摘要:

The amniotic band syndrome is an unusual cause of craniofacial deformities. The syndrome, which is initiated by rupture of the amnion, results in an unpredictable combination of compression deformities of the fetus, construction or amputation defects of the extremities, and craniofacial clefting deformities. The type and extent of ophthalmic abnormalities are dependent on the band location and timing. They include a combination of bony orbital clefts or hypertelorism; lid anomalies such as colobomas, ptosis, and ectropion; lacrimal outflow obstruction; and globe involvement. We review the clinical course of 14 patients diagnosed with, or suspected as having, this syndrome and describe the methods of treatment. In most instances, multiple surgical procedures were required to restore function. Satisfactory cosmesis proved more difficult to obtain.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Involutional entropion is an inturning of the eyelid margin caused by changes of lid tissues due to aging. Two patients with the uncommon finding of involutional entropion of the upper lid were treated with surgery based on the principles used to treat common lower lid entropion. The causes of lower lid entropion include increased horizontal and vertical lid laxity, and correcting these same factors in the upper lid resulted in a satisfactory repair of the entropion. Treatment of involutional entropion in the upper lid is compared and contrasted with that of the lower lid.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A distinct entity of entropion involving the middle portion of the lower eyelids is presented. This condition is not related to any local or systemic disorder and does not progress to entropion of the entire lower eyelid. Segmental atrophy of the lower lid tarsus is present.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Ptosis may develop after cataract surgery because of a dehiscence of the levator aponeurosis. A series of patients undergoing entropion repair was examined in order to determine the mechanism of entropion and the correlation with cataract surgery. It is suggested that involu-tional senile entropion may develop related to cataract surgery, on the same basis as ptosis, due to disinsertion of the capsulopalpebral fascia. It is suggested that the cataract surgeon should examine the patient closely for pre-operative entropion to prevent or anticipate the development of frank entropion after the cataract surgery.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The primary functional support for the medial eyelid is from the deep attachments of the orbicularis muscle to the posterior lacrimal crest and lacrimal diaphragm. A dehiscence of the deep medial canthal attachments can alter the position of the lower eyelid with subsequent tearing, medial ectropion, and ocular exposure. In this study, medial palpebral tendon reconstruction was performed on seven lower eyelids with medial instability or ectropion and a dehiscence of the medial palpebral tendon. A periosteal flap left attached to the posterior lacrimal crest was used to replace the attenuated or absent medial palpebral tendon. After a mean follow-up of 7 months, 86% (6/7) of the eyelids had acceptable cosmetic and functional results. The use of a periosteal flap to replace a dehiscence of the medial palpebral tendon has several advantages. The periosteal flap is readily available, strong, and autogenous. The lower eyelid and punctum are pulled tightly against the globe. Lastly, the procedure may be repeated or combined with other ectropion procedures.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 35-year-old woman presented with bilateral lower lid ectropion associated with lamellar ichthyosis. She was successfully treated with postauricular skin grafts and horizontal lid shortenings. This report reviews the literature on the surgical management of this condition and suggests several modifications to prevent recurrence.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A mathematical formula that allows for the computation of the true angle between the upper and lower canaliculi using dacryocystograms is described. It was used to determine the true canalicular angle in 33 patients. The mean calculated angle at the 1.0 mm distance was 57.2° ± 13.°, and at the 0.5 mm distance was 65.2° ± 16.2°. The true calculated angle was highly correlated with the angle measured in the Waters view. There was no statistically significant correlation between the right and left sides in the same patient. There was no statistically significant difference between the canalicular angle in males and females, and there was no correlation between canalicular angle and patient's age. A clinical application of this model is discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

From 1977 through 1987, a total of 222 patients (166 male and 56 female patients) underwent surgical repair of canalicular laceration at Wills Eye Hospital. Demographic and clinical information were collected from the medical records and by written questionnaire or telephone interview. Most injuries occurred in children or young adults (median age, 20 years). Overall, blows from fists was the most common cause of injury (52 patients, 23.4%). Dog bites or scratches were the most frequent causes among children. A total of 147 injuries (66.2%) involved the lower eyelid, 61 (27.5%) the upper eyelid, and 14 (6.3%) the upper and lower eyelids on the same side. Constant or stress epiphora occurred postopera-tively significantly more often among patients with combined upper and lower canalicular injuries (61.5%) than among those with single canalicular laceration (19.7%) (p < 0.01). Analysis with logistic regression showed epiphora to be more common among adults than children (p < 0.05) when the pigtail probe had been used intraop-eratively (p < 0.05), or when no canalicular stent had been placed at the time of surgical repair (p < 0.05). No statistically significant associations were found between sex, cause of injury, type of canalicular stent, or time interval from injury to surgical repair and presence of postoperative epiphora.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Conjunctivodacryocystorhinostomy is a much maligned procedure, and there are widely varying opinions about its efficacy and long-term success. We present our modification of the procedure used in 38 eyes of 29 patients over 10 years, with an average follow-up of 2.5 years, which has resulted in a very high rate of success.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Although Stevens-Johnson syndrome (SJS) has long been recognized as a cause of punctal and canalicular obstruction, nasolacrimal duct obstruction secondary to SJS is rare and has not been reported in the ophthalmologic literature. Keratoconjunctivitis sicca, entropion, and tri-chiasis are well-known complications of SJS that may require measures to supplement or preserve tears. Lac-rimal drainage system obstruction may occasionally occur in the face of relatively normal tearing, resulting in clinically significant epiphora. We report two cases of SJS, one associated with epidemic keratoconjunctivitis, that led to nasolacrimal duct obstruction and canalicular obstruction or stenosis. Epiphora and, in one case, dac-ryocystitis, necessitated dacryocystorhinostomy and Crawford tube insertion.

ISSN:0740-9303    

出版商:OVID    

年代:1990

数据来源: OVID