摘要:

SummaryFourteen different wire materials were evaluated for use as palpebral springs. Three of these, stainless steel 0.010− and 0.012-in diameter, respectively, and Australian stainless steel 0.012-in diameter, fulfilled the designated criteria for suitability. The physiologic deflection range of palpebral springs was determined by examining 20 normal individuals. Angles that a spring would subtend were measured with eyes closed (42 ± 3°), in primary position (20 ± 3°), and in upgaze (6 ± 3°). The effects of spring design on load-deflection (the force required for angular deflection) were evaluated for 0.010− and 0.012-in stainless steel wire within the physiologic deflection range. Variations in spring design in addition to wire diameter (gauge) included alteration of external loop size, number of external loop coils, and resting spring angle. There was a direct linear relationship between force and angular deflection (load-deflection). Larger wire diameter increased the load-deflection. Australian stainless steel had a higher load deflection (stiffer) for a given gauge than regular stainless steel. Smaller diameter external loops and fewer external loop coils increased load-deflection. Although definite conclusions could not be drawn regarding the effect of resting angle on load-deflection, it appeared that no relationship (zero correlation) existed over the angles tested (55°, 60°, 65°, 70°, 75°). These findings were consistent with predictions based on standard spring equations. The clinical significance of the findings is discussed with reference to surgical planning and evaluation of lid dynamics.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryThis article describes a procedure for repair of severe blepharoptosis by means of supraorbital rim periosteal rotation flaps. The results of a group of patients undergoing the procedure are analyzed, and the potential for the successful use of this procedure is discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryWe report a case of biopsy-proven orbital lymphangioma with contiguous spread intracranially in a 14-year-old boy. The patient had a history of congenital orbital lymphangioma and hydrocephalus. Multiple functional and cosmetic periorbital surgeries were done over the years. Severe unresponsive amblyopia developed along with disfiguring anterior orbital and brow invasion of tumor. Since the age of 4 years, the patient had had 12 episodes of periorbital and orbital cellulitis, often after upper respiratory infections. CT and MRI scans have shown progression of the tumor posteriorly beyond the orbital confines. The tumor, now present in the superior and inferior orbital fissure and the paranasal sinuses, extends extradurally into the middle cranial fossa. This case is unique, with documentation of the benign tumor's progressive posterior extension intracranially, along with repeated episodes of severe periorbital cellulitis.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryOrbital tuberculosis (TB) is an extremely rare condition in North America. The authors present a case of TB involving the orbit, lower lid, and zygoma and review pertinent literature regarding orbital TB. Following excision of the orbital lesion, the patient responded well to anti-TB therapy. With the reemergence of TB associated with AIDS, orbital TB may be a more frequent presentation and should be considered in the differential diagnosis of inflammatory orbital disease.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryThe caruncle is an ocular adnexal structure composed of both mucosal and epidermal elements. Consequently, a number of benign and malignant lesions of epithelial and supportive tissues may arise in this area. Lesions of the caruncle are rarely reported, and their appropriate diagnosis and management may be uncertain. One such lesion is sebaceous gland hyperplasia. Of all caruncular lesions that undergo excision, sebaceous gland hyperplasia is infrequently encountered. We have observed four cases of sebaceous gland hyperplasia of the caruncle over the last 2 years. Our observations suggest that this lesion has a characteristic onset, progression, and appearance, enabling diagnosis to be made on clinical examination alone. Excision is indicated only if there is an atypical presentation, a carcinoma is suspected, if mass effect causes discomfort or epiphora, or if cosmesis is an issue.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryA 39-year-old woman presented with a vermiform superior conjunctival mass that progressively enlarged during 4 years of follow-up. Although magnetic resonance imaging suggested that the lesion was located in the superior forniceal conjunctiva, surgical exploration disclosed a vascular anomaly (varix) that extended deep into the orbit. The clinical features and management of orbital varices are discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryFive patients with a history of sinus surgery with nasal packing and postoperative hemorrhage developed nontender, firm tumors of the periorbit. There was no spontaneous regression. Surgical excision was difficult due to diffuse cellular infiltration and intracutaneous deposits, requiring re-operations in all patients. Histology showed a marked lipogranulomatous reaction to dispersed lipid material with fibrosis. Paraffinoma is a known complication of paraffin injection in dermatology and cosmetic surgery. Reports of it in the ophthalmic literature are rare. This series documents a late complication of sinus surgery, very probably due to the intraoperative nasal packing with paraffin-containing ointments.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryIt is frequently difficult to identify and localize organic intraorbital foreign bodies despite modern day high-resolution imaging studies. Although there can be grave complications associated with retention of organic intraorbital foreign bodies, many believe that removal of such bodies in most cases is unwarranted. A high clinical suspicion, proper choice of imaging studies, and removal by a skilled orbital surgeon probably make the risk of surgical exploration and foreign body removal less than the risk of foreign body retention. We present a case of an intraorbital wood foreign body that required two separate explorations for retrieval. An initial intraconal exploration failed to locate the foreign body. Although the clinical suspicion was high, the imaging studies were equivocal, complicating the management. A second exploration yielded a large intraorbital wooden foreign body in the inferior extraconal space. The patient fully recovered and regained visual acuity of 20/20. The evaluation of such patients and details of management strategy are discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryA 24-year-old man sustained orbital and facial injury when an industrial suction device attached to his face. Hemorrhage and edema within the orbital soft tissues were clinically evidenced by proptosis and restricted ocular motility and confirmed by computed tomography. No retinal hemorrhages or exudates were noted. Orbital soft tissue injury caused by sudden extreme decrease in extravascular atmospheric pressure (i.e., orbital barotrauma) is not well described in the ophthalmic literature. The findings in our case are remarkably similar to those seen with traumatic asphyxia and the ophthalmological hydrostatic pressure syndrome, two conditions attributed to an increase in intravascular pressure. Physiologically, our case and these conditions share a similar increase in transmural pressure at the capillary level that is responsible for fluid transudate and hemorrhage in the orbital soft tissues. Intraretinal hemorrhages and exudates typical of Purtscher's retinopathy were conspicuously absent in our patient.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

SummaryEndoscopic laser-assisted dacryocystorhinostomy (DCR) offers several advantages over standard external (SE) DCR. The technique eliminates the cutaneous scar and cosmetic blemish of an external dissection and causes less surgical trauma and bleeding than SE-DCR, with shortened postoperative recovery time and lessened postoperative pain. However, the equipment is expensive. We modified this technique using simple instruments such as the curette, Kerrison punch, Freer elevator, Storz endoscope, Ellman Surgitron unit, and the Javate DCR electrodes instead of the laser. Fifty patients with epiphora and nasolacrimal obstruction underwent surgery with our new technique. Fifty age-matched, paired external DCR were performed, and comparisons were made with the endoscopic procedure described. If preoperative epiphora was resolved and nasolacrimal patency was confirmed by lacrimal irrigation 3 months after tube removal, the operation was considered a success. The study attained a 90% success rate for endoscopic radiofrequency-assisted DCR, as compared to a 94% success rate (p> 0.05, not statistically significant) for the SE-DCR.

ISSN:0740-9303    

出版商:OVID    

年代:1995

数据来源: OVID