Pub Date : 2024-05-27eCollection Date: 2024-04-01DOI: 10.4103/tjo.TJO-D-24-00010
Jonathan T W Au Eong, Jarryl H J Tsai, Niall J Crosby, Kah-Guan Au Eong
{"title":"Childhood myopia and the coronavirus disease 2019 pandemic: Lessons for future pandemics.","authors":"Jonathan T W Au Eong, Jarryl H J Tsai, Niall J Crosby, Kah-Guan Au Eong","doi":"10.4103/tjo.TJO-D-24-00010","DOIUrl":"10.4103/tjo.TJO-D-24-00010","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 2","pages":"284-285"},"PeriodicalIF":1.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27eCollection Date: 2024-04-01DOI: 10.4103/tjo.TJO-D-24-00011
Shanel Sharma, Loreto Rose, Angela Schulz, Daya P Sharma, Alina Zeldovich, Cristena Azzi, Ken Nischal
There has been an increased understanding of the protective effect of two or more hours in high lux light on the development and progression of myopia. The aim of myopia management is to reduce the incidence of high myopia and sight-threatening myopic complications. Equally important are the sight-threatening complications of ultraviolet radiation (UVR) on the eye and adnexal structures. This review will analyze the literature for both these epidemics to help guide public health policy. Whilst increasing childhood high lux light exposure is important, consideration of a holistic eye health policy should ensure that UV eye diseases are also prevented. The advent of ultraviolet (UV) fluorescence photography has increased our understanding that significant UV eye damage occurs in childhood, with 81% of children aged 12-15 years having signs of UV eye damage. Hence, the need to reduce myopia and protect from UV-related eye diseases needs simultaneous consideration. Advocating for eye protection is important, particularly as the natural squint reflex is disabled with dark sunglasses lenses. The pathways UV reaches the eye need to be considered and addressed to ensure that sunglasses offer optimum UV eye protection. The design of protective sunglasses that simultaneously allow high lux light exposure and protect from UVR is critical in combating both these epidemics.
{"title":"Myopia intervention and ultraviolet radiation related eye diseases: A narrative literature review.","authors":"Shanel Sharma, Loreto Rose, Angela Schulz, Daya P Sharma, Alina Zeldovich, Cristena Azzi, Ken Nischal","doi":"10.4103/tjo.TJO-D-24-00011","DOIUrl":"10.4103/tjo.TJO-D-24-00011","url":null,"abstract":"<p><p>There has been an increased understanding of the protective effect of two or more hours in high lux light on the development and progression of myopia. The aim of myopia management is to reduce the incidence of high myopia and sight-threatening myopic complications. Equally important are the sight-threatening complications of ultraviolet radiation (UVR) on the eye and adnexal structures. This review will analyze the literature for both these epidemics to help guide public health policy. Whilst increasing childhood high lux light exposure is important, consideration of a holistic eye health policy should ensure that UV eye diseases are also prevented. The advent of ultraviolet (UV) fluorescence photography has increased our understanding that significant UV eye damage occurs in childhood, with 81% of children aged 12-15 years having signs of UV eye damage. Hence, the need to reduce myopia and protect from UV-related eye diseases needs simultaneous consideration. Advocating for eye protection is important, particularly as the natural squint reflex is disabled with dark sunglasses lenses. The pathways UV reaches the eye need to be considered and addressed to ensure that sunglasses offer optimum UV eye protection. The design of protective sunglasses that simultaneously allow high lux light exposure and protect from UVR is critical in combating both these epidemics.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 2","pages":"151-158"},"PeriodicalIF":1.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26eCollection Date: 2024-07-01DOI: 10.4103/tjo.TJO-D-24-00014
Dhruval Ashok Khurana
{"title":"Seeing the future: Ophthalmology gets \"eye-tech\" savvy with Internet of Medical Thing.","authors":"Dhruval Ashok Khurana","doi":"10.4103/tjo.TJO-D-24-00014","DOIUrl":"10.4103/tjo.TJO-D-24-00014","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 3","pages":"458-460"},"PeriodicalIF":1.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-15eCollection Date: 2024-01-01DOI: 10.4103/tjo.TJO-D-24-00009
Jorge L Alio
{"title":"Corneal transplantation surgery: Where we are and where are we going?","authors":"Jorge L Alio","doi":"10.4103/tjo.TJO-D-24-00009","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-24-00009","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 1","pages":"1-2"},"PeriodicalIF":1.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-15eCollection Date: 2024-01-01DOI: 10.4103/tjo.TJO-D-23-00176
Francisco Arnalich-Montiel
This case report presents a unique instance of a 55-year-old male patient exhibiting features of both Terrien marginal degeneration (TMD) and Fuchs' superficial marginal keratitis. Characterized by peripheral corneal thinning vascularization, and a pseudopterygium, the patient experienced recurrent photophobia, redness, and tearing over 15 years. This case challenges the traditional distinction between TMD and Fuchs' superficial marginal keratitis, suggesting a potential common underlying disorder. Mycophenolate mofetil provided a partial response, while pseudopterygium removal led to sustained remission, emphasizing its therapeutic significance. This case highlights the first documented use of mycophenolate in TMD and supports the notion of shared vasculitic origins between TMD and Fuchs' keratitis, raising intriguing questions about targeted therapeutic interventions.
{"title":"Systemic treatment and surgical intervention in inflammatory Terrien disease.","authors":"Francisco Arnalich-Montiel","doi":"10.4103/tjo.TJO-D-23-00176","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-23-00176","url":null,"abstract":"<p><p>This case report presents a unique instance of a 55-year-old male patient exhibiting features of both Terrien marginal degeneration (TMD) and Fuchs' superficial marginal keratitis. Characterized by peripheral corneal thinning vascularization, and a pseudopterygium, the patient experienced recurrent photophobia, redness, and tearing over 15 years. This case challenges the traditional distinction between TMD and Fuchs' superficial marginal keratitis, suggesting a potential common underlying disorder. Mycophenolate mofetil provided a partial response, while pseudopterygium removal led to sustained remission, emphasizing its therapeutic significance. This case highlights the first documented use of mycophenolate in TMD and supports the notion of shared vasculitic origins between TMD and Fuchs' keratitis, raising intriguing questions about targeted therapeutic interventions.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 1","pages":"108-111"},"PeriodicalIF":1.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ocular comorbidities can happen as congenital defective gene associations. We present a 37-year-old female patient who was mentally challenged and had coexisting achromatopsia gene abnormality on genetic analysis. She was operated in childhood for congenital cataract, and posterior chamber intraocular lens (IOL) was implanted at 10 years of age elsewhere. The patient presented 27 years later with luxated IOL with endothelial decompensation. There was a coexisting steep and thin cornea noted on corneal topography. She was managed with pre-Descemet's endothelial keratoplasty with transpositioning of posterior chamber IOL to glued IOL with single-pass four-throw pupilloplasty. Postoperatively, the cornea was clear with centered glued IOL. The lesser postanesthetic challenges and faster rehabilitation are obtained in combination procedures with reduced complications in such rare scenarios.
{"title":"Pre-Descemet's endothelial keratoplasty with glued intraocular lens implantation with pinhole pupilloplasty in a case of ocular comorbidity in achromatopsia.","authors":"Dhivya Ashok Kumar, Amar Agarwal, Swetha Ravichandran","doi":"10.4103/tjo.TJO-D-23-00172","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-23-00172","url":null,"abstract":"<p><p>Ocular comorbidities can happen as congenital defective gene associations. We present a 37-year-old female patient who was mentally challenged and had coexisting achromatopsia gene abnormality on genetic analysis. She was operated in childhood for congenital cataract, and posterior chamber intraocular lens (IOL) was implanted at 10 years of age elsewhere. The patient presented 27 years later with luxated IOL with endothelial decompensation. There was a coexisting steep and thin cornea noted on corneal topography. She was managed with pre-Descemet's endothelial keratoplasty with transpositioning of posterior chamber IOL to glued IOL with single-pass four-throw pupilloplasty. Postoperatively, the cornea was clear with centered glued IOL. The lesser postanesthetic challenges and faster rehabilitation are obtained in combination procedures with reduced complications in such rare scenarios.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 1","pages":"112-116"},"PeriodicalIF":1.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00110
Soumen Chakraborty, Satish Reddy Satty, Badal Kumar Sahu, Soumya Ray
A sudden surge of Mucormycosis cases during the second wave of Covid 19 was observed in certain parts of India. The reasons for this upsurge remain unknown. However its impact on the overall healthcare system was quite overwhelming. In this context this study was decided to estimate and assess the spectrum of orbital involvement in patients with Mucormycosis, to find its association with coexisting disease entities if any, and at the same time evaluate the therapeutic response to established treatment regimens. This descriptive longitudinal study was conducted over a period of six months. Patients presenting with symptoms of Mucormycosis were jointly evaluated by a multi speciality team. After confirmation of diagnosis, patients were treated with intravenous Amphotericin B, surgical debridement of affected sinuses and orbital exenteration when indicated. They were followed up for three months after discharge. Forty-three patients were enrolled in this study. Thirty-seven (86.04%) were COVID positive. All of them had history of steroid exposure during COVID treatment. Ninety five percent of study participants had diabetes mellitus. Twenty-seven (62.79%) patients had orbital involvement. Most common clinical presentation was peri-orbital or facial pain and edema. Besides medical treatment, thirty-nine patients (90.69%) required sinus debridement and nine patients (20.9%) required orbital exenteration. Thirteen patients (30.23%) expired during the follow up period. With treatment disease regressed in twenty patients (46.51%). Diabetes and use of steroids to prevent anticipated cytokine storm may be the inciting factors for Orbital Mucormycosis in COVID patients. Early diagnosis, treatment and control of risk factors are keys for recovery and survival..
{"title":"Resurgence of orbital mucormycosis during COVID-19 pandemic: Study from a tertiary care center in Eastern India","authors":"Soumen Chakraborty, Satish Reddy Satty, Badal Kumar Sahu, Soumya Ray","doi":"10.4103/tjo.tjo-d-23-00110","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00110","url":null,"abstract":"\u0000 \u0000 \u0000 A sudden surge of Mucormycosis cases during the second wave of Covid 19 was observed in certain parts of India. The reasons for this upsurge remain unknown. However its impact on the overall healthcare system was quite overwhelming. In this context this study was decided to estimate and assess the spectrum of orbital involvement in patients with Mucormycosis, to find its association with coexisting disease entities if any, and at the same time evaluate the therapeutic response to established treatment regimens.\u0000 \u0000 \u0000 \u0000 This descriptive longitudinal study was conducted over a period of six months. Patients presenting with symptoms of Mucormycosis were jointly evaluated by a multi speciality team. After confirmation of diagnosis, patients were treated with intravenous Amphotericin B, surgical debridement of affected sinuses and orbital exenteration when indicated. They were followed up for three months after discharge.\u0000 \u0000 \u0000 \u0000 Forty-three patients were enrolled in this study. Thirty-seven (86.04%) were COVID positive. All of them had history of steroid exposure during COVID treatment. Ninety five percent of study participants had diabetes mellitus. Twenty-seven (62.79%) patients had orbital involvement. Most common clinical presentation was peri-orbital or facial pain and edema. Besides medical treatment, thirty-nine patients (90.69%) required sinus debridement and nine patients (20.9%) required orbital exenteration. Thirteen patients (30.23%) expired during the follow up period. With treatment disease regressed in twenty patients (46.51%).\u0000 \u0000 \u0000 \u0000 Diabetes and use of steroids to prevent anticipated cytokine storm may be the inciting factors for Orbital Mucormycosis in COVID patients. Early diagnosis, treatment and control of risk factors are keys for recovery and survival..\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"37 29","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00100
Hwa-Shin Fang, Chang-Sue Yang, Cheng-Kuo Cheng, Yuangwei Wang
A 56-year-old female presented with bilateral progressive blurred vision over 1 month. She has no known malignancy before her initial visit to our ophthalmologic clinic. Her best-corrected visual acuity decreased to hand motion from 30 cm in both eyes. Optical coherence tomography exhibited parafoveal thinning of outer retinal layers bilaterally. Fluorescein angiography and indocyanine green angiography disclosed hypofluorescent spots in late phase in both eyes. The suspicion of cancer-associated retinopathy (CAR) prompted us to investigate and refer for further systemic disease including occult malignancy. The patient was diagnosed with small-cell carcinoma of the endometrium or cervix, which is an extremely rare and aggressive neuroendocrine tumor. The patient was treated with oral prednisone with improved visual acuity. The patient expired from sepsis 2 months after her initial visit to our ophthalmologic clinic. In selected cases, CAR may present before the diagnosis of primary cancer. It is essential to recognize its ophthalmic manifestation for early discovery of primary malignancy.
{"title":"Cancer-associated retinopathy as an initial presentation of gynecologic small-cell carcinoma","authors":"Hwa-Shin Fang, Chang-Sue Yang, Cheng-Kuo Cheng, Yuangwei Wang","doi":"10.4103/tjo.tjo-d-23-00100","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00100","url":null,"abstract":"\u0000 A 56-year-old female presented with bilateral progressive blurred vision over 1 month. She has no known malignancy before her initial visit to our ophthalmologic clinic. Her best-corrected visual acuity decreased to hand motion from 30 cm in both eyes. Optical coherence tomography exhibited parafoveal thinning of outer retinal layers bilaterally. Fluorescein angiography and indocyanine green angiography disclosed hypofluorescent spots in late phase in both eyes. The suspicion of cancer-associated retinopathy (CAR) prompted us to investigate and refer for further systemic disease including occult malignancy. The patient was diagnosed with small-cell carcinoma of the endometrium or cervix, which is an extremely rare and aggressive neuroendocrine tumor. The patient was treated with oral prednisone with improved visual acuity. The patient expired from sepsis 2 months after her initial visit to our ophthalmologic clinic. In selected cases, CAR may present before the diagnosis of primary cancer. It is essential to recognize its ophthalmic manifestation for early discovery of primary malignancy.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"14 21","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00106
Christina Wang, Arturo Castillo, Federico Cortes-Bejarano, Eduardo Lopez, Eduardo Cunha de Souza, Lihteh Wu
Dengue is the most common arboviral disease. It is typically spread by the bite of an infected female Aedes aegypti or Aedes albopictus mosquitoes. Dengue is endemic in subtropical and tropical regions, but its geographic reach keeps expanding. Ophthalmic manifestations of dengue are common and may present with a wide spectrum of ophthalmic findings. These may range from conjunctival petechiae, retinal hemorrhage, retinal vasculitis to panophthalmitis. Some of these may be vision threatening and may require urgent ophthalmic evaluation. The precise pathophysiologic mechanisms involved in dengue infection involve a complex interplay between host immune responses, virus, and host genes. There is no specific treatment for ocular dengue. Therefore, treatment is supportive. Despite the lack of proven efficacy, corticosteroids have been used in vision-threatening dengue-related ocular complications. Dengue must be considered in endemic areas, and a careful travel history needs to be elicited in nonendemic areas.
{"title":"An update on the ocular manifestations of dengue","authors":"Christina Wang, Arturo Castillo, Federico Cortes-Bejarano, Eduardo Lopez, Eduardo Cunha de Souza, Lihteh Wu","doi":"10.4103/tjo.tjo-d-23-00106","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00106","url":null,"abstract":"\u0000 Dengue is the most common arboviral disease. It is typically spread by the bite of an infected female Aedes aegypti or Aedes albopictus mosquitoes. Dengue is endemic in subtropical and tropical regions, but its geographic reach keeps expanding. Ophthalmic manifestations of dengue are common and may present with a wide spectrum of ophthalmic findings. These may range from conjunctival petechiae, retinal hemorrhage, retinal vasculitis to panophthalmitis. Some of these may be vision threatening and may require urgent ophthalmic evaluation. The precise pathophysiologic mechanisms involved in dengue infection involve a complex interplay between host immune responses, virus, and host genes. There is no specific treatment for ocular dengue. Therefore, treatment is supportive. Despite the lack of proven efficacy, corticosteroids have been used in vision-threatening dengue-related ocular complications. Dengue must be considered in endemic areas, and a careful travel history needs to be elicited in nonendemic areas.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05DOI: 10.4103/tjo.tjo-d-23-00081
R. Goel, Sonam Singh, Shalin Shah, S. Khanam, Priyanka Golhait, Tanvi Gaonker
The purpose of this study was to compare the outcomes of “closed posterior levator advancement” (CPLA) in acquired aponeurotic and simple congenital ptosis with good levator function (LF). A prospective interventional study was conducted on 20 adult patients, 10 simple congenital ptosis, and 10 acquired aponeurotic ptosis with LF ≥8 mm. Complicated, posttraumatic, neurogenic ptosis and previous lid surgery were excluded. A detailed history and assessment of visual acuity, upper eyelid margin reflex distance (MRD1), margin-crease distance, LF, Bell’s phenomenon, ocular surface disease index (OSDI), and phenylephrine test were undertaken. CPLA was performed in the 20 eyes and were followed up for 3 months. The ages of the study participants ranged from 18 to 64 years, and the male: female ratio was 11:9. There were nine aponeurotic and one congenital severe ptosis, the remaining 10 being mild–moderate ptosis. The etiologies in the aponeurotic group were involutional (2), contact lens wear (1), allergic conjunctivitis (3), and idiopathic in four eyes. The success rates were 90% in both groups. The amount of ptosis correction showed a positive relation with LF (r s = 0.6, P = 0.004) and phenylephrine test (r s = 0.7, P < 0.001). The complications in the aponeurotic group were lagophthalmos (2/10), subjective dry eye (2/10), subconjunctival hemorrhage (1/10), symblepharon (1/10), temporal flare (1/10), and overcorrection (1/10). The congenital group showed only undercorrection (1/10). CPLA is an effective procedure for the treatment of mild–moderate simple congenital and all grades of aponeurotic ptosis with good LF. Response to phenylephrine test serves as a useful guide to the amount of ptosis correction.
{"title":"Comparative evaluation of “closed posterior levator advancement” in simple congenital and aponeurotic ptosis","authors":"R. Goel, Sonam Singh, Shalin Shah, S. Khanam, Priyanka Golhait, Tanvi Gaonker","doi":"10.4103/tjo.tjo-d-23-00081","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00081","url":null,"abstract":"\u0000 \u0000 \u0000 The purpose of this study was to compare the outcomes of “closed posterior levator advancement” (CPLA) in acquired aponeurotic and simple congenital ptosis with good levator function (LF).\u0000 \u0000 \u0000 \u0000 A prospective interventional study was conducted on 20 adult patients, 10 simple congenital ptosis, and 10 acquired aponeurotic ptosis with LF ≥8 mm. Complicated, posttraumatic, neurogenic ptosis and previous lid surgery were excluded. A detailed history and assessment of visual acuity, upper eyelid margin reflex distance (MRD1), margin-crease distance, LF, Bell’s phenomenon, ocular surface disease index (OSDI), and phenylephrine test were undertaken. CPLA was performed in the 20 eyes and were followed up for 3 months.\u0000 \u0000 \u0000 \u0000 The ages of the study participants ranged from 18 to 64 years, and the male: female ratio was 11:9. There were nine aponeurotic and one congenital severe ptosis, the remaining 10 being mild–moderate ptosis. The etiologies in the aponeurotic group were involutional (2), contact lens wear (1), allergic conjunctivitis (3), and idiopathic in four eyes. The success rates were 90% in both groups. The amount of ptosis correction showed a positive relation with LF (r\u0000 s = 0.6, P = 0.004) and phenylephrine test (r\u0000 s = 0.7, P < 0.001). The complications in the aponeurotic group were lagophthalmos (2/10), subjective dry eye (2/10), subconjunctival hemorrhage (1/10), symblepharon (1/10), temporal flare (1/10), and overcorrection (1/10). The congenital group showed only undercorrection (1/10).\u0000 \u0000 \u0000 \u0000 CPLA is an effective procedure for the treatment of mild–moderate simple congenital and all grades of aponeurotic ptosis with good LF. Response to phenylephrine test serves as a useful guide to the amount of ptosis correction.\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"2 22","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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