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GLAUCOMA AS ETIOPATHOGENETIC HYPOTHESIS OF AMAUROSIS AFTER BLEPHAROPLASTY - CASE-REPORT
No full textAmaurosis after blepharoplasty is a complication which is considered to be rare, but which nevertheless deserves extreme attention. Although various hypoteses have been proposed (and sometimes proved) its etiopathogenesis is still uncertain. The observation of a case of temporary loss of vision after blepharoplasty, which promptly regressed after medical therapy, led us to a revision of the most common causes of amaurosis, and to formulate, for this case, the etiopathogenetic hypothesis of acute glaucoma, which has already been reported in scientific literature, but without any case report
[Glaucoma as etiopathogenic hypothesis of amaurosis after blepharoplasty. Apropos of a clinical case]
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Comparison between discriminant analysis models and "glaucoma probability score" for the detection of glaucomatous optic nerve head changes
No full textPURPOSE: The aim of this study was to evaluate and compare 4 different discriminant analysis formulas and the new Glaucoma Probability Score (GPS) for the detection of morphometric optic nerve head changes in chronic open-angle glaucoma. METHODS: This is a prospectively planned cross-sectional study. Two hundred and fourteen consecutive eyes were recruited into this study. For each patient, the eyes were evaluated by a slit lamp examination, and the visual fields were assessed by a Humphrey Field Analyzer 750 (HFA, Humphrey Inc, San Leandro, CA), using the standard full threshold 24-2 (Swedish Interactive Threshold Algorithm) program. The optic nerve heads were morphometrically evaluated using the Heidelberg Retina Tomograph 3 (HRT 3, Heidelberg Engineering, Heidelberg, Germany; software version 3.0). From the HRT data, 4 discriminant analysis formulas and the GPS were considered. All data were analyzed by Student t test and Pearson r coefficient. A linear regression model was also used to determine the independent contribution of variables included in the model. Sensitivity, specificity, diagnostic precision, and receiver operating characteristic curve areas were calculated for all the 5 methods examined. κ statistic was used to study the agreement among, and between, the 5 different methods. RESULTS: One hundred and nineteen normal eyes and 95 eyes with primary open-angle glaucoma were included in the study. No significant difference was found between the 2 study subgroups in both age and refractive error. Significant (P<0.001) correlations were found between visual field indices and the HRT parameters. Sensitivity, specificity, and diagnostic precision of the 4 formulas ranged between 50% and 99.16%. Bathija et al's formula had the highest diagnostic precision, followed by Mikelberg's formula. Using κ statistics, κ ranged from 0.177 to 0.528 when comparing each single discriminant formula with the GPS. CONCLUSIONS: The GPS showed similar sensitivity and specificity to the Mikelberg and Bathija formulas; this method is a promising one for differentiating between healthy and glaucomatous eyes, requiring no subjective user input. © 2008 by Lippincott Williams & Wilkins
Surgical correction of blepharoptosis using the levator aponeurosis-Müller's muscle complex readaptation technique: a 15-year experience
No full textPalpebral ptosis is defined as abnormal drooping of the upper lid, caused by partial or total reduction in levator muscle function. It may be caused by various abnormalities, both congenital and acquired. The aim of this article is to report the long-term follow-up of results obtained with the levator aponeurosis-Müller's muscle complex readaptation technique.
METHODS:
In a clinical study, 144 eyelids (102 patients) affected by congenital or acquired blepharoptosis were treated using the levator aponeurosis-Müller's muscle complex readaptation technique. Degree of ptosis and levator function were measured preoperatively and postoperatively. All patients were followed up for 1 year, 54 of them for 3 years, 22 for 5 years, and 12 for 10 years.
RESULTS:
Complete correction or mild residual ptosis was achieved in over 83 percent. All ptosis with preoperative levator function greater than 8 mm was completely corrected, whereas eyelids with poor or absent levator function showed a variable degree of postoperative correction and a statistically significant difference. Ptosis correction between eyelids with levator function greater than 8 mm or less than 8 mm was analyzed statistically using the McNemar test for paired data.
CONCLUSIONS:
This surgical technique is effective in both acquired and congenital ptosis. In particular, the authors obtained better results in those with fair to good (> 8 mm) levator function than in those with poor or absent (< or = 8 mm) levator function
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