 silk sutures, which were removed five days post-operatively. Five cases underwent horizontal lid shortening and 15 had preaponeurosis fat sculpting in addition. RESULTS. 37 procedures were performed on 31 patients (23 M & 8 F). The mean age was 76.5 yrs. (range 63-90). The patients had had one to four (mean = 1.7) previous surgeries. All patients had OOM override. Fifteen had significant preaponeurosis fat prolapse. Lower lid laxity was not identified in all cases, in some due to previous lid surgery. There was no evidence of lower lid retractor laxity in the majority of cases. After a mean follow-up time of 18 months (5-36) there were three recurrences. One underwent further tarsal fixation and the other two had horizontal lid shortening with a favourable outcome. CONCLUSIONS. Excision of overriding OOM and tarsal fixation for recurrent entropion is simple and effective. Its success is due to direct tackling of the aetiological factors.

Journal Article↗
PubMed2001

Rosai-Dorfman syndrome affecting the lacrimal gland.

This is a case report of Rosai-Dorfman syndrome in a 36-year-old Caucasian male, involving the lacrimal gland, cervical lymph nodes, nasal and sinusal mucosa. It was successfully treated with appropriate immunosuppression. He had initially presented to the ENT surgeon with nasal and sinusal mucosal thickening and bleeding. Cervical lymph node biopsy produced a histological diagnosis compatible with Rosai-Dorfman disease. Later he developed an acute red proptotic eye. He had severe proptosis due to an enlarged lacrimal gland. He refused surgical excision of the tumour, which is suggested if there is an ocular adnexal involvement. Conservative treatment with systemic steroid resulted in the resolution of lacrimal gland swelling, nasal sinusal mucosal thickening and cervical lymphadenopathy. Previous studies have shown that patients with Rosai-Dorfman syndrome are often black males1 and require surgery.

Journal Article↗
PubMedDate not supplied

Management of a broken needle during the frontalis suspension procedure.

A 19-month-old girl with bilateral congenital ptosis and abnormal head posture underwent a bilateral frontalis sling procedure. As the needle was directed through the submyocutaneous tunnel, its tip (eye) snapped. When the needle was withdrawn, the tip was missing. The problem was addressed and the procedure was completed.

Blepharoptosis↗
PubMedDate not supplied

Late reexposure after upper eyelid tarsoconjunctival flap for exposed porous orbital implant.

The records of four patients with exposed porous orbital implant treated with the upper eyelid tarsoconjunctival Hughes flap were reviewed. The tarsoconjunctival Hughes flap was fashioned for two patients with recurrent orbital porous implant exposure and two patients with primary orbital porous implant exposure (5 to 6 mm at largest dimension; mean, 5.6 mm). There were two hydroxyapatite and two high-density polyethylene implants. In all patients, reexposure (2 to 3 mm at largest dimension; mean, 2.5 mm) occurred 6 to 24 weeks (mean, 13 weeks) after the tarsoconjunctival Hughes flap procedure at the junction of the flap and the socket surface conjunctiva. Mean follow-up duration was 18.7 months (range, 7 to 27 months). Linear late reexposure is the main drawback of the upper eyelid tarsoconjunctival Hughes flap to cover an exposed orbital porous implant.

Adult↗