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The Correction of Involutional Entropion of Eyelid by Lateral Strip Procedure
K Balaji, V Balaji, G Kummararaj
Journal of Surgical Technique and Case Report , 2010,
Abstract: Aim: To determine cosmetic and functional outcome following lateral strip procedure (LSP) for involutional entropion. Materials and Methods: This study was a prospective analysis of 15 patients (20 eyelids) of involutional entropion, who needed surgical repair. After thorough evaluation, the surgical treatment (LSP) was done in all 15 patients. Results: Cosmetic and functional outcome was excellent in all cases following LSP. No complications and recurrence were encountered in any case. Conclusions: LSP is simple, physiologic, easy and quick to perform as OPD procedure for involutional entropion under local anesthesia without hospitalization by a general ophthalmologist.
Application of 2-octyl-cyanoacrylate for corneal perforation and glaucoma filtering bleb leak  [cached]
Okabe M,Kitagawa K,Yoshida T,Koike C
Clinical Ophthalmology , 2013,
Abstract: Motonori Okabe,1 Kiyotaka Kitagawa,2 Toshiko Yoshida,1 Chika Koike,1 Takeshi Katsumoto,2 Etsuko Fujihara,2 Toshio Nikaido1 1Department of Regenerative Medicine, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 2Division of Ophthalmology, Matsue Red Cross Hospital, Japanese Red Cross Society, Shimane, Japan Background: This paper reports on the efficacy of a tissue adhesive, 2-octyl-cyanoacrylate, in the treatment of corneal perforation and glaucoma filtering bleb leak. Methods: Two eyes from two patients with corneal perforation or laceration and two eyes from two patients with bleb leak were included. The patients underwent application of 2-octyl-cyanoacrylate onto the perforated or leaking site, and a hydrogel contact lens was applied as a bandage. We also evaluated the in vitro cell toxicity of 2-octyl-cyanoacrylate in HeLa cells. Results: The two cases of corneal perforation were repaired within 22 days with one application of the tissue adhesive. The two cases of bleb leak were repaired with 2–4 applications of the tissue adhesive over 134 (range 17–134) days). There were no recurrences or adverse effects during a mean follow-up period of 12.7 months. In vitro testing revealed that 2-octyl-cyanoacrylate was markedly toxic to HeLa cells. Conclusion: Four patients with corneal perforation or bleb leak were successfully managed using 2-octyl-cyanoacrylate tissue adhesive. This simple and easy surgical technique may become an alternative therapeutic option for corneal perforation or bleb leak, although several applications of this tissue adhesive may be required. Although 2-octyl-cyanoacrylate was toxic to HeLa cells, no adverse clinical effects were noted using this adhesive. Keywords: corneal perforation, bleb leak, tissue adhesive, 2-octyl-cyanoacrylate
Involutional Lower Eyelid Entropion: Combined Wheeler’s and Wedge Resection of Tarsal Plate
C Olali, V Burton, E Samaila
West African Journal of Medicine , 2010,
Abstract: BACKGROUND: Involutional entropion, a common eyelid condition, has different methods of surgical correction and attendant variable recurrence rates, depending to a large degree on the method used. OBJECTIVE: To describe and evaluate a modified technique of entropion repair where the Wheeler’s method is combined with wedge resection of the tarsal plate. METHODS: This was a chart review study of 49 patients who had the modified technique carried out to correct their involutional entropion. The technique essentially involves dissecting and separating the lower lid pre-tarsal orbicularis muscle from the tarsal plate, resecting a down-base triangular wedge of the tarsus followed by shortening the orbicularis and anchoring it to the tarsal plate superiorly. RESULTS: Over the three and a half-year review period, 54 eyelids of 49 patients underwent the procedure to correct their lower eyelid entropion. Of these, 28(57%) were females and 21(43%) males with a mean age of 73.5 years. The mean follow up period was 30.3 months. One (1.9%) recurrence was recorded in all the cases during the follow-up period. Complications were minimal. CONCLUSION: The combined Wheeler and wedge resection of the tarsal plate produces very good post-operative results and can be used in primary involutional entropion or as the procedure of choice if an initial different surgical technique used fails.
Combination of a modified Hotz procedure with the Jones procedure decreases the recurrence of involutional entropion  [cached]
Nakauchi K,Mimura O
Clinical Ophthalmology , 2012,
Abstract: Kazuaki Nakauchi, Osamu MimuraDepartment of Ophthalmology, Hospital of Hyogo College of Medicine, Nishinomiya, Hyogo, JapanPurpose: Involutional entropion is a common condition in Asian countries, including Japan. One cause of involutional entropion is weakening of the capsulopalpebral fascia (CPF). The aged, thin, membranous nature of the CPF limits the results of correction by the original Jones procedure (CPF tightening) alone, so we added the modified Hotz procedure to the entropion repair. We then compared the recurrence rates and operation times in corrections performed with and without this additional procedure.Cases: From April 2010 to December 2011, one surgeon performed lower-lid surgery using the Jones procedure with the addition of the modified Hotz procedure. Fifteen patients (a total of 21 eyes) underwent this combined procedure. Previously, the same surgeon performed the Jones procedure alone for eight patients (a total of nine eyes).Results: The average age of the two groups was 76.4 years, with an age range of 66–85 years. All cases reported acceptable ciliary orientation at the end of the surgery. However, patients who underwent the Jones procedure alone (nine eyes total) reported three cases of recurrence after at least 6 months of follow-up. Patients who underwent the combined procedure reported two complications: one recurrence and one ectropion. The recurrence rate was 5%. The Jones procedure using eyelid pinch required an average of 22.6 minutes to complete; the combined method required 33.4 minutes to complete.Conclusion: The combined method resulted in a significantly higher success rate than the Jones procedure alone (P < 0.05). The 5% failure rate of the combined method was found to be superior to the 30% recurrence rate of the Jones procedure. As a result, the Hotz procedure enhanced the results of the entropion correction and required only 10 additional minutes of surgery. We now perform this combined procedure for all cases.Keywords: Jones procedure, Hotz procedure, entropion, recurrence, operation time
Combination of a modified Hotz procedure with the Jones procedure decreases the recurrence of involutional entropion
Nakauchi K, Mimura O
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S36819
Abstract: mbination of a modified Hotz procedure with the Jones procedure decreases the recurrence of involutional entropion Case Series (1369) Total Article Views Authors: Nakauchi K, Mimura O Published Date November 2012 Volume 2012:6 Pages 1819 - 1822 DOI: http://dx.doi.org/10.2147/OPTH.S36819 Received: 07 August 2012 Accepted: 10 September 2012 Published: 02 November 2012 Kazuaki Nakauchi, Osamu Mimura Department of Ophthalmology, Hospital of Hyogo College of Medicine, Nishinomiya, Hyogo, Japan Purpose: Involutional entropion is a common condition in Asian countries, including Japan. One cause of involutional entropion is weakening of the capsulopalpebral fascia (CPF). The aged, thin, membranous nature of the CPF limits the results of correction by the original Jones procedure (CPF tightening) alone, so we added the modified Hotz procedure to the entropion repair. We then compared the recurrence rates and operation times in corrections performed with and without this additional procedure. Cases: From April 2010 to December 2011, one surgeon performed lower-lid surgery using the Jones procedure with the addition of the modified Hotz procedure. Fifteen patients (a total of 21 eyes) underwent this combined procedure. Previously, the same surgeon performed the Jones procedure alone for eight patients (a total of nine eyes). Results: The average age of the two groups was 76.4 years, with an age range of 66–85 years. All cases reported acceptable ciliary orientation at the end of the surgery. However, patients who underwent the Jones procedure alone (nine eyes total) reported three cases of recurrence after at least 6 months of follow-up. Patients who underwent the combined procedure reported two complications: one recurrence and one ectropion. The recurrence rate was 5%. The Jones procedure using eyelid pinch required an average of 22.6 minutes to complete; the combined method required 33.4 minutes to complete. Conclusion: The combined method resulted in a significantly higher success rate than the Jones procedure alone (P < 0.05). The 5% failure rate of the combined method was found to be superior to the 30% recurrence rate of the Jones procedure. As a result, the Hotz procedure enhanced the results of the entropion correction and required only 10 additional minutes of surgery. We now perform this combined procedure for all cases.
Effects of ethyl-cyanoacrylate and octyl-cyanoacrylate on experimental corneal lesions in rabbits
Barbosa, V.T.;Thiesen, R;Soares, E.G.;Machado, M.R.F.;Laus, J.L.;
Arquivo Brasileiro de Medicina Veterinária e Zootecnia , 2009, DOI: 10.1590/S0102-09352009000500009
Abstract: the use of ethyl-cyanoacrylate and octyl-cyanoacrylate were clinically and histopathologically compared on the corneas of 36 rabbits after lamellar keratectomy (standardized diameter and depth). the animals were distributed into two groups, one for each type of adhesive. from each group, six subgroups were histopathologically evaluated on the 3rd, 7th, 14th, 21st, 30th, and 60th day post-operative. general (daily) and ophthalmic (days 0, 1, 3, 5, 7, 14, 21, 30, 44, and 60) evaluations clinically indicated that there were significant differences for the variables water intake, attitude, blepharitis, corneal edema, and fluorescein test. the adhesive permanence time for octyl-cyanoacrylate (17.22 days) was greater than that for ethyl-cyanoacrylate (7.66 days). with respect to the histopathological evaluation, corneal epithelization and collagen organization occurred without severe complications. however, treatment with ethyl-cyanoacrylate led to a moderate inflammatory reaction in the initial phases. with octyl-cyanoacrylate, re-epithelization and collagen organization proceeded more slowly with a discrete inflammatory reaction in the initial phases. from clinical and histopathologic points of view, octyl-cyanoacrylate showed advantages over ethyl-cyanoacrylate, whereas wound healing was achieved in both groups without major complications.
Efficacy of lid everting suture in the management of involutional lower eyelid entropion using 4-0 silk versus 4-0 chromic catgut  [PDF]
SK Singh,H Das,P Lavaju
Nepalese Journal of Ophthalmology , 2009, DOI: 10.3126/nepjoph.v1i1.3672
Abstract: Background: Involutional lower eyelid entropion is a common ophthalmic condition requiring surgical correction. Objective: To compare the efficacy of lid everting sutures in the management of involutional lower lid entropion using 4-0 silk versus 4-0 chromic catgut. Materials and methods: Fifty eyes with involutional lower eyelid entropion were enrolled into the study and divided randomly into two groups, A and B. Group A underwent lid everting suture with 4-0 chromic catgut and group B with 4-0 silk. The parameters assessed were pre- and post-operative lower lid excursion (LLE) and horizontal lid laxity (HLL). Statistical analysis: Data were plotted in the excel spread sheet and analyzed using SPSS 11.0 software program. The difference between the two groups was compared using Chi square test and unpaired t test. Results: While comparing the pre-operative and post-operative changes of HLL within the two groups separately, there was 63% reduction of HLL in group A (p=0.001) and 68% reduction (p=0.001) in group B. In group A, there was 48.2% improvement in LLE and in group B 52% postoperatively (p=0.001). The success rate in each group was 92%. The cost of surgery in group A was higher than that in group B (p=0.003). Conclusion: Lid everting suture by 4-0 silk is as effective as 4-0 chromic catgut. The cost of lid everting suture by 4-0 catgut is higher than that of 4-0 silk. The silk suture can be recommended for correction of lower lid involutional entropion in a country with low socioeconomic status. Key words: involutional entropion; lid laxity; lid excursion; lid everting suture DOI: 10.3126/nepjoph.v1i1.3672 Nep J Oph 2009;1(1):37-42
2-Octyl-Cyanoacrylate Skin Adhesive Used as a Splinting Material in Auricular Surgery  [PDF]
Naoto Yamamoto, Satoshi Yanagibayashi, Ryuichi Yoshida, Hiroyuki Ogi, Megumi Takikawa, Akio Nishijima, Eri Maruyama
Modern Plastic Surgery (MPS) , 2016, DOI: 10.4236/mps.2016.64004
Abstract: In cases of auricular surgery, postoperative dressings are thought to be important for keeping auricular contour and in helping to prevent from dressing failures due to edema or subcutaneous hematoma, which may result in fibrous or cartilaginous proliferation. However, it is often difficult to achieve success with standard dressings because of the complicated shape of the auricle. We used 2-octyl-cyanoacrylate skin adhesive to dress the auricle after different types of auricular procedures (five cases of cryptotia, two of prominent ear, two of severe auricular laceration, two of skin grafting and one of flap repair of the partial auricle defect). The 2-octyl-cyanoacrlaate skin adhesive was applied to the suture line and the operated and peripheral areas for wider coverage. No dressing materials were placed over the surface. In all cases, the desired outcome was achieved, without subcutaneous hematoma, wound dehiscence, and wound infection. Contact dermatitis caused by the skin adhesive was not observed in any of the cases. Dressing and splinting after auricular surgery can be simply and successfully achieved using 2-octyl-cyanoacrylate skin adhesive. There is no need for more complicated dressings and post-surgical dressing changes, resulting in higher patient satisfaction.
Efficacy of percutaneous transhepatic variceal embolization with 2-Octyl-cyanoacrylate in patients with severe recurrent hepatic encephalopathy  [cached]
WANG Guangchuan
Journal of Clinical Hepatology , 2013,
Abstract: ObjectiveTo investigate the efficacy and safety of percutaneous transhepatic variceal embolization (PTVE) performed with 2-Octyl-cyanoacrylate (2-OCA) tissue adhesive for treating recurrent hepatic encephalopathy (HE) involving large portosystemic shunts. MethodsTwelve cirrhotic patients (8 males, 4 females; mean age: 62 years old) with recurrent HE (≥3 episodes/year, despite drug therapy) were treated by PTVE with 2-OCA. The surgery was performed under local anesthesia with B ultrasound- or X-ray-guided percutaneous needle injection of the adhesive into the hepatic portal vein with balloon dilation to occlude the portosystemic shunts. Preoperative and postoperative clinical and laboratory parameters, including HE episodes, with or without gastrointestinal bleeding, markers of liver and renal function and coagulation indicators, were recorded. Significance of surgery-induced change in portal vein pressure was assessed by paired t-test. ResultsThe PTVE was performed successfully in all 12 patients. The average injected volume of 2-OCA was 8.6 ml (range: 4-16 ml). The most frequent postoperative complications were pyrexia (6/12, 50.0%) and abdominal pain (5/12, 41.7%). The mean follow-up period was 22.7±9.8 months (range: 6-37 months). During the follow-up period, two patients (16.7%) developed transient ascites and two (16.7%) patients developed upper gastrointestinal bleeding (due to esophageal varices and portal hypertensive gastropathy, respectively). In addition, three patients (25.0%) experienced HE recurrence (at postoperative months 16, 19, and 30, respectively). Two patients (16.7%) died, one from progression of hepatic failure and the other from liver cancer. In general, the PTVE procedure significantly increased the portal pressure (preoperative: (21.9±1.8) mm Hg vs. postoperative: (26.3±3.2) mm Hg; P=000). ConclusionPTVE with 2-OCA is an effective and safe procedure for managing recurrent HE with large portosystemic shunts.
2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery  [PDF]
Rebecca L. James, Marilyn Alejandro-Rodriquez, Elba Adriana Perez, Jeffrey Mangel
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.55041
Abstract: Background: 2-octyl cyanoacrylate (2OCA) high viscosity tissue adhesive (Medline Industries, Inc., Mundelein, IL) is a liquid topical skin adhesive. 2OCA offers the same design features and clinical utility in terms of flexibility, strength, and low complication rate as the commercially available 2OCA tissue adhesives. Additionally, 2OCA features high viscosity allowing for better control during the application process, polymerization without the use of an external activator, and a distinctive violet color for ease of application visualization. Objective: The aim of this prospective case series is to descriptively report clinical data with the application of 2OCA as a topical incision closure system in female pelvic surgery. The primary outcomes included: incisional pain, incisional dehiscence, and post-operative bleeding. The secondary outcome included drying times of the adhesive with regard to incision length. Methods: A prospective open-label observational case series study was conducted to evaluate the use of 2OCA in surgical wound closure of the topical skin in adult patients undergoing gynecologic surgical procedures. A total of 50 adult women undergoing gynecologic surgery were enrolled. 2OCA was applied only by surgeons who had undergone product training to the incisions in a standardized, protocol-defined fashion. Drying times for the adhesive and photography were recorded intraoperatively. Post treatment follow-up was conducted with queries of pain level, incisional dehiscence, and incisional bleeding immediately post-operatively, 48 hours, 5 - 10 days and 14 days post-treatment. Adverse events were documented. Results: 2OCA was applied to a total of 154 incisions from the 50 patients enrolled to the study. The procedures included: 16 laparoscopic total hysterectomies, 4 diagnostic laparoscopies, 2 laparoscopic myomectomies, 2 laparoscopic bilateral or unilateral salpingo-oophorectomies, 5 total robotic-assisted laparoscopic surgeries (2 total hysterectomies, 1 supracervical hysterectomy, 1 sacrocolpopexy, and one excision of endometriosis), 7 sacral neuromodulation procedures, and 18 midurethral slings. The overall rate of incisional dehiscence was 3% (4/154). The rate of reported incisional bleeding was 3% (4/154). There was 1 incisional infection. The pain reports based on a 10-point scale had a mean of 4.96 immediately post-operatively, which decreased to a mean score < 1 (0.2) by post-op day (POD) 14. The mean drying times for the various lengths of incisions included the following: 1.28 minutes for incisions ≤ 5 mm, 1.53 minutes for
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