Search

Background To present the outcomes of the tarsal switch procedure using an anterior approach to correct severe ptosis with poor levator muscle function (<4 mm) with absent or poor Bell's phenomenon. Methods This retrospective case series included 11 patients with severe neurogenic or acquired myogenic palpebral ptosis. All patients underwent the tarsal switch procedure through an anterior approach from 2012 to 2015. Margin reflex distance (MRD1 and MRD2) and the palpebral fissure were evaluated preoperatively and postoperatively. Data were compared using the Wilcoxon signed-rank test. P-values <0.05 were considered to indicate statistical significance. Results Surgery was performed on 18 eyelids (11 patients). The median age at surgery was 57 years (range, 29-86 years). Four patients had unilateral ptosis and seven had bilateral ptosis. Nine patients had myogenic ptosis and two had neurogenic ptosis. Postoperatively, the chin-up position improved in all patients. The MRD1 increased statistically significantly, from 0 mm preoperatively to 1.0 mm postoperatively (P=0.001). The MRD2 decreased statistically significantly, from 4.5 mm preoperatively to 3.0 mm postoperatively (P=0.001). The palpebral fissure did not change (4.0 mm preoperatively to 4.0 mm postoperatively) (P=0.13). Conclusions The tarsal switch procedure through an anterior approach is an effective alternative for correcting severe ptosis, especially neurogenic or acquired myogenic ptosis. This procedure can be performed with minimal risk of ocular surface exposure and provides stable outcomes. [ABSTRACT FROM AUTHOR] more...

Purpose: To assess the prevalence of trachoma in schoolchildren of Botucatu/ SP-Brazil and its spatial distribution., Methods: Cross-sectional study in children aged from 7 to 14 years, who attended elementary schools in Botucatu/SP in November/2005. The sample size was estimated in 2,092 children, considering the 11.2% historic prevalence of trachoma, accepting an estimation error of 10% and confidence level of 95%. The sample was random, weighted and increased by 20%, because of the possible occurrence of losses. The total number of children examined was 2,692. The diagnosis was clinical, based on WHO guidelines. For the evaluation of spatial data, the CartaLinx program (v1.2) was used, and the school demand sectors digitized according to the planning divisions of the Department of Education. The data were statistically analyzed, and the analysis of the spatial structure of events calculated using the Geode program., Results: The prevalence of trachoma in schoolchildren of Botucatu was 2.9% and there were cases of follicular trachoma. The exploratory spatial analysis failed to reject the null hypothesis of randomness (R= -0.45, p>0.05), with no significant demand sectors. The analysis for the Thiessen polygons also showed that the overall pattern was random (I= -0.07, p=0.49). However, local indicators pointed to a group of low-low type for a polygon to the north of the urban area., Conclusion: The prevalence of trachoma in schoolchildren in Botucatu was 2.9%. The analysis of the spatial distribution did not reveal areas of greater clustering of cases. Although the overall pattern of the disease does not reproduce the socio-economic conditions of the population, the lower prevalence of trachoma was found in areas of lower social vulnerability. more...