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Biomedical subjects

J R Collin

Publications and source records attributed to J R Collin.

At least 55 records · Page 3Linked to original sources
PubMed1989

Unusual complication of strabismus and lid surgery.

A patient with longstanding dysthyroid eye disease developed a broad adhesion between the globe and the upper eyelid following simultaneous surgery to recess the levator palpebrae superioris and lateral rectus muscles. This unusual complication may have developed as a consequence of failure to suture the conjuctiva of the upper fornix to the tarsus and also due to the prolonged static contact between the resulting adjacent raw areas due to postoperative eyelid traction and pressure dressings. Periods of such contact may have been further prolonged by the action of diazepam, which reduces the peak velocity of saccadic eye movements and suppresses rapid eye movement of sleep. Eyelid surgery should be performed as a separate procedure, under local anesthetic after healing of areas bare of conjunctiva from strabismus surgery utilizing the adjustable suture technique.

Conjunctiva↗
PubMed1989

Benign hair-follicle derived tumours in the differential diagnosis of basal-cell carcinoma of the eyelids: a clinicopathological comparison.

Benign eyelid tumours derived from hair follicles are rare and frequently misdiagnosed as basal-cell carcinoma when evaluation is based on clinical evidence alone. They include trichoepithelioma, trichofolliculoma, trichilemmoma, and pilomatrixoma. We reviewed 117 such tumours received in the Department of Pathology, Institute of Ophthalmology, London, in the last 30 years, a number which compared with 2447 basal-cell carcinomas seen over the same period. The hair follicle tumours may be safely excised with a narrow margin of clearance, whereas a macroscopic clearance of 3 to 5 mm or surgery with frozen section histological control is desirable for excision of basal-cell carcinoma. Therefore confirmation by incisional biopsy of the nature of any large lesion suspected of being a basal-cell carcinoma is essential in order to avoid performing an unnecessarily extensive or time consuming excision.

Adolescent↗
PubMed1989

Functional lid surgery in Down's syndrome.

Down's syndrome is associated with characteristic eyelid abnormalities. Ten patients presented with lid abnormalities leading to corneal problems. Five patients had ectropion, four of whom required skin grafting to correct the abnormality. One patient had entropion and four had chronic blepharoconjunctivitis leading to trichiasis, which was treated with double freeze thaw cryotherapy.

Adolescent↗
PubMed1989

The Mersilene mesh sling--a new concept in ptosis surgery.

The use of a Mersilene mesh sling in brow suspension ptosis surgery is presented. Seventeen cases of severe blepharoptosis have been treated by means of this sling with favourable results. Materials used in brow suspension procedures are categorised and discussed, and it is concluded that the Mersilene sling is an alternative to those currently available for the management of severe blepharoptosis requiring brow suspension surgery.

Aged↗
PubMed1988

Amblyopia and strabismus in congenital ptosis.

Seventeen per cent of 216 cases of simple congenital ptosis developed amblyopia and 19% had a squint. Of those patients with amblyopia, 14% had amblyopia attributable to stimulus deprivation, 21% had anisometropic amblyopia and 51% had strabismic amblyopia. Early refraction, orthoptic assessment and treatment and, where the pupillary axis is occluded, surgery to prevent stimulus deprivation amblyopia are recommended.

Amblyopia↗
PubMed1988

New concepts in the management of ptosis.

New concepts affecting congenital, Marcus Gunn jaw-winking, and involutional ptosis are discussed. A surgical technique for saving Muller's muscle is described. Recent studies of the histopathological changes in Marcus Gunn jaw winking ptosis and involutional ptosis are reviewed and the implications for surgery in these conditions presented.

Blepharoptosis↗
PubMed1987

Thyroid lid surgery.

A retrospective study of 58 thyroid patients undergoing eyelid surgery for thyroid related lid malposition is reported. A treatment strategy is suggested, based on the results of this experience. The following points are stressed: (1) The importance of recognising and relieving the inferior rectus tethering component of upper lid retraction when present. (2) The usefulness of a scleral graft in lower lid retractor recession. (3) The inadequacy of lateral tarsorrhaphy in relieving lid retraction but its value in camouflage.

Adult↗
PubMed1987

Oncocytoma of the eyelid: a case report.

Oncocytic tumours of the eyelids are rare, only one previous case having been reported. This paper describes a second such lid tumour affecting the medial upper lid. We present the clinical features, surgical management, and histology of the lesion.

Adenoma↗
PubMed1987

Congenital horizontal tarsal kink: a simple surgical correction.

A case is reported in which a simple anterior lamellar repositioning procedure was used successfully to repair an upper lid entropion associated with a horizontal tarsal kink. This obviates the need for the more complex and destructive procedures which have previously been described for the treatment of this condition.

Entropion↗
PubMed1987

Treatment of ptosis in chronic progressive external ophthalmoplegia.

Seventeen patients with ptosis as a feature of chronic progressive external ophthalmoplegia were managed in accordance with a new protocol. An anterior approach levator advancement was performed on seven patients (13 lids) with more than 4 mm of levator function and a brow suspension procedure on eight patients (14 lids) with minimal levator function, in whom the frontalis muscle was relatively spared. Ptosis props were prescribed for two patients with a very weak orbicularis and poor lid closure. Six patients required long term lubricants, and one developed a postoperative corneal abscess associated with a poor Bell's phenomenon. Satisfactory elevation of the lids was achieved in 16 patients (25 lids).

Adolescent↗
PubMed1986

Malignant melanoma of the eyelid and conjunctiva.

Four patients with malignant melanoma of the eyelid skin and 14 patients with conjunctival malignant melanoma are presented. Surgery was recommended for eyelid lesions and local excision followed by cryotherapy for conjunctival lesions. One patient with an eyelid skin malignant melanoma died and two patients with extensive malignant melanoma of the conjunctiva died. Nodular lesions involving the lid margin have the worst prognosis of eyelid skin malignant melanomas, and the greater the extent of conjunctival involvement the worse the prognosis for conjunctival malignant melanomas. The complications of cryotherapy are minor, but the follow-up period in this series is too short to comment on survival times.

Adult↗
PubMed1986

Involutional ptosis.

Involutional ptosis was corrected by either an anterior or posterior approach in 105 eyelids. The posterior approach was preferred unless there was a specific indication for the anterior approach which included excess skin and bulky eyelids. At operation approximately 10% of cases were found to have fatty degenerative changes in the anterior part of the levator muscle. These changes were associated with a relatively normal skin crease, bulky eyelids, lateral displacement of the tarsus, and a more marked ptosis in the medial part of the lid. A second procedure was required in 14 eyelids to achieve eyelid heights which remained within approximately 1 mm of each other for the follow-up period, which extended to eight years.

Blepharoptosis↗
PubMed1986

Congenital upper lid coloboma.

Twenty-two patients with congenital upper lid colobomas were assessed. Strabismus occurred in 13 cases and was associated with bands of fibrous tissue or adhesions, high refractive errors and opacities in the ocular media. A traction test is strongly recommended early in all children with congenital upper lid colobomas. A lateral cantholysis and direct closure was the commonest type of surgery, but unless the coloboma closed easily a lower lid rotation flap gave the best results.

Adolescent↗
PubMed1986

Elevating the hypotropic globe.

Twelve consecutive cases are reviewed of unilateral hypotropia due to various causes. In most of them the presenting complaint was of ipsilateral blepharoptosis. Some patients had undergone previous ineffective surgery. The surgical techniques employed and the results obtained are discussed, with emphasis on the necessity to test for inferior rectus restriction. Some interesting sensory results are also noted.

Adolescent↗
PubMed1986

Management of ipsilateral ptosis with hypotropia.

Thirty-one patients presented for surgical correction of unilateral hypotropia of the globe and blepharoptosis. The hypotropia and pseudoptosis were corrected by Knapp procedures. The Bell's phenomenon was thereby improved, allowing safe correction of the true ptosis, generally by an anterior levator resection whose magnitude depended on measured levator function.

Blepharoptosis↗