Diana Proshutinskaia, Ph.D, MD. She is a leading researcher of department of dermatology. She has published 30 papers in reputed journals. She is a member of EADV, ESPDrnrnVladimir Volnukhin, Ph.D, MD. He is a leading researcher of department of dermatology. He has published 80 papers in reputed journals. He is a member of EADV.
Introduction: There is a view of the impossibility of recovery of skin pigmentation in the long-existing vitiligo lesions. We studied efficacy of UVB phototherapy in long-existing vitiligo. Materials and methods: The 80 patients enrolled in the study had non-segmental vitiligo with duration of disease from 4 month to 42 years. The 64 patients underwent Narrowband UVB phototherapy (311 nm) in the cabin Waldmann UV 7001K (Germany), 16 patients - ultraviolet excimer laser irradiation with a wavelength of 308 nm (XTRAC XL PLUS, PhotoMedex Inc, USA). Median number of procedures per course was 54. Results: Analysis of treatment results showed the efficacy of phototherapy in long-existing vitiligo. In patients with duration of disease less 10 years (n=54) the average percentage of repigmentation in lesions after a course of phototherapy was 46,4%, in patients with duration of disease 10-20 years (n=15) - 26,9%, in patients with duration of disease more than 20 years (n=11) - 36,8%. The correlation analysis in the general group (n=80) revealed weak inverse correlation of percentage of skin repigmentation and disease duration (Kendall tau rank correlation coefficient is -0,15). Three of the 11 patients with duration of disease more than 20 years after treatment had the percentage of skin repigmentation more 70% in vitiligo lesions, four patients – from 30 to 50%, four patients – less 15%. The patient with duration of disease 42 year showed percentage of repigmentation 30%. Conclusions : The findings suggest the ability of UVB phototherapy to stimulate repigmentation in vitiligo patients with long duration of disease, including more than 40 years.
Dr. Sameera Irfan is a Consultant Oculoplastics Surgeon & Strabismologist, in Mughal Eye Trust Hospital, Lahore, Pakistan. She completed her M.B.B.S from Fatima Jinnah Medical College, Lahore, Pakistan and she is a gold medalist in ophthalmology. She is an active member of various societies like, Royal College of Ophthalmologists, Royal College of Surgeons, Ophthalmological Society of Pakistan, Pakistan Oculoplastic Association, Pakistan Association of Pediatric Ophthalmology, All India Ophthalmological Society, Oculoplastic Association of India.
Introduction: Benign Essential Blepharospasm causes a lot of ocular morbidity. A new surgical technique is being introduced to offer these patients a permanent relief. This study was conducted to assess how efficient and safe this technique is to relieve blepharospasm in such cases permanently. Materials and Methods: This is a prospective clinical, interventional study conducted at the oculoplastics department of a tertiary care centre. A total of 25 consecutive cases (50 eyes) were included in the study, conducted from Jan 2012 to Dec 2014. There were 19 females and 6 males between the ages 28-66 years (mean age 52 years). They were referred to the oculoplastics clinic because of their inability to keep their eyes open and frequent blinking. After a thorough history, a complete ophthalmological examination was carried out by a single examiner (SI). Any associated causes of ocular irritation like dry eyes, meibomitis and blepahritis were first treated with lid hygiene, lubricants, and tetracycline eye ointment massaged into the lid margins and wearing tinted glasses. After one month of this therapy, a limited orbicularis myectomy of both the upper and lower lids was performed under local anesthesia by a single surgeon. All cases were followed up after 1 week, one month, 3 months, 6 months and 1 year. The patients were asked about subjective improvement while the presence and extent of spasms was also noted objectively. Any complications like lid edema, lagophthalmos, and corneal exposure was also noted. Results: A total of 25 consecutive cases (50 eyes) were included in the study, with 19 females and 6 males between the ages 28-66 years (mean age 52 years). A positive family history was present in only 3 cases (12%), the rest were all sporadic. After treating or removing the triggering factors and a meticulous control of their diabetes and hypertension, all patients underwent a limited orbicularis myectomy of all 4 eyelids simultaneously, under local anesthesia by a single surgeon. After the first post-operative dressing, ecchymosis of lower lids was noted in 13 cases (52%); a slight lid swelling at the lateral lid margin was present only in 3 cases (12%). No lad lag, lid asymmetry or corneal exposure was noted in any case. The patient satisfaction was 100%.rnConclusion: Limited orbicularis myectomy by this procedure was found to be effective in providing a long-term relief of spasms and was not associated with any complications. However, proper patient selection and treatment of triggering factors pre-operatively is mandatory.