ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:Orbital inflammation is common, but the mechanisms underlying leukocytic infiltration of orbital tissue are poorly understood. We studied human orbital fibroblast (OF) interleukin-6 (IL-6) gene expression in response to proinflammatory stimuli and the effects of dexamethasone (DEX) and cyclosporin A (CSA) on cytokine-stimulated OF IL-6 gene expression.Methods:Cultured OFs were left unstimulated or incubated with varying concentrations of lipopolysaccharide (LPS), or recombinant (r) interleukin-1-beta (rIL-1β), tumor necrosis factor-alpha (rTNF-α), or interferon-gamma (rIFN-γ) for 2, 4, 8, or 24 hours. OFs were also incubated with rIL-1β (0.2, 2.0, 20 ng/ml) alone or in the presence of DEX (10-8, 10-7, 10-6mol/1) or CSA (3, 30, 300 ng/ml) for 8 hours to determine the effects of these immunomodulating drugs on IL-6 expression. Northern blot analyses were performed to determine OF IL-6 mRNA expression in response to varying concentrations of these agents. Experiments were repeated four times on different cell lines.Results:OFs lacked constitutive IL-6 gene expression. Substantial time- and dose-dependent increases in steady-state IL-6 mRNA expression occurred by 4 hours of LPS or cytokine stimulation (rIL-1β>rTNF-α>LPS>rIFN-γ), peaked at 8 hours, and were maintained at 24 hours. DEX caused dose-dependent inhibition of IL-1-induced IL-6 mRNA expression, while CSA potentiated IL-1-induced OF IL-6 mRNA expression.Conclusions:OFs express IL-6 mRNA in response to proinflammatory stimuli. DEX is a potent inhibitor of OF IL-6 mRNA while CSA increases IL-1-induced OF IL-6 gene expression. These observations may in part explain the lack of CSA effectiveness in human orbital diseases that respond to corticosteroids.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:We compared bovine pericardium and homologous sciera as wrapping materials for hydroxyapatite (HA) ocular implants in enucleated New Zealand white rabbits.Methods:Eighteen rabbits were unilaterally enucleated and the sockets implanted with 10-mm HA spherical implants. Six implants were wrapped with homologous sciera, 6 with bovine pericardium, and 6 were not wrapped. The rabbits were killed 7 weeks later and the sockets were examined clinically for inflammation and implant exposure. Exenterated specimens were assessed histopathologically for inflammation and vascularization.Results:No clinical evidence of implant exposure or extrusion was detected in rabbits receiving sciera or bovine pericardium wrapped implants. Histopathologically, the bovine pericardium displayed more inflammation in its outer portion, as well as more disruption of its lamellar arrangement than did the sciera. Fibrovascular ingrowth was complete in all wrapped implants.Conclusion:Bovine pericardium behaves similar clinically to homologous sciera as a wrapping material for spherical HA ocular implants in a rabbit model, and may represent a reasonable alternative to sciera in such procedures in humans.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:Fibrovascular ingrowth into various porous ocular implants as a function of implant material composition, porosity, growth factors, and coatings was investigated in a pilot study in an animal model.Methods:Eighty-one New Zealand white rabbits underwent unilateral enucleation and implantation with ocular implants composed of the following materials: coralline hydroxyapatite (HA) with 200-μm pores (HA200) or 500-μm pores (HA500), synthetic HA (synHA), and high-density porous polyethylene (PP). The HA200, HA500, and PP implants were implanted untreated or after treatment with recombinant human basic fibroblast growth factor (Rh-bFGF). Nine HA500 implants were implanted after coating with calcium sulfate (plaster of Paris) to provide a smooth outer surface. Implants were harvested at 1-, 2-, 4-, or 8-week intervals and were examined histologically.Results:A significant difference was found between untreated HA500 and PP, with PP showing better ingrowth. There was no significant difference between untreated HA and PP, nor between untreated HA500 and synHA. Significant increases in ingrowth were found in HA200 compared with HA500, and in Rh-bFGF-treated implants compared with untreated controls. The calcium sulfate-coated implants showed less vascularization compared with the uncoated implants, although the difference was not significant.Conclusions:Fibrovascular ingrowth occurred earlier in HA200 implants than in HA500 implants, and was enhanced when implants were treated with Rh-bFGF.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To develop a poly(2-hydroxyethyl methacrylate) orbital implant that allows tissue ingrowth and direct muscle attachment to minimize the risk of extrusion and to enhance cosmesis.Methods:Assessment of clinical outcomes and histologic findings after implantation of 18 prototype prostheses into rabbits. The implants were not wrapped with other tissues or materials.Results:One case of infection was observed but there were no extrusions, with up to 21 months follow-up. Biocolonization was confirmed histologically. Good movement was observed when a cosmetic shell was fitted.Conclusions:The prototype prosthesis appears promising, with particular advantages being the direct attachment of extraocular muscles, good cosmesis and movement, and a low complication rate in this pilot study.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To describe a tarsal transfer procedure, which we have named the “tarsal switch,” to correct the eyelid malpositions and camouflage the socket defects of acquired anophthalmos.Methods:The technique consists of an upper eyelid tarsectomy, with transfer of the autologous tarsoconjunctival graft to the posterior lamella of the lower eyelid.Results:The operation was performed in 21 anophthalmic patients. In 16 patients with eyelid malpositions, excellent results (within 1 mm of the fellow eye) were attained in 100% of the patients with ptosis, and in 88% of patients with lower eyelid retraction. In the remaining 5 patients, orbital volume loss with secondary implant migration, inferior prosthetic displacement and eyelid asymmetry predominated. In these patients the anophthalmic orbital defects and eyelid asymmetry were masked well. Patient satisfaction was high and complications were few during an average follow-up interval of 16 months.Conclusion:The tarsal switch procedure is useful in managing the eyelid malpositions and masking the orbital deficiencies of the anophthalmic socket.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To investigate the effectiveness of a procedure that addresses both the lower eyelid retractors and the lateral canthus in the treatment of patients with lower eyelid retraction.Methods:Through a combined lateral canthotomy and full-length transconjunctival incision, the lower eyelid retractors were disinserted across the horizontal length of the eyelid, recessed to the inferior fornix, and excised. A lateral canthopexy elevated the mobilized eyelid, and horizontal length disparity was corrected.Results:Forty lower eyelid operations in 23 patients yielded good results; all patients attained significant improvement in both eyelid position and function. No re-operations were required during a mean follow-up period of 28 months.Conclusion:Although not ideal for severe cases requiring posterior lamellar spacers or anterior lamellar (skin) grafts, this union of techniques successfully treats many types of lower eyelid retraction.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To determine the effectiveness of transconjunctival frontalis suspension in patients with blepharoptosis and poor levator function (eyelid excursion less then 5 mm).Methods:The medical records of 29 patients (50 ptotic eyelids) were reviewed.Results:Four patients (eight eyelids) had blepharophimosis syndrome, ten patients (27 eyelids) had congenital ptosis, seven patients (14 eyelids) had myogenic ptosis, and one patient (one eyelid) had neurogenic ptosis. Surgical results were good and complications were minimal during follow-up intervals ranging from six months to seven years.Conclusions:Transconjunctival frontalis suspension is technically simpler than traditional external frontalis suspension and yields satisfactory functional and cosmetic results in patients with poor levator function.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To describe the clinical characteristics of congenital horizontal tarsal kink.Methods:Retrospective clinical series derived from a literature review and mail survey. Characteristics included sex, race, association with systemic diseases, interval between birth and diagnosis, laterality, presence of corneal ulcer and causative infectious agent, treatment, and visual outcome.Results:Twenty-five cases were reviewed. The typical patient is a white male diagnosed at 7.2 weeks of age. Right-sided and bilateral cases were most common. Ulcers were present in 12/24 patients; most were culture negative. Various methods of surgical repair were successful. Visual outcomes, in general, were favorable although amblyopia developed in 4/15 patients.Conclusions:Congenital horizontal tarsal kink is rare and its cause is unknown. A poor visual outcome usually results from a corneal ulcer scar and a delay in diagnosis. Amblyopia not related to corneal opacification can also occur.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To present a patient with congenital entropion of the upper eyelid caused by levator aponeurosis disinsertion.Methods:Case report.Results:Surgical correction of the levator aponeurosis disinsertion corrected the upper eyelid entropion.Conclusions:Congenital upper eyelid entropion may be caused by levator aponeurosis disinsertion and treated effectively by repairing the anatomic defect.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID