Oculoplastics News

The applications for botulinum toxin type A have undergone an explosion since the drug was first studied as a treatment for strabismus and focal dystonias such as benign essential blepharospasm and hemifacial spasm more than 20 years ago.

Severe dry eye is an important and common problem. Although many different types of artificial tears, gels and ointments are available, frequent eye drop instillations sometimes offer only temporary or partial relief of symptoms.

The applications for Botox seem endless. Since Allergan’s botulinum toxin type A received approval from the Food and Drug Administration in 1989, its indications have quickly expanded. Once a therapy limited to ocular dystonias, Botox is now used in numerous areas throughout the body, with applications ranging from medicinal to cosmetic.

The aging face has sagging tissues that are currently treated with surgical lifts in different areas using different procedures. Forehead and brow ptosis are among the common problems encountered in the aging face.

There is a 4% increase in the rate of malignant melanoma diagnosed each year. There were 51,400 new melanoma cases diagnosed in 2002 with 7,800 deaths. The lifetime risk in the United States of developing a melanoma is 1 in 71, while in Australia the chance is 1 in 14 to 17. Twenty-five percent of malignant melanoma patients are under 40 years of age.

Right eye proptosis and superior orbit fullness.Right eye showing upgaze restriction.

CHICAGO -- A new clamp may help surgeons avoid injury to the marginal artery during the Cutler-Beard procedure, said Allen M. Putterman, MD.

SAN DIEGO – Botulinum toxin has other uses beyond blepharospasm and its recently approved cosmetic applications. The drug can also be used to treat hyperlacrimation, spastic entropion, strabismus caused by thyroid eye disease and several other eye conditions, according to a surgeon.

Hyaluronic acid skin fillers are part of the new frontier in facial plastic rejuvenation. Although not all of them have regulatory approval in the United States, these exciting new agents are used for the correction of facial lines such as nasolabial folds. They are also effective for use in lip augmentation.

Most surgeons agree that autogenous fascia lata is the best material for use in repairing ptosis with poor levator function. Failure (ie, ptosis) with lyophilized banked human fascia is 40% to 50% at 8 to 9 years, according to Crawford.