Background: To evaluate the efficacy (complete resolution, tolerability, and recurrance of BCC) andsafety (adverse effect during and after treatment) of imiquimod 5% cream as primary therapy inmanagement of nodular basal cell carcinoma.Methods: Journal articles published that were published between 2007 and 2011 related to themanagement of eyelid nodular basal cell carcinoma with imiquimod 5% cream were reviewed.Results: Of all 6 articles: 1 article was randomized trial study; 1 article was case series study; whilethe others were prospective studies. The rate of complete resolution with imiquimod 5% therapy wasoverall high with range 80-100% between all studies. Four studies reported tolerability of imiquimodtherapy assessed by ophthalmologist also range from 80-100%. No occurance of relapse were reportedin all studies. Skin reaction is the most common adverse effect seen with the rate widely variedbetween 53.5% to 100%. Skin reaction could be seen as erythema, crusting, or scabbing in the site ofimiquimod application during and after treatment of the therapy. The other side effects were skinulceration (40-55.5%), keratitis (15%), conjunctivitis (13.3-40%), and ocular discomfort (60%). Nosystemic side effect were reported in all studies.Conclusion: Imiquimod 5% cream gains good evidence of efficacy and safety in treating nodular eyelidand periocular BCC. Imiquimod may be used as first-line treatment in patients with small eyelidnodular BCC located in patients who refuse surgery or have existing pathologies that contraindicatesurgery.Keywords: imiquimod 5% cream, basal cell carcinoma of the eyelid or periocular
Introduction: Purpose, to evaluate patient demographic characteristics, indications and variables related to penetrating keratoplasty (PK) survival. Study design, this study was retrospective case series. Methods: We trace all medical records of PK patients from 2015 to 2018 in Cipto Mangunkusumo Hospital Jakarta. The traced variables were indications of surgery, corneal vascularization, previous failed graft, glaucoma after PK, and other complication. PK survival rate is shown in the Kaplan Meier curve using SPSS v20.0. Results: A total of 214 patients underwent PK (men 67.3%, woman 32,7%) with mean age of 42.11 (0-85) years were included in this study. Three most common indications of keratoplasty were corneal scar (32.7%), infectious corneal ulcer (25.5%), and failed graft (19.2%). The overall graft survival rate for PK is 61.7%. The mean graft survival time was 14.388 ± 0.580 months (95% CI; 13.252-15.524). Conclusion: The graft survival rate for penetrating optic keratoplasty was 61.7%. Establishing an appropriate early diagnosis, reasonable surgical procedures, close monitoring, and early detection of complications with proactive interventions lead to better outcomes. Further research is needed to determine the relationship between the risk factors for corneal graft failure.
Background: To compare corneal thickness and endothelial cell morphology in myopic patients wearing 1 month hydrogel conventional and silicon hydrogel contact lenses in daily wear.Methods: This is a prospective, single blind, randomized study. Seventeen (34 eyes) myopic patients were randomly assigned to receive either nelfilcon A or lotrafilcon B. Central corneal thickness (CCT), coefficient of variation (CV), and percentage of six-sided cell (6A) were examined using specular noncon robo Konan microscope. Changes in CCT, CV, and 6A were evaluated before contact lenses fitting as well as 1 week and 1 month after the treatment. Patients were also evaluated for any subjective side effects and complications during the treatment period. Results: There were 64.7% subjects with history of contact lens wearers and 52.9% of them was hydrogel wearers. After 1 month daily wear of nelfilcon A and lotrafilcon B, no statistically differences changes in CCT (p=0.285; Mann Whitney test), CV (p=0.587; unpaired t-test), and 6A (p=0.353; unpaired t-test). General linear model analysis in follow up evaluation with test of within subject effect revealed decreased in CCT (p=0.001) and CV (p=0.001), also increased in 6A (p=0.022) in all subjects.Conclusion: There were no statistically difference in CCT, CV, and 6A between daily wear of nelfilcon A and lotrafilcon B. Subjects with history of contact lens wearers gained advantages in oxygen availability, which decrease corneal thickness and improve endothelial cell morphology. Â Keywords: nelfilcon A, lotrafilcon B, simple myopic, corneal thickness, endothelial cell morphology
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