Oculoplastics News

Amar Agarwal There are various techniques for treating and managing ptosis. We will describe a new surgical technique for acquired and congenital ptosis with poor levator function in which the Seiff silicone suspension set is used in a frontalis sling procedure. The entire length of the silicone set is guided in the muscle plane through a single stab incision. The advantages of the procedure include less surgical time, absence of multiple incisions, minimal postoperative scars or edema, and early recovery. Six eyes of five patients underwent this technique for congenital ptosis with poor levator function, and the postoperative outcomes were comparable with conventional frontalis sling surgery. Thus, it provides enhanced cosmesis while retaining the usual advantages of standard sling procedures.

我对大多数眼球摘除者或眼内容物剜出术后病人，用一种整合植入物，即羥磷灰石或聚乙烯。

Thomas J. Joly, MD, PhD Superior stability within the muscle cone I use an integrated implant, either hydroxyapatite or polyethylene, in the great majority of cases for enucleation or evisceration. Thomas J. Joly The superior stability of these implants within the muscle cone is my primary reason for choosing them. The risk of migration or extrusion seen with non-integrated implants is practically eliminated with an integrated implant. In addition, an integrated implant allows the option of pegging for improved prosthesis motility, although in my practice, it is the rare patient who pursues this option.

The term ocular surface squamous neoplasia, or OSSN, refers to dysplasias, carcinoma in situ and squamous cell carcinoma of the ocular surface epithelium, conjunctiva and cornea (Figure 1).

Early stent extrusion or removal after external dacryocystorhinostomy may not be as detrimental as previously thought, a retrospective study suggests. Furthermore, longer stent retention and reintubation after early extrusion do not appear to yield a higher success rate.

Surgeons, anesthesia staff and other operating room personnel should be aware that periocular anesthetic injections can elicit potentially dangerous reflex sneezing when delivered under intravenous sedation to reduce ocular complications, a large retrospective study suggests.

In the long term, performing posterior lamellar grafting and lateral eyelid tightening appears effective for correcting lower eyelid retraction, according to 15-year results from a retrospective chart review by researchers in Canada.

Because a directly proportional decrease in levator function and eyelid height may be observed among patients with involutional blepharoptosis, abnormalities in levator muscle function appear to be a contributing factor for developing the disorder, a recent study suggests.

DALE R. MEYER, MD, FACS External DCR remains gold standard I believe the short answer to this question is “no,” and that external DCR still remains the gold standard for treating most forms of acquired nasal lacrimal obstruction in adults (and more complex congenital types). Dale R. Meyer There is an increasing abundance of literature examining the effectiveness of endoscopic (endonasal) DCR; the relative indications, contraindications, advantages and limitations; as well as patient selection, surgical technique, postoperative care and complications in comparison with external DCR. While not universal, most studies have demonstrated lower success rates with endoscopic DCR. However, endoscopic DCR may be a reasonable option in many patients as a primary procedure or particularly for surgical revision after failed primary DCR. With the exception of avoidance of external incision scar, reported complications of endoscopic DCR appear to be similar. Disadvantages of endoscopic DCR include the preferred use/need of general anesthesia, expensive equipment and instrumentation, and relatively steep learning curve. While shorter operating time has been cited by some authors, total operating room time may actually be greater when equipment set-up is considered.

A 39-year-old white woman was referred to the New England Eye Center for evaluation of a new onset of discoloration over her right upper eyelid. The discoloration had been present over the past 7 months and had not changed in appearance over that time. She remembered an episode of minor trauma within the past year in which her 6-year-old son’s head struck her above the right brow, which did not break the skin. She otherwise denied pain, diplopia, subjective proptosis or vision changes. Isabel M. Balderas Tom Hsu The patient’s review of systems was unremarkable. Her ocular history was also noncontributory. She was healthy and not currently taking any prescription medications or eye drops. The patient denied smoking or alcohol intake.