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Kristen E Dunbar, Cristina Abascal, Saagar A Pandit, Michael Kazim
PURPOSE: This study evaluates the reliability of a frequently used subjective measurement of orbital compliance (0-3 scale) and describes a simple, quantitative measure with excellent intra- and interrater reliability. METHODS: Two examiners performed both measurements on 100 orbits (50 consecutive patients) from the office of 1 oculoplastics surgeon. Each measurement was obtained at 2 different time points, 10 minutes apart. For the subjective measurement, the patient was asked to close their eyes, and the globe was displaced posteriorly with digital pressure until moderate resistance was felt...
March 14, 2018: Ophthalmic Plastic and Reconstructive Surgery
A Klingenstein, C Hintschich
BACKGROUND: Upper eyelid blepharoplasty is among the most frequent oculoplastic surgical procedures. It is often performed as one of the first esthetic surgical interventions by surgeons of various disciplines. While there is a high probability of happy and satisfied patients postoperatively, there are important potential surgical complications that should be prevented. This requires a careful preoperative, perioperative and postoperative approach. OBJECTIVE: This synopsis presents the basic considerations concerning upper eyelid blepharoplasty to serve as practical surgical guidelines...
March 7, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Akshay Gopinathan Nair, Nayana A Potdar, Suchit Dadia, Simranjeet Aulakh, Mohammad Javed Ali, Chhaya A Shinde
AIM: To assess patient perceptions regarding medical photography and the use of smart devices, namely mobile phones and tablets for medical photography. METHODS: A questionnaire-based survey was conducted among 280 consecutive adult patients who presented to the oculoplastics clinic at a tertiary eye care centre. The responses were tabulated and analysed. RESULTS: Of the 280 patients surveyed, 68% felt that medical photography had a positive impact on their understanding of their illnesses and 72% felt that the use of smartphones for medical photography was acceptable...
March 6, 2018: International Ophthalmology
Huijing Ye, Rongxin Chen, Xiufen Lian, Jingxia Huang, Yuxiang Mao, Rong Lu, Siming Ai, Wenfang Ma, Jingyi Lin, Huasheng Yang, Wenjun Guo
Purpose: To evaluate patient pain and discomfort following oculoplastic surgery performed under general anesthesia and to assess key factors associated with postoperative pain and discomfort. Methods: A prospective observational cohort study was conducted among 212 consecutive patients who underwent oculoplastic surgery performed under general anesthesia. The patients were assessed according to quantified levels of pain and discomfort postoperatively. Analgesic requests were recorded, and responses were statistically analyzed...
2018: Journal of Pain Research
Balaji Perumal, Dale R Meyer
The purpose of the current study was to analyze brow and ear position, and examine the relationship between these structures in patients presenting for blepharoplasty evaluation. A retrospective chart review was performed, which included all patients presenting to one oculoplastic physician for a blepharoplasty evaluation from November, 2012 to March, 2014. The prevalence of brow ptosis and brow and ear asymmetry was calculated; the proportional distribution was determined, and chi-square analysis and the z-test of proportions were used to calculate the significance...
February 21, 2018: Facial Plastic Surgery: FPS
Atalie C Thompson, P Divya Parikh, Eleonora M Lad
PURPOSE: To describe characteristics of closed medical professional liability (MPL) claims against ophthalmologists in the United States. DESIGN: Retrospective analysis of MPL claims from 2006-2015. Data were obtained from the Physician Insurers Association of America (PIAA) Data Sharing Project (DSP). Comparison was made between ophthalmology and all healthcare specialties for physician demographics, prevalence and costs associated with closed claims, and resolution of claims...
January 13, 2018: Ophthalmology
Elizabeth A Insull, Varajini Joganathan, Jonathan H Norris
PURPOSE: The "reading man" flap (RMF), a double advancement transposition cutaneous flap named for its appearance, has been described in the reconstruction of various circular skin defects, particularly in the malar region. We describe two cases where this flap was used to reconstruct the lower eyelid/periorbital region. METHODS: Two oculoplastic patients with lower eyelid basal cell carcinomas underwent Mohs micrographic excision resulting in a large skin defects...
January 15, 2018: Orbit
A M Porteous, A S Haridas, J R O Collin, D H Verity
PurposeCorrection of upper eyelid ptosis is one of the most commonly performed oculoplastic procedures on the NHS but there is currently no data in the literature informing the surgeon of the optimal time for the first postoperative review. Our aim was to investigate how often a complication that warranted intervention occurred in the first 6 weeks after surgery and whether such a complication could have been predicted preoperatively.Patients and methodsA retrospective review was performed of 300 operations in 239 patients over a 9-month period at Moorfields Eye Hospital, London...
January 12, 2018: Eye
Francesco Klinger, Luca Maione, Valeriano Vinci, Andrea Lisa, Federico Barbera, Laura Balia, Fabio Caviggioli, Alessandra Di Maria
Autologous fat grafting has been extensively and successfully adopted in a number of pathologic conditions in regenerative surgery especially on irradiated fields in order to improve pain symptoms and tissue trophism promoting scar release. In the present study, we report our experience with autologous fat grafting for the treatment of postirradiation fibrosis and pain on three consecutive patients undergoing orbital enucleation for locally advanced retinoblastoma (RB) and subsequent radiotherapy. We selected three consecutive patients who underwent orbital enucleation for locally advanced RB and subsequent local radiotherapy showing severe reduction in orbital volume and eyelid length and retraction due to fibrosis, spontaneous local pain exacerbated after digital pressure with no possibility to place an ocular implant...
January 5, 2018: Orbit
Monica Michelotti, Dirk F de Korne, Jennifer S Weizer, Paul P Lee, Declan Flanagan, Simon P Kelly, Anne Odergren, Sukhpal S Sandhu, Charity Wai, Niek Klazinga, Aravind Haripriya, Joshua D Stein, Melanie Hingorani
BACKGROUND: To determine alignment of proposed international standard outcomes sets for ophthalmic conditions to metrics currently reported by eye hospitals. METHODS: Mixed methods comparative benchmark study, including eight eye hospitals in Australia, India, Singapore, Sweden, U.K., and U.S. All are major international tertiary care and training centers in ophthalmology. Main outcome measure is consistency of ophthalmic outcomes measures reported. RESULTS: International agreed standard outcomes (ICHOM) sets are available for cataract surgery (10 metrics) and macular degeneration (7 metrics)...
December 29, 2017: BMC Ophthalmology
Bipasha Mukherjee, Vathsalya Vijay, Swatee Halbe
Periorbital arteriovenous malformations (AVMs) are congenital lesions that may cause significant morbidity such as amblyopia, cosmetic disfigurement, or chronic pain. Due to the rarity of these lesions, they are frequently misdiagnosed and treated inappropriately. We managed a 6-year-old girl with preseptal AVM by endovascular embolization followed by complete surgical excision after 2 days. She was previously diagnosed as capillary hemangioma and was being treated with intralesional steroid injections and oral propranolol...
January 2018: Indian Journal of Ophthalmology
Jenny Hult, Rafi Sheikh, Cu Dinh Nguyen, Kajsa Tenland, Ulf Dahlstrand, Malin Malmsjö
OBJECTIVE: The time taken to reach maximal haemostatic effect following local anaesthesia with epinephrine is generally believed to be <10 min. This is based on clinical experience and indirect measurements of perfusion using methods such as laser Doppler flowmetry and oxygen spectroscopy. However, the only study in which bleeding has been measured quantitatively in an intra-operative setting in humans showed that the full haemostatic effect was not achieved until 30 min after anaesthesia...
December 13, 2017: Acta Ophthalmologica
Alexander Isted, Lilli Cooper, R James Colville
BACKGROUND: Anticoagulant and antiplatelet (AC/AP) use is common and practice surrounding AC/AP continuation or cessation peri-operatively for minor cutaneous surgery lacks evidence-based consensus. OBJECTIVE: To determine the risks of haemorrhagic and thromboembolic complications associated with the continuation or cessation of AC/AP therapy in minor cutaneous surgery. METHODS: A systematic literature search was conducted using PubMed, MEDLINE, Embase and CENTRAL, to identify all articles involving the use of AC/AP in patients undergoing minor cutaneous surgery, including skin grafts and local flaps...
April 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ferdinand Rodríguez-Agramonte, Juan Carlos Jiménez, José Raúl Montes
OBJECTIVE: To describe the prevalent side effects of prostaglandin analogues (PA) in a Hispanic population and their effect on quality of life (QOL). PATIENTS AND METHODS: This is a cross-sectional study conducted in a tertiary medical facility in which patients were evaluated in a single visit. Total of 14 participants in the study, 10 women and 4 men. Ages ranged from 26-78 years old. Subjects underwent a single full Oculoplastic evaluation by two physicians; one was blinded on patient medical history and assessed for PA side effects...
December 2017: Puerto Rico Health Sciences Journal
M Keserü, S Dulz, A Wolf, S Green, U Press, U Schaudig
Oculoplastic surgery places special demands on postoperative care because of the functional importance of the eyelids for the ocular surface. We present an overview of postoperative care after surgical eyelid interventions. All options, limits and the scientific evidence are discussed with a special focus on the treatment of postoperative edema, analgesia, infection prophylaxis and scar treatment.
November 29, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Dennis Monks, Allison Weyer, Peter Thurlow, Khaled Aziz, Erik Happ, Michael Goldberg
Background and Purpose  The transpalpebral "eyelid" approach is a novel alternative to the traditional ciliary or supraciliary incision for supraorbital frontal craniotomy and access to the anterior cranial fossa. Though a prior publication from our institution has described the surgical approach in detail along with cosmetic and clinical outcomes, postoperative imaging findings have not yet been described. As this surgical technique becomes more widely practiced, it is essential for neuroradiologists, oculoplastic surgeons, and skull base neurosurgeons to be familiar with the expected postoperative imaging findings, especially those that prompt subsequent intervention...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
Emmy Y Li, Emily S Wong, Alex C Wong, Hunter K Yuen
Importance: Endoscopic dacryocystorhinostomy (EN-DCR) is emerging as the preferred procedure in the management of nasolacrimal duct obstructions. However, its safety and long-term efficacy in the setting of acute dacryocystitis with lacrimal sac abscess have not been well studied. Objective: To compare outcomes of EN-DCR as primary treatment with EN-DCR as a secondary treatment after percutaneous drainage of lacrimal sac abscess in acute dacryocystitis. Design, Setting, and Participants: This randomized clinical trial was conducted from October 1, 2012, to October 31, 2015, at a tertiary ophthalmic center...
December 1, 2017: JAMA Ophthalmology
Ting Yin Lu, Kathreena Kadir, Wei Cheong Ngeow, Siti Adibah Othman
This study aimed to determine the prevalence of double eyelid among two main Mongoloid ethnicities, the Malays and Chinese who reside in Malaysia. We also measured their periorbital tissue parameters for application in anthropology, optometry, ophthalmology, oculoplastic surgery and maxillofacial trauma surgery. The images of the 103 Malay and 97 Chinese volunteers were captured using indirect 3D photogrammetry, and quantitative measurement was obtained using the software provided by the manufacturer. All Malays and 70...
November 1, 2017: Scientific Reports
Andrew W Thorne, Rao V Chundury, Julian D Perry, Daniel B Rootman
PURPOSE: This study aims to determine if ocular dominance plays a role in predicting compensatory eyebrow elevation in cases of ptosis. METHODS: This retrospective observational cohort study screened all individuals presenting to two tertiary oculoplastics practices with complaints of ptosis for entry. Primary position photographs were obtained. Ocular dominance was assessed via a modified Porta test. Ptosis was defined in bilateral cases as marginal reflex distance of <2...
October 20, 2017: Orbit
Katherine Anne Mcveigh, Rhys Harrison, Rebecca Ford
We aim to provide a snapshot of the current surgical practice for correction of entropion and ectropion, the two most common oculoplastic procedures carried out in the UK, by surveying 135 consultant oculoplastic surgeons via the tool Survey Monkey. Forty-seven (35%) consultants responded. For entropion, 44% of surgeons opted for lateral tarsal strip (LTS) + everting sutures (ES). Other first-line choices included LTS + transcutaneous retractor plication (21%), Quickert's procedure (14%), ES (7%), and Wies procedure (5%)...
October 20, 2017: Orbit
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