631 results on '"Conjunctival Diseases surgery"'
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2. Resolving conjunctival prolapse following severe blepharoptosis correction: A simple sutureless direct excision technique and systematic review.
- Author
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Lee CC, Lai YW, Huang SH, Lin IW, Wang PH, Su WJ, Lee SS, and Lai CS
- Subjects
- Humans, Prolapse, Postoperative Complications surgery, Postoperative Complications etiology, Conjunctiva surgery, Blepharoptosis surgery, Blepharoptosis etiology, Blepharoplasty methods, Sutureless Surgical Procedures methods, Conjunctival Diseases surgery, Conjunctival Diseases etiology
- Abstract
Background: Conjunctival prolapse (CP) is an uncommon but challenging condition following maximal levator resection (MLR) and other extensive periorbital procedures. MLR extending beyond the Whitnall's ligament is frequently performed to address severe blepharoptosis with poor levator function (LF). Patients with CP may encounter symptoms such as ocular discomfort, tearing, vision impairment, persistent conjunctival chemosis, lagophthalmos, or exposure keratopathy. Typically, surgical intervention becomes necessary if conservative measures prove to be ineffective; nevertheless, there is no consensus regarding the optimal treatment approach., Objectives: This study aimed to propose a simple sutureless direct excision method and explore the surgical advancements in CP correction through a systematic review., Methods: Patients with recurrent CP after MLR who underwent sutureless direct excision of the conjunctiva using loupe magnifiers at a tertiary hospital were included in this study. The clinical evolution and surgical results were recorded. PubMed, MEDLINE, EMBASE, and Web of Science databases were queried following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol., Results: The comprehensive analysis of 1858 articles identified 88 patients from 24 studies, highlighting that blepharoptosis surgery is predominantly associated with CP (36.6%). Surgically treated CP showed a higher resolution rate compared to those managed conservatively (54.8% vs. 45.2%; p = 0.034). No relapse was observed in patients treated with sutureless direct excision of CP in long-term follow-up., Conclusion: We proposed a simple sutureless direct excision technique that offers a straightforward and efficient approach in treating CP, which is particularly suitable for cases requiring excision lengths >16 mm during MLR. Furthermore, stitch removal can be obviated after surgery., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
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- 2024
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3. Clinical outcomes of conjunctivochalasis treatment with a new ophthalmic radiofrequency device.
- Author
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Kim B, Lee Y, Son HS, and Choi CY
- Subjects
- Humans, Female, Male, Retrospective Studies, Middle Aged, Aged, Treatment Outcome, Adult, Aged, 80 and over, Conjunctiva surgery, Follow-Up Studies, Conjunctival Diseases surgery
- Abstract
Purpose: To investigate the safety and efficacy of a new micro-controlled radiofrequency device for treatment of conjunctivochalasis (Cch)., Methods: Data of 127 patients (230 eyes) who underwent ophthalmic radiofrequency treatment for Cch from January 2020 to June 2023 were analyzed retrospectively. Cch coagulation was performed with a radiofrequency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio-wave electric unit (0.6 ~ 0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Pre- and postoperative Cch grading, slit-lamp photography, tear film break-up time (TBUT), and bulbar conjunctival hyperemia using Keratograph 5 M (Oculus, Wetzlar, Germany) were evaluated. Cch grade 0 or 1 after surgery was regarded as 'success'. Complications, recurrence, and additional treatment rates were analyzed., Results: In 227 (98.7%) eyes, the radiofrequency treatment led to marked improvement of Cch, with 224 (97.4%) eyes achieving grade 0 or 1 at 2 months postoperatively. Eight eyes (3.5%) received additional treatment. TBUT improved from 3.17 ± 0.82 s to 5.28 ± 1.10 s after surgery (P < 0.001). The total bulbar conjunctival hyperemia value showed an improvement from 1.7 ± 0.6 to 1.4 ± 0.6 postoperatively (P < 0.05). No serious complications were observed., Conclusion: The novel ophthalmic radiofrequency device led to a marked improvement of Cch with no serious adverse events during the entire follow-up period. Our results suggest that the radiofrequency device presents a safe and efficacious treatment option for Cch., (© 2024. The Author(s).)
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- 2024
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4. Comparison of 2 Different Treatments for Conjunctivochalasis: Plasma-Based Conjunctivoplasty Versus Argon Laser Photocoagulation.
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Ucar F and Unluzeybek M
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Treatment Outcome, Retrospective Studies, Adult, Ophthalmologic Surgical Procedures methods, Conjunctival Diseases surgery, Conjunctiva surgery, Laser Coagulation methods
- Abstract
Purpose: The aim of this study was to compare the clinical outcomes of plasma-based conjunctivoplasty and argon laser photocoagulation techniques used in the treatment of conjunctivochalasis., Methods: The study included 119 eyes from 67 patients who underwent plasma-based conjunctivoplasty or argon laser photocoagulation for conjunctivochalasis in our clinic between February 2021 and March 2022. Group 1 included 62 eyes from 35 patients who had plasma-based conjunctivoplasty. Group 2 included 57 eyes from 32 patients who had argon laser photocoagulation. Main outcomes were patient symptoms, the degree of conjunctivochalasis, fluorescein staining score, tear breakup time, the amount of conjunctival shrinkage, and complications., Results: Before surgery, Group 1 had grade 1 conjunctivochalasis in 8 eyes (12.9%), grade 2 in 20 eyes (32.2%), and grade 3 in 34 eyes (54.8%). In Group 2, 9 eyes (15.7%) had grade 1, 21 eyes (36.8%) had grade 2, and 27 eyes (47.3%) had grade 3 conjunctivochalasis ( P = 0.43). At the sixth postoperative month, only 2 eyes (3.2%) in Group 1 had grade 1 conjunctivochalasis, whereas the other cases (96.7%) had no conjunctivochalasis. However, Group 2 had grade 1 conjunctivochalasis in 16 eyes (28.0%), grade 2 in 21 eyes (36.8%), and grade 3 in 2 eyes (3.5%). Conjunctival shrinkage in Group 1 (5.1 ± 1.2 mm) was significantly higher than in Group 2 (3.3 ± 0.9 mm; P < 0.001). Postoperative tear breakup time in Group 1 (10.2 ± 2.1 seconds) was significantly longer than in Group 2 (8.8 ± 2.0 seconds; P < 0.001)., Conclusions: Plasma-based conjunctivoplasty demonstrated greater clinical improvement and efficacy than argon laser photocoagulation for the treatment of conjunctivochalasis., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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5. The current alternative for ocular surface and anophthalmic socket reconstruction, cryopreserved umbilical amniotic membrane (cUAM).
- Author
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Topcu H, Serefoglu Cabuk K, Cetin Efe A, Ulas MG, Poslu Karademir F, Kandemir Besek N, Aydin Arslan R, and Ahmet S
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- Humans, Male, Female, Adult, Middle Aged, Entropion surgery, Entropion etiology, Aged, Conjunctiva transplantation, Conjunctiva surgery, Sclera surgery, Sclera transplantation, Contracture surgery, Contracture etiology, Eye, Artificial, Conjunctival Diseases surgery, Conjunctival Diseases etiology, Amnion transplantation, Cryopreservation methods, Plastic Surgery Procedures methods, Anophthalmos surgery
- Abstract
Purpose: This report presents the results of using cryopreserved umbilical amniotic membrane (cUAM) as an alternative mucosal graft for ocular surface reconstruction in cases of anophthalmic socket contracture (ASC), cicatricial entropion (CE), and conjunctival-scleral defects., Methods: The study included patients who underwent non-commercial implantation of cUAM grafts (prepared by corneal banking methods) for ASC, CE, conjunctival defect, and scleral melting. The main success criteria for this study were the comfortable fitting of the ocular prosthesis in ASC patients, the natural eyelid position in CE patients, and the degree of conjunctivalisation in melting patients., Results: cUAM transplantation was performed in 2 patients who could not use a prosthetic eye due to conjunctival contracture, 2 patients with CE, and 1 patient with conjunctival defect and 1 patient with conjunctival-scleral melting. The primary outcome was achieved in 83.3% (5/6) of patients. In one patient with CE, partial healing was achieved due to the persistence of CE in the medial upper eyelid., Conclusions: cUAM is a viable alternative to mucosal grafting for reconstructing the bulbar and palpebral conjunctival surface, fornix, and orbit, with reduced donor morbidity and shorter surgical time. Its regenerative ability allows for tissue defect healing and improves cosmetic appearance through epithelialization within weeks., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2024
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6. Modified conjunctival sac plasty and personalized eye model implantation in the treatment of patients with conjunctival sac stenosis and sunken eye socket.
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Meng J, Niu J, Zhang N, Hao Y, Gao T, and Wei M
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- Humans, Constriction, Pathologic etiology, Constriction, Pathologic surgery, Male, Female, Conjunctiva, Middle Aged, Conjunctival Diseases etiology, Conjunctival Diseases surgery
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- 2024
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7. Multiple conjunctival autografts from the contralateral eye for management of recurrent symblepharon in eyes with unilateral chemical burn.
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Ganguly S, Sharma S, Singh C, and Shanbhag SS
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- Humans, Male, Adult, Female, Transplantation, Autologous, Conjunctival Diseases surgery, Limbus Corneae surgery, Recurrence, Burns, Chemical surgery, Eye Burns surgery, Eye Burns chemically induced, Conjunctiva transplantation, Autografts
- Abstract
We present two cases which underwent complex ocular surface reconstruction to achieve a stable ocular surface. Conjunctival autograft (CAG) procedure was required more than once, in addition to simple limbal epithelial transplantation to address extensive symblepharon in the eyes with total unilateral limbal stem cell deficiency secondary to acid ocular burns. These cases demonstrate that multiple CAGs may be harvested from the contralateral unaffected eye to correct recurrent symblepharon without any donor site complications if the correct surgical technique is adopted., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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8. Epibulbar simple cartilaginous choristoma associated with unique pigmented multicystic component.
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Yu J, Eagle RC Jr, and Syed ZA
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- Humans, Female, Aged, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Cartilage pathology, Cysts diagnosis, Cysts surgery, Conjunctiva pathology, Ophthalmologic Surgical Procedures, Pigment Epithelium of Eye pathology, Choristoma diagnosis, Choristoma pathology, Choristoma surgery
- Abstract
Purpose: To report an atypical presentation of an epibulbar simple cartilaginous choristoma with a unique pigmented multicystic component., Case Description: A 69-year-old African American female presented for evaluation of a right nasal epibulbar lesion that had progressed over the prior year. Slit-lamp evaluation revealed an immobile, mildly pigmented multicystic lesion measuring 6.0 × 4.5 mm that involved the nasal bulbar conjunctiva and the plica semilunaris. The lesion appeared benign, without feeder vessels or features of epithelial dysplasia. Given its recent growth and the patient's cosmetic concerns, the lesion was excised with ocular surface reconstruction. Histopathological evaluation disclosed a well-circumscribed nodule of well-differentiated cartilage in the substantia propria, consistent with a simple cartilaginous choristoma. The overlying conjunctival stroma contained multiple cysts lined by focally pigment epithelium. The patient recovered well from surgery, with satisfactory cosmetic results., Conclusions: Our case of epibulbar simple cartilaginous choristoma includes a prominent superficial component of pigmented epithelial cysts, which has not been previously reported in the literature. This augments our knowledge on the spectrum of presentations of cartilaginous choristomas and underscores the importance of histopathological evaluation for definitive diagnosis., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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9. Late-Onset Traumatic Corneal Conjunctival Epithelial Disorders due to Granular Formation After Cosmetic Suture Blepharoplasty.
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Morishige N and Kakizaki H
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- Humans, Female, Adult, Middle Aged, Eyelids surgery, Conjunctiva surgery, Cornea surgery, Sutures, Blepharoplasty adverse effects, Blepharoplasty methods, Corneal Diseases etiology, Corneal Diseases surgery, Conjunctival Diseases etiology, Conjunctival Diseases surgery
- Abstract
Purpose: The purpose of this study was to report conjunctival granular formation as one of the causative factors of a traumatic corneal conjunctival epithelial disorder after plastic suture blepharoplasty., Methods: Clinical charts of 7 patients who had visited Ohshima Eye Hospital with a symptomatic corneal epithelial disorder and history of suture blepharoplasty were reviewed. Clinical evidence of conjunctival granular formations was observed in all patients at the tarsal conjunctiva facing to corneal conjunctival traumatic epithelial disorders. The desired outcome was to alleviate the disorder. The assessment included tabulating results after the placement of a soft contact lens bandage and subsequent partial tarsal plate resection of the granular formation., Result: Seven women (mean age 45.0 ± 10.9 years) enrolled in this study had previously undergone suture blepharoplasty (mean 18.3 ± 6.9 years before). Soft contact lens bandages relieved all of the patients' complaints immediately. After resecting the granular formation, the traumatic corneal conjunctival epithelial disorder disappeared, and no recurrence was observed after surgery., Conclusions: The conjunctival granular formation within the tarsal conjunctiva after suture blepharoplasty caused the late-onset traumatic corneal conjunctival epithelial disorder. A complete cure was obtained after resection of the granular formation at the tarsal conjunctiva. To the best of our knowledge, this is the first report to identify the removal of granular formations in 7 patients with late-onset traumatic corneal conjunctival disorders many years after blepharoplasty. The resection of these lesions is a promising procedure to treat late-onset ocular epithelial disorder after suture blepharoplasty., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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10. Alternative Approach for the Treatment of Conjunctivochalasis: Plasma-Based Conjunctivoplasty.
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Ucar F
- Subjects
- Humans, Middle Aged, Aged, Aged, 80 and over, Prospective Studies, Conjunctiva surgery, Tears, Fluoresceins, Conjunctival Diseases surgery, Conjunctival Diseases diagnosis, Lacrimal Apparatus Diseases, Dry Eye Syndromes etiology
- Abstract
Purpose: The aim of this study was to evaluate the efficacy of plasma-based conjunctivoplasty as a new surgical approach for conjunctivochalasis., Methods: This prospective, noncomparative, interventional study included research on 42 eyes of 33 patients who underwent plasma therapy because of conjunctivochalasis between February 2020 and December 2021. Maintaining a 2-mm distance from the limbus, at least 3 lines (approximately 2 mm deep) of plasma therapy were applied to the conjunctiva from the temporal quadrant to the nasal quadrant. Patient symptoms, the fluorescein clearance test, ocular surface integrity with fluorescein staining, the Ocular Surface Disease Index questionnaire, tear breakup time (TBUT), tear meniscus height, and complications were evaluated., Results: The mean patient age at the time of surgery was 67.3 ± 7.2 (range: 54-81) years. After surgery, the grades of conjunctivochalasis decreased in all patients. Although epiphora was present in 28 eyes (66.6%) preoperatively, none of the cases had epiphora during the follow-up period. The Ocular Surface Disease Index score improved significantly from 34.7 ± 10.3 preoperatively to 5.0 ± 4.2 3 months postoperatively ( P <0.001). Although the preoperative TBUT was 5.1 ± 2.2 seconds, the TBUT increased to 10.0 ± 2.3 seconds 3 months postoperatively ( P <0.001). Chemosis developed in only 1 eye (2.3%) and completely regressed with topical steroid treatment in the first postoperative week., Conclusions: Plasma-based conjunctivoplasty is a minimally invasive and simple surgery with less intraoperative and postoperative discomfort, a fast recovery, and can be suggested as an alternative approach to other treatment methods., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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11. Spontaneous resolution of a wooden foreign-body granuloma in the conjunctiva of a child.
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Madan S, Beri S, and Yadav N
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- Humans, Male, Child, Preschool, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Conjunctival Diseases diagnosis, Conjunctiva pathology, Conjunctiva surgery, Wood, Remission, Spontaneous, Granuloma, Foreign-Body diagnosis, Granuloma, Foreign-Body etiology, Granuloma, Foreign-Body surgery, Eye Foreign Bodies surgery, Eye Foreign Bodies diagnosis, Eye Foreign Bodies complications
- Abstract
A conjunctival foreign-body (FB) granuloma may result following trauma with synthetic and non-synthetic materials including organic and non-organic objects. Children usually manifest with FB granulomas that develop due to inoculation of FBs from soft toys, blankets or woollen clothes. Encapsu- lation of these FBs following a granulomatous inflammatory response results in a nodular swelling in the conjunctiva. Reports of a wooden FB granuloma in the conjunctiva in children are anecdotal. A 5-year-old boy suffered an un- witnessed direct ocular trauma to his left eye (OS) with a wooden arrow while playing. He developed redness and nodular swelling at the inferotemporal aspect of the OS without any visual complaints. The diagnosis of a wooden FB granuloma is a challenge to ophthalmologists and may go undetected in children who neglect their symptoms. It characteristically presents as a unilateral conjunctival nodule. Surgical excision is the definitive management. However, spontaneous extrusion of the FB might be observed due to protective blinking and tearing mechanisms in the eye.
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- 2023
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12. Sutureless Amniotic Membrane Transplantation Using Pediatric Nasogastric Tube for Patients With Acute Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.
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Ceylan A, Mergen B, Aydin FO, Avci E, and Yildirim Y
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- Humans, Child, Young Adult, Adult, Middle Aged, Cicatrix, Amnion transplantation, Vision Disorders, Corneal Diseases surgery, Stevens-Johnson Syndrome complications, Stevens-Johnson Syndrome surgery, Trichiasis, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Conjunctival Diseases diagnosis, Eyelid Diseases etiology, Eyelid Diseases surgery, Meibomian Gland Dysfunction
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Purpose: Evaluation of the results of sutureless amniotic membrane transplantation (AMT) using a pediatric nasogastric tube (NGT) for patients with acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) was aimed., Methods: Twenty-six eyes of 13 patients with SJS/TEN with ocular involvement at a single tertiary care hospital between May 2020 and January 2022 were included in the study. An amniotic membrane was implanted to the ocular surface and conjunctival fornix using a modified symblepharon ring (MR) created by inserting NGT end-to-end. Patients were followed for at least 6 months. The mean duration of the surgery was recorded. The presence of corneal epithelial defect and vascularization, meibomian gland dysfunction (MGD) grade, conjunctival scarring, eyelid margin keratinization, symblepharon, and trichiasis were recorded., Results: The mean age of the patients was 38.4±17.6 years. Amniotic membrane transplantation was performed only once for eight patients and twice for five patients. The mean duration of the surgery was 3.2±0.4 min. The modified symblepharon ring was removed 28 days after its application. At the first examination, 20 eyes (76.9%) had a corneal epithelial defect and 6 (23.1%) had early symblepharon. At the postoperative 6 months, although seven eyes (26.9%) had conjunctival scarring and 5 (19.2%) had eyelid margin keratinization, all patients were without any corneal defect, corneal vascularization, or symblepharon. Only 11 eyes (42.3%) showed MGD, and 1 eye (3.8%) showed trichiasis., Conclusions: This study showed that sutureless AMT using pediatric NGT could be a potentially fast and inexpensive treatment option for the treatment of SJS/TEN with ocular involvement at the bedside without the need for general anesthesia., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Contact Lens Association of Ophthalmologists.)
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- 2023
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13. Acute Exacerbation of Conjunctival Papilloma after High-frequency Radio Wave Electrosurgery for Conjunctivochalasis: A Case Report.
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Kim DS, Choi YH, Kim YJ, and Kang MH
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- Humans, Female, Aged, Conjunctiva surgery, Conjunctiva virology, Conjunctival Diseases diagnosis, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Electrosurgery adverse effects, Radio Waves adverse effects, Human Papillomavirus Viruses
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- 2023
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14. Comparison of Efficacy and Inflammatory Response to Thermoconjunctivoplasty Performed with Cautery or Pulsed 1460 nm Laser.
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de Souza RG, Huang D, Prahl S, Nakhleh L, and Pflugfelder SC
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- Animals, Mice, Female, Mice, Inbred C57BL, Conjunctiva pathology, Cautery, Inflammation pathology, Lasers, Conjunctival Diseases diagnosis, Conjunctival Diseases pathology, Conjunctival Diseases surgery
- Abstract
Conjunctivochalasis is a degenerative condition of the conjunctiva that disrupts tear distribution and causes irritation. Thermoreduction of the redundant conjunctiva is required if symptoms are not relieved with medical therapy. Near-infrared laser treatment is a more controlled method to shrink the conjunctiva than thermocautery. This study compared tissue shrinkage, histology, and postoperative inflammation in thermoconjunctivoplasty performed on the mouse conjunctiva using either thermocautery or pulsed 1460 nm near-infrared laser irradiation. Three sets of experiments were performed on female C57BL/6J mice ( n = 72, 26 per treatment group and 20 control) to assess conjunctival shrinkage, wound histology, and inflammation 3 and 10 days after treatment. Both treatments effectively shrunk the conjunctiva, but thermocautery caused greater epithelial damage. Thermocautery caused greater infiltration of neutrophils on day 3 and neutrophils and CD11b
+ myeloid cells on day 10. The thermocautery group had significantly higher conjunctival expression of IL-1β on day 3. Expression of chemokine CCL2 was higher in the conjunctiva on day 3 and tear concentrations were higher on day 7 in the laser group. These results suggest that pulsed laser treatment causes less tissue damage and postoperative inflammation than thermocautery while effectively addressing conjunctivochalasis.- Published
- 2023
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15. The Management of Chemosis after Blepharoplasty.
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Ní Dhubhghaill S and Faris C
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- Humans, Edema etiology, Postoperative Complications therapy, Postoperative Complications surgery, Eyelids surgery, Blepharoplasty adverse effects, Conjunctival Diseases complications, Conjunctival Diseases surgery
- Abstract
Chemosis is a common, though typically temporary complication of both upper and lower blepharoplasty surgery, though it is much more common after the latter. It occurs due to extravasation of fluid into the subconjunctival space precipitated by desiccation, inflammation, and manipulation of the conjunctiva and associated lymphatic drainage. Intraoperatively, minimizing surgical exposure and manipulation as well as maintaining a moist ocular surface can reduce the risks. Postoperatively, we propose a stepwise approach, starting with lubricants and escalating to increasingly potent anti-inflammatories with compression bandaging and surgery reserved for persistent cases., Competing Interests: None declared., (Thieme. All rights reserved.)
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- 2023
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16. Presenting features for developmental cysts of the orbit.
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Wilde C, Vahdani K, Thaung C, and Rose GE
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- Humans, Male, Orbit pathology, Retrospective Studies, Inflammation, Granuloma, Dermoid Cyst diagnosis, Dermoid Cyst surgery, Dermoid Cyst pathology, Orbital Diseases diagnosis, Orbital Diseases surgery, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Eye Neoplasms
- Abstract
Purpose: To evaluate the clinical features of developmental cysts of the orbit., Patients and Methods: Retrospective study of patients who had excision of cysts between 1992 and 2020., Results: Three hundred and 58 patients (189 male; 53%) with orbital developmental cysts were identified, all being unilateral. Age at surgery varied from birth to 77 years (mean 17, median 18 years) and the average symptom duration was 5 years (median 18 months; range 1 day-50 years). The commonest presenting features were a peribulbar lump or upper lid swelling, followed by proptosis, pain, diplopia and reduced vision. Most patients (82%) had a palpable mass, with epidermoids, sebaceous dermoids and keratinised dermoids commonly affecting the superotemporal quadrant, and conjunctiva-containing cysts usually being biased to a medial location. Cysts were lined by keratinised epithelium with dermal structures (224/358; 63%), non-keratinised epithelium with dermal structures (69/358; 19%), epidermis without identifiable dermal structures (19/358 'epidermoids'; 5%), conjunctiva (12/358; 3%), respiratory epithelium (4/358; 1%), or mixed dermal and conjunctival epithelia (30/358 'dermo-conjunctival' cysts; 8%). Overall, two-thirds (242/358; 66%) had histological evidence of chronic intramural inflammation, and a half of cysts showed granuloma formation (178/358 cysts). Chronic inflammation was less common with conjunctival cysts (54%, 7/12 patients) and none showed granuloma formation., Conclusion: Developmental cysts of the orbit vary from the relatively common dermoid cysts to the extremely rare respiratory epithelial-lined cysts. Respiratory cysts, being deeper, may present late in life and cysts containing conjunctival epithelium tend to be less inflamed and typically favour the superonasal quadrant., (© 2022. Crown.)
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- 2023
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17. Treatment outcomes of modified argon laser photocoagulation for conjunctivochalasis.
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Han J, Lee SH, Choi CY, and Shin HJ
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- Humans, Argon, Treatment Outcome, Laser Coagulation methods, Conjunctiva surgery, Conjunctival Diseases surgery
- Abstract
To determine the effectiveness of conjunctivoplasty using a modified argon laser photocoagulation method on patients with conjunctivochalasis (CCh). This study included 25 cases of symptomatic inferior CCh. After staining the surface of a redundant conjunctiva using a dark-purple marker, low-energy argon laser photocoagulation (500 μm spot size for 0.5 seconds at power 300 mW) was applied under topical anesthesia for a mean of 80 times. The patients were aged 67.6 ± 7.1 years (mean ± standard deviation). During a mean follow-up period of 7.8 months (range of 6-12 months), the CCh grades of 21 eyes (84%) decreased after laser conjunctivoplasty. Calculated reduction rates of grades 1, 2, and 3 were 90%, 75%, and 67%, respectively. Patient subjective symptoms were improved in 80% of cases. No postoperative complications such as conjunctival scarring or persistent ocular irritation were observed. Our modified argon laser photocoagulation method employs staining the conjunctival surface to increase the thermal laser energy absorbed by the target. This novel technique is simple and effective for treating mild-to-moderate-grade CCh in outpatient clinics., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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18. Clinical and histopathological features of conjunctival "Teddy bear" granuloma: A case series.
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Lozano-Bustillo A, Ríos Y Valles-Valles D, Hernández-Ayuso I, and Rodríguez-Reyes AA
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- Adrenal Cortex Hormones, Child, Child, Preschool, Cicatrix complications, Communicable Disease Control, Eosine Yellowish-(YS), Female, Formaldehyde, Hematoxylin, Humans, Male, Pandemics, Periodic Acid, COVID-19, Conjunctival Diseases diagnosis, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Conjunctivitis, Granuloma, Foreign-Body diagnosis, Granuloma, Foreign-Body etiology, Granuloma, Foreign-Body surgery
- Abstract
Purpose: To describe the clinical features, histopathological findings, and prognosis of conjunctival Teddy bear granuloma (TBG) diagnosed in a Mexican ophthalmologic referral center in a period of 64 years., Methods: We reviewed clinical and histopathological material from all patients with documented conjunctival TBG. Patient's age, gender, location, clinical signs and symptoms, duration, treatment and, specimen size, were evaluated. Formalin-fixed paraffin embedded 5 microns hematoxylin-eosin stained slides and periodic acid-Schiff special stain as well as examination under polarized light microscopy were performed in all cases., Results: A total of 5 conjunctival TBG were collected. The ages of the patients ranged between 2 and 11 with a mean of 6 years. Female to male ratio was 4:1. The right inferior fornix was involved in 4 cases (80%) with clinical diagnosis of conjunctival mass of unknown etiology. Treatment consisted of surgical removal by slit-lamp biomicroscopy (3 cases) and in the operating room (2 cases). No complications were informed in a short follow-up period. Histopathologically, numerous cross-sections of synthetic and non-synthetic fibers surrounded by multinucleated foreign body giant cells, epithelioid histiocytes, lymphocytes, plasma cells and sparse neutrophils were seen. Polarization light microscopy demonstrated numerous birefringent colorful foreign fibers. The follow-up period of the patients ranged between 1 and 32 weeks with a mean of 10 weeks., Conclusions: Most patients with TBG are children with vague, non-specific symptoms troubling precise clinical diagnosis. Treatment of choice involves surgical excision of the foreign body granuloma followed by topical corticosteroids. All surgical specimens obtained must be sent for histopathological examination. Special awareness is recommended during COVID-19 pandemic lockdown to prevent potential exposure to fibers that may cause conjunctival TBG.
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- 2022
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19. Clinicopathologic analysis of conjunctivochalasis and paste-pinch-cut conjunctivoplasty for management.
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Liu T, Siadati S, Eberhart CG, and Akpek E
- Subjects
- Conjunctiva pathology, Conjunctiva surgery, Fluorescein, Humans, Inflammation, Retrospective Studies, Tears, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Dry Eye Syndromes complications, Dry Eye Syndromes diagnosis, Dry Eye Syndromes surgery
- Abstract
Objective: To correlate the histopathologic results of conjunctival specimens with clinical findings in patients with conjunctivochalasis and report the results of the paste-pinch-cut technique for management., Design: Retrospective chart review., Setting: Single tertiary ophthalmological centre (Ocular Surface Diseases and Dry Eye Clinic, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Md.)., Methods: Twenty-five patients (32 eyes) with clinically significant conjunctivochalasis. All patients were referred for clinically significant dry eye without previous diagnosis of chalasis. Sixteen patients had an underlying inflammatory systemic condition. Intervention or Observation Procedure(s): Patients underwent surgery with paste-pinch-cut technique. Subjective dry eye symptoms and ocular surface staining scores (corneal and conjunctival staining using fluorescein and lissamine green respectively) were assessed at every visit., Main Outcome Measures: Change in patient symptoms and ocular surface staining scores and histopathologic findings in conjunctival specimens., Results: After surgery, significant improvement was achieved in dry-eye symptoms as well as both corneal and conjunctival staining scores in 29 eyes on reduced topical therapy. Only 3 eyes had persisting conjunctival lissamine staining. Light microscopic examination disclosed mild to moderate lymphoplasmocytic inflammation of the conjunctivae with areas of epithelial goblet cell loss, squamous metaplasia, stromal edema, and fibrosis., Conclusion: Conjunctivochalasis appears to be associated with significant inflammation in the setting of dry eye and underlying inflammatory systemic conditions. Although topical anti-inflammatory treatment could be attempted in the initial management, surgical excision should be considered in the absence of clinical response., (Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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20. Conjunctival Lymphangiectasia - case report.
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Cristea AP, Petrescu LT, and Stan C
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- Female, Humans, Young Adult, Adult, Vascular Endothelial Growth Factor A, Lymphangiectasis diagnosis, Lymphangiectasis pathology, Lymphangiectasis surgery, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Lymphatic Vessels pathology, Vascular Diseases, Foreign Bodies pathology
- Abstract
Conjunctival lymphangiectasia is a rare pathology that represents the enlargement of the lymphatic vessels localized in the conjunctiva. Patients may be asymptomatic or experience symptoms such as foreign body sensation, congestion, irritation, dryness, and blurry vision. There are various methods of therapy for patients with severe and symptomatic conjunctival lymphangiectasia. Surgical excision has the lowest rates of recurrence. We present a case of a 24-year-old woman with conjunctival lymphangiectasia and a history of left lower limb enlargement and bilaterally enlarged submandibular and upper jugular lymph nodes without an identifiable cause, who presented to the ophthalmology clinic accusing ocular discomfort, foreign body sensation and transparent conjunctival cystic lesions in the left eye for the last five months. Abbreviations: OD = right eye, OS = left eye, OCT = optical coherence tomography, VEGF = vascular endothelial growth factor., (#x00A9; The Authors.Romanian Society of Ophthalmology.)
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- 2022
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21. Clinical Results of the Use of Amniotic Membrane Transplantation Alone or in Combination with Adjuvant Therapies in Conjunctival Fornix Reconstruction.
- Author
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Aslan Katırcıoğlu Y, Kaderli A, Şingar Özdemir E, and Örnek F
- Subjects
- Adult, Amnion transplantation, Conjunctiva, Female, Humans, Male, Middle Aged, Mitomycin, Retrospective Studies, Conjunctival Diseases surgery, Eyelid Diseases etiology, Eyelid Diseases surgery
- Abstract
Objectives: To evaluate the clinical results of amniotic membrane transplantation alone or in combination with adjuvant therapies in conjunctival fornix reconstruction., Materials and Methods: The clinical results of patients who presented to our clinic between 2002 and 2016 due to conjunctival fornix obliteration and underwent amniotic membrane transplantation alone or in combination with additional treatments were retrospectively analyzed. The Foster and Mondino classifications were used to grade fornix obliteration. In all cases, the area of conjunctival defect formed after symblepharon lysis was covered with amniotic membrane. In advanced fornix obliteration, amniotic membrane transplantation was combined with 0.04% mitomycin-C (MMC), oral mucosal transplantation, fornix formation (anchoring) sutures, symblepharon ring, eyelid surgery, fibrin glue, and limbal autograft. Deep and scarless restoration of the fornix was considered surgical success., Results: Twenty-two men and 5 women with a mean age of 45.54±4.17 years were included in the study. The etiology of fornix obliteration was mechanical trauma in 16 cases, chemical burn in 6 cases, recurrent pterygium in 3 cases, thermal burn in 1 case, and recurrent chalazion surgery in 1 case. Indications for amniotic membrane transplantation were socket insufficiency in 12 cases, cosmetic reasons in 4 cases, keratoplasty preparation in 3 cases, ptosis in 3 cases, entropion in 2 cases, strabismus in 2 cases, and diplopia in 1 case. The mean follow-up period was 45.04±8.4 months. Twenty-four of 27 cases (88.8%) were successful, while 3 (12.2%) failed due to recurrence of symblepharon., Conclusion: Amniotic membrane transplantation is a successful method when used alone in the reconstruction of early-stage conjunctival fornix obliteration and provides safe and effective results in advanced-stage fornix obliteration when performed in combination with topical 0.04% MMC, oral mucosal transplantation, and limbal autograft surgeries.
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- 2022
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22. Palpebral Conjunctival Osseous Choristoma.
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Spadaro JZ, Wang K, and Habib L
- Subjects
- Conjunctiva, Humans, Calcinosis, Choristoma diagnosis, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery
- Abstract
Competing Interests: The authors have no financial or conflicts of interest to disclose.
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- 2022
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23. Large Subconjunctival Mass in a Patient With a History of Multiple Previous Ocular Surgeries.
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Pavlenko D, Birnbaum FA, and Chen TC
- Subjects
- Conjunctiva, Humans, Ophthalmologic Surgical Procedures, Conjunctival Diseases diagnosis, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Ophthalmology
- Published
- 2022
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24. Modified Gundersen Flap Using Inferior Palpebral-Bulbar Conjunctiva.
- Author
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Mekonnen B, Kossler AL, and Lin CC
- Subjects
- Aged, Cicatrix etiology, Cicatrix pathology, Conjunctival Diseases etiology, Conjunctival Diseases pathology, Female, Humans, Postoperative Complications etiology, Postoperative Complications pathology, Cicatrix surgery, Conjunctiva transplantation, Conjunctival Diseases surgery, Ophthalmologic Surgical Procedures methods, Postoperative Complications surgery, Surgical Flaps
- Abstract
Purpose: The purpose of this article was to describe a modification to the traditional Gundersen flap technique that expands eligible eyes to include those with severe conjunctival scarring and to report results from a clinical case., Methods: A 68-year-old woman with a history of herpes simplex keratitis, multiple failed penetrating keratoplasties, lagophthalmos, persistent epithelial defect, and low visual potential in the left eye presented for the evaluation of a Gundersen flap. Severe superior bulbar conjunctival scarring precluded a traditional approach. A modified Gundersen flap technique using a contiguous flap of inferior palpebral-bulbar conjunctiva extending from the inferior tarsal border to the limbus was devised and performed., Results: The modified Gundersen flap technique successfully stabilized the ocular surface, obviating the need for a cosmetically disfiguring permanent tarsorrhaphy or an evisceration., Conclusions: This modified Gundersen flap technique expands the indications to eyes with severe conjunctival scarring and can be offered in eyes with previous trabeculectomies, glaucoma drainage implants, and scleral buckles, which were previously excluded from the globe-preserving option., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2022
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25. The Overlap Syndrome: A Case Report of Chronic Graft-Versus-Host Disease After the Development of a Pseudomembrane.
- Author
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Hayashi S, Shimizu E, Uchino M, Yazu H, Aketa N, Tsubota K, and Ogawa Y
- Subjects
- Acute Disease, Betamethasone therapeutic use, Chronic Disease, Conjunctival Diseases surgery, Graft vs Host Disease drug therapy, Humans, Immunosuppressive Agents therapeutic use, Intestinal Diseases drug therapy, Male, Middle Aged, Ophthalmologic Surgical Procedures, Skin Diseases drug therapy, Tacrolimus therapeutic use, Conjunctival Diseases etiology, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects, Intestinal Diseases etiology, Leukemia, Myeloid, Acute therapy, Skin Diseases etiology
- Abstract
Background: Ocular graft-versus-host disease (GVHD) is one of the most severe complications of hematopoietic stem cell transplantation. It manifests as an impairment of the ocular surface, such as severe dry eye disease, and deteriorates the recipient's visual function and quality of life. We encountered an "overlap syndrome" of ocular GVHD, which is characterized by the presence of both acute and chronic GVHD symptoms. In this report, we present the treatment progress of the overlap syndrome in a case with ocular GVHD., Case Presentation: A 57-year-old man with acute myeloblastic leukemia underwent hematopoietic stem cell transplantation. Six weeks after the treatment, the recipient complained of eye pain and discharge. He was diagnosed with the overlap syndrome due to low tear volume, severe corneal epithelitis, hyperemia, and a pseudomembrane on the conjunctiva. Immune cells infiltration, fibrinoid degeneration, fibroblastic and spindle-shaped cells, and fibrosis were observed in the pathology of the pseudomembrane. The recipient was treated with topical immunosuppression and pseudomembrane removal. One week after the initial treatment, ocular GVHD improved. Twelve weeks after the treatment, the topical steroid was discontinued due to the elevation of intraocular pressure., Conclusions: The assessment of conjunctival pseudomembrane in ocular GVHD is important to determine the stage of the case and to assess systemic GVHD. Furthermore, prompt removal of the pseudomembrane after diagnosis is an appropriate management to reduce the symptoms of ocular GVHD. The combination of topical steroids and immunosuppressive agents is suggested to be an effective treatment in management of overlap syndrome., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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26. Bilateral Cryptophthalmus: First Case Report from Nepal.
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Pant N, Bhatta S, Shrestha GB, and Thapa M
- Subjects
- Eyelids surgery, Humans, Infant, Newborn, Male, Nepal, Conjunctival Diseases surgery, Eyelid Diseases etiology, Microphthalmos complications
- Abstract
Introduction: Cryptophthalmus is characterized by a partial or complete casing of the eyeball by the skin. Cryptophthalmus alongside other systemic abnormalities is well-known as Fraser syndrome. It is an unusual genetic disorder with limited literature. The complexities of disease and limited experience pose challenges in its management., Case: A two-day-male neonate was brought by his parents with a complaint of swelling in the right orbital region and deformed left eye since birth. Examination revealed bilobed globular swelling in the right orbital region covered by a continuous sheet of skin from forehead to cheek with no visible ocular tissue. On the left side, there was absence of upper lid margin and eyelashes and superior symblepharon. He also had bilateral ear abnormalities and right renal agenesis. Surgical intervention was done. On the right side, removal of the globe and cyst was done. On the left side, upper eyelid reconstruction with symblepharon release was done with amniotic membrane transplantation., Conclusions: The management of cryptophthalmus is challenging. Reconstructive surgeries allow cosmesis but useful vision is rarely gained. This is the first case report from Nepal to date to the best of our knowledge., (© NEPjOPH.)
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- 2021
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27. A Novel Technique to Treat a Recurrent Giant Conjunctival Cyst: A Case Report.
- Author
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Aketa N, Katayama T, Ogawa Y, and Tsubota K
- Subjects
- Adolescent, Conjunctiva surgery, Conjunctival Diseases diagnosis, Cysts diagnosis, Female, Humans, Recurrence, Severity of Illness Index, Conjunctiva pathology, Conjunctival Diseases surgery, Cysts surgery, Ophthalmologic Surgical Procedures methods
- Published
- 2021
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28. Conjunctival calcinosis circumscripta in a dog: Treatment combining surgical resection and amniotic membrane grafting.
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Robin MC, Raffestin S, Etienne CL, Raymond Letron I, Regnier A, and Douet JY
- Subjects
- Animals, Calcinosis surgery, Combined Modality Therapy, Conjunctival Diseases surgery, Dogs, Female, Amnion transplantation, Calcinosis veterinary, Conjunctival Diseases veterinary, Dog Diseases surgery
- Abstract
This report describes the clinical features, histopathology, and surgical treatment of a case of conjunctival calcification in a 5-month-old female English Setter, referred with a history of recurrent conjunctivitis in the right eye (OD). The ophthalmic findings were limited to multifocal white plaques embedded in a markedly inflamed conjunctiva of the eyelids and the anterior nictitating membrane OD. Calcification was suspected. The blood cell count, blood chemical profile, and urinalysis were within normal limits, and long-bone radiographs appeared normal. After removal of the affected area by means of a large conjunctivectomy, cryopreserved canine amniotic membrane (AM) was transplanted to fill in the defect. Multifocal ectopic calcium deposits in the conjunctival lamina propria were confirmed histopathologically. The postoperative healing was uneventful, and no recurrence was observed during a follow-up period of five years. Conjunctival mineralization is uncommon in canine ophthalmology, and the cause remained undetermined in the present case, for which AM transplantation was able to promote conjunctival healing after a large surgical excision., (© 2021 American College of Veterinary Ophthalmologists.)
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- 2021
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29. Application of superficial keratectomy and soft contact lens for the treatment of symblepharon in a cat: a case report.
- Author
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Kim Y, Kang S, and Seo K
- Subjects
- Animals, Cat Diseases etiology, Cat Diseases surgery, Cats, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Conjunctival Diseases therapy, Contact Lenses, Hydrophilic statistics & numerical data, Eyelid Diseases etiology, Eyelid Diseases surgery, Eyelid Diseases therapy, Female, Treatment Outcome, Cat Diseases therapy, Conjunctival Diseases veterinary, Contact Lenses, Hydrophilic veterinary, Eyelid Diseases veterinary, Keratectomy veterinary
- Abstract
A 7-month-old intact female Persian cat was diagnosed with symblepharon accompanied by epiphora, brownish ocular discharge, and ocular discomfort in the left eye. Superficial keratectomy (SK) was performed to remove adhesions between the conjunctiva and cornea. To prevent re-adhesion after SK, the detached conjunctival tissue was sutured to the corneal limbus, and a soft contact lens (SCL) was inserted and a partial temporary tarsorrhaphy was performed. The SCL and tarsorrhaphy sutures were maintained for 22 days, and symblepharon did not recur 347 days postoperatively. SK combined with SCL is a relatively easy and cost-effective surgical option for feline symblepharon., Competing Interests: The authors declare no conflicts of interest and there was no financial support by the manufacturer of the products used in the case report., (© 2021 The Korean Society of Veterinary Science.)
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- 2021
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30. Case Report: Crying Blood.
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Idowu OO, Kaidonis G, Husain S, and Winn BJ
- Subjects
- Cautery, Conjunctival Diseases surgery, Contact Lenses, Female, Granuloma, Pyogenic surgery, Humans, Lacrimal Apparatus Diseases etiology, Young Adult, Blood, Conjunctival Diseases diagnosis, Crying, Granuloma, Pyogenic diagnosis, Lacrimal Apparatus Diseases diagnosis, Tears
- Abstract
Significance: Hemolacria (bloody tears) is a rare clinical presentation with varied underlying etiologies. Thorough clinical evaluation is essential to diagnosis and management., Purpose: This study aimed to report unilateral hemolacria in a known contact lens wearer with an occult, palpebral, conjunctival pyogenic granuloma and review the literature., Case Report: A 21-year-old female contact lens wearer presented to the clinic after three episodes of sudden painless bloody tears from the right eye. She was referred to the oculoplastic clinic for evaluation. On everting her right upper lid, a fleshy, nontender, ovoid, pedunculated mass was found attached to the palpebral conjunctiva of the right, nasal, upper tarsus. Surgical excision was performed in the office, and pathological examination of the lesion was consistent with pyogenic granuloma., Conclusions: Unilateral hemolacria should raise clinical suspicion for a hidden conjunctival lesion such as pyogenic granuloma, although other more sinister causes of hemolacria must also be considered. Thorough evaluation including eyelid eversion is critical in identifying and managing occult conjunctival lesions., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2021 American Academy of Optometry.)
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- 2021
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31. Plasma cell granuloma of the conjunctiva in a young female.
- Author
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Alam MS, Vijay V, Barh A, and Subramanian K
- Subjects
- Biopsy, Child, Conjunctiva, Female, Humans, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Granuloma, Plasma Cell
- Abstract
Plasma cell granuloma is a rare non-neoplastic inflammatory condition of unknown etiology commonly involving lung and gastrointestinal tract. Conjunctival disease per se is very rare and usually associated with involvement of other organs. We report a case of conjunctival plasma cell granuloma without any systemic involvement in a 9-year-old girl who presented with bilateral reddish vascularised subconjunctival episcleral mass. An excision biopsy of the mass in the left eye followed by histopathologic examination and Immunohistochemistry confirmed the diagnosis. At 1 year follow-up, the child had no recurrence in the operated eye whereas the lesion remained the same in the other eye despite systemic treatment with immunosuppressants. This case is being reported for its rarity and to insist on the mandatory need for a thorough systemic workup to identify multiorgan involvement as well as to rule out other systemic disorders.
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- 2021
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32. Systematic Review: Effects of Pterygium and Pingueculum on the Ocular Surface and Efficacy of Surgical Excision.
- Author
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Linaburg T, Choi D, Bunya VY, Massaro-Giordano M, and Briceño CA
- Subjects
- Conjunctival Diseases surgery, Humans, Ophthalmologic Surgical Procedures, Pterygium surgery, Tears physiology, Treatment Outcome, Conjunctival Diseases physiopathology, Cornea physiopathology, Dry Eye Syndromes physiopathology, Pterygium physiopathology
- Abstract
Purpose: This systematic review examines the specific effects of pingueculum and pterygium on the ocular surface and evaluates the efficacy of surgical excision in reversing those effects., Methods: A systematic review was performed according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses statement and included 59 articles studying the effects of pterygium and pingueculum on the ocular surface as measured by tear break-up time (TBUT), Schirmer testing, tear osmolarity, Ocular Surface Disease Index (OSDI), and the effects of surgical removal on these ocular surface parameters., Results: In most studies, eyes with pterygium or pingueculum when compared with control eyes had a statistically significantly lower TBUT (average 3.72 s), lower Schirmer I without anesthesia (average 3.01 mm), lower Schirmer II (average 4.10 mm), higher tear osmolarity (average 12.33 mOsm/L), and higher OSDI (average 6.82 points). Moreover, excision of pterygium and pingueculum led to a statistically significantly higher TBUT (average 3.15 s higher at 1 mo postexcision), lower tear osmolarity (average 3.10 mOsm/L lower at 3 mo postexcision), and lower OSDI score (average 2.86 points lower 1 mo postexcision) in most of the studies. The effect of excision on Schirmer test scores was equivocal because most studies did not reach significance., Conclusions: Our data confirm the relationship between pterygium and pingueculum and abnormal tear function and symptoms of dry eye disease. Furthermore, the data suggest that tear film parameters might improve after surgical removal of pterygium or pingueculum. Future studies would be helpful in exploring the potential role of pterygium and pingueculum excision in the management of dry eye disease., Competing Interests: V. Y. Bunya is a consultant for Verily and has received funding from the National Eye Institute (R01 EY026972), Research to Prevent Blindness, and Bausch & Lomb. M. M.-Giordano is a consultant for Dompe, Lynthera, and PRN. The remaining authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2021
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33. Supraglottic cyst in adult patient with Shabbir syndrome.
- Author
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Kajal S, Reddy CS, Sikka K, and Thakar A
- Subjects
- Adult, Airway Obstruction surgery, Conjunctival Diseases complications, Conjunctival Diseases surgery, Consanguinity, Cysts complications, Cysts surgery, Glottis diagnostic imaging, Glottis surgery, Humans, Laryngeal Diseases complications, Laryngeal Diseases surgery, Magnetic Resonance Imaging, Male, Natural Orifice Endoscopic Surgery, Tracheostomy, Treatment Outcome, Airway Obstruction etiology, Conjunctival Diseases diagnosis, Cysts diagnosis, Laryngeal Diseases diagnosis
- Abstract
A 29-year-old male patient presented with a history of voice change and feeling of a lump in throat for the last 20 years. He was tracheostomised at the age of 10 years. Endolaryngeal examination showed a mucosal bulge in supraglottic region arising predominantly from right side. He had multiple healed scar marks on neck, arms and elbows, and had dystrophic nail changes. MRI of the neck showed a supraglottic cyst covering glottis. The patient was diagnosed as a case of laryngo-onycho-cutaneous syndrome which is also known as Shabbir syndrome. He underwent supraglottic cyst excision via transoral ultrasonic surgery. Glottic scarring along with subglottic stenosis was found intraoperatively, which was released using carbon dioxide laser and finally Montgomery (MT) tube was inserted. The patient got his tracheostomy tube removed for the first time in 20 years. He tolerated corking of MT tube. He was able to breathe through nose and phonate using false cords., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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34. Clinicopathologic characteristics and surgical outcome of synthetic fiber conjunctival granuloma.
- Author
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Chen Z, Wang T, Pan Q, Zhang Z, and Zhang Z
- Subjects
- Adolescent, Child, Child, Preschool, Granuloma surgery, Humans, Retrospective Studies, Treatment Outcome, Conjunctival Diseases surgery, Conjunctivitis
- Abstract
Background: Until recently, synthetic fiber conjunctival granuloma (SFCG) is rarely reported and has been poorly understood. Our study was to explore the clinical features, histopathologic characteristics, surgical outcomes, and prognosis of SFCG after surgical excision., Methods: Retrospective review of clinical findings, histopathological and immunohistochemical studies identified 18 cases of SFCG. Specimens were routinely processed and stained with H&E. Immunohistochemical stains for GMS, PAS, CD68 and CK-pan were also performed., Results: Eighteen patients with an average age of 9.3 ± 6.6 years had a tender white to red mass on the conjunctiva. All the lesions were completely removed, and none of the patients relapsed. Histologically, all of the specimens revealed inflammatory granulation tissues with a large number of inflammatory cells infiltration and the presence of synthetic fibers. Immunohistochemical stains were positive for CD68, CK, GMS and PAS., Conclusions: Synthetic fiber conjunctival granuloma is an uncommon lesion with foreign body sensation caused by inoculation of synthetic exogenous materials. These lesions are mostly unilateral and occur in the inferior conjunctival fornix. SFCGs are characterized by a large number of inflammatory cells infiltration and the presence of synthetic fibers. Surgical excision followed by topical corticosteroids has been clinically proven to be effective.
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- 2020
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35. Four in one: Four recepients with a single donor tissue - A novel concept for eye transplantation surgery post-COVID-19.
- Author
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Siddharthan KS, Agrawal A, and Reddy JK
- Subjects
- Adolescent, Aged, COVID-19, Conjunctival Diseases surgery, Descemet Stripping Endothelial Keratoplasty, Female, Filtering Surgery, Humans, Male, Middle Aged, Pandemics, SARS-CoV-2, Stem Cell Transplantation, Transplant Recipients, Betacoronavirus, Corneal Transplantation, Coronavirus Infections epidemiology, Fuchs' Endothelial Dystrophy surgery, Glaucoma surgery, Keratoconus surgery, Pneumonia, Viral epidemiology, Sclera transplantation, Stevens-Johnson Syndrome surgery, Tissue Donors
- Abstract
A donor corneo-scleral button was dissected into four parts using a simple manual technique. The anterior corneal lamellae was stripped from the Descemet's Membrane (DM) and Deep Anterior Lamellar Keratoplasty (DALK) was performed in a patient with advanced keratoconus after removing the recipient's stroma using the big bubble technique. Descemet's Membrane Endothelial Keratoplasty (DMEK) was done with the stripped donor DM in a patient with Fuch's endothelial dystroph (FECD). The cadaveric limbal stem cells from the tissue were used for simple limbal epithelial transplantation (SLET) in a Steven- Johnson Syndrome (SJS) with localized limbal stem deficiency and symblepharon. The sclera was used to revise a leaking hypotonus bleb in an advanced single-eyed glaucoma patient. No intraoperative or postoperative complications were observed. At 1 year, all the 4 cases retained healthy transplanted tissues with good visual outcomes. Shortage of donor eyes is a global problem and with the present COVID-19 scenario the situation is bound to worsen. The advent of customized component corneal transplantation using simple cost-effective techniques will be the future trend in the years to come., Competing Interests: None
- Published
- 2020
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36. Global Consensus on the Management of Limbal Stem Cell Deficiency.
- Author
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Deng SX, Kruse F, Gomes JAP, Chan CC, Daya S, Dana R, Figueiredo FC, Kinoshita S, Rama P, Sangwan V, Slomovic AR, and Tan D
- Subjects
- Cell Transplantation, Cells, Cultured, Conjunctival Diseases pathology, Conjunctival Diseases surgery, Corneal Diseases pathology, Eyelid Diseases pathology, Eyelid Diseases surgery, Global Health, Humans, Transplantation, Autologous, Transplantation, Homologous, Visual Acuity physiology, Corneal Diseases surgery, Epithelial Cells transplantation, Limbus Corneae pathology, Mouth Mucosa cytology, Stem Cell Transplantation methods, Stem Cells pathology
- Abstract
Purpose: In recent decades, the medical and surgical treatment of limbal stem cell deficiency (LSCD) has evolved significantly through the incorporation of innovative pharmacological strategies, surgical techniques, bioengineering, and cell therapy. With such a wide variety of options, there is a need to establish a global consensus on the preferred approaches for the medical and surgical treatment of LSCD., Methods: An international LSCD Working Group was established by the Cornea Society in 2012 and divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to reach agreement on a strategic plan and methods after a comprehensive literature search. A writing group drafted the current study., Results: A consensus in the medical and surgical management of LSCD was reached by the Working Group. Optimization of the ocular surface by eyelid and conjunctival reconstruction, antiinflammatory therapy, dry eye and meibomian gland dysfunction treatment, minimization of ocular surface toxicity from medications, topical medications that promote epithelialization, and use of a scleral lens is considered essential before surgical treatment of LSCD. Depending on the laterality, cause, and stage of LSCD, surgical strategies including conjunctival epitheliectomy, amniotic membrane transplantation, transplantation of limbal stem cells using different techniques and sources (allogeneic vs. autologous vs. ex vivo-cultivated), transplantation of oral mucosal epithelium, and keratoprosthesis can be performed as treatment. A stepwise flowchart for use in treatment decision-making was established., Conclusions: This global consensus provides an up-to-date and comprehensive framework for the management of LSCD.
- Published
- 2020
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37. Treatment of Oculoplastic and Ocular Surface Disease in Eyes Implanted with a Type I Boston Keratoprosthesis in Southern China: A Retrospective Study.
- Author
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Zhang Y, Ou Z, Zhou J, Zhai J, Gu J, and Chen J
- Subjects
- Adult, China, Humans, Male, Middle Aged, Retrospective Studies, Burns, Chemical surgery, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Corneal Diseases surgery, Lens Implantation, Intraocular adverse effects, Prosthesis Implantation adverse effects, Stevens-Johnson Syndrome surgery
- Abstract
Introduction: This study aimed to describe the clinical features, surgical management of the eyelid and ocular surface, and outcomes of 16 patients implanted with a Boston type I keratoprosthesis (KPro)., Methods: A retrospective, single-center, consecutive case series of 16 patients with Stevens-Johnson syndrome (1), ocular chemical burns (12), and ocular thermal burns (3) implanted with KPro was studied. All subjects were men aged 27-51 years. Surgical treatment and outcomes for eyelid malposition, symblepharon, and glaucoma were assessed., Results: From September 2010 to February 2019, 29 patients were admitted to Zhongshan Ophthalmic Center for KPro implantation, of whom 16 (55%) required eyelid or ocular surface surgeries to maintain hydration and protect the corneal tissue, which is vulnerable to epithelial defects. Forty-one adnexal surgical procedures were performed. The most common indication for surgery was symblepharon, and the most frequent procedures were symblepharon lysis with ocular mucous membrane grafts and amniotic membranes (7) and full-thickness skin grafts to the eyelids (7). Preoperative conjunctival injection and corneal staining were documented in 9 (56%) and 8 (50%) eyes, respectively, and at up to 4 months postoperative follow-up (the last adnexal surgery before KPro) were recorded in 3 (19%, p = 0.03) and 2 (12%, p = 0.02) eyes, respectively. Glaucoma drainage devices were inserted in six patients. One patient with Stevens-Johnson syndrome underwent FP7 Ahmed glaucoma valve (AGV) implantation inferotemporally and developed plate exposure 2 months postoperatively. Five patients underwent FP8 AGV implantation with tube insertion into the vitreous cavity due to the scarred conjunctiva and limited subconjunctival space. In the study period, intraocular pressure (IOP) was in the normal range, and no tube or plate exposure was observed., Conclusion: The ocular environment is critical for successful KPro surgery. A multidisciplinary approach for any lid and ocular surface abnormality in ocular burns or Stevens-Johnson syndrome is important to improve the quality of the ocular surface and accommodate KPro and AGV, which is vital for maintaining vision after KPro surgery. FP8 AGV may be feasible for IOP control in adult KPro cases with restricted subconjunctival space.
- Published
- 2020
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38. Epibulbar osseous choristoma: A clinical case and review of the literature.
- Author
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Arenas-Canchuja F, Muro-Mansilla P, Urbano Ale E, Silva-Ocas I, Gálvez-Olortegui T, and Marroquín-Loayza L
- Subjects
- Child, Preschool, Humans, Male, Bone and Bones, Choristoma diagnosis, Choristoma surgery, Conjunctival Diseases diagnosis, Conjunctival Diseases surgery
- Abstract
We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8×10mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumours., (Copyright © 2020 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2020
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39. Mechanical blepharoptosis from giant conjunctival cyst.
- Author
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Mechel E, Daniel D, and Shinder R
- Subjects
- Adult, Biopsy, Conjunctival Diseases diagnostic imaging, Conjunctival Diseases surgery, Cysts diagnostic imaging, Cysts surgery, Female, Humans, Magnetic Resonance Imaging, Ophthalmologic Surgical Procedures, Blepharoptosis etiology, Conjunctival Diseases complications, Cysts complications
- Published
- 2020
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40. Eosinophilic Angiocentric Fibrosis in Bilateral Upper Eyelid Conjunctivas: A First Case Report.
- Author
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Okuyama S, Yazu H, Ito Y, Minato H, and Fujishima H
- Subjects
- Conjunctiva surgery, Conjunctival Diseases surgery, Female, Fibrosis surgery, Humans, Middle Aged, Conjunctiva pathology, Conjunctival Diseases pathology, Eosinophilia pathology, Fibrosis pathology
- Abstract
BACKGROUND Eosinophilic angiocentric fibrosis (EAF) is an extremely rare disease with characteristic histopathological findings of fibrotic onion-skin appearance and eosinophils. The lesion primarily affects the nasal cavity, paranasal sinus, and orbit. Although there have been approximately 78 cases of EAF reported in the literature to date, no cases of EAF in the eyelid conjunctiva have ever been reported. CASE REPORT Herein, we describe the case of a 55-year-old Japanese woman with a history of eosinophilic sinusitis and EAF in bilateral upper eyelid conjunctivas who underwent surgical resection of the affected tissue. Histopathological examination revealed collagen bundles winding around the vessels in an onion-skin pattern, and the presence of eosinophils, lymphocytes, and plasma cells. CONCLUSIONS We describe the first reported case of EAF in bilateral upper eyelid conjunctivas. It can be successfully treated by surgical resection, and with no recurrence within 6 months postoperatively.
- Published
- 2020
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41. Case report of conjunctival sac fistula after cosmetic lateral canthoplasty.
- Author
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Zhang W, Huang Q, and Li J
- Subjects
- Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Cutaneous Fistula diagnosis, Cutaneous Fistula surgery, Female, Fluorescein administration & dosage, Fluorescent Dyes administration & dosage, Humans, Lacrimal Apparatus Diseases etiology, Suture Techniques, Young Adult, Conjunctival Diseases etiology, Cutaneous Fistula etiology, Eyelids surgery, Surgery, Plastic adverse effects
- Abstract
Background: To report a case of conjunctival sac fistula after cosmetic lateral canthoplasty which is rare., Case Presentation: A young women who underwent bilateral canthoplasty appeared with lacrimation of the right eye. We found there was a skin fistula with transparent tears at 2 mm lateral to the right canthus ligament and the liquid containing fluorescein was seen to overflow at the fistula after using fluorescein sodium eye drops. The number 7 lacrimal duct probe was visible under the temporal conjunctiva when exploring the fistula, and the fistula was about 4 mm. The patient was diagnosed with conjunctival sac fistula and fistula excision was performed. The patient did not tear abnormally after observation 3 months later and the incision healed well., Conclusions: The case report illustrates an uncommon post-lateral canthoplasty complication. We suggested that surgeons who perform this kind of surgery should ask about epiphora and look for conjunctival sac fistula at follow-up assessment.
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- 2020
- Full Text
- View/download PDF
42. Conjunctival Fungal Ball Mimicking Melanoma.
- Author
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Chuang K, Vortmeyer A, and Liu S
- Subjects
- Aged, Conjunctival Diseases surgery, Diagnosis, Differential, Eye Infections, Fungal surgery, Female, Humans, Mycoses surgery, Periodic Acid-Schiff Reaction, Cladosporium isolation & purification, Conjunctival Diseases diagnosis, Conjunctival Neoplasms diagnosis, Eye Infections, Fungal diagnosis, Melanoma diagnosis, Mycoses diagnosis
- Published
- 2020
- Full Text
- View/download PDF
43. Treatment Outcome of Modified Argon Laser Photoablation for Conjunctival Cysts.
- Author
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Han J, Lee SH, Choi CY, and Shin HJ
- Subjects
- Aged, Aged, 80 and over, Conjunctiva surgery, Conjunctival Diseases diagnosis, Cysts diagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Conjunctiva pathology, Conjunctival Diseases surgery, Cysts surgery, Laser Therapy methods, Lasers, Gas therapeutic use
- Abstract
Purpose: To evaluate the effectiveness of conjunctival cyst removal using a modified method of argon laser photoablation., Methods: Seventeen cases of symptomatic conjunctival cysts were included. After staining the surface of a conjunctival cyst with a dark purple marker, the cyst was incised using a 26-gauge needle. Low-energy argon laser photoablation was then applied around the incision site for a mean of 100 times., Results: During a mean follow-up period of 13.3 months (range 6-28 months), all conjunctival cysts were successfully corrected by applying either one or 2 laser sessions. Complete resolution occurred after a single laser session in 14 eyes (82.4%). There were 3 cases of recurrence with medium to large cysts, and repeating the same procedure produced surgical success in all of these cases; the conjunctival cyst recurred again after the second laser session in one of the 3 eyes, but this spontaneously regressed without further treatment. No postoperative complications such as conjunctival scarring or persistent ocular irritation were observed., Conclusions: Our modified method of argon laser photoablation uses staining of the conjunctival cyst surface to increase the amount of thermal laser energy absorbed by the target. This novel technique is simple and effective for treating conjunctival cysts in an outpatient clinic.
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- 2020
- Full Text
- View/download PDF
44. Recurrent preseptal cellulitis in Boston keratoprosthesis type II implantation for ocular Stevens-Johnson syndrome.
- Author
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Marchand M and Harissi-Dagher M
- Subjects
- Conjunctival Diseases diagnostic imaging, Female, Humans, Middle Aged, Orbital Cellulitis diagnostic imaging, Orbital Cellulitis surgery, Prostheses and Implants, Recurrence, Stevens-Johnson Syndrome diagnostic imaging, Tomography, X-Ray Computed, Visual Acuity physiology, Artificial Organs, Conjunctival Diseases surgery, Cornea, Orbital Cellulitis etiology, Prosthesis Implantation, Stevens-Johnson Syndrome surgery
- Published
- 2020
- Full Text
- View/download PDF
45. Intraocular endoscopy for the evaluation and treatment of hypotony due to a traumatic cyclodialysis: a case report.
- Author
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Bair H, Lin CJ, Lai CT, Hsia NY, and Tsai YY
- Subjects
- Adult, Conjunctival Diseases diagnosis, Conjunctival Diseases etiology, Conjunctival Diseases surgery, Cyclodialysis Clefts etiology, Cyclodialysis Clefts surgery, Eye Hemorrhage diagnosis, Eye Hemorrhage etiology, Eye Hemorrhage surgery, Eye Injuries diagnosis, Glucocorticoids therapeutic use, Humans, Hyphema diagnosis, Hyphema etiology, Hyphema surgery, Intraocular Pressure, Lens Subluxation diagnosis, Lens Subluxation etiology, Lens Subluxation surgery, Lens, Crystalline surgery, Male, Ocular Hypotension drug therapy, Ocular Hypotension etiology, Tonometry, Ocular, Vision Disorders diagnosis, Vision Disorders etiology, Visual Acuity physiology, Vitrectomy, Wounds, Nonpenetrating diagnosis, Ciliary Body injuries, Cyclodialysis Clefts diagnosis, Endoscopy, Eye Injuries complications, Ocular Hypotension diagnosis, Wounds, Nonpenetrating complications
- Abstract
Background: A cyclodialysis cleft often leads to direct communication between the anterior chamber and the suprachoroidal space. It is a rare condition that is encountered with blunt trauma, and less commonly, after surgery. Hypotony is the major sequelae that may lead to hypotonous maculopathy, optic disc edema, corneal folds, and astigmatism. These may cumulatively lead to visual loss. We describe how endoscopy in a cyclodialysis repair allowed us to accurately locate the cleft and guided its appropriate management avoiding unnecessary cryopexy., Case Presentation: A 41-year-old male experienced a traumatic cyclodialysis cleft, which resulted in persistent hypotony. Pars plana vitrectomy was performed to treat vitreous hemorrhage. Scleral indentation was attempted to visualize the cyclodialysis cleft. However, the depression distorted the visualization. Intraocular endoscopy was therefore used to evaluate the cleft. Guided by this assessment, only intraocular gas tamponade was used to reposition the ciliary body. The patient's intraocular pressure was restored to 13 mmHg 3 days after the operation, and OCT confirmed cleft closure 1 month after the operation., Conclusion: Endoscopy-assisted repair of cyclodialysis is an approach that enhances visualization and can guard against common causes of persistent cleft and hypotony, as well as reveal the causes of recurrent failure. Hence, it can eliminate unnecessary cryopexy that might worsen the hypotonous state. In our case, intraocular endoscopy was effective for the evaluation of a cyclodialysis cleft and the subsequent selection of an appropriate management technique, gas tamponade, that was more conservative than other approaches initially considered.
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- 2020
- Full Text
- View/download PDF
46. Listen to the patient as postoperative discomfort is real and treatable.
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Wong ELS, Lee BWH, Jiang IW, Lin M, and Francis IC
- Subjects
- Conjunctival Diseases diagnosis, Conjunctival Diseases surgery, Corneal Diseases diagnosis, Corneal Diseases surgery, Eye Foreign Bodies diagnosis, Eye Foreign Bodies surgery, Eye Pain diagnosis, Female, Humans, Lens Implantation, Intraocular, Middle Aged, Postoperative Complications, Visual Acuity physiology, Conjunctival Diseases etiology, Corneal Diseases etiology, Eye Foreign Bodies etiology, Eye Pain etiology, Phacoemulsification, Physician-Patient Relations, Surgical Tape adverse effects
- Published
- 2020
- Full Text
- View/download PDF
47. Ophthalmic use of amniotic membrane tissue in Australia: Introduction and initial use of a service.
- Author
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Treloggen J, McKeon H, Hodge C, and Petsoglou C
- Subjects
- Australia, Cryopreservation methods, Humans, Organ Culture Techniques, Organ Preservation methods, Tissue Donors, Tissue and Organ Procurement, Wound Healing physiology, Amnion transplantation, Biological Dressings, Conjunctival Diseases surgery, Corneal Diseases surgery
- Published
- 2020
- Full Text
- View/download PDF
48. Ocular amyloid: adnexal and systemic involvement.
- Author
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Kang S, Dehabadi MH, Rose GE, Verity DH, Amin S, and Das-Bhaumik R
- Subjects
- Adult, Age Distribution, Amyloidosis epidemiology, Amyloidosis surgery, Biopsy, Needle, Cohort Studies, Conjunctival Diseases epidemiology, Conjunctival Diseases surgery, Eyelid Diseases surgery, Female, Finland, Humans, Immunohistochemistry, Incidence, Male, Middle Aged, Orbital Diseases epidemiology, Orbital Diseases surgery, Prognosis, Retrospective Studies, Severity of Illness Index, Sex Distribution, Tomography, X-Ray Computed methods, Young Adult, Amyloidosis diagnosis, Conjunctival Diseases diagnosis, Eyelid Diseases diagnosis, Orbital Diseases diagnosis
- Abstract
Purpose : To investigate the natural history of ocular adnexal and orbital amyloidosis. Methods : In a retrospective, non-comparative case series, the clinical records of patients with biopsy-proven ocular, adnexal, and orbital amyloidosis managed at our institution between 1980 and 2016 were evaluated. Results : Forty-one patients (29 female; 71%) were identified. The mean interval from presentation to diagnosis was 24 months (median 12 months, range 1-84 months). Whilst most patients presented with a conjunctival mass (34/41; 83%) or ptosis (15/41; 37%), the diagnosis was not immediately evident in all - two patients had 3 ptosis operations prior to obtaining a tissue biopsy that revealed amyloid deposition. Three-quarters (31/41; 76%) of patients had localised primary ocular adnexal and orbital amyloidosis, 4 (10%) had associated systemic disease, and 6 (15%) were found to have underlying haematological malignancy on further investigation. During a mean follow-up of 8 years (median 7 years; range 6 months - 36 years), 2 (5%) patients lost vision, 21 (51%) had surgical intervention other than biopsy, and 2 (5%) had local radiotherapy for amyloid deposition secondary to lymphoproliferative disease. Conclusions : The varied presentations of ocular adnexal and orbital amyloidosis and the need for confirmatory biopsy often leads to a significant delay between first symptoms and diagnosis. While rarely sight-threatening, ocular adnexal and orbital amyloidosis carries significant morbidities and has a systemic association in a quarter of patients.
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- 2020
- Full Text
- View/download PDF
49. The Effects of Intraoperative Tarsorrhaphy on Conjunctival Chemosis During Orbital Fracture Repair Surgery.
- Author
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Wang Y, Yang F, Li Z, and Deng Y
- Subjects
- Adolescent, Adult, Conjunctival Diseases etiology, Edema etiology, Female, Humans, Male, Middle Aged, Ophthalmologic Surgical Procedures, Orbital Fractures complications, Retrospective Studies, Sutures, Young Adult, Conjunctival Diseases surgery, Eyelids surgery, Orbital Fractures surgery
- Abstract
Purpose: We employed intraoperative tarsorrhaphy depending on the degree of edema to treat moderate conjunctival chemosis during orbital fracture repair surgery., Methods: This is a retrospective case review of 1367 patients (1384 eyes) who underwent orbital fracture repair surgery by a transconjunctival approach. All cases of moderate conjunctival chemosis during surgery were included and were divided into 2 groups. In one group, intraoperative tarsorrhaphy was performed immediately the chemosis reached a moderate degree and the conjunctiva was incarcerated by the lower eyelid margin; once severe chemosis developed, stitches were added to cover all of the prolapsed conjunctiva with a palpebral margin. In the second group, moderate chemosis was treated with bandage pressure without stitches even after appearance of severe chemosis. The time course of conjunctival edema was recorded., Results: The incidence of moderate conjunctival chemosis in orbital reconstruction surgery by the transconjunctival approach was 9.4%. The average time for resolution of moderate chemosis in the tarsorrhaphy group (3.5 ± 1.4 days) was obviously shorter than in the bandage group (6.2 ± 1.9 days). The incidence of severe chemosis in the intraoperative tarsorrhaphy group (14.1%) was significantly lower than in the bandage group (31.8%). Overall, the total duration of severe chemosis in the tarsorrhaphy group was obviously shorter than that of the bandage group., Conclusion: Intraoperative tarsorrhaphy was a highly effective method of treating moderate chemosis and preventing severe conjunctival chemosis during orbital fracture repair surgery.
- Published
- 2020
- Full Text
- View/download PDF
50. Amniotic membrane, clinical applications and tissue engineering. Review of its ophthalmic use.
- Author
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Lacorzana J
- Subjects
- Amnion chemistry, Amnion ultrastructure, Biological Dressings, Bioprosthesis, Cell Culture Techniques, Cell Movement, Conjunctival Diseases surgery, Contraindications, Procedure, Corneal Diseases surgery, Humans, Keratinocytes cytology, Ophthalmic Solutions, Scleral Diseases surgery, Tissue Extracts therapeutic use, Tissue Preservation methods, Tissue Scaffolds, Tissue and Organ Harvesting methods, Transplantation, Heterotopic adverse effects, Transplantation, Heterotopic methods, Amnion transplantation, Ophthalmologic Surgical Procedures methods, Tissue Engineering
- Abstract
The use of amniotic membrane in ophthalmology has been increasing in recent years due to its multiple biological and tectonic properties, improvement in the process of obtaining, ease of use, and advancement in tissue engineering. The amniotic membrane has become one of the main adjuvant treatments, in ophthalmic surgery as well as in other medical-surgical specialties. The development of tissue engineering has allowed it to be used, not only in its classic form, but also by the use of drops and other presentations. The different steps prior to its use (preparation and conservation), the different surgical techniques, and their main clinical applications are described throughout the article., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
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