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Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
It is important to recognise when a blepharoplasty is inappropriate. This includes risk factors that expose a patient to exposure keratopathy, namely a history of contact lens wear, previous corneal laser refractive surgery, dry eye, facial palsy or thyroid dysfunction (which causes thickening of the subcutaneous region). Postmenopausal women should be specifically warned of the temporary risk of dry eyes immediately post-operatively (which may last weeks). Serious complications include orbital hemorrhage (0.05%) or a retrobulbar hematoma, which may present as severe pain, and result in disrupted cosmesis and/or blindness (which is a surgical emergency).
Levator denervation for upper lid retraction secondary to seventh nerve palsy
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
K. G. Boboridis, N. G. Ziakas, N. S. Georgiadis
The outcome measures recorded were vertical palpebral aperture, marginal reflex distance for upper and lower lid, levator function, lagophthalmos, the state of corneal epithelium (punctate keratopathy) and patient symptoms. Follow up was performed the following day, in two weeks and every month post treatment.
Chronic Hyperglycemia Impairs Vision, Hearing, and Sensory Function
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
The journal Investigative Ophthalmology and Visual Science featured a report titled “Advanced glycation end products in diabetic corneas.” The aim of this study was to determine the role of AGEs in the pathogenesis of diabetic keratopathy because, as the authors pointed out, corneas in diabetic patients are exposed to increased glucose concentration despite their relatively avascular property, and this condition may contribute to the accumulation of AGEs. Keratopathy is any corneal disease, damage, dysfunction, or abnormality. There are several varieties.
Guidelines for non-transplant chemotherapy for treatment of systemic AL amyloidosis: EHA-ISA working group
Published in Amyloid, 2023
Ashutosh D. Wechalekar, M. Teresa Cibeira, Simon D. Gibbs, Arnaud Jaccard, Shaji Kumar, Giampaolo Merlini, Giovanni Palladini, Vaishali Sanchorawala, Stefan Schönland, Christopher Venner, Mario Boccadoro, Efstathios Kastritis
The B-cell maturation antigen (BCMA) is another cell surface molecule ubiquitously expressed on plasma cell as well as their B-cell progenitors. There have been several unique targeting strategies demonstrating clear anti-plasma cell activity in multiple myeloma [82]. To date, however, the experience specifically in AL amyloidosis is limited. A novel antibody-drug conjugate, Belantamab mafodotin, combines the potent mafodotin toxin with plasma cell targeting anti-BCMA monoclonal antibody [83]. It has demonstrated excellent single agent activity in advanced relapsed and refractory multiple myeloma. Combination studies with various immunomodulating agents and proteasome inhibitors are ongoing. A prospective EMN study (NCT04617925) is examining Belantamab in relapsed AL amyloidosis. An important consideration with this agent is the unique ocular toxicity in the form of keratopathy which has proven to be a challenge in the delivery of this agent. In AL amyloidosis, with the often-lower clonal burden, less frequent and finite dosing strategies built around response adapted approaches may help limit this issue without compromising efficacy.
Management of Marcus Gunn jaw wink syndrome with tarsofrontalis sling vis a vis levator excision and frontalis sling: a comparative study
Published in Orbit, 2023
Parinita Singh, Kirthi Koka, Md Shahid Alam, Bipasha Mukherjee
Data analyzed included demographic details, clinical details, and pre- and post-operative severity of ptosis and MGJWS. Ptosis was classified as mild (2 mm), moderate (3 mm), and severe (≥4 mm) based on the difference in marginal reflex distance (MRD-1) between the two eyes or considering MRD-1 of 4 mm as normal in bilateral cases.6 The lid excursion due to jaw winking was graded as mild (<2 mm), moderate (2–5 mm), and severe (>5 mm).3 In patients with associated strabismus, the measurements were recorded following strabismus correction. All patients were given the option of either TFS alone or LPS excision plus TFS. The patients who had undergone the former surgery were categorized under group A and the latter under group B. Follow-up ptosis measurements and amount of lid excursion were recorded at 6 weeks and 6 months post-surgery. The resolution of MGJWS was defined as an excursion of less than or equal to 1 mm following surgery.7 Lagophthalmos was measured with gentle lid closure at 6 weeks and 6 months. Early and late complications in both the groups and their management were recorded. Exposure keratopathy was defined as damage to the ocular surface resulting from inadequate eyelid closure and it ranges from superficial punctate keratopathy to epithelial defect, ulcer. A difference of more than 1 mm in MRD-1 was defined as under-correction.8
Incidence of corneal adverse events in patients with multiple myeloma and their clinical and economic impact: A real-world retrospective cohort study
Published in Journal of Medical Economics, 2022
Feng Wang, Leah Sansbury, Shannon Ferrante, Eric M. Maiese, Jenny Willson, Chi-Chang Chen, Sasikiran Nunna, Kainan Sun, David M. Kleinman
Patients without any ICD-9/10 diagnosis codes or treatments indicative of diagnosis of corneal AEs in the baseline period (defined as up to 12 months prior to the index period for both cohorts) but who had incidence of corneal AEs during any line of therapy were assessed. Corneal AEs were identified by cross-walking from MedDRA “corneal disorders” codes to ICD codes (ICD-9 or ICD-10). The incidence of any corneal AE as well as individual corneal AEs are reported as a percentage of patients with incident corneal AEs (patients without corneal AE in the baseline period but who had an incidence in the follow-up period) among all patients, irrespective of the baseline presence of corneal AEs. This study specifically investigated the incidence of keratopathy/keratitis, blurred vison/decreased acuity, and dry eye, as well as eye pain and photophobia. The incidence of corneal AE was assessed by LOT (1, 2, 3, and 4+).