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Ophthalmic Plastic and Reconstructive Surgery

Michelle M Maeng, Carlos Gustavo De Moraes, Bryan J Winn, Lora R Glass Dagi
PURPOSE: To study the effect of periocular steroid use on intraocular pressure (IOP). METHODS: Charts of adult patients with atopic dermatitis or eczema treated with topical periocular steroid creams and ointments from January 1st, 2007 to October 1st, 2017 were reviewed. Patients with the following were excluded: glaucoma, ocular hypertension, known systemic/topical/injectable steroid history, and lack of documented IOP prior to or during treatment with periocular steroid ointment...
February 4, 2019: Ophthalmic Plastic and Reconstructive Surgery
Timothy Z Cheong, Rodger P Davies
An 81-year-old man with unilateral nasolacrimal duct obstruction underwent routine endonasal dacryocystorhinostomy and 2 days postoperatively developed a severe headache and rigors. Subsequent CT and MRI imaging demonstrated a defect in the floor of the right anterior cranial fossa, which possibly was damaged during the operation, and meningoencephalitis of the adjacent frontal lobe gyrus. Following intravenous antibiotic treatment, the patient made a full recovery with no ongoing sequelae, and his epiphora completely resolved...
February 4, 2019: Ophthalmic Plastic and Reconstructive Surgery
Joseph Raevis, Bo Lin, Roman Shinder
No abstract text is available yet for this article.
January 25, 2019: Ophthalmic Plastic and Reconstructive Surgery
Ravneet S Rai, Megan A Rowlands, Peter M Kally, Floyd Warren
The authors describe the case of a 19-year-old female who suffered posttraumatic emphysema of the optic nerve sheath. She suffered massive head trauma requiring emergent neurosurgery and was incidentally found to have air in her optic nerve sheath on CT scan. At 6 weeks follow up, her visual acuity (20/25 uncorrected) and color perception in the affected eye were excellent. Her examination was notable for an afferent pupillary defect, mild disc pallor, and optic nerve atrophy on optical coherence tomography...
January 25, 2019: Ophthalmic Plastic and Reconstructive Surgery
Victor Liou, Smith Ann Chisholm, Valentina Logunova, Robert Havlik, Neda Esmaili
Dermatofibroma sarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue sarcoma with a tendency for recurrence after excision. Although reports of unilateral orbital and bilateral eyelid disease exist, there have been no prior reports of DFSP with bilateral orbital involvement and no previously described cases of DFSP associated with transient optic neuropathy. The authors present a case report of a 34-year-old woman with a giant scalp DFSP involving the bilateral orbits. Despite radical resection with 5 cm margins where possible, multiple positive margins remained including deep positive margins at the bilateral superomedial retroseptal soft tissue...
January 25, 2019: Ophthalmic Plastic and Reconstructive Surgery
Mohammad Javed Ali, Friedrich Paulsen
PURPOSE: To provide a systematic review of the literature on the etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO). METHODS: The authors performed a PubMed search of all articles published in English with specific reference to etiopathogenesis of PANDO or associations of PANDO. Data captured include demographics, study techniques, hypothesis, presumed or confirmed interpretations with regards to pathogenesis, mechanisms, or pathways. Specific emphasis was laid on addressing the lacunae and potential directions for future research...
January 25, 2019: Ophthalmic Plastic and Reconstructive Surgery
Keirnan L Willett, Mike Sheng, Thomasine Gorry, John H Woo
PURPOSE: CT is the standard of care for assessment of ocular and orbital trauma; however, artifacts from metallic foreign bodies can limit the utility of CT. The authors hypothesize that implementation of metal artifact reduction techniques can improve image quality and diagnostic confidence for a diverse group of interpreters. METHODS: A case series of ten subjects with retained periocular metallic foreign bodies imaged with CT were identified retrospectively from a large urban trauma center...
January 24, 2019: Ophthalmic Plastic and Reconstructive Surgery
Johanna Berggren, Kajsa Tenland, Cu Dinh Ansson, Ulf Dahlstrand, Rafi Sheikh, Jenny Hult, Karl Engelsberg, Sandra Lindstedt, Malin Malmsjö
PURPOSE: It has recently been shown that the flap pedicle does not supply blood to a tarsoconjunctival graft in the modified Hughes procedure in patients. This raises questions concerning the rate of revascularization of the free skin graft commonly used to reconstruct the anterior lamella. The aim of this study was, thus, to monitor the course of revascularization in free skin grafts overlying modified Hughes tarsoconjunctival flaps, using laser-based techniques. METHODS: Free skin grafts from the upper eyelid or upper arm in 9 patients were used to cover a tarsoconjunctival flap according to the modified Hughes procedure...
January 18, 2019: Ophthalmic Plastic and Reconstructive Surgery
Mišo Gostimir, Ahsen Hussain
PURPOSE: Various factors help minimize pain during the injection of local anesthetic. The majority of current evidence involves nonspecific injection sites. The objective of this review was to provide a comprehensive summary of all existing evidence for methods used to reduce injection pain specifically in the context of periocular procedures. METHODS: A literature search of the MEDLINE, EMBASE, and Scopus databases was conducted to identify all relevant experimental and observational studies from 1946 to 2018...
January 9, 2019: Ophthalmic Plastic and Reconstructive Surgery
Divya Harshwardhan Jain, Veena Olma Noronha, Bipasha Mukherjee
No abstract text is available yet for this article.
January 9, 2019: Ophthalmic Plastic and Reconstructive Surgery
Shoaib Ugradar, Jonathan Hoenig
PURPOSE: To measure the force required by blunt-tipped microcannulas of various sizes to penetrate the wall of the facial artery. METHODS: Twenty hemifaces of 10 fresh frozen cadavers were dissected to reveal the facial artery from its origin at the external carotid artery until the angular artery was found. On the right side of each cadaver, the facial artery was removed at the nasolabial fold, while arteries on the left were kept in situ, preserved with their fascial attachments...
January 7, 2019: Ophthalmic Plastic and Reconstructive Surgery
Seanna R Grob, Katherine G Chen, Jeremiah P Tao
PURPOSE: To describe a surgical technique of orbital roof reconstruction with a thin nylon foil implant. METHODS: This study is a description of a surgical technique with a retrospective chart review of 3 consecutive patients treated with a nylon foil implant for a complete superior orbital defect after meningioma resection via craniotomy approach. RESULTS: The nylon foil reconstruction achieved an anatomically stable orbit without globe dystopia, pulsatile proptosis, cerebrospinal fluid leak, or other serious cranio-orbital problems, in all cases...
January 7, 2019: Ophthalmic Plastic and Reconstructive Surgery
Kai-Ling Yong, Chiaw-Ling Chng, Nicole Ming Sie, Stephanie Lang, Morgan Yang, Audrey Looi, Chai-Teck Choo, Sunny Shen, Lay Leng Seah
PURPOSE: To compare the efficacy and safety of adjunctive oral methotrexate with intravenous pulsed methylprednisolone against methylprednisolone alone in the treatment of severe thyroid eye disease. METHODS: Retrospective review of clinical data of patients with severe sight-threatening thyroid eye disease with compressive optic neuropathy treated with methylprednisolone with and without methotrexate. Eye disease outcome measures (e.g., VISA inflammatory score and vision) at 0, 3, 6, 12, and 18 months were recorded...
January 7, 2019: Ophthalmic Plastic and Reconstructive Surgery
Robert J Purgert, Alexander D Blandford, Michael K Schowalter, Melissa P Piliang, Catherine J Hwang, Julian D Perry
The rare case of an eyelid lesion comprised of hamartomatous dermal collagen, known as a collagenoma, is presented. Collagenomas may be sporadically acquired, or inherited as part of numerous autosomal dominant syndromes. In the appropriate clinical context, their diagnosis should prompt a thorough review of systems, systemic examination, and inquiry into family history, to assess for underlying autosomal dominant syndromes. Recognition of collagenomas may thus allow diagnosis of inherited syndromes, allowing patients to obtain appropriate genetic counseling, as well as screening and treatment of associated systemic pathology...
January 7, 2019: Ophthalmic Plastic and Reconstructive Surgery
Swati Singh, Mohammad Javed Ali
PURPOSE: To provide a systematic review of the literature on congenital dacryocystoceles (CDCs) and summarize their presentations, investigations, management, and outcomes. METHODS: The authors performed a PubMed search of all articles published in English on CDCs. Data captured include demographics, clinical presentations, investigations, management modalities, complications, and outcomes. Fourteen major series (10 or more than 10 cases) and 89 isolated case reports/series on CDCs with a collective patient pool of 1,063 were studied in detail...
December 28, 2018: Ophthalmic Plastic and Reconstructive Surgery
Sonal S Chaugule, Anirudha Putambekar, Smita Gavade, Rahul Deshpande
A 71-year-old male presented with a history of noticing gradual painless progressive proptosis along with a pinkish mass seen on the outer aspect of his left eyeball. Orbital CT revealed a fairly defined homogenous lesion, abutting the left eyeball and involving the lateral orbit reaching almost till orbital apex. Histopathology analysis aided with immunohistochemistry after an incision biopsy was consistent with leiomyosarcoma. Positron emission tomography scan ruled out presence of any distant primary or metastatic tumor...
December 28, 2018: Ophthalmic Plastic and Reconstructive Surgery
Sathyadeepak Ramesh, Gary Duckwiler, Robert A Goldberg, Daniel B Rootman
PURPOSE: To review a representative case series and share a stepwise approach to the diagnosis and treatment of periorbital venolymphatic malformations. METHODS: A case series of 9 patients with representative periorbital venolymphatic malformations. All patients managed at the University of California, Los Angeles Orbital Center for a vascular malformation over the last 5 years were reviewed. Cases representative of the varied pathologic findings and techniques were selected...
December 28, 2018: Ophthalmic Plastic and Reconstructive Surgery
Sruti S Akella, Thomas Lee, Anne Barmettler
This is the first reported case of lichenoid dermatitis erupting after surgical excision of basal cell carcinoma on the upper eyelid of an African-American woman. Lichenoid dermatitis is a common dermatologic diagnosis which may coexist with superficial malignancies, although the exact interaction between the 2 entities is not entirely known. The authors propose that successful treatment of basal cell carcinoma induces inflammation in the form of lichenoid dermatitis, which may play an adjunct role in eradication of the malignancy...
December 28, 2018: Ophthalmic Plastic and Reconstructive Surgery
Clara J Men, Patrick Yang, Zvi Gur, Ji-Sun Paik, Don O Kikkawa, Bobby S Korn
A 69-year-old woman presented to the oculofacial plastic service with a painless superotemporal subconjunctival mass in the OS. Over the past year, the lesion had been progressively enlarging, resulting in horizontal diplopia with lateral gaze. Visual acuity was within normal limits with no evidence of optic neuropathy. On examination, the lesion was tense, transilluminated, and was clinically consistent with a simple dacryops. Complete excision of the lesion was planned under local anesthesia with monitored care...
December 17, 2018: Ophthalmic Plastic and Reconstructive Surgery
Syed Ali Raza Rizvi, Mehnaz Sabah, Mohammmed Saquib, Faizan Mahmood, Md Shahid Alam
PURPOSE: To compare the cosmetic outcome of the surgical scar of external dacryocystorhinostomy by the subcuticular versus sutureless technique. METHODS: This was a prospective interventional randomized control study conducted at tertiary level hospital. Fifty patients of primary-acquired nasolacrimal duct obstruction were included in this study. The control group patients underwent the technique of wound closure in 2 layers, subcutaneous interrupted suture with 6-0 vicryl and superficial skin with 6-0 prolene continuous subcuticular sutures...
December 7, 2018: Ophthalmic Plastic and Reconstructive Surgery
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