Measuring Health-Related Quality of Life in Thyroid Eye Disease.

Health-related quality of life (HQOL) is a concept that aims to understand the totality of an individual's experience of their disease state. This can include the physical, psychosocial, emotional, and psychological effects of a disease state. A complex and multifactorial concept, HQOL can be challenging to measure accurately and reliably.

The success rate of TED upper eyelid retraction reoperations.

Although reoperation rates for upper lid retraction surgery for thyroid eye disease (TED) typically range between 8% and 23%, there is little literature describing the outcomes of these second operations. In this retrospective observational cohort study, all patients that underwent surgery for upper eyelid retraction over a 14-year period at a single institution were included. Cases were included if a second eyelid retraction surgery was performed during the study period.

Long-Term Evaluation of Eyebrow Soft Tissue Expansion in Thyroid Eye Disease.

Purpose: To evaluate the long-term transformation of lateral eyebrow soft tissue in a group of patients with known thyroid eye disease.

Methods: A retrospective review of all patients with a known diagnosis of thyroid eye disease with clinical photos available from both their initial diagnosis visit and at least 7 years following their initial visit was performed. Age at diagnosis, sex, disease activity, previous orbital, and eyelid surgery were noted, as was history of treatment with radioactive iodine, steroids, and external beam radiation.

The role of tissue resection length in the determination of post-operative eyelid position for Muller's muscle-conjunctival resection surgery.

Purpose: To investigate the relationships between pre-operative marginal reflex distance (MRD), tissue resection length, phenylephrine response, and change in MRD with surgery for a cohort of individuals undergoing Muller's muscle conjunctival resection (MMCR) surgery.

Methods: All cases of MMCR surgery performed over a 13-year period at a single institution were screened for entry. Individuals with adequate photographic documentation and follow up were included.

Does the Tyndall effect describe the blue hue periodically observed in subdermal hyaluronic acid gel placement?

Background: The blue hue of skin overlying injected hyaluronic acid (HA) fillers in certain cases has been hypothesized in the literature as related to the Tyndall effect. This investigation aims to understand the relevant optical concepts and to discuss the plausibility of this assertion.

Methods: Theoretic and physical aspects of relevant optical theories including the Tyndall effect, the Raleigh criterion and the Mie Solution are discussed, with simple examples.

Localization and Retrieval of an Eyelid Metallic Foreign Body With an Oscillating Magnet and High-Resolution Ultrasonography.

A patient was found to have a metallic foreign body in the left anterior orbit on CT imaging, but the foreign body was not evident on clinical examination. On high-resolution ultrasonography, an object was identified in the left upper eyelid; however, the typical shadow with metallic foreign bodies was not seen. A high-power oscillating magnet was then applied to the eyelid, which revealed a subcutaneous metallic foreign body in the left upper eyelid.

Adalimumab as steroid-sparing treatment of inflammatory-stage thyroid eye disease.

Purpose: Steroids are often used as medical therapy for active thyroid eye disease (TED). While high-dose steroids have been shown to be effective in reducing the severity of TED symptoms, the side effects of steroids can be severe. As the pathogenesis of TED is thought to involve the upregulation of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), it has been postulated that anti-TNF agents may be used as steroid-sparing agents in the treatment of TED.

Ocular surface, fornix, and eyelid rehabilitation in Boston type I keratoprosthesis patients with mucous membrane disease.

Purpose: To understand the efficacy of various approaches for ocular surface reconstruction in eyes with implanted Boston Type I keratoprosthesis.

Methods: All eyes implanted with a Boston Type I keratoprosthesis over a 9-year period by a single surgeon were reviewed. Any case in which mucosal rehabilitation was performed was included in the study sample.

Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature.

Purpose: The purpose of this investigation is to describe the clinical, imaging, histologic and flow dynamic characteristics of orbital cavernous haemangioma.

Methods: In this clinicopathologic series, clinical features were obtained from patient records. All imaging studies were reviewed.

Predictors of treatment failure for pneumatic retinopexy.

Objective: The purpose of this study was to define the overall anatomic success rate in pneumatic retinopexy and to identify morphologic features that may be predictive of treatment failure in pneumatic retinopexy.

Design And Participants: Prospective consecutive interventional case series of patients with new-onset primary rhegmatogenous retinal detachments treated with pneumatic retinopexy.

Methods: In this interventional case series, consecutive patients with new-onset primary rhegmatogenous retinal detachments were treated with pneumatic retinopexy and followed prospectively.

Zig Zag versus Top Hat configuration in IntraLase-enabled penetrating keratoplasty.

Aim: To compare the outcomes with IntraLase-enabled keratoplasty using (IEK) Top Hat (TH) versus Zig Zag (ZZ) configuration.

Methods: Retrospective comparative series of 24 eyes that underwent TH and 10 eyes that underwent ZZ IEK.

Results: There were no significant differences in LogMar Best-spectacle corrected visual acuity (TH- IEK=0.

Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking.

Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure-lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking.

Repair of eroded glaucoma drainage devices: mid-term outcomes.

Purpose: Glaucoma drainage devices (GDD) are used in the surgical management of medically refractory glaucoma. One late serious complication is erosion and exposure of the tube, clip, or plate. In this study, we evaluated the effectiveness of oral buccal mucous membrane allografts with corneal lamellar grafts for the repair of GDD erosions.

Psychometric properties of a new tool to assess task-specific and global competency in cataract surgery.

Background And Objective: To establish and validate an assessment tool of cataract surgery performed by residents suitable for a competency-based curriculum.

Patients And Methods: A three-component evaluation tool was created based on review of the literature and was refined using a modified Delphi technique. Faculty surgeons viewed two videos of cataract surgery, performed by a novice and an expert, and completed the evaluation tool.

Outcomes of deep anterior lamellar keratoplasty versus intralase enabled penetrating keratoplasty in keratoconus.

Objective: To compare the visual and refractive outcomes after deep anterior lamellar keratoplasty (DALK) and intralase enabled keratoplasty (IEK) for keratoconus.

Design: A retrospective comparative case series.

Participants: Eighteen eyes that underwent DALK and 18 that had IEK for keratoconus.

Concurrence of retinitis pigmentosa and central serous retinopathy.

We describe a patient with concurrent retinitis pigmentosa and central serous chorioretinopathy. Both conditions involve dysfunction of the retinal pigment epithelium and evince distinct clinical, angiographic, and electrophysiologic features. Potential pathophysiologic connections are explored.

Sterile single use cover for the G-probe Transscleral Cyclodiode.

Purpose: Multiuse of the G-probe transscleral cyclophotocoagulation (TSCPC) device can lead to contamination. We evaluated the mechanical stability and clinical efficacy of a disposable sterile barrier for the G-probe footplate.

Methods: We measured diode laser output with and without the G-probe barrier both before and after cadaver TSCPC (18 shots at 2000 mW for 2000mS).

Glaucoma aqueous drainage device erosion repair with buccal mucous membrane grafts.

Purpose: Glaucoma aqueous drainage devices are important and effective in the management of recalcitrant glaucoma. One complication of this procedure is erosion and exposure of the tube or plate. Strategies to re-cover glaucoma aqueous drainage devices in such cases have met with variable success.

Buccal mucous membrane for the reconstruction of complicated leaking trabeculectomy blebs.

Purpose: Late onset trabeculectomy bleb leaks often require surgical repair to avoid hypotony and/or infection. Repair using local conjunctiva is typically performed. However, in cases in which local conjunctiva is limited and/or has failed, buccal mucous membrane can be used as a conjunctival substitute.

Perceptions and realities of testing for alcohol and other drugs in trauma patients.

Background: Routine testing for acute intoxication with alcohol and other drugs in trauma patients is a widely accepted practice at major trauma centers. However, there is often a significant difference between policy and practice. We sought to study the perception and the reality of testing practices at an urban Level I trauma center.

In situ versus whole-globe harvesting of corneal tissue from remote donor sites: effects on initial tissue quality.

Purpose: There are 2 methods of corneal tissue procurement currently in widespread use: in situ extraction of the corneal button directly to preservation media and whole-globe enucleation of eyes with removal of the button to preservation media at a later time. This study evaluates the effects of these 2 procurement procedures on the initial quality of donor corneal tissue.

Methods: Slit-lamp examination results and endothelial cell counts were compared for a total of 468 donor corneas harvested at 2 remote locations: one where in situ procurement was practiced and the other that used whole-globe enucleation procedures.

Predictors of completion status in a remedial program for male convicted drinking drivers.

Objective: Rates of attrition in alcohol and drug treatment programs are often greater than 50%, and completion of treatment has been shown to be a potent predictor of posttreatment outcome. The current study examined both rates and predictors of completion among male participants in a remedial measures program for convicted drinking drivers.

Method: Male individuals (n = 5,409) convicted of a drinking driving offense in Ontario between October 2000 and December 2002 who did and did not complete a mandatory rehabilitation program were described in terms of demographic, drug use and legal variables collected at time of assessment.