Monday, January 28, 2008

DryEyeTalk news: New Q&A with Frank Holly

I'm very pleased to announce that Dr. Frank Holly has joined Dry Eye Talk, answering questions in a special Q&A forum.

To many of you who have heard his name, you know him as the scientist who formulated the Dwelle, Dakrina, NutraTear, and FreshKote products. Some of you LASIK old-timers will fondly recall all the time he has dedicated to patiently answering questions and helping struggling patients back on the former SurgicalEyes website some years ago.

Dr. Holly's scientific contributions to the field of lacrimology, however, extend so far beyond the development of these products that I feel quite inadequate to the task of writing any kind of introduction for him. I'll just let him speak for himself. The Q&A is already underway and promises to be most interesting. Come join!

Check it out at this link:

It's a moderated forum, so please have a look at the guidelines to get a sense of how it runs.

Study: Ptosis surgery and dry eye

This study claims that incidence of dry eye was surprisingly low after this particular form of surgery to correct mild to moderate ptosis. I would be curious to know how they evaluated dryness - clinical signs (and if so which), patient symptoms, or both. - Particularly given the timeframe of all these patients' cases, 1988-1996, when there was not nearly as much attention paid to dry eye as there is today.

Fasanella-Servat procedure: indications, efficacy, and complications.
Pang NK, Newsom RW, Oestreicher JH, Chung HT, Harvey JT.
Can J Ophthalmol. 2008 Feb;43(1):84-8

Background: The Fasanella-Servat procedure is used for the repair of mild to moderate ptosis. The purpose of this study was to determine the efficacy of the Fasanella-Servat procedure for the repair of several forms of ptosis. Methods: The authors retrospectively reviewed 169 charts of 2 surgeons from 1988 to 1996. All patients had undergone a Fasanella-Servat procedure for ptosis. Patients with less than a 1-month follow-up were excluded, leaving 153 eyelids of 144 patients. Surgical success was defined as lid symmetry within 0.5 mm or correction of eyelid contour abnormality from previous surgery or trauma. Results: Ptosis was classified as involutional, occurring after intraocular surgery, congenital, due to Horner's syndrome present after levator surgery, and myogenic/other. With a mean follow-up of 7 months, success was achieved in 89.5% of cases (137/153). Among subgroups, success was highest at 100% in Horner's syndrome (8/8) and post-levator surgery (11/11), and lowest in congenital ptosis at 76.4% (13/18). Postoperative problems included dry eye symptoms (6/144 patients), contour abnormalities in 12 lids, and dermatochalasis in 10 lids. Interpretation: The Fasanella-Servat operation is effective for mild to moderate ptosis from a variety of causes and for contour abnormality correction in patients with little or no ptosis. Despite the long-held belief that excision of the accessory lacrimal glands of Wolfring leads to dry eye symptoms, our study found this to be the exception. This procedure has the advantage of high reliability when reasonable preoperative criteria are applied and is minimally invasive.