The FICI grading for a dacryocystorhinostomy ostium

2021 ◽  
pp. 112067212199474
Author(s):  
Mohammad Javed Ali ◽  
Adit Gupta ◽  
Chittabhathina Sri Lakshmi ◽  
Mohammad Hasnat Ali
Keyword(s):  
Functional Outcomes ◽  
Statistical Tests ◽  
Recursive Partitioning ◽  
Case Series ◽  
Conditional Inference ◽  
Statistical Software ◽  
Fluorescein Dye ◽  
Prospective Case Series ◽  
Larger Sample ◽  
Significant Factors

Purpose: The objective of this study is to propose a simple grading to assess the health of a dacryocystorhinostomy (DCR) ostium. Methods: Prospective case series of 237 Ostia evaluated following dacryocystorhinostomy were included in the study. All the ostia were assessed for 10 parameters in detail using the earlier published DCR ostium scoring (DOS scoring). Each of the 10 parameters were scored individually, and final DOS scores were obtained. The anatomical and functional outcomes of each of the surgery were noted. The most significant parameters that influenced the success were determined using the binary recursive partitioning in a conditional inference framework. Data management and statistical tests were performed using the statistical “Software R” and the library “partykit” toolkits. Results: The most significant DCR ostium parameters that influenced the outcomes were anatomical and functional fluorescein dye transit ( p < 0.001), dynamicity of internal common opening (ICO) on the blink ( p < 0.001), end-on threats to ICO from granuloma, membrane or a synechia, and cicatricial closure of the Ostia. Each of these significant factors (FICI – Fluorescein endoscopy dye test, ICO dynamicity, Cicatricial ostium closure and ICO threats) were assigned simple scoring and the final scores were graded from 0 (poor DCR ostium) to +5 (excellent DCR ostium). FICI grading can guide the physician on the health status of the DCR ostium and the possible need for intervention. Conclusion: FICI DCR ostium grading is a simple, easy to perform, and physician-friendly system. More studies with larger sample size would help in further validating the FICI grading.

LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

2018 ◽  
Vol 103 (5) ◽  
pp. 592-598 ◽  
Author(s):  
Sayan Basu ◽  
Ritu Nagpal ◽  
Juan Carlos Serna-Ojeda ◽  
Swapnil Bhalekar ◽  
Bhupesh Bagga ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Retention Rate ◽  
Survival Rates ◽  
Case Series ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Dry Eyes ◽  
Corneal Blindness ◽  
Prospective Case Series ◽  
End Stage

PurposeTo describe the anatomical and functional outcomes of the novel LVP keratoprosthesis (Kpro), developed as an alternative to the modified osteo-odonto keratoprosthesis (MOOKP), in eyes with end-stage corneal blindness where conventional corneal surgeries are contraindicated.MethodsThis prospective case series included 58 eyes of 56 patients (12 children and 44 adults) with severe bilateral keratopathy and completely dry, dermalised ocular surfaces who underwent unilateral LVP Kpro implantation from 2012 to 2016. In this two-stage procedure, an ocular surface labial mucous membrane grafting was performed, followed for 3 months by the implantation of the device under the engrafted mucosal flap. The primary outcome measures were anatomical retention rate and improvement in best corrected visual acuity (BCVA). The secondary outcome measure was rate of occurrence of complications.ResultsMean postoperative follow-up was 2.5±1.1 years. Kaplan-Meier survival analysis showed an anatomical retention rate of 90.8%±3.9% at 1 year, 80%±5.7% at 2 years and 76.6%±6.5% at 3–5 years. The survival rates were comparable in children and adults (91% vs 72% at 5 years, p=0.258). About 61.5% of eyes maintained 20/400 or better vision and median BCVA improved from perception of light to 20/70 at 1 year postoperatively (p<0.0001). Complications like retroprosthetic membrane formation, glaucoma, vitritis, endophthalmitis and panophthalmitis occurred in 43%, 26%, 22%, 12% and 3% of the eyes, respectively.ConclusionThe LVP Kpro is an effective procedure for the treatment of end-stage corneal blindness in completely dry eyes. The LVP Kpro can be particularly useful in situations where the MOOKP is contraindicated or difficult to perform.

Ultrasound-Guided Lumbar Sympathetic Ganglion Blockade Using Shamrock Method: A Prospective Case Series

2016 ◽  
Vol 3 (3) ◽  
pp. 114-118 ◽  
Author(s):  
Dan-Xu Ma ◽  
Yun Wang ◽  
Meng-Meng Bao ◽  
Chen Zhang ◽  
Xue-Yang Li ◽  
...  
Keyword(s):  
Sympathetic Ganglion ◽  
Case Series ◽  
Ultrasound Guided ◽  
Prospective Case Series

Epidemiology of pediatric hydrocephalus in Haiti: analysis of a surgical case series

2019 ◽  
Vol 23 (5) ◽  
pp. 568-576
Author(s):  
Michael Ragheb ◽  
Ashish H. Shah ◽  
Sarah Jernigan ◽  
Tulay Koru-Sengul ◽  
John Ragheb
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Head Circumference ◽  
Rainy Season ◽  
Statistical Tests ◽  
Multivariate Logistic Regression Analysis ◽  
Case Series ◽  
Multivariate Logistic Regression ◽  
Surgical Case ◽  
Operative Notes

OBJECTIVEHydrocephalus is recognized as a common disabling pediatric disease afflicting infants and children disproportionately in the developing world, where access to neurosurgical care is limited and risk of perinatal infection is high. This surgical case series describes the Project Medishare Hydrocephalus Specialty Surgery (PMHSS) program experience treating hydrocephalus in Haiti between 2008 and 2015.METHODSThe authors conducted a retrospective review of all cases involving children treated for hydrocephalus within the PMHSS program in Port-au-Prince, Haiti, from 2008 through 2015. All relevant epidemiological information of children treated were prospectively collected including relevant demographics, birth history, hydrocephalus etiology, head circumference, and operative notes. All appropriate associations and statistical tests were performed using univariate and multivariate logistic regression analyses.RESULTSAmong the 401 children treated within PMHSS, postinfectious hydrocephalus (PIH) accounted for 39.4% (n = 158) of cases based on clinical, radiographic, and endoscopic findings. The majority of children with hydrocephalus in Haiti were male (54.8%, n = 197), born in the rainy season (59.7%, n = 233), and born in a coastal/inland location (43.3%, n = 61). The most common surgical intervention was endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) (45.7%, n = 175). Multivariate logistic regression analysis yielded coastal birth location (OR 3.76, 95% CI 1.16–12.18) as a statistically significant predictor of PIH. Increasing head circumference (adjusted OR 1.06, 95% CI 0.99–1.13) demonstrated a slight trend toward significance with the incidence of PIH.CONCLUSIONSThis information will provide the foundation for future clinical and public health studies to better understand hydrocephalus in Haiti. The 39.4% prevalence of PIH falls within observed rates in Africa as does the apparently higher prevalence for those born during the rainy season. Although PIH was the most frequent etiology seen in almost all birth locations, the potential relationship with geography noted in this series will be the focus of further research in an effort to understand the link between climate and PIH in Haiti. The ultimate goal will be to develop an appropriate public health strategy to reduce the burden of PIH on the children of Haiti.

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