A Prospective Randomized Comparative Clinical Trial to Analyze Pain and Surgical Outcomes Between Frontal Nerve Blocks and Subconjunctival Anesthesia for Conjunctival Mullerectomy Resection

Zatezalo, Chad C.; Tavakoli, Mehdi; Ayala-Haedo, Juan; Callaway, Natalia F.; Ko, Marcia G.; Anagnostopoulos, Apostolos G.; Vanner, Elizabeth A.; Lee, Wendy W.

doi:10.1097/iop.0000000000001108

Cited by 5 publications

(2 citation statements)

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“…In MMCR, since the efficacy of subcutaneous and subconjunctival anesthesia continues for a short period, pain typically starts in the early postoperative period. Eye patching and topical antibiotic ointments are the most common treatments during the postoperative period [7, 17, 18]. If the pain is excessive, systemic NSAIDs can be used.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Bandage Contact Lenses versus Eye Patching in Early Postoperative Period of Müller’s Muscle-Conjunctival Resection

2020

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Purpose: Patients with blepharoptosis who are treated with Müller’s muscle-conjunctival resection (MMCR) may experience postoperative pain and discomfort related to the suture material on the palpebral conjunctiva. This study aims to compare the postoperative subjective complaints, such as pain and discomfort, with a visual analog scale (VAS), and objectively evaluate the cornea with a tear break-up time (TBUT) test and fluorescein staining following MMCR that was managed by either a bandage contact lens (BCL) or eye patching. Methods: Forty patients who had undergone a unilateral MMCR were randomized into 2 groups. Group 1 (n = 20) received a BCL, and group 2 (n = 20) received an eye patch following the MMCR. Patients were evaluated postoperatively at 1 and 7 days in this prospective study. The postoperative pain was measured using a VAS, and the requirement for anti-inflammatory medication was analyzed. A slit-lamp examination was performed to evaluate the cornea with a TBUT test and fluorescein staining by objectively using the National Eye Institute (NEI) classification. Results: BCL treatment decreased the VAS score, the need for anti-inflammatory medications, and fluorescein staining using the NEI score and increased the TBUT score significantly compared with the eye patch treatment (p < 0.001). Conclusions: Our findings suggest that the use of a BCL may be beneficial in terms of reducing early postoperative pain and eye stinging, protecting the cornea, and retaining the ability to perform daily activities following a MMCR.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Bandage Contact Lenses versus Eye Patching in Early Postoperative Period of Müller’s Muscle-Conjunctival Resection

2020

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“…Subconjunctival injection is a standard technique in numerous ocular procedures with a relatively low complication rate. 19 Considering its high reproducibility and consistency, it provides a suitable delivery mechanism to the surface of the eye. Subconjunctival injection of MSCs has previously been reported in several animal studies.…”

Section: Introductionmentioning

confidence: 99%

Preclinical Evaluation of the Safety and Efficacy of Cryopreserved Bone Marrow Mesenchymal Stromal Cells for Corneal Repair

Putra

Shen

Anwar

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose Mesenchymal stromal cells (MSCs) have been shown to enhance tissue repair as a cell-based therapy. In preparation for a phase I clinical study, we evaluated the safety, dosing, and efficacy of bone marrow–derived MSCs after subconjunctival injection in preclinical animal models of mice, rats, and rabbits. Methods Human bone marrow–derived MSCs were expanded to passage 4 and cryopreserved. Viability of MSCs after thawing and injection through small-gauge needles was evaluated by vital dye staining. The in vivo safety of human and rabbit MSCs was studied by subconjunctivally injecting MSCs in rabbits with follow-up to 90 days. The potency of MSCs on accelerating wound healing was evaluated in vitro using a scratch assay and in vivo using 2-mm corneal epithelial debridement wounds in mice. Human MSCs were tracked after subconjunctival injection in rat and rabbit eyes. Results The viability of MSCs after thawing and immediate injection through 27- and 30-gauge needles was 93.1% ± 2.1% and 94.9% ± 1.3%, respectively. Rabbit eyes demonstrated mild self-limiting conjunctival inflammation at the site of injection with human but not rabbit MSCs. In scratch assay, the mean wound healing area was 93.5% ± 12.1% in epithelial cells co-cultured with MSCs compared with 40.8% ± 23.1% in controls. At 24 hours after wounding, all MSC-injected murine eyes had 100% corneal wound closure compared with 79.9% ± 5.5% in controls. Human MSCs were detectable in the subconjunctival area and peripheral cornea at 14 days after injection. Conclusions Subconjunctival administration of MSCs is safe and effective in promoting corneal epithelial wound healing in animal models. Translational Relevance These results provide preclinical data to support a phase I clinical study.

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Outcomes of conjunctival-Müller’s muscle resection surgery with and without epinephrine in local anesthetic

Mohammad

Hussain

2020

Orbit

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A Prospective Randomized Comparative Clinical Trial to Analyze Pain and Surgical Outcomes Between Frontal Nerve Blocks and Subconjunctival Anesthesia for Conjunctival Mullerectomy Resection

Abstract: There was no statistically significant difference in pain scores or surgical outcomes in patients receiving frontal nerve block compared with those receiving subconjunctival injection during CMMR surgery.

Cited by 5 publications

References 9 publications

Efficacy of Bandage Contact Lenses versus Eye Patching in Early Postoperative Period of Müller’s Muscle-Conjunctival Resection

Efficacy of Bandage Contact Lenses versus Eye Patching in Early Postoperative Period of Müller’s Muscle-Conjunctival Resection

Preclinical Evaluation of the Safety and Efficacy of Cryopreserved Bone Marrow Mesenchymal Stromal Cells for Corneal Repair

Outcomes of conjunctival-Müller’s muscle resection surgery with and without epinephrine in local anesthetic

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