Oculoplastics News

Optic nerve decompression may have an important adjuvant role to radiation for treating patients with optic nerve sheath meningioma, a recent study suggests.

Treating incompletely excised eyelid tumors using Mohs’ micrographic surgery may result in a lower recurrence rate compared with frozen section histology, according to a study.

A new silicone intubation method appears effective for treating lacrimal system disorders in children and adults, researchers in one study report.

Botulinum toxin may be safe to use long-term at higher than recommended doses without compromising efficacy, according to a small retrospective study.

Using donor sclera to cover porous and nonporous enucleation implants is a successful technique that causes few complications, according to a recent study.

Congenital ptosis, or dysmyogenic ptosis, is the most common ptosis seen in childhood. It comprises a group of diseases in which the ptosis is due to a developmental dystrophy of the levator muscle characterized by fibrosis and deficiency of striated muscle fibers. Most cases of congenital ptosis are idiopathic. However, congenital ptosis may occur through autosomal dominant inheritance. Common familial occurrences suggest that genetic or chromosomal defects are likely. There is no known racial or gender preference, and roughly 75% of cases are unilateral. The condition may be associated with anisometropia, astigmatism, strabismus or amblyopia. Incidence of amblyopia was measured to be 20%, of which 3% was attributable to the ptotic occlusion of the pupil.

I now use only unpegged quasi integrated implants. Unfortunately, I jumped on the integrated pegged coral hydroxyapatite implant bandwagon several years ago. While the pegged implants provided good motility, they also provided many complications. I have removed more pegs than I have placed in my career. The concept that exposed hardware will not cause problems and infections with time is fallacious. No matter what material is used, eventually irritation, chronic discharge, infection and extrusion are predictable complications. Integrated implants were popular 70 to 80 years ago. The old Cutler integrated pegged implant had the best motility I have ever seen. However, virtually none survived. It seems that we seldom learn from our mistakes and everything recycles. Almost any implant works for several years, and then we start seeing the complications.

Some invasive oculoplastic surgical techniques are being replaced by less invasive procedures that provide equivalent or better results, according to Robert A. Goldberg, MD.

Francis W. Price Jr.

Francis W. Price Jr.