Biomedical subjects
Publications and source records attributed to J R Collin.
One hundred and eighty-three surgical procedures were conducted on 107 patients over seven years. 91% of the cases of upper lid entropion were corrected satisfactorily with only one operation. It is postulated that this level of success is achieved by grading the degree of surgical intervention according to the clinical established on systematic examination of upper lid entropion.
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This study analyses the management of ptosis associated with minimal levator function in 105 cases over an eight-year period. A 96 per cent success rate has been recorded which parallels previous authors' results. Clinical indications and relevant pathology are detailed with early identification and graded operative intervention postulated as suitable management for most cases. The overall success rate depended on the use of autogenous fascia lata, delaying its use until after the age of four, and adopting a bilateral approach whenever possible. Stored fascia lata was used in infants and in certain acquired unilateral cases.
Histological sections from 24 patients with malignant melanoma of the eyelid skin were studied and correlated with clinical follow-up for an average of 8.6 years. There was an average post-treatment follow-up of 7.4 years with a cure rate of 78% in the superficial spreading group. The average follow-up in the nodular melanoma group was 9.4 years with a cure rate of 75%. Nodular melanoma patients with the lesion in the lid margin have a worse prognosis than those with the lesion on the eyelid skin.
A series of 112 eyelids with symptomatic aberrant eyelashes were treated by cryotherapy using a specially designed large-surfaced high-flow nitrous oxide probe. Either thermocouple control to -20 degrees C or timing of the application to 20 seconds (lower lid) or 25 seconds (upper lid) was used to monitor the freeze. Both techniques obtained a high cure rate and a low incidence of complications.
Thirty-five secondary and six primary 'baseball' implants--acrylic balls in envelopes of donor sclera--were followed up for a minimum of 24 months. 97.1% secondary and 50% primary implants were retained. Volume replacement was satisfactory in 83.8% with a single operation, and motility of the artificial eye was at least 14 degrees of horizontal gaze in 86%, at least 7 degrees of upgaze in 95%, and at least 14 degrees of downgaze in 62.6%. Ptosis associated with the procedure occurred in 22%, and 12.2% developed a shallow fornix with instability of the artificial eye.
Aponeurotic defects are consistently found in senile ptosis and the ptosis following cataract surgery. Correction by an anterior approach to the levator aponeurosis is satisfactory and has the advantages that excess skin can be excised at the same time and the posterior lid lamella is left intact. Results in 25 patients (36 lids) are reviewed.
A posterior approach repair of aponeurotic defects is described and the results in 55 cases reviewed. The complications of surgery for senile (involutional) ptosis are discussed.
This study confirms the previously suggested high incidence of menstrual irregularity and infertility in females with the blepharophimosis syndrome.
Ten cases of paralytic medial ectropion associated with 7th nerve palsy were treated with a new procedure involving shortening of the medial canthal structures and division of the inferior canaliculus with subsequent marsupialisation. The success of this operation is supported by anatomical and functional studies.
Acute ocular complications of erythema multiforme such as infection causing conjunctivitis, suppurative keratitis or endophthalmitis are well recognized and usually easily managed. Late complications include disorders to tear production and drainage, position of lids, abberant or metaplastic lashes and metaplasia of the conjunctiva. Early detection and active management of these abnormalities greatly improves the long term prognosis. The techniques employed and the indications for their use in a recent series of 34 patients are presented.
This paper presents a classification of the causes of socket discharge with a review of new patients attending the Prosthetic Clinic. The aim of classifying socket discharge is to allow more accurate diagnosis of its cause and thus more effective treatment of this distressing symptom.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
542 cases of choroidal malignant melanoma were reviewed. Local recurrence occurred in only 6 patients (1.11%). Five of the 6 patients had distant metastases when the local recurrence was diagnosed, and the remaining patient also developed metastases after a passage of time. These figures do not support the concept of withholding a primary implant at the time of enucleation.