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Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
E Tan, F Lin, L Sheck, P Salmon, S Ng
PURPOSE: To derive a decision rule for predicting surgical complexity in periorbital basal cell carcinoma (pBCC). DESIGN: Prospective, cohort study. PARTICIPANTS: Patients referred to an oculoplastic service for excision of pBCC from September 2010 to November 2015 METHODS: This study was conducted at two centres in New Zealand from September 2010 to November 2015. Baseline demographic information, and an initial assessment of operative complexity (a four-point grading scale) were collected...
October 14, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Priscilla A Mathewson, Geraint P Williams, Stephanie L Watson, James Hodson, Anthony J Bron, Saaeha Rauz
PURPOSE: Unifying terminology for the description of ocular surface disease (OSD) is vital for determining treatment responses and ensuring robust clinical trial outcomes. To date, there are no agreed parameters describing 'activity' and 'damage' phases of disease. METHODS: A working group of international experts in OSD, oculoplastics, and uveitis from a range of backgrounds (university, teaching, district general and private hospitals) participated in a modified Delphi consensus-building exercise (October 31, 2011 to March 20, 2015)...
September 24, 2016: Ocular Surface
S Young, R Murphy, S Iyer
Ocular thermal burns represent an oculoplastic emergency, with the potential for blindness owing to limbal ischaemia. We present a rare case of a 66-year-old man who sustained a direct thermal contact burn to the right eye.
September 23, 2016: Annals of the Royal College of Surgeons of England
L Zikmund
AIM: In the contemporary medicine, strong emphasis is put on early closing of body surface defects, which contributes to good and early healing, but, of course, closes the entrance gate for possible infection as well. The easiest closing of the defect is the direct suture of the emerged wound. But some defects are of such an extent, so their closure is necessary to handle other way than simple suture, e.g. by rotating flap plastic surgery. In the paper are evaluated results of flap surgery technique in 56 patients...
2016: Ceská a Slovenská Oftalmologie
Chin T Ong, Jun Fai Yap, Yong Zheng Wai, Qi Xiong Ng
Clinical photography in the field of oculoplastic surgery has many applications. It is possible for clinicians to obtain standardized clinical photographs without a studio. A clinician photographer has the advantage of knowing exactly what to photograph as well as having immediate access to the images. In order to maintain standardization in the photographs, the photographic settings should remain constant. This article covers essential photographic equipment, camera settings, patient pose, and digital asset management...
2016: Curēus
Sonali T Nagendran, We Fong Siah, Andre Litwin, Christine Barbosa, Jan Jayatilake, Raman Malhotra
Operating theatre utilization has become the principal measure of NHS operating theatre service performance. We analysed data from oculoplastic theatres in a tertiary centre to identify factors influencing theatre efficiency. We conducted three audits on operating theatre utilization in 2011, 2014 and 2015. Data was collected from real time information entered into the hospital database, including time of arrival, induction, first cut and close of operation. The primary outcome measure was the operating list utilization rate, a combined value of anaesthetic and surgical time as a proportion of the total planned session time...
September 12, 2016: Orbit
Fiona C Pearce, Alan A McNab, Thomas G Hardy
PURPOSE: To report 4 cases of Marcus Gunn jaw-winking synkinesis (MGJWS) in the absence of ptosis. METHODS: A retrospective review of patients with MGJWS and congenital ptosis was compiled from the public and private subspecialty adult and pediatric oculoplastic practices of the 2 senior authors (AAM, TGH). Clinical data collected on patients with MGJWS included visual acuity, stereopsis, ocular motility, side of jaw-wink, presence or absence of ptosis, levator function, clinical photographs and videos, and any management undertaken...
September 7, 2016: Ophthalmic Plastic and Reconstructive Surgery
Peter M Mota, Jonathan H Norris
We assess current practice using topical phenylephrine by British Oculoplastic Surgery Society (BOPSS) consultants in the surgical management of ptosis. All UK consultant BOPSS members were invited to participate in a web-based survey, consisting of 8 questions relating to the surgical management of adult primary involutional ptosis with normal levator function and the use of phenylephrine in the management of ptosis. 53 BOPSS consultants (43%) completed the survey, of which 76% perform anterior approach levator advancement as first-line surgery...
September 6, 2016: Orbit
Ze Zhang, Soroosh Behshad, Pooja Sethi-Patel, Alejandra A Valenzuela
This article evaluates malignant transformation of lesions presenting in the periocular skin under the eye spectacle nose pad. A non-comparative retrospective chart review of clinical features and pathological findings of patients presenting with periocular malignancies in the exact vicinity where the nose pads of their eye spectacles rested was completed. The study took place in one tertiary oculoplastic referral center between 2007-2013. Ten patients were included, six of whom were male. All subjects wore eye spectacles while awake for at least 15 years, and had an evident suspicious lesion in the exact area that coincided with the resting place of the nose pad...
October 2016: Orbit
Tarjani V Dave, Sathish Kumar, Jaya Vasanthalin, Swathi Kaliki, Mohammad Javed Ali, Milind N Naik
PURPOSE: To develop a standardized and universally reproducible grading scale for artistic outcome of a custom ocular prosthesis. METHODS: A retrospective review of photographs of patients with custom ocular prosthesis. From the ocularistry database of a tertiary eye care hospital, photographs of patients with custom ocular prosthesis (30 random photos with additional 18 repetitions, total n = 50) were selected. Two independent oculoplastic surgeons, on the basis of characteristics of limbus, vascularity, and pigmentation, graded these photos...
August 12, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Akshay Gopinathan Nair, Saurabh Kamal
BACKGROUND: To assess the preferred practice patterns in the management of congenital nasolacrimal duct obstruction (CNLDO) among oculoplastic surgeons in India. The survey was aimed at obtaining data on the timing of intervention, procedure of choice, and the use of adjunctive techniques such as silicone intubation and nasal endoscopy. METHODS: An anonymized survey that included questions on the management of lacrimal disorders was sent in April 2015 to members of the Oculoplastic Association of India (OPAI), through an e-mail communication...
September 2016: International Journal of Pediatric Otorhinolaryngology
Irene J Tan, Lucy P Dobson, Stephen Bartnik, Josephine Muir, Angus W Turner
INTRODUCTION: Advances in imaging capabilities and the evolution of real-time teleophthalmology have the potential to provide increased coverage to areas with limited ophthalmology services. However, there is limited research assessing the diagnostic accuracy of face-to-face teleophthalmology consultation. This systematic review aims to determine if real-time teleophthalmology provides comparable accuracy to face-to-face consultation for the diagnosis of common eye health conditions. METHODS: A search of PubMed, Embase, Medline and Cochrane databases and manual citation review was conducted on 6 February and 7 April 2016...
July 20, 2016: Journal of Telemedicine and Telecare
N Beshay, R Ghabrial
PurposeEndonasal dacryocystorhinostomy (END-DCR) is a relatively novel approach that has recently been shown in some studies to provide similar success rates to the more traditional external approach for the treatment of nasolacrimal duct obstruction (NLDO). However, a range of success rates using this approach are reported within the literature and the majority of oculoplastic surgeons are still favouring the external approach. The purpose of this study was to review the anatomical and subjective success rates of END-DCRs performed over a 7-year period...
July 15, 2016: Eye
Shu-I Pao, Shih-Min Lin, Yun-Hsiang Chang, Shang-Yi Chiang
A 72-year-old Taiwanese woman had the history of cosmetic cryopreserved autologous fat injection on her forehead ~21 years ago and was referred to our oculoplastic clinic and presented with multiple painless mass, which she had for 4 years, on both upper eyelids. Histopathology confirmed the diagnosis of foreign body granuloma on both upper eyelids. Clinicians should be aware of the potential complication of granuloma reaction and migration even many years after the injection. We advise that autologous fat injection should be performed solely by trained physicians and it should be made known that there is a possible occurrence of migration...
2016: International Medical Case Reports Journal
Smith Ann M Chisholm, Steven M Couch, Philip L Custer
PURPOSE: Allergic dermatitis is a common but often misdiagnosed condition that can present with a variety of findings including inflammation, eyelid malposition, and tearing. This study was performed to identify likely etiologies, along with presenting findings and treatment strategies for allergic dermatitis. METHODS: A retrospective review of clinical records was performed of patients diagnosed with allergic dermatitis in academic oculoplastics practices from 2002 to 2014...
June 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Nirojini Sivachandran, Jason Noble, Michael Dollin, Michael D O'Connor, R Rishi Gupta
OBJECTIVE: To evaluate the trends in subspecialty fellowship training by Canadian ophthalmology graduates over the last 25 years. DESIGN: Cross-sectional study. PARTICIPANTS: Canadian-funded, Royal College-certified graduates from 1990 to 2014 who completed a full residency in an English-language Canadian ophthalmology postgraduate training program. METHODS: Data were obtained by contacting all 11 English-language ophthalmology residency programs across Canada for demographic and fellowship information regarding their graduates...
June 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Somin Ahn, Hwa Lee, Joonsik Lee, Jinhwan Park, Minsoo Park, Sehyun Baek
PURPOSE: The authors analyzed changes in eyelid contour after levator advancement by measuring multiple radial midpupil lid distance (MPLD). METHODS: The study enrolled 61 eyes of 61 patients with involutional ptosis who underwent levator advancement from 2 oculoplastic surgeons from September 2008 to December 2013. An analysis of upper lid contours was performed using front gaze photographs of the preoperative and postoperative states and comparing them to the front gazes of normal patients...
July 2016: Journal of Craniofacial Surgery
Mostafa A Waly, Osama E Shalaby, Molham A Elbakary, Aiman A Hashish
PURPOSE: To study the cosmetic outcome of external dacryocystorhinostomy (Ex-DCR) and to detect the factors affecting it. PATIENTS AND METHODS: Prospective randomized interventional study included forty patients who were treated by 40 Ex-DCRs. In twenty patients, medial canthal vertical incision was used and in the other twenty cases, subciliary incision was used. The skin was closed using vicryl 6-0 or prolene 6-0 interrupted sutures, and each one was randomly used in twenty patients (10 patients of each incision type)...
April 2016: Indian Journal of Ophthalmology
Richard C Allen
PURPOSE OF REVIEW: Classical orbital approaches in skull base surgery have involved large incisions with extensive bone removal resulting in prolonged recovery with associated morbidity and mortality. The purpose of this review is to explore recent advances in skull base surgery that are applicable to the orbital surgeon. RECENT FINDINGS: Transnasal endoscopic surgery provides access to the medial 180 degrees of the orbit. Access to the lateral 180 degrees may be obtained using transmaxillary and transcranial techniques...
September 2016: Current Opinion in Ophthalmology
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