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Biomedical subjects

C R Leone

Publications and source records attributed to C R Leone.

At least 55 records · Page 3Linked to original sources
PubMed1986

Botulinum toxin for the treatment of essential blepharospasm.

Twenty-six patients with essential blepharospasm were treated with botulinum toxin by injection. The onset of protractor weakness in all patients ranged from one to five days following treatment. Maximal weakness developed within 12 days. There was a variable and gradual return of protractor strength over eight to 29 weeks in most patients and, with it, a return of spasm. Twenty-five patients received some degree of functional relief following initial injection. In most patients, however, the post-injection result could not be stabilized and repeat injections have been necessary to control recurrent spasms. There was one treatment failure. Three patients treated by injection following previous neurectomy and myectomy appeared to have a reduced requirement for subsequent injections. Complications included transient ptosis in six patients and mild exposure symptoms in four patients. Extraocular muscle paresis did not occur. There were no systemic side effects from the botulinum toxin injections.

Aged↗
PubMed1985

Treatment protocol for orbital inflammatory disease.

Forty-five consecutive patients suspected of having orbital inflammatory disease (OID) were treated according to a protocol that provided specific dosages of steroids and a formula of dose reduction. Nonresponsive cases were managed with intravenous dexamethasone and, when brought under control, were switched to oral therapy. The cases that continued to be unresponsive or escaped from control were biopsied. If the frozen section was read as inflammatory, intralesional steroid was injected. For resistant or recurrent cases, 1000-3000 rads of orbital irradiation were delivered in fractionated doses. For extreme cases, radiotherapy was combined with steroids and chemotherapy (cyclophosphamide). Twenty-nine patients improved with steroids alone, four with additional intralesional steroid injections, six with radiotherapy, and two required both radiotherapy and chemotherapy.

Administration, Oral↗
PubMed1985

Transient bilateral blindness following blepharoplasty.

A case of bilateral transient visual loss following elective four-lid blepharoplasty is described. Postoperative retrobulbar hemorrhages developed sequentially and were immediately treated by decompression, restoring full vision. The critical importance of supervised postoperative observation and immediate availability of medical help is underscored. The etiology of retrobulbar hemorrhage following blepharoplasty, the steps necessary to reduce its incidence, and the treatment of this complication are discussed.

Aged↗
PubMed1985

The management of the ptosis patient: Part I.

The various types of congenital and acquired ptosis are discussed as well as the findings on history and examination. From this information the appropriate operation can be chosen. Emphasis is placed on obtaining accurate and reproducible measurements in addition to assessing visual acuity, extraocular muscle movement, Bell's phenomenon, and tear secretion, especially in older patients. The operations described are the tarsal-Muller's muscle resection, levator aponeurosis advancement, levator resection, and frontalis suspension. Since the aim in ptosis surgery is symmetry in the primary position, overcorrections and undercorrections must occasionally be dealt with to achieve a satisfactory result.

Blepharoptosis↗
PubMed1984

Malignant melanoma of the lacrimal sac.

A 79-year-old man with a bloody ocular discharge and a mass above the medial canthal tendon was found to have a malignant melanoma of the lacrimal sac. Because he refused radical surgery, he was treated with radiotherapy and chemotherapy. Within a year the tumor had spread to his palate and cervical nodes. Because of the uncommon occurrence of melanoma in the lacrimal area and the fact that the microscopic appearance may resemble other malignancies, special stains are necessary for identification to implement the appropriate therapy.

Adult↗
PubMed1984

Surgical repair of medial wall fractures.

We treated ten patients with medial wall fractures, five of whom had concomitant floor fractures. The most consistent preoperative findings were restriction in abduction with retraction of the globe and limitation in adduction. A direct medial canthal surgical approach provided adequate exposure for removing incarcerated tissue as well as covering the defect with a thin silicone implant. There were no surgical complications or evidence of implant migration, the longest follow-up being two years. Of the ten patients, six had satisfactory results with full or nearly full ductions, one was orthophoric in the primary position but still had significant restriction in abduction, and three had persistent diplopia in the primary position.

Adult↗
PubMed1984

The management of ophthalmic Graves' disease.

From a series of 124 consecutive patients, parameters were developed in the management of Graves' disease. Patients who were stable with symptomatic treatment were observed and followed. Oral steroids, 40 to 80 mg prednisone daily, were moderately effective in reducing progressive soft tissue inflammatory signs, but were less effective in controlling myopathy and lid retraction. Radiotherapy, 1000 rad from each lateral port, was most effective in halting the progressive inflammatory component, particularly in those who had a recent rapid rate of change. Dysthyroid optic neuropathy required high dose steroids; if it was not effective, decompression of the orbit was carried out. Once the disease became stable, myopathy, lid retraction, and exophthalmos were surgically treated on an elective basis. The techniques utilized were tarsorrhaphy, lateral canthoplasty, upper and lower eyelid retractor release, and one- to three-wall orbital decompression.

Administration, Oral↗
PubMed1983

Tarsal-conjunctival advancement flaps for upper eyelid reconstruction.

For subtotal or total upper eyelid reconstruction, a technique combining tarsal-conjunctival advancement flaps from the upper and lower eyelids was used. A tarsal-conjunctival flap was begun just inside the lower lid margin, and was brought into the upper eyelid so that the tarsus formed the new upper eyelid margin. The remaining tarsus and conjunctiva from the upper eyelid were brought forward to join the lower lid flap. On this conjoined tarsal-conjunctival flap, a full-thickness skin graft was placed. Four weeks later, the conjunctival flap from the lower eyelid was separated. The main advantage of this technique is that it provides stability and support for the new upper eyelid margin while keeping the skin and hair from turning in against the globe.

Aged↗
PubMed1983

Surgical approach to the medial retrobulbar space.

To expose the medial retrobulbar space, an incision is made across the entire brow from the level of the lateral canthal ligament into the medial canthal area. The periosteum is incised and separated from the roof and medial wall to the level of the posterior ethmoidal foramen. The orbital tissues may then be brought forward and downward, making the area more accessible. Damage to the trochlea and levator palpebrae superioris muscle may be avoided by separation of the periorbita and careful handling of the tissues. This approach permitted the removal of a cavernous hemangioma in a 69-year-old woman. The only postoperative complication was supraorbital nerve anesthesia.

Aged↗
PubMed1983

Radiation therapy for Graves' disease.

We used radiation therapy (a total of 2,000 rads) to treat 14 patients (three men and 11 women, ranging in age from 27 to 72 years) with Graves' disease. Three of these patients had refused to take corticosteroids and the other 11 had failed to respond to them, had experienced side effects, or had other contraindications to their use. After follow-up periods ranging from six months to three years, soft-tissue inflammation was reduced in 13 of the 14 patients. All but two patients showed a decrease in proptosis of 1 to 3 mm. Myopathy showed the least improvement. Although we noted transient eyelid erythema, there were no permanent sequelae and none of the patients has had a recurrence of the inflammation.

Adult↗
PubMed1982

Kaposi's sarcoma involving eyelid and conjunctiva.

This is a case report of Kaposi's sarcoma involving the eyelid an conjunctiva in a man of North American Indian descent. Ocular involvement is rare and has been documented in less than 30 cases in the world literature. The association with visceral lesions and resultant poor prognosis was discussed and illustrated in our patient. Treatment of the eyelid lesion consisted of surgical excision; follow-up observation was limited to four months, as the patient died of a gastrointestinal malignancy.

Adenocarcinoma↗
PubMed1981

Ectopic lacrimal gland cyst of the orbit.

Ectopic lacrimal gland tissue is most common in the eyelid, conjunctiva, and cornea, but may also be found in the uvea or orbit. A 7-year-old boy developed a mass in the anterior superiomedial orbit close to the trochlea. A superior medial orbitotomy, done when the boy was 9 years old, disclosed a tense, thin-walled, fluid-filled cyst containing a small nest of normal lacrimal gland with a large capsule of fibrous tissue containing areas of singly layered epithelial cells.

Adolescent↗
PubMed1981

Inferior orbital decompression for dysthyroid optic neuropathy.

Six bilateral and two unilateral cases of dysthyroid optic neuropathy are presented. These patients underwent inferior orbital decompression through a lower-lid approach, with removal of the orbital floor and underlying antral mucosa. They demonstrated improved visual function as evidenced by visual acuity, visual fields, or visually evoked potentials.

Aged↗
PubMed1981

Silicone rod frontalis sling for the correction of blepharoptosis.

A frontalis sling procedure for blepharoptosis using a 1 mm solid silicone rod is described. This procedure is ideal for patients requiring frontalis suspension who are at risk for postoperative exposure keratopathy, or for patients likely to need postoperative eyelid position adjustment. These would include individuals with chronic progressive external ophthalmoplegia, third nerve paralysis, and myasthenia gravis. The advantages of this technique are the elasticity and the availability of the silicone rod, together with formation of an eyelid crease and ability postoperatively to adjust the position of the upper eyelid.

Adult↗
PubMed1980

Inferior orbital decompression for thyroid ophthalmopathy.

A technique of inferior orbital decompression for thyroid ophthalmopathy is described. The orbital floor is exposed through a lower eyelid incision, and completely removed while preserving the infraorbital nerve and vessels. A central strip of periorbita is retained under the globe for support. The amount of decompression averages 4 mm and ranges from 2 to 6 mm, depending on the amount of inflammatory residue and extraocular muscle enlargement.

Aged↗