摘要:

Nonabsorbable sutures are often recommended for use in oculoplastic surgery. This study compares the in vivo performance of nonabsorbable and absorbable sutures in an animal model and attempts to determine if one suture type is clearly superior for subcutaneous wound closure. The performance of each suture was evaluated using three surgical techniques. Comparison of results revealed that different techniques produce profoundly different results, independent of suture choice. Clinically, all suture types behaved similarly when used with the same surgical technique. Thus, absorbable and nonabsorbable sutures are equally effective under the conditions of these experiments.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Hydroxylapatite. a synthetic bone mineral, was implanted alone or as a composite with either calcium sulfate (plaster of Paris) or Avitene (microfibrillar collagen hemostatic agent) into the orbital bony detects and orbital soft tissues of 23 rabbits. Plain Avitene was also placed into these bony and soft tissue sites and hone defects with no additives served as controls. Additionally, each implant material was placed into subcutaneous tissues to determine its relative inflammatory potential. New bone formation was noted in bony delects as early as 10 days. Bone ingrowth was greatest when hydroxyl-apatite was in direct apposition to bone. Material implanted away from bone showed predominately connective tissue ingrowth. Minimal inflammatory reaction was noted early on in the hydroxylapatite and hydroxylapatite/calcium sulfate samples and had resolved by 2 months when placed in both soft and bony tissues. Samples of Avitene and the hydroxylapatite/Avitene composite demonstrated an intense inflammatory response, and in several cases large granulomas were seen after 2 months.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Dermis-fat grafts have been widely used in the reconstruction of the anophthalmic socket, both primarily after enucleation and secondarily after extrusion or migration of an existing implant. The dermis-fat graft is an effective means of replacing orbital volume and affording motility of the ocular prosthesis with both low morbidity and a satisfactory cosmetic result. We present a modification to the dermis-fat graft technique. Our modification creates a domed shape to the anterior surface of the graft that simulates the curvature of the eye. The dome-shaped graft creates deeper fornices than a standard flat-surfaced dermis-fat graft. It also allows better contact between the prosthesis and the dermis as the graft moves. The prosthesis can be thinner centrally and lighter than a prosthesis fabricated for a socket with a standard dermis-fat graft or spherical implant. This results in better motility of the prosthesis while also replacing orbital volume. There is no additional morbidity associated with this technique. We have used this procedure successfully in 18 patients; 10 were primary grafts and eight secondary grafts. Motility of the prosthesis was satisfactory in all cases. There was no abnormal graft shrinkage. All grafts maintained their domed shape. Follow-up ranged from 6 to 21 months.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We describe the use of a magnetic search coil technique for measuring the movement of prosthetic eyes. The technique allows for accurate comparison of implant designs and surgical techniques.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Early and rapid expansion of the tiny socket is desirable in clinical anophthalmos. This paper reports three cases utilizing an expandable conformer made of silicone. Socket enlargement adequate for fitting of a satisfactory cosmetic prosthesis was attained rapidly in each case. The design of the conformer allows the greatest expansion toward the fornices.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The frontalis suspension operation has proven effective for patients with significant ptosis and poor levator function. In patients with poor eye protective mechanisms, silicone rods may be used since the material has enough tensile strength to raise the eyelids yet it is sufficiently elastic to allow closure via action of the orbicularis muscle. This article reports the technique and results of a modified operation that uses two silicone rods per upper eyelid and eliminates fixation sutures to tarsus inferiorly and frontalis muscle superiorly. The results obtained are discussed. This technique provides a better upper eyelid contour and is easily adjustable postoperatively.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Motor points (areas of maximal sensitivity to electrical stimulation) were found in constant locations over orbicularis oculi when measured in both eyes of six normal subjects. All subjects had a motor point at the lateral terminus of the upper lid crease and the medial extent of the lower lid crease. A study of the innervation zone [distribution of neuromuscular junctions (NMJ) was conducted on strips of pretarsal and preseptal portions of the upper eyelid orbicularis that had been removed routinely during involutional ptosis surgery. There was no significant difference in NMJ concentration between the medial and lateral sections, as determined by cholinesterase staining. Therefore, we concluded that the innervation zone is diffuse for the orbicularis muscle within this portion of the upper eyelid. Single-point injections of botulinum toxin were then compared to the conventional multiple injection sites on separate eyes in 10 patients with benign essential blepharospasm. Eight of the 10 patients reported greater relief on the side given injections into multiple points; the other two patients experienced no difference between the two methods. Both histologic data and clinical observation of response to botulinum toxin injection suggest the innervation zone for the upper orbicularis is diffuse. Thus, we conclude that multiple injections are superior to the injection of a single motor point.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Sebaceous carcinoma of the eyelid is frequently misdiagnosed clinically and histopathologically. The tumor may present as a lid mass, recurrent chalazion, or diffuse unilateral blepharoconjunctivitis. Fifty percent of cases are misdiagnosed, often by an inexperienced general pathologist interpreting the initial biopsy. Frozen-section monitoring of surgical margins has been reported unreliable in 25% of cases. Mohs surgery is also unreliable in cases where there is pagetoid intraepithelial spread or skip lesions. This tumor may spread regionally into the lacrimal secretory and excretory systems, to regional lymph nodes, and rarely disseminate hematogenously. Guidelines for management are discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Stereoscopic external photography is a simple but helpful aid in teaching oculoplastic surgical anatomy. Binocular slides or photographs may be taken freehand and may be viewed stereoscopically without special equipment (the free-stereo viewing technique).

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A combination punctal dilator and lacrimal probe intended for diagnostic and therapeutic probing of the entire lacrimal outflow system is described. This instrument allows for a single-handed comfortable transition from dilating to probing without release of lateral lid traction. The dilator-probe has a familiar pencil-like maneuverability and may be customized to satisfy the surgeon's preferences with regard to probe caliber and punctal dilator style.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID