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Morgan PB, Efron N, Papas E, Barnett M, Carnt N, Dutta D, Hepworth A, Little JA, Nagra M, Pult H, Schweizer H, Shen Lee B, Subbaraman LN, Sulley A, Thompson A, Webster A, Markoulli M. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye 2024:102158. [PMID: 38631935 DOI: 10.1016/j.clae.2024.102158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom.
| | - Nathan Efron
- Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eric Papas
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Andy Hepworth
- EssilorLuxottica Europe North, Bristol, United Kingdom
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Young Street, Cambridge, United Kingdom
| | - Heiko Pult
- Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany
| | - Helmer Schweizer
- CEO Helmer Schweizer Consulting Group (HSCG), Bassersdorf, Switzerland
| | - Bridgitte Shen Lee
- Vision Optique and Ocular Aesthetics dba Ocular Clinical Trials, Houston, TX, United States
| | | | - Anna Sulley
- CooperVision International Ltd, Chandlers Ford, United Kingdom
| | | | | | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Hou X, Rokohl AC, Meinke MM, Li S, Liu J, Fan W, Lin M, Jia R, Guo Y, Heindl LM. A novel standardized distraction test to evaluate lower eyelid tension using three-dimensional stereophotogrammetry. Quant Imaging Med Surg 2021; 11:3735-3748. [PMID: 34341746 DOI: 10.21037/qims-20-1016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 04/01/2021] [Indexed: 11/06/2022]
Abstract
Background Standardized pre-operative assessment of the lower eyelid tension is essential to determine the optimal surgical technique. However, quantitative analysis using the conventional distraction test is inaccurate and user-dependent. Our purpose was to introduce a novel, standardized three-dimensional distraction test for measuring lower eyelid tension and to determine its standard values in a Caucasian population. Methods In 94 participants (50 men and 44 women; age 21-85 years), a 15.9-g weighted eyelid hook was used to pull down the lower eyelid. Two three-dimensional images were acquired with a VECTRA M3 stereophotogrammetry device-one in the neutral position without a hook and the other in the distracted position with the eyelid hook. The images of all participants in both positions were measured twice by a single observer. Results There was no clinical (>1 mm) or statistically significant difference between the two repeated measurements of all the inter-landmark linear distances in both positions (P≥0.05, respectively). The mean distracted displacement between the neutral and distracted position for margin reflex distance was 5.50±1.53 mm, without any age-specific difference (P=0.08); however, a significant gender-specific difference was observed as men had significantly greater displacement than women (P<0.001). Conclusions Our proposed standardized three-dimensional distraction test for assessing lower eyelid tension using an eyelid hook and a simple landmark-based system seems to provide high reliability. This novel and simple method might be helpful for the preoperative planning of eyelid surgeries.
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Affiliation(s)
- Xiaoyi Hou
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Alexander C Rokohl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Marius M Meinke
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Senmao Li
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Jinhua Liu
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Wanlin Fan
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Ming Lin
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongwei Guo
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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Abstract
PURPOSE The evaluation of palpebral laxity can be performed by the distraction test (DT). Although widely used in ophthalmologic practice, there is no consensus about the results considered normal by the test. The objectives of this study are to obtain the value of DT in a group of individuals with healthy eyelids and to compare with the measurements in subjects with senile ectropion. METHODS Lower eyelid DT was performed in 200 individuals without any eyelid pathology and in 30 individuals with lower lid ectropion. The results were analyzed by age and sex in the control group and compared with the results of the ectropion group. RESULTS The mean value of DT in the control group was 6.96 mm, lower than in the ectropion group (9.48 mm) (p < 0.001). In the control group, the mean female DT was 6.70 mm, while the male was 7.22 mm. There were differences in the DT values in the subgroups of 20-39 and 40-59-year old according to gender, with men presenting higher measurements than women. In the other age subgroups, both genders presented similar DT values. Even when considering only individuals in the control group with the same range of age as in the ectropion group, the DT value was higher in individuals with ectropion (7.23 and 9.48 mm, respectively, p < 0.001). CONCLUSIONS The mean DT value is 6.96 mm; however, the measurement varies according to age and sex in people without palpebral pathology. Individuals with senile eyelid ectropion present higher measurements than healthy ones.In this study, the authors performed the eyelid distraction test in 200 healthy individuals, bringing to the literature the new information that there is a variability of the normal test's value regarding age and gender.
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Chen HC, Polisetty TS, Zhu K, Phan BN, Durr NJ, Tian J, Mahoney NR. A quantitative analysis of factors influencing lower lid retraction and involutional ectropion. J Plast Reconstr Aesthet Surg 2018; 72:137-171. [PMID: 30467002 DOI: 10.1016/j.bjps.2018.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/18/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Hung-Chang Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 333,5, Fu-Shin Street, Kwei-Shan, Taoyuan, Taiwan
| | - Teja S Polisetty
- Department of Biomedical Engineering, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, USA
| | - Kevin Zhu
- Department of Biomedical Engineering, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, USA
| | - BaDoi N Phan
- University of Pittsburgh School of Medicine, 3550 Terrace St., Pittsburgh, PA, USA; Medical Scientist Training Program, School of Medicine, University of Pittsburgh, 3550 Terrace St., Pittsburgh, PA, USA
| | - Nicholas J Durr
- Department of Biomedical Engineering, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, USA; Center for Bioengineering Innovation and Design, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, USA
| | - Jing Tian
- Department of Biostatistics, Johns Hopkins School of Public Health, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, USA
| | - Nicholas R Mahoney
- Wilmer Eye Institute, Johns Hopkins University, 600N Wolfe St, Maumenee 505, Baltimore, 21287 MD, USA.
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Ehrhardt A, Guechi O, Zaidi M, Sot M, Lhuillier L, Houmad N, Ouamara N, Goetz C, Perone JM. Lateral tarsal strip versus lateral tarsal strip with three-snip punctoplasty for managing epiphora in involutional ectropion. J Fr Ophtalmol 2018; 41:752-758. [PMID: 30217604 DOI: 10.1016/j.jfo.2017.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 10/28/2022]
Abstract
PURPOSE To compare the efficacy of two surgical techniques-lateral tarsal strip (canthoplasty) alone, and lateral tarsal strip with three-snip punctoplasty-in reducing epiphora arising from involutional ectropion with partial punctal stenosis. METHODS Fourty patients with involutional ectropion and partial stenosis of the lacrimal punctum were randomly allocated to two treatment groups. Group 1 patients received lateral tarsal strip alone with only non-invasive stenting of the punctum, and group 2 patients received tarsal strip plus three-snip punctoplasty. Subjective assessment of epiphora was achieved via completion of a quality of life (QoL) questionnaire preoperatively and at postoperative month 3. Eyelid position, adverse outcomes and corneal dryness (via Oxford grading scheme) were also assessed postoperatively. Only patients with unilateral problems were included in the study. RESULTS Forty eyes of 40 patients were included: 20 in each group. The mean ages of group 1 and group 2 patients were 79±11 and 80±9 years, respectively. All patients reported significantly reduced eye watering after surgery, with no significant intergroup difference in subjective outcomes, except that computer usage and night driving (P<0.05), improved in a more significant way in group 2. Eyelid malposition was corrected in all cases, there were no cases of postoperative punctal eversion, and no significant adverse events or complications occurred. Finally, the mean improvements in the dryness/keratitis score (using the Oxford scheme) were comparable between the 2 groups (P=0.34). CONCLUSION The study findings indicate that treatment of involutional ectropion with partial punctal stenosis by lateral tarsal strip with three snip punctoplasty does not provide greater reduction in discomfort secondary to epiphora than conventional lateral tarsal strip alone, except for specific situations such as night driving or computer use.
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Affiliation(s)
- A Ehrhardt
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - O Guechi
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - M Zaidi
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - M Sot
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - L Lhuillier
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - N Houmad
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France
| | - N Ouamara
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Mercy Hospital, Metz, France
| | - C Goetz
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France; Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Mercy Hospital, Metz, France
| | - J-M Perone
- Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, 1, allée du Château, 57085 Metz cedex 03, France.
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How Important Is the Etiology in the Treatment of Epiphora? J Ophthalmol 2016; 2016:1438376. [PMID: 27595013 PMCID: PMC4995336 DOI: 10.1155/2016/1438376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/06/2016] [Accepted: 07/17/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1-92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p = 0.012) and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients' comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.
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Balogun BG, Adekoya BJ, Balogun MM, Ehikhamen OA. Orbito-oculoplastic diseases in lagos: a 4-year prospective study. Middle East Afr J Ophthalmol 2014; 21:236-9. [PMID: 25100908 PMCID: PMC4123276 DOI: 10.4103/0974-9233.134678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims: To determine the prevalence of orbito-oculoplastic diseases and thereby contributing a data base to the emerging orbito-oculoplastics subspecialty in the sub-Saharan region. Settings and Design: A tertiary eye care centre. Materials and Methods: A descriptive prospective study was done in a tertiary eye care center. Demographic and clinico-pathological diagnoses of 269 patients presenting to the oculoplastics clinic over a 4-year period (January 2008 -December 2011) were collected at entry and during follow-up visits. These were patients referred from the general ophthalmology clinics of the study center, secondary eye care centers within and from neighboring states. Patients were categorized based on the primary diagnosis after examination by the oculoplastics surgeon. Ethical issues were considered though data collection did not involve direct patient participation. Statistical Analysis Used: Microsoft Excel 2007 software. Results: Two hundred and sixty-nine patients were seen with 141 (52.4%) females. Leading etiological factors were trauma; 81 (30.0%), congenital anomalies 55 (21.0%) and tumors 44 (16.0%). Eyelid diseases were the most frequent 115 (42.8%), with ectropion 36 (31.0%) and ptosis 33 (29.0%) being the most common. Orbital and peri-orbital lesions 44 (16.4%) were mainly dermoids 12 (27.3%) and capillary heamangioma 4 (9.1%) in the pediatric age while thyroid orbitopathy 11 (25.0%) was predominant in adults. Ocular and degenerative diseases were retinoblastoma in 4 (16.7%) and phthisis bulbi in 10 (33.3%). Contracted socket was 22 (84.0%) of socket pathologies. Primary conjunctival diseases occurred less often, rather Stevens-Johnson syndrome in 9 (30.0%) and its ocular complications were more frequent. Conclusions: It is expected that this survey will provide a database for oculoplastics surgeons and ophthalmologists in an emerging subspecialty and thus enhance training focus and equipment acquisition.
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Affiliation(s)
- Bolanle G Balogun
- Department of Surgery, Ophthalmology Unit, Lagos State University Teaching Hospital/College of Medicine, 1-5 Oba Akinjobi Street GRA Ikeja, Lagos, Nigeria
| | - Bola J Adekoya
- Department of Surgery, Ophthalmology Unit, Lagos State University Teaching Hospital/College of Medicine, 1-5 Oba Akinjobi Street GRA Ikeja, Lagos, Nigeria
| | - Modupe M Balogun
- Department of Surgery, Ophthalmology Unit, Lagos State University Teaching Hospital/College of Medicine, 1-5 Oba Akinjobi Street GRA Ikeja, Lagos, Nigeria
| | - Olufunke A Ehikhamen
- Department of Surgery, Ophthalmology Unit, Lagos State University Teaching Hospital/College of Medicine, 1-5 Oba Akinjobi Street GRA Ikeja, Lagos, Nigeria
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Abstract
SummaryAge-related changes affect all structures of the eye, and while age-related changes may influence the quality of vision, it is important to distinguish age-related physiological changes from pathological changes. This is important particularly when identifying pathological changes that may be treatable. The prevalence of visual loss increases substantially after 60 years of age and poor vision is the second most prevalent physical disability in older people. This review describes the normal ageing changes of the eye and outlines common ophthalmic diseases affecting older people. We refer to recent advances in diagnosis and treatment, and relevant current research.
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Entropion-ectropion: the influence of axial globe length on lower eyelid malposition. Ophthalmic Plast Reconstr Surg 2012; 28:199-203. [PMID: 22581083 DOI: 10.1097/iop.0b013e31824c86e7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of axial globe length and other biometry parameters on age-related lower eyelid malposition. METHODS Consecutive patients with involutional lower eyelid malposition underwent preoperative biometry with Zeiss IOL Master and Hertel's exophthalmometer prior to surgery. Patients with other causes of eyelid malposition and thyroid eye disease were excluded. GraphPad InStat was used for t test and chi-square statistical analysis. RESULTS Data on 57 eyelids of 52 Caucasian patients were collected. There were 28 ectropions and 29 entropions. The mean axial globe length in the ectropion group (23.5 mm, standard deviation ± 0.9) was significantly longer than in the entropion group (22.7 mm, standard deviation ± 1.03) (p = 0.008). There was significant sex predilection, with entropion more common in women and ectropion more common in men (p = 0.03). The mean axial globe projection in the ectropion group was 16.6 mm (standard deviation ± 2.4) and in the entropion group was 14.6 mm (standard deviation ± 2.7) (p = 0.002). There was no statistical difference in age, keratometry, amount of astigmatism, and cylinder axis. CONCLUSION Involutional eyelid malposition directly correlates with axial globe length with the ectropion group having lengthier eyes compared with the entropion group. Hence, axial globe length could be an influential factor in the onset of involutional eyelid malposition.
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Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly population. Ophthalmic Plast Reconstr Surg 2011; 27:317-20. [PMID: 21415800 DOI: 10.1097/iop.0b013e3182115229] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the prevalence of involutional entropion and ectropion of the lower eyelid in the elderly population; to examine how these disorders are related to gender, age, skin color, and axial ocular globe projection; and to define the incidence of associated ocular surface and pathologic eyelid findings. METHODS An ophthalmic survey was conducted in 24,565 elderly people. All participants underwent ophthalmic examination by general ophthalmologists to identify entropion and ectropion. Information about associated ocular surface and pathologic eyelid findings were collected from all patients with involutional eyelid malposition. Patients with involutional entropion and ectropion underwent measurements of the axial ocular globe projection. The Pearson chi-square test and the Mann-Whitney U test were performed. RESULTS The prevalence of involutional entropion was 2.1%; 1.9% in men and 2.4% in women. The prevalence of involutional ectropion was 2.9%; 5.1% in men and 1.5% in women. Dry eye syndrome, lower retractor laxity, and superficial punctate keratopathy were seen significantly more often in patients with involutional entropion than in those with involutional ectropion (p < 0.001). Chronic conjunctivitis was significantly more common in patients with involutional ectropion than in those with involutional entropion (p < 0.001). The axial ocular globe projection was significantly smaller in patients with involutional entropion than in those with involutional ectropion (p < 0.001). CONCLUSIONS The prevalence of involutional entropion and ectropion in the elderly population is 2.1% and 2.9%, respectively. The axial ocular globe position plays a pathogenic role in involutional lower eyelid malposition.
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Chua J, Choo CT, Seah LL, Fong KS, Chee SP, Chuah CT, Looi A. A 5-year Retrospective Review of Asian Ectropion: How Does It Compare to Ectropion Amongst Non-Asians? ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2011. [DOI: 10.47102/annals-acadmedsg.v40n2p84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: This study reviews the differences in demographics and surgical outcomes between ectropion in Asian and non-Asian eyes. Materials and Methods: Medical records of surgically corrected ectropion cases from January 2002 to December 2006 were reviewed. Pre- and postoperative lid-globe apposition was graded: grade 0 with normal lid-globe apposition, grade 1 with punctal ectropion, grade 2 with partial lid eversion and scleral show, grade 3 with conjunctival hyperemia and thickening and grade 4 as for grade 3 with exposure keratitis. Results: Sixty-nine eyes in 50 patients underwent surgical correction of lower lid ectropion, making up 3.3% of all lid procedures performed. Eighty-four percent of patients were above 50 years of age, 72% were males and 88% were Chinese. Involutional change was the commonest aetiology, accounting for the majority of bilateral cases. The mean duration to surgery was 10.0 ± 16.0 months. The most frequent preoperative severity grade was 2. Lateral tarsal strip (LTS) was the commonest procedure performed, comprising 91.3% of eyes. The mean duration of postoperative review was 19.4 ± 19.2 months (range, 1 to 74 months). Postoperative improvement of at least one grade was observed in 98% while normal lid-globe apposition was achieved in 76% of eyes. Conclusions: Involutional change is the most common cause of ectropion amongst both Asians and non-Asians. Ectropion is less prevalent amongst Asians as a result of anatomical differences and possibly reduced sun exposure. The LTS procedure is the most commonly performed surgical procedure for the successful correction of ectropion in both Asians and non-Asians.
Keywords: Asian eyes, Lateral tarsal strip
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Awotesu S, Dubois V, El-Hindy N, Watts M. Jessner's lymphocytic infiltrate: a rare cause of lid ectropion. BMJ Case Rep 2010; 2010:bcr07.2009.2064. [PMID: 22347890 PMCID: PMC3029424 DOI: 10.1136/bcr.07.2009.2064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Ectropion is a condition in which the lower eyelid turns outwards from the globe. It is commonly due to age related involutional laxity of the lid tissue. Ectropion may also be secondary to scarring or contracture of the periorbital skin and underlying tissues which pulls the eyelids outwards. Jessner's lymphocytic infiltrate is a rare and enigmatic dermatological condition which is uncommon in the elderly. We describe a case of recurrent ectropion following redo lid surgery in which Jessner's lymphocytic infiltrate was fortuitously diagnosed on skin biopsy. We are unaware of any report in the literature describing recurrent cicatrical ectropion due to this condition.
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Affiliation(s)
- Segun Awotesu
- Arrowe Park Hospital, Ophthalmology Department, Arrowe Park Road, Upton, Wirral CH49 5PE, UK
| | - Vincent Dubois
- Arrowe Park Hospital, Ophthalmology Department, Arrowe Park Road, Upton, Wirral CH49 5PE, UK
| | - Nabil El-Hindy
- Norfolk & Norwich, Ophthalmology Department, Colney Lane, Norwich NR4 7UY, UK
| | - Mark Watts
- Arrowe Park Hospital, Ophthalmology Department, Arrowe Park Road, Upton, Wirral CH49 5PE, UK
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Wagner H, Fink BA, Zadnik K. Sex- and gender-based differences in healthy and diseased eyes. ACTA ACUST UNITED AC 2009; 79:636-52. [PMID: 19811761 DOI: 10.1016/j.optm.2008.01.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Revised: 12/18/2007] [Accepted: 01/08/2008] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to identify sex- and gender-based differences in ocular anatomy, physiology, and disease susceptibility or manifestation. METHODS Review of current indexed literature was conducted. RESULTS Sex and sex hormones influence the lacrimal system, eyelids and blinking, corneal anatomy and disease, aqueous humor dynamics and glaucoma, crystalline lens and cataract, uveitis and retinal disease, ocular circulation, and optic nerve anatomy and disease. Systemic conditions, particularly autoimmune disease, and conditions that are unique to women, such as pregnancy and menopause, further illustrate the effects of sex hormones on the eye. Gender-based differences in ocular conditions and disease should be considered within the context of the underlying physical and social environment. CONCLUSIONS Many sex- and gender-based differences exist in healthy and diseased eyes.
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Affiliation(s)
- Heidi Wagner
- Nova Southeastern University College of Optometry, Ft. Lauderdale, Florida 33328, USA.
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Caviggioli F, Klinger F, Villani F, Fossati C, Vinci V, Klinger M. Correction of cicatricial ectropion by autologous fat graft. Aesthetic Plast Surg 2008; 32:555-7. [PMID: 18293030 DOI: 10.1007/s00266-008-9117-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Over the past few years, treatment of burn scars with lipofilling has shown encouraging clinical results in terms of texture, color, softness, and quality of skin patterns. This clinical application has been widened to include treatment for scars resulting from surgical correction of cicatricial ectropion. In fact, although standard surgery with flaps and skin grafts can grant significant functional and cosmetic improvements, these often are not complete because of secondary surgical scars. METHODS The case of a 43-year-old man with cicatricial outcomes from chemical burns and subsequent surgical repair of medial ectropion in the lower eyelid is reported. The scar area was treated with injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. RESULTS At the 1-year follow-up assessment after lipostructure, the patient no longer reported xeroftalmia and epiphora. He had experienced complete functional recovery with excellent cosmetic results. CONCLUSIONS Lipostructure of cicatricial ectropion seems to complete and improve the results of the standard surgical approach, and its long-lasting benefits are in keeping with the theoretical basis of this procedure.
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