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A non-surgical approach to the management of exposure keratitis due to facial palsy by using mini-scleral lenses.

Abstract This is a retrospective study aimed to determine the efficacy of mini-scleral contact lens in protecting the cornea and improving vision in cases of facial palsy.
PMID
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Authors

Mayor MeshTerms

Cornea

Lenses, Intraocular

Keywords
Journal Title medicine
Publication Year Start




PMID- 28178141
OWN - NLM
STAT- MEDLINE
DA  - 20170208
DCOM- 20170227
LR  - 20170227
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 6
DP  - 2017 Feb
TI  - A non-surgical approach to the management of exposure keratitis due to facial
      palsy by using mini-scleral lenses.
PG  - e6020
LID - 10.1097/MD.0000000000006020 [doi]
AB  - RATIONALE: This is a retrospective study aimed to determine the efficacy of
      mini-scleral contact lens in protecting the cornea and improving vision in cases 
      of facial palsy. PATIENT CONCERNS: Patients with facial palsy get exposure
      keratitis because the cornea is dry. They feel pain, discomfort and excessive
      watering. If left untreated, it leads to permanent damage to the cornea and loss 
      of good functional vision. Mini-scleral lens keep the cornea covered by saline
      solution all wearing hours. DIAGNOSES: Three patients (4 eyes) with acoustic
      neuroma, two unilateral and one bilateral, who underwent acoustic neuroma
      surgeries resulting in facial palsy, are presented.The gold implant and lateral
      tarsorrhaphy were not enough for corneal protection.Two patients (patients 1 and 
      2) suffered continuous pain and watering. They had to apply thick lubricant,
      Lacri-Lube ointment (Allergan, Inc., Dublin, Ireland), several times daily to the
      affected eye for 15 years. The vision of these patients in the affected eyes were
      counting fingers (CF) at one foot.Patient 3 with bilateral facial palsy had
      exposure keratitis in both eyes resulting in constant watering, pain and blurred 
      vision. INTERVENTIONS: The 4 eyes were fitted with mini-scleral lenses. The
      lenses were 15.8 mm rigid gas permeable filled with preservative free saline
      solution that continuously covers the cornea all wearing hours. OUTCOMES: In
      patients 1 and 2 with unilateral facial palsy, vision improved through the
      mini-scleral lenses to 20/30 and all their symptoms disappeared.The keratitis in 
      case 3 with bilateral facial palsy disappeared within one week of mini-scleral
      lens use.Follow up for 2 years showed that these patients maintained good vision 
      with no side effects. LESSONS: Mini-scleral lenses protected the cornea, gave
      comfort and improved the vision and the quality of life of these three patients
      with facial palsy and should be considered for all patients with facial palsy.
FAU - Zaki, Victor
AU  - Zaki V
AD  - Lexington Eye Associates, Westford, MA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - *Cornea
MH  - Facial Paralysis/*complications/etiology
MH  - Female
MH  - Humans
MH  - Keratitis/*etiology/*therapy
MH  - *Lenses, Intraocular
MH  - Male
MH  - Middle Aged
MH  - Neuroma, Acoustic/surgery
MH  - Visual Acuity
PMC - PMC5312998
EDAT- 2017/02/09 06:00
MHDA- 2017/02/28 06:00
CRDT- 2017/02/09 06:00
AID - 10.1097/MD.0000000000006020 [doi]
AID - 00005792-201702100-00022 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Feb;96(6):e6020. doi: 10.1097/MD.0000000000006020.

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