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At least 1,207 records · Page 67Linked to original sources
PubMed1989

Punctal occlusion and topical medications for glaucoma.

We studied the effects of punctal occlusion on the intraocular pressures of patients treated with topical medications for glaucoma. Silicone punctal plugs were used to occlude the inferior punctum of one eye in each of 19 patients treated with identical antiglaucoma eyedrops in both eyes. The intraocular pressures before and after punctal occlusion were compared. The eyes with the punctal plugs showed a statistically significant (P less than .0001) decrease in pressure of 1.32 mm Hg after punctal occlusion when compared to that of the fellow control unplugged eyes. The intraocular pressures in the plugged eyes decreased an average of 1.82 mm Hg after punctal occlusion when compared to before punctal occlusion (P = .001). The intraocular pressure in the unplugged control eyes did not change significantly after punctal occlusion of the fellow treated eye.

Administration, Topical↗
PubMed2004

The length of unsutured mucosal margins in external dacryocystorhinostomy.

PURPOSE: To compare the extent of mucosal margins remaining unsutured at the end of external dacryocystorhinostomy (DCR) using single or double flap techniques and to evaluate the influence on outcome. DESIGN: Prospective, consecutive case series. METHODS: The number and length of mucosal margins remaining unsutured at the end of external DCR were evaluated in 64 patients. Mucosal anastomosis was performed using either a conservative (group 1) or extended (group 2) double flap, or a single flap (group 3) dissection. Patients were selected for group 1 if the regional anatomy permitted the desired dissection. All other patients were randomized to group 2 or 3. The mean length of unsutured mucosal margins was calculated for each group. Subjects were followed up to 12 months, with final success rate recorded. RESULTS: In groups 1, 2, and 3 respectively: 11, 24 and 29 patients were recruited; four, 12, and 10 mucosal margins remained unsutured; and the mean length of unsutured mucosal margins was 16.36 mm (SD = 2.8), 70.66 mm (SD = 9.3), and 62.00 mm (SD = 6.0). The mean length of unsutured mucosal margins was significantly different, although groups 1 and 2 collectively did not have a significantly different mean length of unsutured mucosal margin from group 3. Mean follow-up was 11 months (SD = 2.2), 63 patients (98.43%) had a successful outcome with no significant difference among groups (P = .429). CONCLUSION: Different patterns of mucosal dissection in external DCR create a different number and extent of unsutured mucosal margins which do not appear to adversely affect the success rate of external DCR.

Dacryocystorhinostomy↗
PubMed2005

Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction.

PURPOSE: To investigate the accuracy of the preoperative evaluation in identifying a membranous obstruction of the distal canaliculus and the success rate of an external dacryocystorhinostomy (DCR) when membranectomy of the canalicular obstruction is also performed. DESIGN: Retrospective, interventional case series. METHODS: The surgical records of the lacrimal cases operated at Moorfields Eye Hospital between January 1997 and December 1999 were reviewed. All the patients with evidence of a membranous block of the canalicular opening into the sac identified and excised during the course of a standard DCR procedure with silastic intubation and a minimum follow-up period of 12 months were selected for this study. The records were analyzed for preoperative evaluation with syringing and probing, surgical details, outcome, and complications. RESULTS: In 59 (85%) cases a functional anastomosis was established after tube removal. Additionally, 5 cases (7%) had patent system but required later ectropion repair and considered successful. Only 4 (6%) patients needed further lacrimal surgery, and one was referred to the ENT department for nasal polyps. The silastic tube was removed at a mean period of 6 weeks (SD = 4; range, 2-24 weeks), and the mean follow-up period was 13 months (SD = 3; range, 12-29 months). The preoperative evaluation failed to identify the membranous obstruction in 30 (43%) cases, which were correctly diagnosed intraoperatively. CONCLUSIONS: In our series the anatomic success rate of 92% after DCR with membranectomy is comparable to the outcome of the DCR procedure. The distal canalicular membranous obstruction is an anatomic factor that may lead to surgical failure if not identified and excised.

Aged↗
PubMed2005

Evaluation of the cosmetic significance of external dacryocystorhinostomy scars.

PURPOSE: To evaluate the significance of the surgical scar of external dacryocystorhinostomy (DCR) as assessed by the patients. DESIGN: Cross-sectional questionnaire-based study. METHODS: Two hundred ninety-seven external DCRs were performed in 263 patients at the private practices of consultants who were attached to the Sydney Eye Hospital. Structured questionnaires were sent to patients, and the responses were evaluated. Patients were asked to assess the visibility of the scar and the significance of the scar to them on a scale of 1 (least) to 5 (greatest). RESULTS: The average age of patients was 67.9 +/- 16 years, (72% female, 28% male). Ninety-six percent of the patients were caucasians of Australian/West European descent. Sixty-one of 296 scars (20.6%) were felt to be visible by patients; 31 scars (10.5%) were rated >1 on a scale of 1 to 5 and 12 scars (4%) were rated >2. The average age of patients was highest for those patients with invisible scars, and the lowest average age was for those with scars that were rated >1. A significantly higher proportion of female patients complained of marked scarring (>1 on a scale of 1 to 5). A significantly higher proportion of patients who complained of discomfort during suture removal also complained of marked scarring. CONCLUSION: In view of the low percentage of patients who complained of marked scarring, scarring should not be the main ground for deciding the approach to DCR surgery, particularly in older patients. These results are valid for the population that was studied and may be different for different racial backgrounds.

Adolescent↗
PubMedDate not supplied

Primary lymphoma of nasolacrimal drainage system: a case report and literature review.

Primary lymphoma of the lacrimal drainage system (LDS) is an extremely rare condition. All of those previously reported have been of B-cell origin, with the exception of 1 case report of a natural killer/T-cell lymphoma in a Japanese woman. We report a 41-year-old Chinese woman who had a primary diffuse large B-cell non-Hodgkin lymphoma of left LDS. After 8 cycles of CHOP (cyclophosphamide [Cytoxan], doxorubicin hydrochloride [Adriamycin], vincristine, and prednisone) therapy and further 14 months' follow-up, the patient's conditions were stable without evidence of recurrence. After reviewing associated articles, an interesting finding which, to the best of our knowledge, has never been described before is that all the expired or recurrent cases of primary lymphoma of lacrimal drainage system are of women, including the only 1 case of natural killer/T-cell lymphoma. In our opinion, sex should be considered 1 of the prognostic factors in primary lymphoma of LDS. The relationship between this tumor and hormone response is to be determined.

Adult↗
PubMedDate not supplied

Endoscopic dacryocystorhinostomy in patients taking aspirin perioperatively.

PURPOSE: The aim of this study is to report the results of endoscopic dacryocystorhinotomy (EDCR) in patients who did not interrupt their low-dose (75-150 mg daily) aspirin regimen for the procedure. MATERIALS AND METHODS: A case note review was made of all 40 patients taking aspirin who had EDCR at Ipswich Hospital from May 1998 to October 2003. Age, gender, indications for surgery, complications, and outcome were analyzed and the bleeding rate compared to that in patients who were not on aspirin or warfarin who had an EDCR. RESULTS: Of the 51 EDCRs performed in the 40 patients, 47 had complete relief of epiphora. Two of the patients with a persistent watering eye are to have revision surgery, 1 patient was observed (75% improvement), and 1 patient has since died. A total of 33 patients had no postoperative complications; 5 had epistaxis but only 1 of these required a nasal pack; 1 each had minor periorbital bruising, confusion, and facial pain, none of which delayed discharge. None required readmission. Of 257 EDCRs in patients not on aspirin or warfarin, 1.3% had epistaxis resulting in delayed discharged or readmission. CONCLUSIONS: EDCR is a safe and efficacious treatment in patients with distal nasolacrimal obstruction in patients taking aspirin and does not require stopping the aspirin perioperatively.

Aged↗
PubMedDate not supplied

Endoscopic dacryocystorhinostomy in warfarinized patients.

PURPOSE: To report the results of endoscopic dacryocystorhinotomy (EDCR) in anticoagulated patients who did not interrupt their anticoagulant regimen for the procedure. MATERIALS AND METHODS: A case note review was made of all 9 patients taking warfarin who had EDCR at Ipswich Hospital from May 1998 to October 2003. Age, gender, indications for surgery, complications, and outcome were analyzed, and the results were compared to EDCRs in nonwarfarinized patients. RESULTS: Of the 9 patients, 7 had complete relief of epiphora. Two patients had a persistent watering eye. One of them had blockage of upper, lower, and common canaliculi, and the other was found to have adhesions between the lateral nasal wall and middle turbinate. A total of 6 patients had no postoperative complications; 2 had minor periorbital bruising that did not delay discharge, and only 1 patient had ooze through a Kaltostat nasal pack and was kept in the hospital for 2 days. None required readmission. CONCLUSIONS: EDCR is a safe and efficacious treatment in patients with distal nasolacrimal obstruction in anticoagulated patients and does not require stopping the warfarin perioperatively.

Aged↗
PubMed2004

A simple model for practicing surgery on the nasolacrimal drainage system.

Practicing surgical techniques on models prior to operating on patients can be helpful in developing skills needed to perform surgery proficiently. A simple, inexpensive, and readily available model for instruction and practice of surgical maneuvers on the nasolacrimal drainage system is described.

Child↗