ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe the clinical results of systemic corticosteroid use in a series of patients with orbital lymphangioma.MethodsFour patients (two adults and two children) were treated with corticosteroids using intravenous, oral, or both routes for 2 days to a month. Corticosteroids were used with and without other therapies for symptomatic exacerbations.ResultsThe adults showed more improvement with pain than with swelling, whereas the children had improvement with both the signs and symptoms. There were no complications in any patient.ConclusionsSystemic corticosteroids are a useful therapeutic option for patients with orbital lymphangioma and can be used as an adjuvant treatment to surgery and other modalities. Resolution of symptoms with corticosteroids was expedited compared with the natural history of the disease in the patients studied.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo correlate the presence and severity of glabellar rhytids with disease severity in patients with thyroid-associated orbitopathy (TAO).MethodsRetrospective, noncomparative medical record review of 113 consecutive new patient visits with the clinical diagnosis of TAO. Ocular examination features studied included assessment of visual acuity, optic nerve appearance and function, proptosis, strabismus, eyelid position, and exposure keratopathy. These features were correlated with graded clinical photographs evaluating rhytid severity using the Fisher exact text.ResultsEighty of 97 patients included in the study (82.5%) had glabellar rhytids. Eyelid retraction was present in 95 of the 97 patients (98%). Patients with diplopia had more severe rhytids (p< 0.05). Patients with at least three abnormal clinical findings tended to have more severe rhytids.ConclusionsGlabellar rhytids are a common finding in patients with TAO, and tend to be present in patients with diplopia and multiple stigmata of the disease.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe the use of oblique medial and lateral periosteal flaps with the Hughes tarsoconjunctival flap for the repair of maximal defects of the lower eyelid.MethodsA small prospective case series of eight patients requiring lower eyelid reconstruction following with maximal defect of the lower eyelid. The patients underwent a Hughes tarsoconjunctival advancement combined with oblique medial and lateral periosteal flaps, and were assessed for aesthetic outcome and surgical complications.ResultsAll patients had uncomplicated surgery. Outcomes assessed included corneal protection, eye closure, lower eyelid retraction, complications, and patient satisfaction. Eyelid contour and protection was excellent in all patients. Postoperatively, one patient had mild lower eyelid retraction, and in a second patient, medial ectropion with mild lower eyelid retraction developed that required subsequent revision.ConclusionsThe maximal Hughes procedure is a safe and effective procedure that may be performed with patients under local anesthesia and may avoid the need for more extensive techniques for surgical repair of maximal defects of the lower eyelid.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe the results of surgical correction of blepharoptosis in a series of patients with myasthenia gravis (MG).MethodsIn this retrospective case series, we reviewed the medical records of all patients with MG who did not respond to medical therapy and underwent surgical correction for blepharoptosis at the Mayo Clinic between 1985 and 1999. The primary outcome measure was change in interpalpebral eyelid fissure height.ResultsSixteen blepharoptosis procedures were performed on 10 patients with MG. Eight of the 10 patients had ocular MG. Two of the 10 patients had systemic MG. Of the 16 procedures performed, 9 were external levator advancements (ELA), six were frontalis slings, and one was a tarsomyectomy. Patients were followed postoperatively for an average of 34 months (range, 14–126 months). The amount of ptosis was quantified pre-and postoperatively for seven of the nine eyelids that underwent ELA. For these seven eyelids (five patients), there was a statistically significant improvement in the mean interpalpebral eyelid fissure height from 3.7 mm preoperatively to 7.8 mm postoperatively, with a mean difference of 4.1 mm (95% confidence interval 1.9 mm to 6.25 mm,p= 0.0038). Postoperative complications included worsened diplopia in one patient with ELA and exposure keratopathy in one patient with frontalis sling. Two of the ELA eyelids developed recurrent ptosis requiring additional surgery more than 2 years after the initial procedure.ConclusionsBlepharoptosis surgery can achieve eyelid elevation in patients who have failed to respond to medical therapy for MG. Potential complications include worsened diplopia and exposure keratopathy.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo introduce a less invasive therapeutic method in selected patients with primary nasolacrimal duct obstruction.MethodsNoncomparative interventional case series. Seven patients with primary acquired nasolacrimal duct obstruction who were poor candidates for dacryocystorhinostomy because of underlying medical conditions and two symptomatic patients with previous incomplete dacryocystectomy were included. Ethanolamine oleate 5% was slowly injected through the puncta into the patent portion of the lacrimal drainage apparatus.ResultsAfter a mean follow-up period of 26 months, the lacrimal pathway was permanently obliterated in 6 cases (66.7%). In two cases, the procedure was repeated successfully and in one case, the patient refused to repeat the procedure after the initial failure.ConclusionsIn selected patients, ethanolamine oleate dacryocystosclerotherapy appears to offer a simple, low-cost, less invasive alternative to dacryocystectomy.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo assess the efficacy of intraoperative mitomycin C (MMC) in external dacryocystorhinostomy (EXT-DCR).MethodsForty-six cases (50 lacrimal drainage systems [LDS]) with nasolacrimal duct obstruction were randomized into three groups. In the control group, a standard EXT-DCR procedure was performed. In the two MMC groups, a piece of cotton soaked with 0.2 mg/ml MMC (group 1) or 0.5 mg/ml MMC (group 2) was applied to the nasal mucosa and the mucosa of the lacrimal sac in the osteotomy site for 5 minutes.ResultsThe dacryocystorhinostomy in all patients was patent by irrigation 2 to 3 weeks postoperatively. After a mean follow-up interval of 35.2 ± 5.3 months, the dacryocystorhinostomy was patent in 15 (83%) of 18 LDS in the control group, 16 (100%) of 16 LDS in group 1, and 15 (94%) of 16 LDS in group 2. The mean ostium sizes were 22.2 ± 5.0 mm2in group 1, 20.6 ± 4.5 mm2in group 2, and 13.2 ± 2.7 mm2in group 3 at the final follow-up visit; the difference between the patients treated with MMC and the control group was statistically significant. There was no statistically significant difference between the two MMC groups, however. No surgical complications occurred.ConclusionsIntraoperative MMC in DCR is a safe and effective adjuvant that helps achieve favorable long-term success rates.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeAlthough several reports of supernumerary orbital muscles related to the levator palpebrae superioris have been published, no case has been associated with congenital eyelid retraction. This report describes an apparent causal relationship between an accessory levator muscle slip and congenital eyelid retraction.MethodsCase report and literature review.ResultsRelease of the anomalous muscle’s attachment from the superior tarsal border alone resulted in resolution of the eyelid retraction.ConclusionsEyelid muscle anomalies may be a cause of congenital eyelid retraction. Ophthalmologists who treat eyelid disorders should be aware of this possibility when evaluating and operating on patients with congenital eyelid retraction.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo report the clinical and histopathologic findings of a patient with sarcoidosis causing bilateral destruction of the lower eyelids.MethodsCase report.ResultsBilateral destructive lower eyelid lesions and cicatricial entropion developed in a 43-year-old man with systemic sarcoidosis. Histopathology was consistent with sarcoid granulomas. Disease progression was arrested with systemic prednisone and methotrexate before eyelid reconstruction was performed.ConclusionsSarcoidosis very rarely can cause destruction of full-thickness eyelid architecture. Active inflammation should be controlled before reconstruction.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe a case of late orbital hematoma after blepharoplasty and review the literature on this subject.MethodsA healthy woman developed an orbital hematoma and loss of vision 7 days after an elective blepharoplasty. Computed tomography and magnetic resonance images of the orbits were obtained 1 day after the vascular accident.ResultsComputed tomography and magnetic resonance images clearly demonstrated that the site of the hemorrhage was the superior nasal fat pad. Blood from this region molded the globe and accumulated in the intraconal space behind the posterior sclera. The patient was successfully treated with conservative measures only.ConclusionsOrbital hematoma, which is the main cause of loss of vision after blepharoplasty, can be a late postoperative complication.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID