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Biomedical subjects

Shu-Lang Liao

Publications and source records attributed to Shu-Lang Liao.

11 recordsLinked to original sources
PubMed2006

Prevention of exposure of porous orbital implants following enucleation.

PURPOSE: To investigate effectiveness of adding a scleral patch graft on a Vicryl mesh-wrapped porous orbital implant to prevent exposure following enucleation. DESIGN: A retrospective, comparative, nonrandomized study. METHODS: From October 1996 to February 2006, 74 consecutive patients (74 sockets) who received porous orbital implants primarily or secondarily after enucleation at National Taiwan University Hospital (72 cases) and at Far Eastern Memorial Hospital (2 cases) were collected. Patient demographics, ocular diagnosis, the surgical technique, prior ophthalmic surgery, type, covering, and size of the implant, follow-up periods, and complications associated with pegs and implants were recorded. Group 1 patients received a Vicryl mesh-wrapped implant without a scleral patch graft. Group 2 patients received anterior capping with a scleral patch on the Vicryl mesh-wrapped implant. RESULTS: Of 74 identified cases, 12 were excluded for insufficient follow-up. The 62 remaining cases had more than a two-year follow-up. There were two implant exposures (12%, two of 17) in group 1. Retroauricular myoperiosteal graft and scleral patch were used to repair exposed implants successfully. No exposure was noted in group 2 (n = 45). A significant between-group difference in exposure rate was found (P = .02). Early conjunctival dehiscence followed by spontaneous healing occurred in three group 2 patients. CONCLUSIONS: Scleral patch graft and Vicryl mesh can act as duplicate barriers between anterior surface of implants and overlying soft tissue. The modified wrapping technique prevents porous implants from exposure effectively.

Adolescent↗
PubMed2006

Transforniceal lateral deep bone decompression--a modified technique to prevent postoperative diplopia in patients with disfiguring exophthalmos due to dysthyroid orbitopathy.

BACKGROUND/PURPOSE: Postoperative diplopia remains a significant complication of orbital decompression in dysthyroid orbitopathy. This study evaluated the results of orbital decompression treatment using a transforniceal approach to sculpt the lateral orbital deep bone area. METHODS: The two areas of bone in the deep lateral orbit (the basin of the inferior orbital fissure and the sphenoid door jamb) were exposed using a transforniceal swinging eyelid approach. An electric drill was used to sculpt these deep bone areas of the lateral orbit, and approximately 1 mL intraconal fat was removed simultaneously. Between October 1999 and March 2003, transforniceal lateral deep bone decompression was performed in 35 consecutive patients (62 orbits) with disfiguring dysthyroid orbitopathy. Data on proptosis reduction effect, new-onset diplopia and other complications of lateral wall decompression were analyzed. RESULTS: The average preoperative Hertel value was 21.2 +/- 1.3 mm (range, 18-23 mm) and decreased to 17.4 +/- 1.2 mm (range, 15-19.5 mm) postoperatively. The mean decrease in proptosis 3 months postoperatively was 3.8 +/- 0.91 mm (range, 1.5-4.6 mm). New-onset downgaze diplopia occurred in two (5.7%) of the 35 patients. Persistent trigeminal paresthesia was noted in one patient (2.8%). No cerebrospinal fluid leak, globe injury or vision deterioration was noted during 9.5 +/- 1.7 months of follow-up. The cosmetic appearance was improved in all patients after surgery. CONCLUSION: Transforniceal lateral deep bone decompression produces less new-onset, persistent diplopia than traditional inferomedial wall decompression, and provides good cosmesis by using a hidden small incisional wound. This approach appears to be a safe and effective procedure for patients with disfiguring exophthalmos, especially for Asian patients without crease fold.

Adult↗
PubMed2006

Intraosseous hemangiomas of the facial bone.

BACKGROUND: Hemangiomas arising in the soft tissue are common in the head and neck region, but intraosseous hemangiomas of the facial bone are rare. METHODS: The authors conducted a retrospective study investigating the clinical features, management, and outcomes for seven patients with facial bone hemangiomas. RESULTS: Three of the hemangiomas arose in the orbital bones, two arose in the mandible, one arose in the frontal bone, and one arose in the zygoma. The mean follow-up was 3 years 9 months. During the first operation, total tumor resection was performed for two symptomatic patients, and partial resection with superficial osteotomy was performed for the remaining five individuals with facial contour deformity. Three patients who underwent partial resection achieved long-term aesthetically satisfactory results without recurrence; the other two developed recurrent tumors and underwent subsequent en bloc resection. No evidence of recurrence was observed in cases where primary or secondary complete tumor resections were performed. CONCLUSIONS: Although complete tumor resection represents a definitive treatment for facial bone hemangiomas, conservative partial resection offers a simple method of restoring facial contour with minimal side effects. Although it appears that recurrence cannot be avoided entirely, partial resection should be considered for patients who seek surgery for cosmetic reasons.

Adolescent↗
PubMed2005

Molecular pathology of Muller's muscle in Graves' ophthalmopathy.

CONTEXT: Upper lid retraction is a common sign in Graves' ophthalmopathy (GO). Whether Müller's muscle is involved in upper lid retraction has not been fully elucidated. OBJECTIVE: The objective of the study was to understand the molecular pathology of Müller's muscle in GO. DESIGN/SETTING/PARTICIPANTS: A method for measurement of histological changes was developed and used to correlate severity and expression of cell-specific genes in GO. MAIN OUTCOME MEASURES: Histological changes, clinical severity of upper lid retraction, and mRNA expression in Müller's muscle in GO were measured. RESULTS: The degree of fibrosis correlates with severity of upper lid retraction. Macrophage infiltration was increased in fibrotic areas, consistent with higher levels of macrophage-colony stimulating factor mRNA. Levels of peroxisome proliferator-activated receptor-gamma mRNA were up-regulated and correlated with fat infiltration. Decreased muscle mass correlated with lower myocardin mRNA expression. The expression of c-kit levels was decreased in diseased muscles, consistent with diminished mast cell numbers. CONCLUSION: The pathological changes of Müller's muscle correlate with clinical severity of upper lid retraction in GO. Patterns of gene expression appear to correlate with the histopathological changes in this disease process.

Adult↗
PubMed2005

Primary orbital leiomyosarcoma.

An 84-year-old woman presented with a right upper eyelid nodule, first noted 1 month earlier. Incisional biopsy revealed leiomyosarcoma, which was subsequently treated with wide excision and adjunctive radiotherapy. There has been no evidence of tumor recurrence in 3 years of follow-up.

Aged, 80 and over↗
PubMed2004

Lanreotide treatment in a patient with interferon-associated Graves' ophthalmopathy.

BACKGROUND: We report a case of Graves' ophthalmopathy (GO) developed after the administration of interferon-alpha for chronic hepatitis C. METHODS: The GO was treated with lanreotide. RESULTS: A 47-year-old female patient presented with euthyroid GO with spontaneous retrobulbar pain, eyelid edema, conjunctival injection and eyelid retraction of the right eye and conjunctival injection of the left eye 6 months after administration of interferon-alpha for chronic hepatitis C. Orbital computed tomography revealed no involvement of extraorbital muscles and no increase in retrobulbar adipose tissue. Only soft tissue was involved. These symptoms subsided after 12 weeks of lanreotide treatment, except right eyelid retraction, which, however, disappeared later during follow-up. CONCLUSION: The use of interferon-alpha may be complicated by GO and lanreotide might be considered for GO if patients cannot accept steroid therapy.

Antiviral Agents↗
PubMed2002

Ultrasound biomicroscopic findings in rabbit eyes undergoing scleral suction during lamellar refractive surgery.

PURPOSE: To evaluate changes of the central anterior chamber depth, cilio-angular cross-sectional surface area, and intraocular pressure in rabbit eyes undergoing application of the scleral suction ring during lamellar refractive surgery. METHODS: Thirty eyes of 30 rabbits were used in the study. The eyes were assigned to one of the following five surgical groups: group 1, no application of the suction ring; group 2, suction for 2 minutes; group 3, suction for 1 minute; group 4, suction for 20 seconds; and group 5, suction for 10 seconds. Ultrasound biomicroscopy (UBM) was performed to determine tomographic features, including central anterior chamber depth, cross-sectional surface area of the ciliary body, and chamber angle structure before and 10 minutes, 1 hour, 2 hours, 1 day, 2 days, 1 week, and 2 weeks after surgery. Intraocular pressure was also measured at each of these time points. RESULTS: Swelling of the ciliary body occurred in groups 2 to 5 of eyes from 10 minutes up to 1 day after the operation, and its severity was positively related to the duration of suction. Shallowness of the chamber angle was positively related to swelling. All UBM-detectable changes became insignificant compared with baseline values at 2 days after the operation. No significant change was found in the central anterior chamber depth and intraocular pressure during the 2-week postoperative observation period. CONCLUSIONS: Transient change in the ciliary body and the chamber angle occurred frequently after application of the scleral suction ring during lamellar refractive surgery in rabbit eyes. Its severity was positively related to the duration of suction. Swelling of the ciliary body corresponded with the shallowness of the chamber angle without alteration of the corneal-lenticular distance and intraocular pressure.

Animals↗
PubMedDate not supplied

Clinical manifestations and management of orbital mucoceles: the role of ophthalmologists.

PURPOSE: To report the clinical features of orbital mucoceles and discuss the role of ophthalmologists in the management of patients with orbital mucoceles. METHODS: A retrospective chart review was performed of all patients with orbital mucoceles treated at the National Taiwan University Hospital from 1990 through 2002. The basic profiles, clinical features, and the management of the patients with orbital mucoceles were recorded and analyzed. RESULTS: The records of a total of 15 patients (aged 22 to 76, mean 45.5 years) with orbital mucoceles were selected for this study. The initial presentations included proptosis in ten patients (66.7%), diplopia in five (33.3%), ocular movement limitation in four (26.7%), periorbital pain in four (26.7%), palpable mass lesion in four (26.7%), ptosis in three (20.0%), decreased visual acuity in three (20.0%), headache in two (13.3%), and pupil abnormality with relative afferent papillary defect in one (6.67%). Of the 15 patients, the origins of the orbital mucocele were in the frontoethmoidal sinus in six (40.0%), the ethmoidal sinus in three (20.0%), the frontal sinus in three (20.0%), the maxillary sinus in one (6.7%), and the sphenoidal sinus in two (13.3%). The transcaruncular approach for the management of orbital mucoceles was performed in eight cases, the Lynch approach in three cases, the transforniceal approach in two cases, and functional endoscopic sinus surgery in one case. After surgery, no recurrence was noted. CONCLUSIONS: The frontoethmoidal sinus was the commonest origin of an orbital mucocele, and proptosis was the most frequent sign in patients with an orbital mucocele. All cases showed a favorable response to surgical intervention, and the transcaruncular approach may offer a good surgical option for the management of orbital mucoceles, especially for ophthalmologists.

Adult↗