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[PMID]:29506509
[Au] Autor:Zhang Z; Zhou M; Liu K; Zhu B; Liu H; Sun X; Xu X
[Ad] Endereço:Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.
[Ti] Título:Development of a new valid and reliable microsurgical skill assessment scale for ophthalmology residents.
[So] Source:BMC Ophthalmol;18(1):68, 2018 Mar 05.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: More and more concerns have been arisen about the ability of new medical graduates to meet the demands of today's practice environment. In this study, we wanted to develop a valid, reliable and standardized assessment tool for evaluating the basic microsurgical skills of residents in a microsurgery laboratory, to get them well prepared before entering the surgical realm of ophthalmology. METHODS: Twenty-three experts who have teaching experience reviewed the assessment scale. Constructive comments were incorporated to ensure face and content validity. Twenty-one attendings from different specialties then graded eight corneal rupture suturing videos with the scale to investigate interrater reliability. Fourteen of them graded the same videos 3 months later to investigate intrarater reliability (repeatability). RESULTS: A total of 280 assessment scales were completed. All the ICC values of interrater reliability were greater than 0.8 with 75% data greater than 0.9 (range 0.860-0.976). All the ICC values of intrarater reliability (repeatability) were also greater than 0.8 with 63% data greater than 0.9 (range 0.833-0.954). CONCLUSIONS: The assessment scale we developed is valid and reliable. This tool could be useful to ensure that junior residents achieve a certain level of microsurgical technique in a laboratory environment before training in the operation room. Hopefully, this tool will provide a structured template for other residency programs to assess their residents for basic microsurgical skills.
[Mh] Termos MeSH primário: Competência Clínica/normas
Avaliação Educacional/métodos
Internato e Residência
Microcirurgia/educação
Procedimentos Cirúrgicos Oftalmológicos/educação
Oftalmologia/educação
Técnicas de Sutura/educação
[Mh] Termos MeSH secundário: Lesões da Córnea/cirurgia
Seres Humanos
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180307
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0736-z


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[PMID]:29506497
[Au] Autor:Park SJ; Noh JH; Park KB; Jang SY; Lee JW
[Ad] Endereço:College of medicine, Soonchunhyang University, 204-ho, 31 Soonchunhyang-6-gil, Dongnam-gu, Cheonan, 31151, Choongcheongnam-do, South Korea.
[Ti] Título:A novel surgical technique for punctal stenosis: placement of three interrupted sutures after rectangular three-snip punctoplasty.
[So] Source:BMC Ophthalmol;18(1):70, 2018 Mar 05.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We developed a novel surgical technique to treat punctal stenosis involving the placement of three interrupted sutures after rectangular three-snip punctoplasty (TSP). METHODS: Retrospective chart review of forty-eight eyes of 44 patients who underwent rectangular TSP with three interrupted sutures was performed. We investigated whether anatomical recurrences (re-stenosis) occurred during the follow-up period. The subjective symptoms of patients were surveyed. RESULTS: The mean patient age was 64.1 years, and the mean follow-up time was 17.4 months. The placement of three interrupted sutures after rectangular TSP afforded satisfactory outcomes. Regarding subjective symptoms, 91.7% of the eyes (44/48) were reported as improved. Among 4 eyes determined as symptomatic failure, anatomical recurrence (re-stenosis of the punctum) was observed in only one eye. The other three (6.25%, 3/48 eyes) showed functional nasolacrimal obstruction, namely epiphora with patent tear duct. CONCLUSIONS: Placement of three interrupted sutures after rectangular TSP to treat punctal stenosis showed promising results. Notably anatomical success rate was about 98%. Further comparisons between the novel surgical technique and conventional techniques are required.
[Mh] Termos MeSH primário: Doenças Palpebrais/cirurgia
Aparelho Lacrimal/cirurgia
Obstrução dos Ductos Lacrimais/terapia
Procedimentos Cirúrgicos Oftalmológicos
Técnicas de Sutura
[Mh] Termos MeSH secundário: Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Nylons
Estudos Retrospectivos
Suturas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nylons)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180307
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0733-2


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[PMID]:29499664
[Au] Autor:Kim WJ; Kim MM
[Ad] Endereço:Department of Ophthalmology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, South Korea.
[Ti] Título:The fast exodrift after the first surgical treatment of exotropia and its correlation with surgical outcome of second surgery.
[So] Source:BMC Ophthalmol;18(1):67, 2018 Mar 02.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To compare the rate of exodrift after a second surgery for recurrent exotropia, in patients grouped to fast versus slow exodrift after their first surgery. To determine whether there is a correlation with surgical outcome, and to evaluate the factors associated with fast exodrift. METHODS: Patients with recurrent intermittent exotropia, who underwent contralateral lateral rectus recession and medial rectus resection as the second surgery and were followed up for 24 months postoperatively between January 1991 and January 2013, were reviewed retrospectively. The patients were divided into two groups according to the rate of exodrift after the first surgery: Group F, patients exhibiting fast exodrift after the first surgery (> 10 prism diopters [PD] before postoperative month 6); and Group S, patients exhibiting slow exodrift after the first surgery (≤10 PD before postoperative month 6). The difference in the clinical course over the 24 months after the second surgery between the two groups and factors associated with fast exodrift were analyzed. RESULTS: In total, 106 patients with recurrent exotropia were enrolled in this study. Of these, 68 (64.2%) and 38 (35.8%) patients were included in group F and S, respectively. Group F showed more exodrift compared with groups S over the 24-month postoperative period; however, there was no significant difference in the clinical course between the two groups during that time (p = 0.54, repeated-measure ANOVA). In logistic analysis, immediate postoperative deviation after the first surgery was associated with fast exodrift (p <  0.001). CONCLUSION: Although patients with recurrent exotropia had shown fast exodrift after the first surgery, no significant difference in the surgical outcome was observed after the second surgery according to the rate of exodrift after the first surgery.
[Mh] Termos MeSH primário: Exotropia/cirurgia
Músculos Oculomotores/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Exotropia/diagnóstico
Exotropia/fisiopatologia
Movimentos Oculares/fisiologia
Feminino
Seguimentos
Seres Humanos
Masculino
Músculos Oculomotores/fisiopatologia
Procedimentos Cirúrgicos Oftalmológicos
Prognóstico
Recidiva
Reoperação
Estudos Retrospectivos
Visão Binocular/fisiologia
Acuidade Visual
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180304
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0722-5


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[PMID]:29320823
[Au] Autor:Shin J; Ahn KS; Suh GH; Kim HJ; Jeong HS; Kim BS; Choi E; Shin SS
[Ad] Endereço:Department of Parasitology, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea.
[Ti] Título:First Blindness Cases of Horses Infected with Setaria Digitata (Nematoda: Filarioidea) in the Republic of Korea.
[So] Source:Korean J Parasitol;55(6):667-671, 2017 Dec.
[Is] ISSN:1738-0006
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Ocular setariases of cattle were reported but those of equine hosts have never been reported in the Republic of Korea (Korea). We found motile worms in the aqueous humor of 15 horses (Equus spp.) from 12 localities in southern parts of Korea between January 2004 and November 2017. After the affected animals were properly restrained under sedation and local anesthesia, 10 ml disposable syringe with a 16-gauge needle was inserted into the anterior chamber of the affected eye to successfully remove the parasites. The male worm that was found in 7 of the cases showed a pair of lateral appendages near the posterior terminal end of the body. The papillar arrangement was 3 pairs of precloacal, a pair of adcloacal, and 3 pairs of postcloacal papillae, plus a central papilla just in front of the cloaca. The female worms found in the eyes of 8 horses were characterized by the tapering posterior terminal end of the body with a smooth knob. Worms were all identified as Setaria digitata (von Linstow, 1906) by the morphologic characteristics using light and electron microscopic observations. This is the first blindness cases of 15 horses infected with S. digitata (Nematoda: Filarioidea) in Korea.
[Mh] Termos MeSH primário: Cegueira/etiologia
Cegueira/veterinária
Doenças dos Cavalos/etiologia
Doenças dos Cavalos/parasitologia
Cavalos
Procedimentos Cirúrgicos Oftalmológicos/veterinária
Setaria (Nematoide)/isolamento & purificação
Setaríase/complicações
Setaríase/parasitologia
[Mh] Termos MeSH secundário: Animais
Cegueira/cirurgia
Feminino
Doenças dos Cavalos/cirurgia
Masculino
Microscopia Eletrônica
Procedimentos Cirúrgicos Oftalmológicos/métodos
República da Coreia
Setaria (Nematoide)/anatomia & histologia
Setaria (Nematoide)/ultraestrutura
Setaríase/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3347/kjp.2017.55.6.667


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[PMID]:29211701
[Au] Autor:Zhong J; Deng Y; Zhang P; Li S; Huang H; Wang B; Zhang H; Peng L; Yang R; Xu J; Yuan J
[Ad] Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
[Ti] Título:New Grading System for Limbal Dermoid: A Retrospective Analysis of 261 Cases Over a 10-Year Period.
[So] Source:Cornea;37(1):66-71, 2018 Jan.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To establish a new scoring system for limbal dermoid, in order to unify the diagnostic criteria and assess the prognosis. METHODS: A retrospective study was conducted on 261 patients with limbal dermoid. The basic information, clinical features, and pathology of dermoids were recorded, and the prognosis at 1 year after keratoplasty was assessed at follow-up. A new visual scoring system was created for the area of corneal involvement, the area of conjunctival involvement, and the surface shape. RESULTS: There were 154 females and 107 males with mean age of 4 ± 3 years at surgery. After scoring, 59% (136) of patients were classified as grade I, 26% (60) as grade II, and 14% (33) as grade III. The pathological results were 124 dermoid cases, 76 lipodermoid, 5 complex choristoma, and 10 epibulbar osseous choristoma. Moreover, patients with lower clinical scores presented a better prognosis; the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity in grade I patients was 0.38 ± 0.05, which was better than the grade II value of 0.61 ± 0.09 (P < 0.05) and the grade III value of 0.94 ± 0.11 (P < 0.001). CONCLUSIONS: New grading systems for limbal dermoid were useful for clinical diagnosis and may have prognostic value in predicting visual acuity. A lower-grade dermoid exhibited better vision postoperatively.
[Mh] Termos MeSH primário: Doenças da Córnea/diagnóstico
Cisto Dermoide/diagnóstico
Neoplasias Oculares/diagnóstico
Limbo da Córnea/patologia
[Mh] Termos MeSH secundário: Pré-Escolar
Doenças da Córnea/cirurgia
Cisto Dermoide/cirurgia
Neoplasias Oculares/cirurgia
Feminino
Seres Humanos
Lactente
Limbo da Córnea/cirurgia
Masculino
Gradação de Tumores
Procedimentos Cirúrgicos Oftalmológicos
Prognóstico
Estudos Retrospectivos
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001429


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[PMID]:27772647
[Au] Autor:Choi CS; Hamrah P; Laver N
[Ad] Endereço:Department of Ophthalmology, Tufts Medical Center, Boston, Massachusetts.
[Ti] Título:Cystic Compound Melanocytic Nevus in a Pediatric Patient.
[So] Source:Ophthalmology;123(11):2293, 2016 11.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias da Túnica Conjuntiva/patologia
Cistos/patologia
Nevo Pigmentado/patologia
[Mh] Termos MeSH secundário: Criança
Neoplasias da Túnica Conjuntiva/diagnóstico por imagem
Neoplasias da Túnica Conjuntiva/cirurgia
Cistos/diagnóstico por imagem
Cistos/cirurgia
Feminino
Seres Humanos
Nevo Pigmentado/diagnóstico por imagem
Nevo Pigmentado/cirurgia
Procedimentos Cirúrgicos Oftalmológicos
Tomografia de Coerência Óptica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29442030
[Au] Autor:Resende AFC; Pereira AF; Moreira TP; Patrício PSO; Fialho SL; Cunha GMF; Silva-Cunha A; Magalhães JT; Silva GR
[Ti] Título:PLGA Implants containing vancomycin and dexamethasone: development, characterization and bactericidal effects.
[So] Source:Pharmazie;71(8):439-446, 2016 08 01.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Post-operative endophthalmitis is an infection and an inflammation of the eye following a surgical procedure. Its treatment is based on drug injections into the eye. However, this treatment can lead to ocular complications. Intraocular implants could substitute the conventional therapy. Poly(lactic-co-glycolic acid) (PLGA) implants comprising on vancomycin and dexamethasone were evaluated as drug delivery system to treat endophthalmitis after cataract surgery. Implants were characterized by drug content uniformity, Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), Wide Angle X-ray Scattering (WAXS), Scanning Electron Microscopy (SEM) and in vitro drug release. The bactericidal effect of vancomycin, eluted from the implants, was demonstrated against Staphylococcus aureus and Staphylococcus epidermidis. The drugs were uniformly distributed in the polymer. The analytical techniques revealed the chemical integrity of the drugs incorporated into the polymer and the modification of dexamethasone semi-crystalline nature. Drugs were controlled released from implants; and the eluted vancomycin showed bactericidal effects. In conclusion, PLGA implants containing vancomycin and dexamethasone may represent a therapeutic alternative to treat post-operative endophthalmitis.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antibacterianos/uso terapêutico
Anti-Inflamatórios/administração & dosagem
Anti-Inflamatórios/uso terapêutico
Bactérias/efeitos dos fármacos
Dexametasona/administração & dosagem
Dexametasona/uso terapêutico
Portadores de Fármacos
Ácido Láctico
Ácido Poliglicólico
Infecção da Ferida Cirúrgica/prevenção & controle
Vancomicina/administração & dosagem
Vancomicina/uso terapêutico
[Mh] Termos MeSH secundário: Antibacterianos/farmacologia
Implantes de Medicamento
Liberação Controlada de Fármacos
Endoftalmite/microbiologia
Endoftalmite/prevenção & controle
Seres Humanos
Testes de Sensibilidade Microbiana
Procedimentos Cirúrgicos Oftalmológicos
Staphylococcus aureus/efeitos dos fármacos
Staphylococcus epidermidis/efeitos dos fármacos
Vancomicina/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents); 0 (Drug Carriers); 0 (Drug Implants); 0 (polylactic acid-polyglycolic acid copolymer); 26009-03-0 (Polyglycolic Acid); 33X04XA5AT (Lactic Acid); 6Q205EH1VU (Vancomycin); 7S5I7G3JQL (Dexamethasone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6009


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[PMID]:29230976
[Au] Autor:Lee JS; Ha SW; Yu S; Lee GJ; Park YJ
[Ad] Endereço:Cheil Eye Hospital, Daegu, Korea.
[Ti] Título:Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium.
[So] Source:Korean J Ophthalmol;31(6):469-478, 2017 Dec.
[Is] ISSN:2092-9382
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
[Mh] Termos MeSH primário: Túnica Conjuntiva/transplante
Procedimentos Cirúrgicos Oftalmológicos/métodos
Pterígio/cirurgia
[Mh] Termos MeSH secundário: Autoenxertos
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.3341/kjo.2016.0135


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[PMID]:29486746
[Au] Autor:Rosentreter A; Lappas A; Widder RA; Alnawaiseh M; Dietlein TS
[Ad] Endereço:Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. andre.rosentreter@googlemail.com.
[Ti] Título:Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices.
[So] Source:BMC Ophthalmol;18(1):60, 2018 Feb 27.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. RESULT: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. CONCLUSIONS: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.
[Mh] Termos MeSH primário: Colágeno/uso terapêutico
Túnica Conjuntiva/lesões
Túnica Conjuntiva/cirurgia
Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Glicosaminoglicanos/uso terapêutico
Procedimentos Cirúrgicos Oftalmológicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Feminino
Seres Humanos
Pressão Intraocular
Masculino
Meia-Idade
Complicações Pós-Operatórias/cirurgia
Reoperação
Estudos Retrospectivos
Esclera/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycosaminoglycans); 9007-34-5 (Collagen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0721-6


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[PMID]:29482520
[Au] Autor:Rau A; Klopfer M; Rommel N; Rau-Fornefeld M; Kolk A
[Ad] Endereço:Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, D-81675, Munich, Germany. andrea.rau@tum.de.
[Ti] Título:Extraocular muscle repositioning as the last therapeutic option for a patient with a severe course of Graves' Ophthalmopathy: a case report.
[So] Source:BMC Ophthalmol;18(1):56, 2018 Feb 27.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Graves' disease is a common autoimmune inflammatory condition of the thyroid. About one in four of affected patients also develop orbital symptoms like exophthalmos, proptosis and diplopia - called Graves' Ophthalmopathy. Not all patients respond well to the standard therapy of systemic glucocorticoid administration. The inflammatory swelling of the intraorbital muscles can lead to pressure-induced damage of the optic nerve. Orbital decompression surgery is a therapeutic option for these patients with varying success. Other symptoms like the extreme malposition of the ocular globe are poorly addressed by decompression surgery and demand for different therapeutic approaches. CASE PRESENTATION: Presented is the case of a 46-year old patient with an acute exacerbation of Graves' ophthalmopathy. Clinically apparent was a convergent strabismus fixus with severe hypotropia of both eyes. The patient suffered from attacks of heavy retrobulbar pain and eyesight deteriorated dramatically. Since neither systemic glucocorticoid therapy nor orbital decompression surgery had helped to halt the progress of the disease, a decision was made in favour of the surgical release and repositioning of the inferior and medial rectus muscle as a final therapeutic option. Surgery of both eyes was performed consecutively within one week. Detailed descriptions and illustrations of the surgical steps and treatment outcome are provided supplemented by a discussion of the current literature. CONCLUSIONS: Graves' Ophthalmopathy is a variant and therapeutically challenging disease. Exceptional courses of the disease call for therapeutic approaches off the beaten track. Surgical extraocular muscle repositioning, which has not been described before in the context of Graves' Ophthalmopathy, proved to be effective in improving the patient's eyesight and quality of life. Furthermore, we regard the measurement of extraocular muscle volume as a valuable method to monitor the course of Graves' Ophthalmopathy.
[Mh] Termos MeSH primário: Oftalmopatia de Graves/cirurgia
Músculos Oculomotores/cirurgia
Procedimentos Cirúrgicos Oftalmológicos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Meia-Idade
Estrabismo/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180228
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0718-1



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