8 results on '"Burns JA"'
Search Results
2. Fibrin sealant for Müller muscle-conjunctiva resection ptosis repair.
- Author
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Foster JA, Holck DE, Perry JD, Wulc AE, Burns JA, Cahill KV, and Morgenstern KE
- Subjects
- Female, Fibrin Tissue Adhesive adverse effects, Follow-Up Studies, Humans, Male, Retrospective Studies, Tissue Adhesives adverse effects, Treatment Outcome, Blepharoptosis surgery, Conjunctiva surgery, Eyelids surgery, Fibrin Tissue Adhesive therapeutic use, Oculomotor Muscles surgery, Ophthalmologic Surgical Procedures, Tissue Adhesives therapeutic use, Wound Healing drug effects
- Abstract
Purpose: To determine the safety and efficacy of fibrin sealant for use in Müller muscle-conjunctiva resection ptosis repair., Methods: This was a retrospective review of a consecutive case series. All patients underwent Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure. Surgery was performed in a manner similar to a previously described technique, using fibrin tissue sealant rather that suture for wound closure. Postoperative symmetry was defined as MRD1 of each eyelid within 0.5 mm., Results: Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure was performed on 53 eyelids of 33 patients. There were 27 female patients and 6 male patients. Twenty patients underwent bilateral ptosis repair and 13 patients underwent unilateral ptosis repair. Average follow-up was 17 weeks (range, 3 to 45 weeks). Mean preoperative MRD1 was 1.22 mm (range, -1.5 to 2.5 mm) in the right upper eyelid and 1.50 mm (range, 0 to 2 mm) in the left upper eyelid. Mean postoperative MRD1 was 3.11 mm (range, 2 to 4.5 mm) in the right upper eyelid and 3.12 mm (range, 1 to 4.5 mm) in the left upper eyelid. Postoperative symmetry was found in 32 of 33 patients (97%). We found no evidence of keratopathy or other complications attributable to the fibrin sealant., Conclusions: Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure may allow for predictable results with few complications and appears to be an acceptable alternative to traditional suture techniques.
- Published
- 2006
- Full Text
- View/download PDF
3. Expression of sodium iodide symporter in the lacrimal drainage system: implication for the mechanism underlying nasolacrimal duct obstruction in I(131)-treated patients.
- Author
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Morgenstern KE, Vadysirisack DD, Zhang Z, Cahill KV, Foster JA, Burns JA, Kloos RT, and Jhiang SM
- Subjects
- Basement Membrane metabolism, Basement Membrane radiation effects, Dacryocystorhinostomy, Epithelial Cells radiation effects, Gene Expression, Humans, Immunoenzyme Techniques, Lacrimal Apparatus metabolism, Lacrimal Apparatus radiation effects, Lacrimal Duct Obstruction etiology, Nasolacrimal Duct radiation effects, RNA, Messenger metabolism, Radiation Injuries etiology, Reverse Transcriptase Polymerase Chain Reaction, Symporters metabolism, Epithelial Cells metabolism, Iodine Radioisotopes adverse effects, Lacrimal Duct Obstruction metabolism, Nasolacrimal Duct metabolism, Radiation Injuries metabolism, Symporters genetics
- Abstract
Purpose: Nasolacrimal outflow obstruction has been associated with high-dose (>150 mCi) radioactive iodine (I(131)) treatment. Commonly used for thyroid cancer treatment, I(131) is effectively transported in the targeted tissue by the Na(+)/I symporter (NIS). We hypothesized that NIS is expressed in the lacrimal sac and nasolacrimal duct and that active accumulation of I(131) is responsible for the clinical observations seen in these patients., Methods: Reverse transcriptase-polymerase chain reaction and immunohistochemical analyses were used to evaluate NIS expression in both archived and fresh human tissues, Results: Reverse transcriptase-polymerase chain reaction analysis showed that NIS mRNA is present in the lacrimal sac. Immunohistochemical analysis indicated that NIS protein is expressed in the stratified columnar epithelial cells of the lacrimal sac and nasolacrimal duct. NIS protein was undetectable in the lacrimal gland, Wolfring and Krause glands, conjunctiva, canaliculus, and nasal mucosa. NIS-expressing columnar epithelial cells were absent and fibrosis was evident in the lacrimal sacs from I(131)-treated patients undergoing dacryocystorhinostomy., Conclusions: NIS is present in the lacrimal sac and nasolacrimal duct of humans, correlating to the anatomic areas of clinical obstruction that develop in patients treated with greater than 150 mCi of I(131). This suggests that NIS may be the vector of radiation-induced injury to the lacrimal system. To our knowledge, this is the first report of any ion transporter in the nasolacrimal outflow system and raises new questions as to the role the lacrimal sac plays in the modification of tears and in lacrimal outflow pathology.
- Published
- 2005
- Full Text
- View/download PDF
4. Botulinum toxin type a for dysthyroid upper eyelid retraction.
- Author
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Morgenstern KE, Evanchan J, Foster JA, Cahill KV, Burns JA, Holck DE, Perry JD, and Wulc AE
- Subjects
- Adult, Aged, Aged, 80 and over, Botulinum Toxins, Type A adverse effects, Female, Humans, Male, Middle Aged, Neuromuscular Agents adverse effects, Prospective Studies, Treatment Outcome, Botulinum Toxins, Type A therapeutic use, Eyelid Diseases drug therapy, Eyelid Diseases etiology, Neuromuscular Agents therapeutic use, Thyroid Diseases complications
- Abstract
Purpose: To evaluate the safety and efficacy of botulinum toxin type A for treatment of eyelid retraction resulting from thyroid eye disease (TED) during the inflammatory phase of the condition., Methods: In this prospective, nonrandomized case series, 18 patients with inflammatory eyelid retraction caused by active TED received botulinum toxin type A injection (10, 5, or 2.5 U) for treatment of upper eyelid retraction. Botulinum toxin type A (Allergan, Irvine, CA, U.S.A.) was injected transconjunctivally just above the superior tarsal border in the elevator complex of the upper eyelid., Results: Seventeen of 18 patients (94%) demonstrated a reduced marginal reflex distance (MRD1) after botulinum toxin injection. The average change in MRD1 of the treated eyelid after injection was -2.35 mm (range, 0 to -8.0 mm). Of the 27 eyelids injected, 33% had a 0- to 1-mm drop in eyelid height, 30% had a 1.5- to 2-mm decrease, 22% had a 2.5- to 3-mm decrease, and 15% had a greater than 3-mm decrease in eyelid height. None of the treated eyelids were noted to increase in height. One patient showed no alteration inafter treatment. One patient had clinically MRD1 significant ptosis and one patient reported worsening of preexisting diplopia after injection. Three patients undergoing unilateral injection had relative contralateral eyelid elevation. All untoward effects resolved spontaneously without sequelae., Conclusions: : Botulinum toxin type A may be used in the inflammatory stage of thyroid eye disease to improve upper eyelid retraction. Individual response to treatment is variable, but this modality should be considered as a temporizing measure until stability for surgery is reached.
- Published
- 2004
- Full Text
- View/download PDF
5. Nasolacrimal obstruction secondary to I(131) therapy.
- Author
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Burns JA, Morgenstern KE, Cahill KV, Foster JA, Jhiang SM, and Kloos RT
- Subjects
- Adolescent, Adult, Aged, Catheterization, Dacryocystorhinostomy, Female, Humans, Intubation methods, Iodine Radioisotopes adverse effects, Male, Middle Aged, Nasolacrimal Duct surgery, Radiation Injuries surgery, Silicone Elastomers, Thyroid Neoplasms radiotherapy, Lacrimal Duct Obstruction etiology, Nasolacrimal Duct radiation effects, Radiation Injuries etiology
- Abstract
Purpose: To report the finding of nasolacrimal drainage system obstruction associated with I(131) therapy for thyroid carcinoma from an updated and expanded cohort., Methods: Patients with a history of epithelial derived thyroid carcinoma who had tearing were offered referral for evaluation by an oculoplastic surgeon. Patients underwent nasolacrimal probing and irrigation procedures with localization of their nasolacrimal obstruction. Therapy for the site of obstruction was instituted., Results: Clinically significant tearing was identified in 26 patients, all of whom had previously undergone I(131) therapy (n = 563). Nineteen patients were evaluated and confirmed to have nasolacrimal drainage system obstruction; 7 have yet to be formally evaluated. Areas of obstruction included nasolacrimal duct, common canaliculus, and, rarely, distal upper and lower canaliculi. Patients were treated with a variety of modalities including silicone intubation, balloon dacryoplasty, dacryocystorhinostomy, and conjunctival dacryocystorhinostomy., Conclusions: The use of I(131) for thyroid carcinoma is associated with a 3.4% incidence of documented nasolacrimal drainage obstruction and an overall 4.6% incidence of documented or suspected obstruction. The true incidence may be higher, since - I(131) treated individuals were neither systematically evaluated nor questioned about tearing. It has yet to be established if the obstructions result from local toxicity caused by the passive flow of radioactive iodine containing tears through these tissues or the active uptake and concentration of I(131) in lacrimal drainage system tissues through the sodium/iodide supporter.
- Published
- 2004
- Full Text
- View/download PDF
6. Management of acute dacryocystitis in adults.
- Author
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Cahill KV and Burns JA
- Subjects
- Acute Disease, Adult, Aged, Aged, 80 and over, Dacryocystitis microbiology, Dacryocystorhinostomy, Female, Humans, Lacrimal Apparatus microbiology, Male, Middle Aged, Prospective Studies, Dacryocystitis therapy, Eye Infections, Bacterial therapy
- Abstract
Acute dacryocystitis frequently is extremely painful and slow to resolve even with systemic antibiotic therapy. We have identified that incision, drainage, and direct application of antibiotics inside the infected sac result in almost immediate resolution of pain and rapid control of infection. This also provides optimal culture material. Twelve consecutive patients treated in this manner had rapid control of the acute infectious process. All eight patients subsequently undergoing dacryocystorhinostomy were fully cured. A total of 58.3% of the patients were infected with gram-negative rods; 50% of the isolates were resistant to most oral antibiotics.
- Published
- 1993
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7. Management of epiphora in the presence of congenital punctal and canalicular atresia.
- Author
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Cahill KV and Burns JA
- Subjects
- Child, Child, Preschool, Dacryocystorhinostomy, Humans, Infant, Intubation, Lacrimal Apparatus Diseases complications, Lacrimal Duct Obstruction complications, Lacrimal Duct Obstruction therapy, Silicone Elastomers, Lacrimal Apparatus Diseases therapy, Lacrimal Duct Obstruction congenital
- Abstract
We treated ten eyes in six pediatric patients with epiphora and punctal and canalicular atresia in one or both lids. Attempted probing and irrigation had failed to improve the epiphora. Nine out of ten of the lacrimal systems had additional anomalies, such as cutaneous lacrimal fistulas (anlage ducts), small sacs, and nasolacrimal duct stenosis or obstruction. A surgical plan is described for the exploration and reconstruction of these markedly abnormal nasolacrimal drainage systems, including a new method of performing bicanalicular intubation. Four of the five eyes with at least part of one canaliculus present have had resolution of epiphora.
- Published
- 1991
- Full Text
- View/download PDF
8. The effect of blepharoptosis on the field of vision.
- Author
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Cahill KV, Burns JA, and Weber PA
- Subjects
- Adult, Aged, Humans, Male, Middle Aged, Pupil, Visual Field Tests, Blepharoptosis physiopathology, Visual Fields
- Abstract
Upper eyelid position, pupillary diameter, and visual field impairment were measured in 26 eyes with adult-onset blepharoptosis. The magnitude of superior visual field impairment was inversely proportional to the distance between the upper lid margin and the pupillary aperture. The distance between the upper lid and the central corneal reflex was the most useful measurement for predicting visual field impairment. Superior visual field impairment was present when the distance between the upper lid and the central corneal reflex was less than 2.5 mm. Visual field impairment inferiorly, temporally, and nasally occurred when the central corneal reflex was obscured and less than 1.5 mm of the vertical diameter of the pupil was visible. Observation of the relationship between the upper eyelid and the pupillary aperture provides useful information for the performance of accurate diagnostic perimetry, as well as for the management of blepharoptosis.
- Published
- 1987
- Full Text
- View/download PDF
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