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Guo S, Borchert MS, Chang M, Nallasamy S, Reid MW, Zhang-Nunes S, Chang JR, Nguyen AM. The Nictavi Tarsus Patch: A New Device for Achieving Temporary Eyelid Closure in Lagophthalmos. Clin Ophthalmol 2023; 17:1877-1884. [PMID: 37425025 PMCID: PMC10327908 DOI: 10.2147/opth.s415766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/23/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To evaluate the effectiveness, tolerability, and safety of the Nictavi Tarsus Patch™ (NTP) in inducing temporary eyelid closure for the management of lagophthalmos in the pediatric and young adult population. Methods We prospectively enrolled 20 patients <21 years of age who had previously been managed for lagophthalmos to trial the NTP in clinic. Inter-palpebral fissure distance (IPFD) was compared before and after the placement of the NTP in the eyes-closed position using paired t-tests. Subjects then underwent a 3-night home trial with the NTP, and parent and subject perceptions of effectiveness, comfort, and complications with the patch were analyzed using Likert scale survey questions. Results Twenty subjects ages 2-20 years with paralytic (65%) and non-paralytic (35%) lagophthalmos were enrolled. The NTP improved lagophthalmos from a mean pre-placement IPFD of 3.3 mm to post-placement IPFD of 0.4 mm (p < 0.01). Overall, 80% of subjects achieved successful eyelid closure defined as ≤1 mm of post-placement IPFD. When stratified by subtype, 100% of subjects with paralytic lagophthalmos achieved successful eyelid closure compared to 71% of subjects with non-paralytic lagophthalmos. On a scale of 1 (worst) to 5 (best), parents rated the NTP at 4.3±0.7 for comfort while wearing, 4.3±1.0 for comfort in removing, 4.6±0.7 for ease of use, and 4.3±0.9 for effectiveness. Ninety-three percent of parents reported preferring NTP to other eyelid closure methods previously tried and indicated that they would use it again. Conclusion The NTP is an effective, tolerable, and safe method of eyelid closure for children and young adults.
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Affiliation(s)
- Sarah Guo
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Mark S Borchert
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Melinda Chang
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Sudha Nallasamy
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Mark W Reid
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Sandy Zhang-Nunes
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Jessica R Chang
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
| | - Angeline M Nguyen
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USA
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MIMOUNI MICHAEL, LIU EUGENES, DIN NIZAR, GOUVEA LARISSA, ALSHAKER SARA, COHEN EYAL, KIM DOOHOB, CHAN CLARAC. Tape Splint Tarsorrhaphy for Persistent Corneal Epithelial Defects. Am J Ophthalmol 2022; 237:235-240. [PMID: 34942108 DOI: 10.1016/j.ajo.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To report outcomes of tape splint tarsorrhaphy (TST) for persistent corneal epithelial defects (PCED). DESIGN Retrospective, interventional case series. METHODS The study population was consecutive patients with a PCED (14 days or longer) treated at a tertiary cornea clinic with TST. Patients with a corneal epithelial defect that did not respond to treatment with a bandage contact lens were included. Patients with a follow-up time of less than 3 months were excluded. Time to PCED resolution was the main outcome measure. RESULTS Thirty-four eyes of 33 patients (mean age 62.9 ± 17.8 years; range, 27-90 years) were included in this study. The main etiologies of the PCED were post keratoplasty (n = 15), herpes simplex virus (n = 4), superficial keratectomy (n = 3), neurotrophic cornea (n = 4), fungal keratitis (n = 2), exposure keratopathy (n = 2), failed graft (n = 1), peripheral ulcerative keratitis (n = 1), rosacea (n = 1), and stitch abscess (n = 1). Mean ± SD time from PCED presentation to TST was 58.9 ± 106.3 days (range, 14-390 days). The mean ± SD area of the PCED was 25.1 ± 15.7 mm2 (range, 0.50-42.0 mm2). After TST, resolution of the PCED was achieved in 29/34 eyes (85.3%) without the need for additional interventions within 22.5 ± 24.3 days (range, 2-105 days). The mean ± SD logMAR best-corrected visual acuity improved significantly from 1.11 ± 0.41 to 0.83 ± 0.70 (P = .02). There were no complications attributed to TST and 2 patients elected to discontinue due to discomfort. CONCLUSIONS TST achieved resolution of PCEDs secondary to various etiologies in 85.3% of eyes, with significant improvement in vision demonstrated. This simple, inexpensive, noninvasive technique may be considered for patients with PCEDs.
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