Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022575 (keratoconjunctivitis sicca)
 772 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In two patients with keratoconjunctivitis sicca, epiphora did not occur after temporary canalicular occlusion with collagen implants, but did occur after subsequent permanent punctal occlusion. This suggests that collagen implants may not always produce total occlusion. Patients should be warned of this possibility.
 ...
PMID:Failure of collagen plugs to predict epiphora after permanent punctal occlusion. 832 13

Although Stevens-Johnson syndrome (SJS) has long been recognized as a cause of punctal and canalicular obstruction, nasolacrimal duct obstruction secondary to SJS is rare and has not been reported in the ophthalmologic literature. Keratoconjunctivitis sicca, entropion, and trichiasis are well-known complications of SJS that may require measures to supplement or preserve tears. Lacrimal drainage system obstruction may occasionally occur in the face of relatively normal tearing, resulting in clinically significant epiphora. We report two cases of SJS, one associated with epidemic keratoconjunctivitis, that led to nasolacrimal duct obstruction and canalicular obstruction or stenosis. Epiphora and, in one case, dacryocystitis, necessitated dacryocystorhinostomy and Crawford tube insertion.
 ...
PMID:Stevens-Johnson syndrome with associated nasolacrimal duct obstruction treated with dacryocystorhinostomy and Crawford silicone tube insertion. 226 2

Punctal occlusion was carried out in 32 eyes with tear deficiency syndromes regardless of the preoperative Schirmer tear test values. Diagnoses included: keratoconjunctivitis sicca, Stevens-Johnson syndrome, congenital alacremia, and post-traumatic tear deficiency. Subjective symptomatic improvement was recorded in 97% of the eyes. Objective improvement was recorded as resolution or improvement of corneal ulceration, filamentary keratitis, and superficial punctate keratitis. All patients (100%) experienced improvement in one or more of these diagnostic signs. A tarsorrhaphy was required as adjunctive therapy to punctal occlusion in three eyes with Stevens-Johnson syndrome. Epiphora did not occur after surgery even though 16 eyes (50%) had preoperative Schirmer tear test values greater than 2 mm (range 0-15 mm). Artificial tears were discontinued or reduced to occasional use in 85% of eyes postocclusion of puncta. Eight puncta reopened; five of the eight required reocclusion. In this series, punctal occlusion was a safe and effective method of managing severe tear deficiency syndromes and should be considered more frequently in patients with the appropriate criteria.
 ...
PMID:Punctal occlusion in tear deficiency syndromes. 715 28

The medical records of 141 patients with dermatochalasis seen during the 32-month period of January 1989 through August 1991 were reviewed. Patients were classified on the basis of symptoms and mode of treatment and were examined for effectiveness of blepharoplasty in ameliorating these symptoms. Seventy-three patients (51.8%) had symptoms similar to those found in keratoconjunctivitis sicca, including mattering, burning, itching, redness, epiphora, foreign-body sensation, and photophobia. Of these 73 patients, 38 (52.1%) underwent upper eyelid blepharoplasty. Subjective improvement in symptoms was achieved in 33 of these patients (86.8%) postoperatively. Upper eyelid blepharoplasty may represent an effective component in the treatment of patients with dermatochalasis and dry-eye symptoms.
 ...
PMID:Dermatochalasis and dry eye. 843 Jul 31

One kind of extragenital effects of estrogens are those on the eye-a topic that should interest gynecologists and ophthalmologists alike. The frequency of ovarian function being relevant to the complaint "dry eye" was the subject of a study among more than 700 women. 1.4 out of 11 particular symptoms related to the "dry eye" showed a lower incidence among postmenopausal women receiving oral estrogen-therapy than among those postmenopausal patients without estrogen substitution. Examples for this are epiphora in 16% respectively 32% and visual disturbance in 27% respectively 3% of patients. 2. The more time had passed since the entrance to menopause the more some symptoms increased without estrogen substitution respectively decreased under estrogen-therapy, e.g. visual flicker more than 10 years after menopause: 35% versus 10%. 3. The symptoms of the "dry eye" are most often medicable by estrogen substitution below the age of 60 years. 4. Postmenopausal women aged under 60 years and not receiving estrogen substitution complained of "severe eye problems" in 32% those with estrogen-therapy in only 11% of cases. 5. During child-bearing period the symptoms of the "dry eye" are also relevant to gynaecological practice. Seven of the 11 particular symptoms showed higher incidence among patients taking ovulation inhibitors than among those having spontaneous menstrual cycles. Visual flicker in 42% respectively 24% of patients may serve as an example. This study demonstrates that functional disorders of tear film with symptoms of keratoconjunctivitis sicca are "relatively often" related to ovarian steroids- and therefore to gynecological practice.
 ...
PMID:[The "dry eye" phenomenon and ovarian function. Study of 700 women pre- and postmenopausal]. 908 99

Free submandibular salivary gland transfer was investigated as a surgical method for the treatment of severe keratoconjunctivitis sicca. In an animal model, we examined the tolerance of warm ischemia of the submandibular gland. After temporary interruption of the blood supply (1 to 6 hours), the morphologic changes in the submandibular gland were analyzed histologically and immunohistochemically in 41 rabbits. From 1.5 hours ischemia onward, an increasing structural damage of the parenchyma with emphasis on the secretory cells was seen. Six hours of ischemia caused total necrosis of the salivary gland. Our clinical experience includes 24 highly selected patients suffering from keratoconjunctivitis sicca, in whom we transferred 31 autologous submandibular glands to the temple for permanent autologous tear substitution within the past 4 years. The glands were implanted into a pocket prepared in the temporalis muscle, and the nourishing vessels were anastomosed to the superficial temporal artery and vein. The submandibular duct was implanted into the upper lateral conjunctival fornix. The transferred glands were left denervated. In addition to the clinical examination, scintigraphy with Tc 99m pertechnetate was used to document the graft's viability after the transfer. Viable incorporation with longstanding secretory function occurred in 26 of the 30 transplanted denervated salivary glands. The resulting lubrication of the treated eyes was irregular for up to 3 months in almost even case. One year after surgery, all patients with a viable transplant developed at least occasional epiphora, which was surgically managed by reducing the size of the graft in 10 patients. No severe side effects were seen in this series. The ophthalmologic evaluation of the method included the assessment of dry eye symptoms and of the volume and quality of ocular lubrication (Schirmer test, fluorescein break-up time), the pathology of the ocular surface (rose bengal staining), and the need for pharmaceutical tear substitutes. One year after surgery, 18 of 27 cases assessed were judged as significantly improved by these tests.
 ...
PMID:Microvascular submandibular gland transfer for severe cases of keratoconjunctivitis sicca. 1098 60

The objective is to evaluate the technique of microvascular autologous submandibular gland transfer for the treatment of severe keratoconjunctivitis sicca. From August 1999 to April 2002, 38 patients with severe keratoconjunctivitis sicca were treated by autologous submandibular gland transfer to the temporal region of the skull. The related vessels were anastomosed to the superficial temporal artery and vein. When the vein was too small, venous bridging was applied. Prior to cutting off the gland, the facial artery was preserved and infused with heparin in normal saline after the gland had been freed to allow inspection of the blood oozing from the three veins. This would be helpful in the selection of a relevant vein for anastomosis. Wharton's duct was transplanted to the upper lateral conjunctiva fornix, and the gland was left denervated. Postoperative scintigraphy with Tc99m pertechnetate, follow-up studies, and management of complications were performed. The transplantations were successful in 33 cases, their symptoms of xerophthalmia disappeared. The discomfort resulting from bright light and wind was also relieved. These patients could stop applying artificial tears. In five patients the transplanted glands did not survive. Epiphora occurred in eight cases. They were successfully treated by reducing the size of the graft. Obliteration of Wharton's duct took place in two cases and was treated by the reconstruction of the duct or duct orifice. Microvascular autologous submandibular gland transfer is a lasting and effective solution for severe cases of keratoconjunctivitis sicca.
 ...
PMID:Microvascular autologous submandibular gland transfer in severe cases of keratoconjunctivitis sicca. 1528 5

Blepharoplasty complications are infrequent, most often minor and transitory, rarely major and permanent with functional or esthetic consequences. Treatment is above all preventive: screening at risk patients with a history of ophthalmic problems, but also general illnesses that would contraindicate blepharoplasty. Patients must be informed of possible risks through informative booklets with the most important points underlined. Complications can be purely ophthalmological, the more serious sequelae being partial or complete visual loss due to ischemic optical neuropathy, with very poor prognosis, or more rarely compression of the ocular globe by intraorbital hemorrhage, which has a better prognosis provided the origins are quickly recognized and treated immediately. Other visual complications include oculomotor problems, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis on the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring and eyelid fold anomalies. The most serious esthetic complication is the malposition of the lower eyelid, which can manifest as retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are quite often minor, sometimes reversible, but at times major, with psychological, esthetic and functional consequences that are difficult for the patient. Other local complications also arise: enophthalmia with a sunken lid, as well as under- and overcorrection. General complications can include scarring related to pigmentation problems and residual hematomas, and exceptionally infections going as far as the orbital fat tissue. Finally, other complications are related to new laser surgical techniques that are responsible for ectropion of the lower eyelid and even burns or residual redness, or complications related to periocular injections of filling material. A comprehensive review of prevention, diagnosis, and management of complications after blepharoplasty is presented.
 ...
PMID:[Complications of blepharoplasty]. 1534 27

The complications of blepharoplasty are infrequent, most often minor and transient, and rarely major and permanent with functional or aesthetic consequences. Treatment is above all preventive with screening of "at risk" patients in whom blepharoplasty would be contra-indicated. Patients must be informed of possible risks through informative booklets stressing the most important points. The complications may affect vision. Partial or complete visual loss due to ischemic optic neuropathy, or rarely to compression of the ocular globe by intraorbital hemorrhage, is the most serious complication. Other visual complications include oculomotor disorders, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis of the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring, and eyelid fold anomalies. The most severe aesthetic complication is the malposition of the lower eyelid resulting in retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are often minor, sometimes reversible, but they can be major, with psychological, aesthetic, and functional consequences. Other local complications include enophthalmia and hypo- or hypercorrection. General complications may include pigmentation anomalies or infections extending as far as the orbital fat tissue. Finally, complications observed after the newer procedures of laser surgery include ectropion, burns and residual redness. Complications related to periocular injections of filling material are also mentioned. The discussion of these complications is followed by a comprehensive review of the prevention, diagnosis and management of the complications after blepharoplasty.
 ...
PMID:Complications of blepharoplasty. 1718 5

Autologous submandibular gland (SMG) transplantation has been proved to ameliorate the discomforts in patients with severe keratoconjunctivitis sicca. The transplanted glands underwent a hypofunctional period and then restored secretion spontaneously. This study aims to investigate whether autonomic nerves reinnervate the grafts and contribute to the functional recovery, and further determine the origin of these nerves. Parts of the transplanted SMGs were collected from the epiphora patients, and a rabbit SMG transplantation model was established to fulfill the serial observation on the transplanted glands with time. The results showed that autonomic nerves distributed in the transplanted SMGs and parasympathetic ganglionic cells were observed in the stroma of the glands. Low-dense and unevenly distributed cholinergic axons, severe acinar atrophy and fibrosis were visible in the patients' glands 4-6 months post-transplantation, whereas the cholinergic axon density and acinar area were increased with time. The acinar area or the secretory flow rate of the transplanted glands was statistically correlated with the cholinergic axon density in the rabbit model, respectively. Meanwhile, large cholinergic nerve trunks were found to locate in the temporal fascia lower to the gland, and sympathetic plexus concomitant with the arteries was observed both in the adjacent fascia and in the stroma of the glands. In summary, the transplanted SMGs are reinnervated by autonomic nerves and the cholinergic nerves play a role in the morphological and functional restoration of the glands. Moreover, these autonomic nerves might originate from the auriculotemporal nerve and the sympathetic plexus around the supplying arteries.
 ...
PMID:Autonomic reinnervation and functional regeneration in autologous transplanted submandibular glands in patients with severe keratoconjunctivitis sicca. 2969 13


1 2 Next >>