摘要:

SummaryThe Universal implant is a quasi-integrated buried orbital implant designed to provide the same motility advantages as does an Iowa implant, but is simpler to implant and associated with fewer complications. The protruding mounds on the implant are keyed to corresponding indentations on the posterior prosthetic surface, allowing more life-like motility. We describe a straight-forward technique for its use as an evisceration implant and report the results in 24 patients. The Universal implant is simple to use and the lock-and-key mechanism obtained between implant and prosthesis provides the patient with a high degree of life-like motility. Its cost is significantly lower than the more popular hydroxyapatite implant and it does not require a drilling procedure for coupling.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThis study investigated the effects of sucralfate and basic fibroblast growth factor (bFGF) on fibrovascular ingrowth into porous implant materials. Seven white female New Zealand rabbits underwent bilateral abdominal incisions through which porous orbital spherical or and disc-shaped implants were inserted between their abdominal muscles. Eighty hydroxyapatite (HA) and porous polyethylene (PP) implants, each material of different pore sizes, were implanted. These implants were either uncoated or coated with suspensions of polyhydroxymethylmethacrylate (hydron); hydron and sucralfate; or hydron, sucralfate, and bFGF. Implants were harvested after 1, 3, or 6 weeks. Observers classified the extent of fibrovascular ingrowth in a blind manner using light microscopy. All discs and spheres showed fibrovascular ingrowth; at 6 weeks, almost all implants were fully vascularized. Although demonstrating different degrees of fibrovascular maturity, all 3− and 6-week discs showed complete cellular ingrowth. Overall, the most extensive and mature fibrovascularization was found in HA implants, regardless of shape, duration of implantation, or angiogenic enhancing agent used. Thus, this study indicates that fibrovascular ingrowth into porous implants is more greatly affected by implant porosity and composition than by addition of angiogenic enhancing agents. Further in vivo study, using other potential angiogenesis-promoting agents as well as implants with different pore characteristics, is warranted using this reliable and predictable animal model.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe enucleation volume of a series of 17 eyes was measured by water displacement and found to be 1–2 ml in excess of the 7 ml usually quoted. This is relevant to the development of postenucleation socket syndrome in patients who have had orbital implants of a conventional size. Enucleation volumes should be measured routinely and the implant volumes selected accordingly.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryBackground: This study aimed to define the anatomy of the eyelash follicles in order to improve methods of selective lash ablation.Materials and Methods: Dimensions of eyelash follicles were determined from histological specimens of the upper and lower lids of 10 patients. For one of these patients, the eyelash follicles were categorized as quiescent or actively growing, according to standard hair-cycle morphology.Results: Follicle dimensions were (mean ± SD): upper lid follicle depth, 1.8 ± 0.3 mm; bulb width, 188 ± 44μ shaft width, 205 ± 28 μm; lower lid follicle depth, 0.9 ± 0.2 mm; bulb width 132 ± 19 μm; and shaft width, 158 ± 26 μm. The upper lid comprised 41% active follicles compared to 15% in the lower lid.Conclusions: There are significant differences in the anatomy of the follicles between the two lids. For an electrolysis needle to completely contact 95% of all follicles, it must be inserted 2.4 mm into the upper lid and 1.4 mm into the lower lid (mean depth +2 SD). Argon laser ablation requires a beam width of <200 and <250 μm for the lower and upper lids, respectively, to treated similar depths as electrolysis. The higher proportion of actively growing upper lid follicles explains why upper lid lashes are longer.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe purpose of the present study was to determine whether proliferating cell nuclear antigen (PCNA), an immunohistochemical marker for a nuclear protein abundant in actively proliferating (dividing) cells, is useful as an aid in differentiating idiopathic orbital inflammatory syndrome (IOIS) from lymphoproliferative lesions (LLs). Records of all patients with IOIS and LLs were studied retrospectively. Tissue biopsy specimens from four patients with IOIS and nine patients with LLs were examined. The diagnosis in each case was based on presenting signs and symptoms, orbital computed tomography (CT) and/or magnetic resonance (MR) scans, histopathologic criteria, and follow-up data consistent with the entity. These findings were correlated with the percentage of B- and T-cells in the lesions as well as with the number of cells that demonstrated staining for PCNA in formalin-fixed tissue. PCNA activity was markedly increased in the higher grade (HG) lymphoma group as compared to that in the low grade (LG) lymphoma and idiopathic inflammatory group. Lymphoma cases showed a significantly increased B-/T-cell ratio compared to IOIS lesions. PCNA activity in conjunction with the ratio of B-/T-cells may be a helpful immunohistologic adjunct for differentiating purely inflammatory lesions of the orbit from lymphoid tumors. Further studies are necessary to compare PCNA activity in fresh frozen tissue with that in formalin-fixed tissue.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe authors reviewed their experience with 524 secondary orbital tumor cases diagnosed histopathologically during 1963–1993. Secondary tumors constituted 48.0% of all orbital biopsies during the same period. There were 186 (35.5%) cases with eyelid tumors, 146 (27.9%) cases with intraocular tumors, 137 (26.1%) cases with conjunctival tumors, 26 (5.0%) cases with nasopharyngeal tumors, 22 (4.2%) cases with sinus carcinomas, 3 (0.6%) cases with intracranial meningiomas, 3 (0.6%) cases with esthesioneuroblastomas, and 1 (0.2%) case with chordoma. The three most frequent tumors making secondary orbital invasion were basal cell eyelid carcinoma (129 cases; 24.6%), squamous cell conjunctival carcinoma (125 cases; 23.8%), and retinoblastoma (123 cases; 23.5%). Squamous cell carcinoma, from various sites of origin, was the most frequent histopathologic tumor variant, accounting for 215 (41.0%) cases. Exenteration was performed on 334 (63.7%) of 524 cases with secondary orbital invasion. The ignorance of many lid and conjunctival lesions until the advanced stages, which could otherwise be easily treatable, caused blindness and life-threatening complications under our conditions. Orbital invasion from ocular retinoblastoma and uveal malignant melanoma led to a markedly poor prognosis, again related to the late presentation of many patients. Lack of health consciousness, inadequate primary surgery, and/or insufficient follow-up were the main reasons for secondary orbital invasion in many tumor cases.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe use of hard palate mucosal grafts (HPG) in eyelid surgery is becoming increasingly popular. We present two palatal donor site complications that have not been previously reported. The first is an oro-nasal fistula discovered 1 week following surgery. The second is oral candidiasis, which compromised healing of the palatal donor site. With appropriate treatment, both complications resolved shortly after surgery. Careful preoperative evaluation and postoperative follow-up is recommended to recognize and manage these complications.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryConjunctival flaps are commonly used to cover the cornea in patients who otherwise can not tolerate a scleral shell. An alternative method of protecting the cornea, oral mucous membrane grafting, is described herein. Ten patients had oral mucous membrane grafting to the cornea. Patients ranged from 5 months to 47 years of age. Diagnoses included partial cryptophthalmia, microphthalmia, congenital orbital fibrosis syndrome, juvenile active ossifying fibroma, and trauma. All patients had poor visual function in the affected eye. Patients were either intolerant of scleral shell wear or had other contraindications to the use of a shell over an unprotected cornea. Following mucous membrane grafting (follow-up, 1–3 years), all patients were successfully fitted with prostheses and obtained good cosmetic results.SUMMARYTen patients had mucous membrane grafting to protect the cornea in order to permit essentially constant wear of a prosthetic scleral shell. The results of this technique are gratifying. Only one patient required additional surgery following significant dehiscence of the graft due to self-induced trauma. The oral mucosal donor site healed quickly and well, and no significant scar formation has been observed (9). Unlike previous reports of similar procedures, neither contracture of the grafts nor production of an abnormal discharge has been observed (10). All patients in this series achieved a superior cosmetic result following prosthetic shell fitting. Most importantly, similar to a properly fitted enucleation prosthesis, the shells could be tolerated with only infrequent removal required.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryIntravascular papillary endothelial hyperplasia is a benign tumor that rarely presents in the orbit and ocular adnexa. Generally, it occurs as an isolated eyelid mass, not associated with systemic or local disease. Histopathologically, it can be easily confused with angiosarcoma or Kimura's disease. We present our experience with four cases of this tumor in the ocular adnexa, along with a literature review.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryA 29-year-old woman presented with a 1-year history of blurred vision in her left eye while chewing. Examination revealed a rubbery mass with ill-defined borders in the superotemporal brow region. Imaging studies demonstrated a cystic lesion extending from the temporal fossa into the orbit through a bony defect in the lateral orbital wall, assuming a dumbbell configuration. Histopathology of the excised specimen confirmed the clinical diagnosis of a dermoid cyst of cutaneous origin. We believe that the patient's visual disturbance was caused by transient displacement of orbital contents by the dermoid cyst as it was compressed into the orbit during mastication. Dermoid cysts are frequently associated with bony defects, which may require preoperative imaging and may produce unexpected symptoms.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID