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Ramón Medel Jiménez, Juan C Sánchez España, José Visa Nassarre, Eva Ayala Barroso, Alfredo Pueyo Ferrer, Alejandra Tapia Bahamondes, Luz M Vasquez
PURPOSE: To describe our experience and outcomes managing complete third cranial nerve palsy. METHODS: This was a retrospective analysis of the clinical records of 7 consecutive patients treated at our centre for unilateral third nerve palsy over the period 2010-2016. We describe our surgical approach using a frontalis muscle flap to correct the eyelid ptosis associated with medial fixation of the rectus muscle tendon to the orbit to correct the horizontal deviation...
March 15, 2018: Orbit
Hemant K Mehta
The purpose is to present a new refined surgical technique for mild-to-severe acquired myogenic ptosis correction under local anaesthesia (LA) as day cases with resection of myotarsal (MT) flap and demonstrate the safety and efficacy of the technique. MT flap consists of 2 mm tarsal strip with attached levator complex - levator muscle, its aponeurosis, and Müller muscle. This is a retrospective personal series of 400+ patients, who underwent surgical correction with MT flap resection of 8-24 mm under LA mostly as day cases...
March 15, 2018: Orbit
Nicholas H Andrew, Dinesh Selva, Alan A McNab
No abstract text is available yet for this article.
March 12, 2018: Orbit
(no author information available yet)
No abstract text is available yet for this article.
March 12, 2018: Orbit
Sarina K Mueller, Suzanne K Freitag, Daniel R Lefebvre, Nahyoung G Lee, Benjamin S Bleier
BACKGROUND: Endoscopic dacryocystorhinostomies (eDCRs) show patency rates between 81% and 94%. However, dacryocystorhinostomy (DCR) failure and the need for revision remain a significant challenge. One of the principal challenges in revision eDCR is the need to surgically identify the correct osteotomy site and maintain long-term patency in the setting of previously instrumented and potentially scarred tissue. At the same time, the surgeon must assume that the blood supply to the commonly described anterior and posteriorly pedicled flaps has been compromised...
March 8, 2018: Orbit
Kyle T Lewis, John R Bullock, Ryan T Drumright, Matthew J Olsen, Alan D Penman
The purpose is to evaluate the utility of optical coherence tomography (OCT) angiography in the evaluation of Graves' orbitopathy (GO) and response to orbital decompression in patients with and without dysthyroid optic neuropathy (DON). This was a single-center, prospective case series in a cohort of 12 patients (24 orbits) with GO and ±DON, (6 orbits) who underwent bilateral orbital decompression. All patients underwent pre- and postoperative OCT angiography of the peripapillary area. Vessel density indices were calculated in a 4...
March 8, 2018: Orbit
(no author information available yet)
No abstract text is available yet for this article.
March 7, 2018: Orbit
Saul N Rajak, Raman Malhotra, Dinesh Selva
PURPOSE: To describe the 'Over-the-Top' Modified Cutler Beard Procedure (OTTMCB) for complete upper eyelid defect reconstruction Methods: This is retrospective case note review of four patients that underwent the OTTMCB procedure. This two-stage procedure comprises the replacement of the posterior lamella with a free tarsal graft from the contralateral upper eyelid, and the anterior lamella with a lower lid skin flap over the lower eyelid margin which is divided 2-4 weeks later. RESULTS: The procedure was undertaken for four patients with 75-90% upper eyelid defects from tumour excision surgery...
March 7, 2018: Orbit
Michael G Sun, Duangmontree Rojdamrongratana, Mark I Rosenblatt, Vinay K Aakalu, Charles Q Yu
Blepharoptosis or ptosis is a common and potentially debilitating clinical problem. Long-term surgical treatment for ptosis caused by progressive myopathies can be challenging due to potential recurrence and complications associated with facial muscle weakness. When surgical treatment is no longer effective, an eyelid crutch can be used as an alternative intervention. This report demonstrates how 3D printing was used to rapidly design, prototype, and manufacture new custom-fit eyelid crutches at a low cost.
March 2, 2018: Orbit
Nathalie N J Lai A Fat, Dion Paridaens, Willem A van den Bosch
PURPOSE: To compare the results of surgical correction of involutional lower eyelid entropion using either buried resorbable imbricating sutures or non-buried non-resorbable sutures that were removed after five to seven days. METHODS: Retrospective analysis of a two-surgeon series. Analysis of the charts of patients surgically treated for involutional lower eyelid entropion between January 2011 and December 2014 with a minimum follow-up of 12 months. MAIN OUTCOME MEASURES: Recurrence rate, postoperative complications...
March 2, 2018: Orbit
Dane H Slentz, Sunil Bellur, M Reza Taheri, M Isabel Almira-Suarez, Jonathan H Sherman, Tamer N Mansour
An elderly female with progressive proptosis was found to have an aggressive retrobulbar solid orbital mass. The mass was distinct from the optic nerve sheath and intracranial meninges, and produced concave erosion of the sphenoid wing. Operative findings demonstrated an orbital mass adherent to the dura of the superior orbital fissure. The mass did not demonstrate meningeal violation, infiltrate the superior orbital fissure, or display intracranial spread. The dura remained intact after gross total resection...
February 27, 2018: Orbit
Jay C Wang, Alexandra T Elliott
We report an unusual case of acute large-angle left exotropia associated with blunt orbital trauma in a healthy 8-year-old boy. Examination revealed a large-angle left exotropia with limitation in adduction of the left eye. Microhyphema and commotio retinae of the left eye were also present. High-resolution orbital magnetic resonance imaging (MRI) demonstrated perimuscular and intramuscular edema mostly involving the left medial rectus muscle but also involving the left lateral rectus muscle. The extraocular muscle insertions were intact...
February 26, 2018: Orbit
A Kumaran, A Chan, K Yong, S Shen
AIM: To describe differences in the deep lateral orbital wall (specifically, trigone) between Chinese, Malay, Indian and Caucasian subjects Methods: Single-centre retrospective Computed Tomogram (CT)-based study; 20 subjects of each ethnicity were used from existing databases, matched for gender, average age and laterality. Subjects below 16 years of age were excluded. DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) and OsiriX version 7.5 (Pixmeo., Switzerland) were used to measure deep lateral wall length, thickness and volume, as well as orbital depth and statistical analyses performed using Statistical Package for Social Sciences version 21 (IBM, USA)...
February 26, 2018: Orbit
Sadık Etka Bayramoğlu, Nihat Sayın, Mehmet Erdogan, Dilbade Yıldız Ekinci, Nail Uzunlulu, Zuhal Bayramoglu
A 35-year-old male patient was presented with pain on his right upper eyelid. A piece of wood injured his orbital and supraorbital regions while working at a furniture factory 10 days prior to our hospital admission. It was learned that the patient was discharged following the primary would closure procedure. Subsequent to the craniofacial computed tomography, primary wound closure was performed in the emergency room of previous hospital. In our clinic, a skin suturing on the nasal side of the right eyebrow was inspected and a foreign body (FB) was palpated on the superonasal contiguity of the patients' right globe...
February 22, 2018: Orbit
Yusuf Dundar, Richard Cannon, Richard Wiggins, Marcus M Monroe, Luke O Buchmann, Jason P Hunt
PURPOSE/OBJECTIVES: Overall non-melanoma head and neck skin cancer has a good prognosis; however, rarely patients have an aggressive variant which results in orbital invasion via perineural spread or direct extension. Despite these consequences, there are limited published studies defining this clinical entity. The main objectives of the current study are to describe orbital invasion patterns of non-melanoma head and neck skin cancers and their impact on survival. METHODS: Retrospective case series from a tertiary-care, academic institution performed between 2004 and 2014...
February 21, 2018: Orbit
Pavindran Gounder, Chandrashan Perera, Glenn Moore, Neil Powers, Kayvan Arashvand
A 9-year-old girl was reviewed by a tertiary ophthalmology service after being hit in her right upper eyelid by a fish whilst swimming. Initial wound exploration demonstrated fish scales in the wound. She was first treated conservatively with washout of the 5-mm wound and was discharged with oral ciprofloxacin. Five days later, the patient re-presented with a worsened ptosis due to periorbital swelling. Ultrasound of the upper lid demonstrated a foreign body in the upper lid. The patient was taken to theatre and, with the assistance of intraoperative ultrasound, the jaws of a needle fish were removed from the upper lid...
February 20, 2018: Orbit
Paul Lang, Jonathan W Kim, Kathleen McGovern, Mark W Reid, Krishnan Subramanian, A Linn Murphree, Jesse L Berry
This study aims to identify risk factors associated with complications in retinoblastoma patients following primary and secondary enucleations with porous implant placement. A retrospective case-control study was performed between 2010 and 2015. Data pertaining to subjects' demographics, medical history, clinical, and pathological findings, implant characteristics and complications were collected. The analysis included 103 eyes of 101 patients age 27.8 ± 21.9 months undergoing enucleation for retinoblastoma...
February 20, 2018: Orbit
Alexander J Brent, Sundeep S Deol, Ram Vaidhyanath, Gerald Saldanha, Raghavan Sampath
Microcystic adnexal carcinoma (MAC) is a very rare and locally aggressive sweat gland tumour. MAC has been well reported presenting as a periocular cutaneous lesion, rarely with subsequent direct orbital invasion and only once as a primary orbital lesion. Local recurrence is frequent after primary surgical excision and the role of adjuvant radiotherapy is ill-defined. We describe a case of orbital MAC treated successfully with radiotherapy after incomplete margin clearance post exenteration surgery and review the associated literature...
February 20, 2018: Orbit
Vincent Qin, Dion Paridaens
PURPOSE: To describe a posterior lamella-sparing technique to resect nodular basal cell carcinoma involving the inferior part of the tarsal skin of the lower eyelid. SURGICAL TECHNIQUE: Excision of nodular basal cell carcinoma of the tarsal skin using a grey-line-splitting technique with preservation of the posterior lamella. Specimen was sent for frozen section control. Additional excision was performed in caseof irradicality. The defect was closed with a free skin graft from the ipsi- or contralateral upper eyelid...
February 20, 2018: Orbit
Valerie Juniat, Karl C Golnik, Francesco P Bernardini, Altug Cetinkaya, Aaron Fay, Bipasha Mukherjee, Farzad Pakdel, Brent Skippen, George M Saleh
PURPOSE: The International Council of Ophthalmology (ICO) is currently developing a series of standardized, internationally validated, teaching tools for key ophthalmic surgical procedures called the Ophthalmology Surgical Competency Assessment Rubrics (OSCARs). This study aims to develop an OSCAR for anterior approach ptosis surgery. METHODS: An international panel of content experts, representing Australia, India, Iran, Italy, Turkey, UK, and the USA was established and worked to develop the rubric using a range of online collaboration tools...
February 14, 2018: Orbit
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