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Biomedical subjects

Stuart R Seiff

Publications and source records attributed to Stuart R Seiff.

At least 19 recordsLinked to original sources
PubMed2006

Bacterial endophthalmitis after resident-performed cataract surgery.

PURPOSE: To determine if there is an increased rate of postoperative bacterial endophthalmitis after resident-performed cataract extraction relative to the reported rates of experienced surgeons. DESIGN: Retrospective, observational case series. METHODS: The operative reports of the resident-performed cataract surgeries at San Francisco General Hospital between 1983 and 2002 were reviewed. Cases of culture-positive bacterial endophthalmitis and vitreous loss were identified. RESULTS: Between 1983 and 2002, three cases (0.11%) of culture-positive bacterial endophthalmitis occurred after 2718 resident-performed cataract extractions. The overall vitreous loss rate was 6.7%. Two endophthalmitis cases were acute (Staphylococcus epidermidis, Streptococcus viridans), presenting within five days of surgeries complicated by vitreous loss, and one case was delayed-onset (Corynebacterium species) after Nd:YAG posterior capsulotomy after uncomplicated cataract extraction. CONCLUSIONS: Despite higher rates of vitreous loss, the rate of endophthalmitis following resident-performed cataract surgery remains comparable with the rates of more experienced surgeons.

Cataract Extraction↗
PubMed2006

Supportive care of facial nerve palsy with temporary external eyelid weights.

BACKGROUND: Patients with facial nerve palsy can have many ocular complications. Lagophthalmos, or poor eyelid closure, and loss of blink secondary to lack of nerve supply to the orbicularis oculi, can lead to exposure keratopathy, corneal breakdown, ulcers, and even perforation. Management of patients should be directed toward the severity of ocular findings and ranges from supportive care to surgical reanimation and soft tissue repositioning. Patients with facial nerve palsy who present at earlier stages can benefit from conservative treatment. Use of temporary external eyelid weights can help restore a functional blink mechanism and prevent corneal decompensation. CASE REPORT: A 29-year-old patient with lagophthalmos secondary to left facial nerve palsy after surgical excision of an acoustic neuroma was treated with a temporary external eyelid weight. CONCLUSION: Temporary external eyelid weights are part of the armamentarium in the supportive care of patients with lagophthalmos and exposure keratopathy secondary to facial nerve palsy. They are most useful in patients who have temporary paralysis or as a bridge until further surgery can be performed.

Adult↗
PubMed2004

Orbital, middle cranial fossa, and pterygopalatine fossa yolk sac tumor in an infant.

A yolk sac tumor, also known as an endodermal sinus tumor, was diagnosed in a 15-month-old infant who presented with rapidly progressive right eye proptosis. Imaging of the orbits and brain revealed a mass in the right orbit, middle cranial fossa, and pterygopalatine fossa. A lateral orbitotomy was performed to take a biopsy specimen and to partially debulk the tumor secondary to signs of optic nerve compromise. The biopsy specimen revealed a yolk sac tumor, and the patient underwent systemic chemotherapeutic treatment. Because orbital endodermal sinus tumors have been infrequently reported, there are no firm prognostic or treatment guidelines. Our case demonstrates that early recognition, limited orbital debulking, and chemotherapy can have an excellent short-term outcome.

Antineoplastic Agents↗
PubMed2003

Infection after blepharoplasty with and without carbon dioxide laser resurfacing.

PURPOSE: To determine the rate of infection in patients who underwent blepharoplasty with and without carbon dioxide laser resurfacing. DESIGN: A retrospective, nonrandomized, consecutive case series. PARTICIPANTS: Eighteen hundred sixty-one patients who underwent upper or lower blepharoplasty, with or without carbon dioxide laser resurfacing. METHODS: Charts of patients who underwent blepharoplasty, with or without laser resurfacing, were analyzed for the presence of postoperative infection, method of treatment, and possible sequelae. MAIN OUTCOME MEASURES: The rate of infection (%) was determined for each group of patients. RESULTS: Infection occurred in 0.2% of patients who underwent blepharoplasty without laser resurfacing and 0.4% of patients who had adjunctive laser resurfacing. No permanent functional or cosmetic sequelae resulted from the episodes of infection. CONCLUSIONS: Infection after blepharoplasty without laser resurfacing is uncommon, indicating that topical antibiotic ointment prophylaxis is a sufficient postoperative regimen. The use of adjunctive laser resurfacing may increase the infection rate slightly.

Blepharoplasty↗
PubMed2003

Surgical quality assurance in the Ischemic Optic Neuropathy Decompression Trial (IONDT).

The purpose of this article is to report the methods and results of the surgical quality assurance program associated with the Ischemic Optic Neuropathy Decompression Trial (IONDT). A surgical quality assurance committee developed and implemented a quality assurance program for a randomized clinical trial requiring surgical intervention. A surgical technique questionnaire was administered at two times during the study course, and maintenance of surgeon certification required submission and approval of a masked videotape of an optic nerve sheath decompression surgery by each study surgeon. Surgical quality was assessed through completion of surgical report forms and standardized, masked review of operative notes. Rates of compliance and intra- and interreviewer agreement were assessed for each aspect of the program. Twenty-five of 32 surgeons (81%) successfully completed and maintained certification. Item agreement varied from 21-92% among reviewers of satisfactory videotapes and 22-89% on unsatisfactory videotapes. Intrarater agreement for videotape acceptability was 11 of 13 (85%), and for specific surgical steps, 147 of 182 (81%). Operative notes were submitted for 123 of 125 (98%) patients receiving surgery. Interrater agreement on individual items ranged from 73-100%. Classification of individual items was identical on first and second review for 1285 of 1344 (95.6%) items. Overall agreement for individual reviewers was 93.8-97.8%. We conclude that use of a small peer review committee, which developed and oversaw a quality assurance program, allowed for consistent certification and monitoring of surgical performance. This in turn increased the credibility of the IONDT results, which demonstrated no difference in outcome between operated and unoperated groups of patients.

Certification↗
PubMed2002

Bacillary angiomatosis of the anterior orbit, eyelid, and conjunctiva.

PURPOSE: To report a case of bacillary angiomatosis of the lower eyelid, conjunctiva, and anterior orbit. DESIGN: Interventional case report. METHODS: A 76-year-old immunocompromised male patient developed a firm vascularized nodule in his left lower eyelid and anterior orbit. RESULTS: An excisional biopsy was performed. Histopathologic examination revealed an abnormal vascular proliferation and a mixed inflammatory infiltrate. A Warthin-Starry stain showed numerous bacilli. These findings are characteristic of bacillary angiomatosis. A serologic specimen was positive for antibodies to Bartonella Quintana. CONCLUSION: The lower lid and anterior orbit are rare locations for bacillary angiomatosis. Our case brings to attention the increasing importance of Bartonella infection as a causative agent of ophthalmic diseases.

Aged↗
PubMed2002

The fat pearl graft in ophthalmic plastic surgery: everyone wants to be a donor!

Autogenous fat pearl grafting offers a solution to several difficult problems in ophthalmic plastic surgery. These include lower eyelid contour and tear trough deformities, depressed scars, and upper eyelid crease asymmetries and hollow superior sulci. The grafting technique is easily learned and patient satisfaction is high.

Adipose Tissue↗
PubMed2002

Amniotic membrane graft in the surgical management of cryptophthalmos.

PURPOSE: To describe a case of cryptophthalmos in which an amniotic membrane graft was used in reconstruction of the upper eyelid and fornix. METHODS: The surgical history of a patient with partial cryptophthalmos is presented. RESULTS: Successful creation of a superior fornix in a case of partial cryptophthalmos was achieved only after an amniotic membrane graft was used. CONCLUSIONS: Amniotic membrane is a useful resource for fornix reconstruction in cryptophthalmos.

Amnion↗
PubMed2002

Dermatochalasis.

Explore the source record for details and available documents.

Cutis Laxa↗
PubMedDate not supplied

Longitudinal correlation of thyroid-stimulating immunoglobulin with clinical activity of disease in thyroid-associated orbitopathy.

PURPOSE: To investigate the possible correlation between the changes in inflammatory active phase of thyroid-associated orbitopathy (TAO) with measured changes in thyroid-stimulating immunoglobulin (TSI) levels over time. This study was undertaken to evaluate the potential usefulness of measured TSI values in following and treating patients with TAO. METHODS: A retrospective chart analysis was performed on 23 patients who had been referred to a tertiary care oculoplastics service between July of 2002 and April of 2004 with suspected TAO. The activity status of patients with TAO was graded by using the TAO activity scale (TAOS), created to distinguish between the active and cicatricial phases of TAO. Laboratory values of TSI reported during the course of the study period were compiled for each study patient. RESULTS: Linear regression analysis revealed a statistical correlation between the changes in activity of TAO, as measured by the TAOS score, and changes in measured values of TSI over time. A statistically significant correlation was also found between the activity of TAO (measured by the TAOS score) and TSI value. CONCLUSIONS: It was found that changes in inflammatory phase of TAO, as measured by the TAOS score, statistically correlate with changes in measured TSI. An additional correlation was also found between the absolute score of TAO activity and measured level of TSI. These findings suggest that serial TSI measurements may be an adjunct in assessing clinical inflammatory activity of TAO and may help direct clinical decision making regarding treatment decisions in TAO.

Adult↗
PubMedDate not supplied

Adverse reactions to permanent eyeliner tattoo.

PURPOSE: To report the potential for serious adverse reactions associated with permanent eyeliner tattoos. METHODS: An observational case series was conducted on 4 patients who presented with inflammatory eyelid reactions after receiving permanent eyeliner tattoo. RESULTS: Clinically, the tattoo-associated lesions were typically firm, raised masses underlying the areas of pigmentation. Histopathologic analysis of tissue from all 4 patients demonstrated a granulomatous inflammatory response with negative cultures for any organisms. Treatment approaches varied between a combination of topical steroid creams, local steroid injections, local resection, intramuscular steroid injection, and systemic oral steroids. These treatments were successful in all 4 cases. CONCLUSIONS: An allergic granulomatous reaction is one of the adverse reactions seen after permanent eyeliner tattoo. Treatment can be challenging and may ultimately require excision of tattoo pigment to remove the inciting factor. Systemic steroids may aid in controlling the inflammation associated with reaction to the tattoo pigment.

Adult↗