* BACKGROUND AND OBJECTIVE: To evaluate the long-term success following external dacryocystorhinostomy, which is used as a standard in comparing endoscopic or laser techniques.
* PATIENTS AND METHODS: A chart review of 128 patients (150 procedures) undergoing external dacryocystorhinostomy within a 14-year period was undertaken. Patient demographics, symptoms, examination findings, surgical and anesthesia information, postoperative course, and complications were recorded. Lack of tearing or evidence of dacryocystitis at the final postoperative visit was considered a successful result.
* RESULTS: External dacryocystorhinostomy was found to be highly successful, with an overall 93% success rate at an average follow-up of 2.7 years. Kaplan-Meier analysis of the data, applied for the first time in this study, predicts a success rate of 90% beyond 4 years. Most important, this demonstrated that most surgical failures were identified in the first 2 years. Postoperative complications were rare and the surgical scar was not a source of patient concern in most cases.
* CONCLUSIONS: This study confirms that external dacryocystorhinostomy is a highly successful longterm solution to nasolacrimal duct obstruction with low morbidity.
[Ophthalmic Surg Lasers Imaging 2005;36:446450.]
To further characterize the role of the carbohydrate sulfotransferase (CHST6) gene in macular corneal dystrophy (MCD) through identification of causative mutations in a cohort of affected patients from southern India. Methods: Genomic DNA was extracted from buccal epithelium of 75 patients (51 families) with MCD, 33 unaffected relatives, and 48 healthy volunteers. The coding region of the CHST6 gene was evaluated by means of polymerase chain reaction amplification and direct sequencing. Subtyping of MCD into types I and II was performed by measuring serum levels of antigenic keratan sulfate. Results: Seventy patients were classified as having type I MCD, and 5 patients as having type II MCD. Analysis of the CHST6 coding region in patients with type I MCD identified 11 homozygous missense mutations (Leu22Arg,
With the introduction of HAART, HIV-infected patients have much longer remission durations from recurrent CMV retinitis. The minimum HIV viral load level reached after the initiation of HAART treatment appears to be more important than other clinical variables in the prediction of favorable CMV retinitis remission status. Furthermore, a rise in CD4 T-lymphocyte count by itself appears to be a less significant clinical predictor but may be useful in combination with the HIV viral load data. Selective discontinuation of anti-CMV therapy may be considered in patients with a favorable set of clinical predictors.
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