The Experts below are selected from a list of 627 Experts worldwide ranked by ideXlab platform
Xiaozhao Zhang - One of the best experts on this subject based on the ideXlab platform.
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New Method for Removing Thermosensitive Acrylic Punctal Plugs From Lacrimal Puncta.
Cornea, 2015Co-Authors: Mingchang Zhang, Xiaozhao ZhangAbstract:This study explored a new method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta.A total of 14 dry eye patients (14 eyes), who required the removal of thermosensitive acrylic punctal plugs from the Lacrimal puncta because of serious complications, were recruited. Among the 14 patients, Lacrimal punctal granuloma formation occurred in 3 patients, tearing occurred in 6 patients, canaliculitis occurred in 3 patients, and chronic inflammation of the ocular surface occurred in 2 patients. The plugs were removed using a new method. Briefly, after local anesthesia was administered, a small lid clamp was used to flip the eyelid outward. After the application of the lid clamp, the plug could be removed without the use of any additional tools if the Lacrimal Punctum was large enough. If the Lacrimal Punctum was not large enough, microforceps were used to expand the Lacrimal Punctum before the application of the lid clamp. If the plug still could not be removed after the expansion of the Lacrimal Punctum, we moved the small lid clamp from the distal side of the Lacrimal ductule to the Lacrimal Punctum.Using this method, the plug was successfully removed in all of the patients.This is a simple and effective method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta.: http://www.clinicaltrials.gov. Unique identifier: ChiCTR-IPR-14005476.
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New Method for Removing Thermosensitive Acrylic Punctal Plugs From Lacrimal Puncta.
Cornea, 2015Co-Authors: Mingchang Zhang, Xiaozhao ZhangAbstract:PURPOSE This study explored a new method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta. METHODS A total of 14 dry eye patients (14 eyes), who required the removal of thermosensitive acrylic punctal plugs from the Lacrimal puncta because of serious complications, were recruited. Among the 14 patients, Lacrimal punctal granuloma formation occurred in 3 patients, tearing occurred in 6 patients, canaliculitis occurred in 3 patients, and chronic inflammation of the ocular surface occurred in 2 patients. The plugs were removed using a new method. Briefly, after local anesthesia was administered, a small lid clamp was used to flip the eyelid outward. After the application of the lid clamp, the plug could be removed without the use of any additional tools if the Lacrimal Punctum was large enough. If the Lacrimal Punctum was not large enough, microforceps were used to expand the Lacrimal Punctum before the application of the lid clamp. If the plug still could not be removed after the expansion of the Lacrimal Punctum, we moved the small lid clamp from the distal side of the Lacrimal ductule to the Lacrimal Punctum. RESULTS Using this method, the plug was successfully removed in all of the patients. CONCLUSIONS This is a simple and effective method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta. CLINICAL TRIAL REGISTRATION-URL : http://www.clinicaltrials.gov. Unique identifier: ChiCTR-IPR-14005476.
Daniel G. Ezra - One of the best experts on this subject based on the ideXlab platform.
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Characterizing the Occluded Lacrimal Punctum Using Anterior Segment Optical Coherence Tomography.
Ophthalmic plastic and reconstructive surgery, 2018Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:PURPOSE Epiphora is sometimes associated with an absent or occluded Lacrimal drainage Punctum (or puncta). This study uses noninvasive "enhanced depth" anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of absent or fully occluded puncta and the underlying canaliculus. METHODS Anterior segment spectral domain OCT images were collected prospectively from 9 lower puncta of 6 patients with epiphora and absent or fully occluded puncta, not amenable to dilation in clinic, to see if a canaliculus was visible on OCT imaging below the occluded Punctum. RESULTS An epithelial lined canalicular lumen was visible on OCT in 4 lower eyelid puncta from 2 patients and OCT identified 80% (4/5) of the canaliculi that were located on microscope-assisted punctal exploration. These lumens were seen within 580 μm depth from the eyelid margin surface. A half of the eyes in which a canaliculus was identified on OCT (the 2 eyes in a single patient) had resolution of epiphora following punctoplasty, and the other patient was found to have coexisting nasoLacrimal duct stenosis and required later dacryocystorhinostomy. The positive predictive value for identifying a canaliculus on lower eyelid punctal exploration in acquired complete punctal occlusion (excluding the congenital case) was 1, with a negative predictive value of 1. CONCLUSIONS This study demonstrates that canaliculi can be imaged with OCT where formal access is precluded by an occluded Punctum. This noninvasive investigation might help predict the likelihood of successful retrieval of a canaliculus at surgical exploration.
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The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora.
Ophthalmology, 2017Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:Purpose To determine the application of imaging the stenotic Lacrimal Punctum with infrared photographs and optical coherence tomography (OCT) and to identify characteristics of the Lacrimal Punctum in patients who benefit from punctoplasty. Design Case-control study. Participants Twenty patients with epiphora who were listed for punctoplasty and 20 healthy controls. Methods Prospectively, 20 patients listed for punctoplasty were asked to rate their epiphora, using the Munk score, before and after punctoplasty. They also underwent preoperative OCT and infrared imaging of the affected Punctum. They were divided into 2 groups, depending on whether the epiphora improved, and were compared with 20 healthy controls. Main Outcome Measures Measurements of puncta from infrared and OCT images were obtained along with Munk scores of patient epiphora. Results The infrared image measurements were significantly smaller in those patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter. Additionally, those patients with improvement in epiphora had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not observed in patients whose epiphora failed to improve. There was no significant difference in the Punctum diameter among the 3 groups at the Punctum surface entrance or at 500 μm depth. Patients with epiphora had a higher tear meniscus within the Punctum compared with healthy controls. Conclusions Lacrimal Punctum infrared and OCT imaging may be helpful in predicting patients more likely to benefit symptomatically from punctoplasty, with patients with smaller puncta having greater symptomatic improvement. However, the results suggest that inner Punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome. Additionally, OCT measurements of the tear meniscus height within the Punctum may be related to the degree of epiphora.
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Characterizing the Lacrimal punctal region using anterior segment optical coherence tomography
Acta ophthalmologica, 2015Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Alexander C Day, Tahrina Salam, Mohammed Abdullah, Daniel G. EzraAbstract:Purpose Abnormalities of Lacrimal Punctum size and morphology probably contribute to excess tearing, with significant effects on quality-of-life for affected individuals. Our current understanding of normal punctal morphology originates from ex vivo studies, which are unlikely to capture the true nature of the living Punctum. This study used enhanced depth anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of Lacrimal punctal structure. Methods Qualitative and quantitative assessments were performed on spectral domain OCT images collected prospectively from 40 lower puncta of 20 healthy volunteers. Results The average external lower lid punctal diameter was 0.646 mm (SD 150 μm) on OCT imaging, measured at the largest diameter, which was in parallel to the mucocutaneous junction. Fifty-five per cent of puncta appeared closed, whilst the eyelids were open. Fluid menisci were visible within 73% of puncta. A postpunctal ‘ampulla’ was visible within three systems, one of which was imaged through the conjunctival surface. Ampullary dilatation occurred laterally, rather than at the medial wall. Conclusion Optical coherence tomography provides quick and non-invasive assessment of the Lacrimal Punctum and its neighbouring tissue layers. This assessment of punctal size and morphology has the potential for further investigation of punctal physiology, for aiding diagnosis, and for monitoring the results of treatment. The average external diameter of the punctal opening measured in this study is greater than that recorded in anatomical textbooks.
Mingchang Zhang - One of the best experts on this subject based on the ideXlab platform.
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New Method for Removing Thermosensitive Acrylic Punctal Plugs From Lacrimal Puncta.
Cornea, 2015Co-Authors: Mingchang Zhang, Xiaozhao ZhangAbstract:This study explored a new method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta.A total of 14 dry eye patients (14 eyes), who required the removal of thermosensitive acrylic punctal plugs from the Lacrimal puncta because of serious complications, were recruited. Among the 14 patients, Lacrimal punctal granuloma formation occurred in 3 patients, tearing occurred in 6 patients, canaliculitis occurred in 3 patients, and chronic inflammation of the ocular surface occurred in 2 patients. The plugs were removed using a new method. Briefly, after local anesthesia was administered, a small lid clamp was used to flip the eyelid outward. After the application of the lid clamp, the plug could be removed without the use of any additional tools if the Lacrimal Punctum was large enough. If the Lacrimal Punctum was not large enough, microforceps were used to expand the Lacrimal Punctum before the application of the lid clamp. If the plug still could not be removed after the expansion of the Lacrimal Punctum, we moved the small lid clamp from the distal side of the Lacrimal ductule to the Lacrimal Punctum.Using this method, the plug was successfully removed in all of the patients.This is a simple and effective method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta.: http://www.clinicaltrials.gov. Unique identifier: ChiCTR-IPR-14005476.
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New Method for Removing Thermosensitive Acrylic Punctal Plugs From Lacrimal Puncta.
Cornea, 2015Co-Authors: Mingchang Zhang, Xiaozhao ZhangAbstract:PURPOSE This study explored a new method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta. METHODS A total of 14 dry eye patients (14 eyes), who required the removal of thermosensitive acrylic punctal plugs from the Lacrimal puncta because of serious complications, were recruited. Among the 14 patients, Lacrimal punctal granuloma formation occurred in 3 patients, tearing occurred in 6 patients, canaliculitis occurred in 3 patients, and chronic inflammation of the ocular surface occurred in 2 patients. The plugs were removed using a new method. Briefly, after local anesthesia was administered, a small lid clamp was used to flip the eyelid outward. After the application of the lid clamp, the plug could be removed without the use of any additional tools if the Lacrimal Punctum was large enough. If the Lacrimal Punctum was not large enough, microforceps were used to expand the Lacrimal Punctum before the application of the lid clamp. If the plug still could not be removed after the expansion of the Lacrimal Punctum, we moved the small lid clamp from the distal side of the Lacrimal ductule to the Lacrimal Punctum. RESULTS Using this method, the plug was successfully removed in all of the patients. CONCLUSIONS This is a simple and effective method for removing thermosensitive acrylic punctal plugs from Lacrimal puncta. CLINICAL TRIAL REGISTRATION-URL : http://www.clinicaltrials.gov. Unique identifier: ChiCTR-IPR-14005476.
Hannah M. Timlin - One of the best experts on this subject based on the ideXlab platform.
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Characterizing the Occluded Lacrimal Punctum Using Anterior Segment Optical Coherence Tomography.
Ophthalmic plastic and reconstructive surgery, 2018Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:PURPOSE Epiphora is sometimes associated with an absent or occluded Lacrimal drainage Punctum (or puncta). This study uses noninvasive "enhanced depth" anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of absent or fully occluded puncta and the underlying canaliculus. METHODS Anterior segment spectral domain OCT images were collected prospectively from 9 lower puncta of 6 patients with epiphora and absent or fully occluded puncta, not amenable to dilation in clinic, to see if a canaliculus was visible on OCT imaging below the occluded Punctum. RESULTS An epithelial lined canalicular lumen was visible on OCT in 4 lower eyelid puncta from 2 patients and OCT identified 80% (4/5) of the canaliculi that were located on microscope-assisted punctal exploration. These lumens were seen within 580 μm depth from the eyelid margin surface. A half of the eyes in which a canaliculus was identified on OCT (the 2 eyes in a single patient) had resolution of epiphora following punctoplasty, and the other patient was found to have coexisting nasoLacrimal duct stenosis and required later dacryocystorhinostomy. The positive predictive value for identifying a canaliculus on lower eyelid punctal exploration in acquired complete punctal occlusion (excluding the congenital case) was 1, with a negative predictive value of 1. CONCLUSIONS This study demonstrates that canaliculi can be imaged with OCT where formal access is precluded by an occluded Punctum. This noninvasive investigation might help predict the likelihood of successful retrieval of a canaliculus at surgical exploration.
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The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora.
Ophthalmology, 2017Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:Purpose To determine the application of imaging the stenotic Lacrimal Punctum with infrared photographs and optical coherence tomography (OCT) and to identify characteristics of the Lacrimal Punctum in patients who benefit from punctoplasty. Design Case-control study. Participants Twenty patients with epiphora who were listed for punctoplasty and 20 healthy controls. Methods Prospectively, 20 patients listed for punctoplasty were asked to rate their epiphora, using the Munk score, before and after punctoplasty. They also underwent preoperative OCT and infrared imaging of the affected Punctum. They were divided into 2 groups, depending on whether the epiphora improved, and were compared with 20 healthy controls. Main Outcome Measures Measurements of puncta from infrared and OCT images were obtained along with Munk scores of patient epiphora. Results The infrared image measurements were significantly smaller in those patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter. Additionally, those patients with improvement in epiphora had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not observed in patients whose epiphora failed to improve. There was no significant difference in the Punctum diameter among the 3 groups at the Punctum surface entrance or at 500 μm depth. Patients with epiphora had a higher tear meniscus within the Punctum compared with healthy controls. Conclusions Lacrimal Punctum infrared and OCT imaging may be helpful in predicting patients more likely to benefit symptomatically from punctoplasty, with patients with smaller puncta having greater symptomatic improvement. However, the results suggest that inner Punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome. Additionally, OCT measurements of the tear meniscus height within the Punctum may be related to the degree of epiphora.
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Characterizing the Lacrimal punctal region using anterior segment optical coherence tomography
Acta ophthalmologica, 2015Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Alexander C Day, Tahrina Salam, Mohammed Abdullah, Daniel G. EzraAbstract:Purpose Abnormalities of Lacrimal Punctum size and morphology probably contribute to excess tearing, with significant effects on quality-of-life for affected individuals. Our current understanding of normal punctal morphology originates from ex vivo studies, which are unlikely to capture the true nature of the living Punctum. This study used enhanced depth anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of Lacrimal punctal structure. Methods Qualitative and quantitative assessments were performed on spectral domain OCT images collected prospectively from 40 lower puncta of 20 healthy volunteers. Results The average external lower lid punctal diameter was 0.646 mm (SD 150 μm) on OCT imaging, measured at the largest diameter, which was in parallel to the mucocutaneous junction. Fifty-five per cent of puncta appeared closed, whilst the eyelids were open. Fluid menisci were visible within 73% of puncta. A postpunctal ‘ampulla’ was visible within three systems, one of which was imaged through the conjunctival surface. Ampullary dilatation occurred laterally, rather than at the medial wall. Conclusion Optical coherence tomography provides quick and non-invasive assessment of the Lacrimal Punctum and its neighbouring tissue layers. This assessment of punctal size and morphology has the potential for further investigation of punctal physiology, for aiding diagnosis, and for monitoring the results of treatment. The average external diameter of the punctal opening measured in this study is greater than that recorded in anatomical textbooks.
Pearse A. Keane - One of the best experts on this subject based on the ideXlab platform.
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Characterizing the Occluded Lacrimal Punctum Using Anterior Segment Optical Coherence Tomography.
Ophthalmic plastic and reconstructive surgery, 2018Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:PURPOSE Epiphora is sometimes associated with an absent or occluded Lacrimal drainage Punctum (or puncta). This study uses noninvasive "enhanced depth" anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of absent or fully occluded puncta and the underlying canaliculus. METHODS Anterior segment spectral domain OCT images were collected prospectively from 9 lower puncta of 6 patients with epiphora and absent or fully occluded puncta, not amenable to dilation in clinic, to see if a canaliculus was visible on OCT imaging below the occluded Punctum. RESULTS An epithelial lined canalicular lumen was visible on OCT in 4 lower eyelid puncta from 2 patients and OCT identified 80% (4/5) of the canaliculi that were located on microscope-assisted punctal exploration. These lumens were seen within 580 μm depth from the eyelid margin surface. A half of the eyes in which a canaliculus was identified on OCT (the 2 eyes in a single patient) had resolution of epiphora following punctoplasty, and the other patient was found to have coexisting nasoLacrimal duct stenosis and required later dacryocystorhinostomy. The positive predictive value for identifying a canaliculus on lower eyelid punctal exploration in acquired complete punctal occlusion (excluding the congenital case) was 1, with a negative predictive value of 1. CONCLUSIONS This study demonstrates that canaliculi can be imaged with OCT where formal access is precluded by an occluded Punctum. This noninvasive investigation might help predict the likelihood of successful retrieval of a canaliculus at surgical exploration.
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The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora.
Ophthalmology, 2017Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Daniel G. EzraAbstract:Purpose To determine the application of imaging the stenotic Lacrimal Punctum with infrared photographs and optical coherence tomography (OCT) and to identify characteristics of the Lacrimal Punctum in patients who benefit from punctoplasty. Design Case-control study. Participants Twenty patients with epiphora who were listed for punctoplasty and 20 healthy controls. Methods Prospectively, 20 patients listed for punctoplasty were asked to rate their epiphora, using the Munk score, before and after punctoplasty. They also underwent preoperative OCT and infrared imaging of the affected Punctum. They were divided into 2 groups, depending on whether the epiphora improved, and were compared with 20 healthy controls. Main Outcome Measures Measurements of puncta from infrared and OCT images were obtained along with Munk scores of patient epiphora. Results The infrared image measurements were significantly smaller in those patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter. Additionally, those patients with improvement in epiphora had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not observed in patients whose epiphora failed to improve. There was no significant difference in the Punctum diameter among the 3 groups at the Punctum surface entrance or at 500 μm depth. Patients with epiphora had a higher tear meniscus within the Punctum compared with healthy controls. Conclusions Lacrimal Punctum infrared and OCT imaging may be helpful in predicting patients more likely to benefit symptomatically from punctoplasty, with patients with smaller puncta having greater symptomatic improvement. However, the results suggest that inner Punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome. Additionally, OCT measurements of the tear meniscus height within the Punctum may be related to the degree of epiphora.
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Characterizing the Lacrimal punctal region using anterior segment optical coherence tomography
Acta ophthalmologica, 2015Co-Authors: Hannah M. Timlin, Pearse A. Keane, Geoffrey E. Rose, Alexander C Day, Tahrina Salam, Mohammed Abdullah, Daniel G. EzraAbstract:Purpose Abnormalities of Lacrimal Punctum size and morphology probably contribute to excess tearing, with significant effects on quality-of-life for affected individuals. Our current understanding of normal punctal morphology originates from ex vivo studies, which are unlikely to capture the true nature of the living Punctum. This study used enhanced depth anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of Lacrimal punctal structure. Methods Qualitative and quantitative assessments were performed on spectral domain OCT images collected prospectively from 40 lower puncta of 20 healthy volunteers. Results The average external lower lid punctal diameter was 0.646 mm (SD 150 μm) on OCT imaging, measured at the largest diameter, which was in parallel to the mucocutaneous junction. Fifty-five per cent of puncta appeared closed, whilst the eyelids were open. Fluid menisci were visible within 73% of puncta. A postpunctal ‘ampulla’ was visible within three systems, one of which was imaged through the conjunctival surface. Ampullary dilatation occurred laterally, rather than at the medial wall. Conclusion Optical coherence tomography provides quick and non-invasive assessment of the Lacrimal Punctum and its neighbouring tissue layers. This assessment of punctal size and morphology has the potential for further investigation of punctal physiology, for aiding diagnosis, and for monitoring the results of treatment. The average external diameter of the punctal opening measured in this study is greater than that recorded in anatomical textbooks.
