摘要:

Summary:Management of blowout fractures involving the orbital floor has been controversial over the past several decades. One school of thought recommends conservative treatment for 4 to 6 months while another recommends a 'wait and watch' period of 2 weeks before intervention. The authors have encountered a group of patients with such fractures, commonly children (less than 16 years of age), who have sustained a blow to the periocular area, yet have marked motility restrictions in up and down gaze, minimal soft tissue signs of trauma, lack of enophthalmos, and very minimal evidence of floor disruption on radiologic exam. A 2-week waiting period has been found to be of little benefit in these persons and possibly harmful to their motility. We advocate surgery within the first few days after injury as it may help to avoid permanent motility restriction. The authors have termed this entity 'the white-eyed blowout fracture.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:The authors determine the efficacy of a new technique, thetarsal patch-flap, in the management of postenucleation and postevisceration porous orbital implant exposures that are recalcitrant to other surgical approaches. All patients treated during a 30-month period with recurrent orbital implant exposures who failed at least one surgical attempt at defect closure were treated using a tarsal patch-flap, a fornix-based tarsoconjunctival flap from the upper eyelid. Eight patients, six after enucleation and two after evisceration, were treated with a tarsal patch-flap. Five implants were porous polyethylene and three were hydroxyapatite. The defect size ranged from 4 mm to 12 mm (largest dimension). All eight patients have maintained closure of their defects for a mean follow-up of 13.8 months (range, 4–30 months). The vascularized tarsal patch-flap provides an excellent alternative surgical approach to the management of recurrent orbital implant exposures recalcitrant to Tenon-conjunctival advancement and autologous fascia grafting.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:A 68-year-old woman experienced an infection of a porous polyethylene orbital implant caused byCapnocytophagaafter a dental procedure. The infection was unresponsive to both topical and oral antibiotics and required removal of the porous polyethylene orbital implant.Capnocytophagais a capnophilic, gram-negative bacillus.Capnocytophagais a normal commensal of the mouth and is responsible for both gingivitis and periodontal disease.Capnocytophagais a rare cause of ocular infections. This is the first reported patient with an infection of a porous polyethylene orbital implant caused byCapnocytophaga.The authors believe infected integrated orbital implants must be removed because neither topical or systemic therapy provide effective treatment.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:This study was designed to evaluate the characteristics of human orbital fat and connective tissue. Two exenteration specimens were studied by light microscopy with special stains. Four distinct regions were identified on the basis of their connective tissue septa, which contained blood vessels and were composed of elastin and collagen types I, III, and IV. Transmission electron microscopy was performed on the opposite orbits. The fibroblasts and adipocytes appeared metabolically inactive and showed no regional differences. The fat was phase extracted from the connective tissue and subjected to biochemical analysis. No regional differences were found in the content of fatty acids and protein. The fatty acids included palmitic acid (22–24.6%), oleic acid (45–51.5%), and linoleic acid (15–18.6%). Despite demarcation of the orbital fat into distinct regions by the connective tissue septa, ultrastructural and biochemical analysis revealed no regional variations in the fat. The diagnostic and therapeutic implications of these findings are discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Twenty-nine infant rabbits from four litters were randomly assigned to three groups. No surgery was performed on left eyes. All right eyes were enucleated. Group 1, the control group, had no right-socket reconstruction. Group 2 had reconstruction using free-fat and dermis grafts. Group 3 had reconstruction using porous polyethylene implants. On attaining adult size, rabbits were killed, decapitated, and prepared for measurements. Orbital volume measurements were performed twice and orbital entrance areas were determined once. No significant differences were noted between first and second measurements of orbital volumes. Right orbital volumes were significantly smaller than left orbits in all groups except for the second measurement of the polyethylene implant group. Right orbital entrance areas were significantly smaller than left areas in the control and the free-fat and dermis graft groups. Right orbital entrance areas of the polyethylene group were not significantly smaller than the corresponding left orbital entrance areas. The use of free-fat and dermis grafts for orbital reconstruction in anophthalmic infant rabbits did not significantly stimulate orbital bone growth. In one trial, the polyethylene implant group displayed right orbital volumes and orbital entrance areas that were not significantly smaller than controls.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:The use of Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ, U.S.A.) spheres as orbital implants is investigated. The left eyes of six New Zealand white rabbits were enucleated and spherical implants made of modified Gore-Tex were implanted. After 6 weeks of follow-up, the implants were harvested. No rabbit developed a postoperative infection and no cases of exposure or extrusion were noted. Histopathologic study revealed varying degrees of acute and chronic inflammation surrounding each implant. There was also evidence of inflammatory infiltration and fibrovascular ingrowth into each implant to a maximum distance of 500 μm. This preliminary study demonstrates that the Gore-Tex implant is well tolerated in vivo, allows cellular ingrowth, and may have a role as a permanent implant.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Twenty-three consecutive patients with orbital masses who were referred to a major medical center and later had biopsies underwent ophthalmic echographic evaluation. The efficacy of orbital echography was compared with both the clinical evaluation and other orbital imaging methods (computed tomography and magnetic resonance imaging). Echography was successful in all patients (100%) in detecting the orbital mass. The diagnosis was accurate in 18 of 22 patients (82%) echographically, 12 of 14 patients (86%) clinically, and 11 of 13 patients (85%) radiologically when a short differential was attempted. If all the patients examined were considered, echographic evaluation arrived at an accurate diagnosis in 18 of 23 patients (78%), clinical impression was accurate in 12 of 23 patients (52%), and radiologie evaluation was accurate in 11 of 20 patients (55%). In three patients, echography was the only imaging method used. The role of ophthalmic echography in the diagnosis of orbital masses is discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Oncocytic tumors of the lacrimal sac are very rare, with only 21 cases documented in the world literature. The authors report a 75-year-old woman who sought treatment for recurrent dacryocystitis and a palpable mass in the left medial canthal area. The patient underwent surgery for removal of a suspected lacrimal sac cancer, but pathologic findings indicated benign oncocytic adenomatous hyperplasia. Complete removal of the tumor and long-term follow-up are necessary in patients with lacrimal sac oncocytic lesions. The authors discuss the characteristic features of ocular adnexal oncocytic lesions and review the literature.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Sclerosing sweat-duct carcinoma or malignant syringoma is a rare eyelid tumor. The authors report the first patient with sclerosing sweat-duct carcinoma involving the upper eyelid and present its immunohistochemical and ultrastructural features. The clinical features and the histopathologic and ultrastructural findings that distinguish this tumor from its benign counterparts are discussed. Sclerosing sweat-duct carcinomas are slow growing but locally invasive neoplasms that have a propensity to recur. Wide and deep surgical excision with frozen section evaluation of margins is recommended.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Patients with dysmorphophobia are preoccupied with an imagined or grossly exaggerated defect of appearance. These patients may seek cosmetic surgical procedures to alter their perceived abnormal appearance. Treatment of patients with dysmorphophobia has not been previously addressed in the ophthalmologic literature. The authors present three case reports and discuss the syndrome of dysmorphophobia.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID