Biomedical subjects
Publications and source records attributed to R P Carroll.
Upper eyelid blepharoplasty as traditionally performed may fail to adequately debulk the eyelids especially in the middle age or older patient. A technique used by the senior author for the past 10 years is described. The en bloc resection of redundant upper eyelid tissue can be readily combined with other procedures.
Transconjunctival surgery provides excellent exposure of the inferior orbit, leaves no visible scar, and poses less risk of the complications typically associated with transcutaneous techniques. The transconjunctival approach can be combined with lateral canthal techniques to increase exposure and surgical options. We review applications of the transconjunctival approach in blepharoplasty, the repair of orbital floor fractures, socket reconstruction, inferior orbital tumor excision, and orbital decompression.
Combined procedures that address multiple etiologic factors in involutional entropion are not new, but ophthalmic surgeons have been slow to accept this surgical approach. Traditional procedures that correct only one or two of the etiologic factors have a high incidence of recurrent entropion. The purpose of this article is to encourage the use of a combined procedure in the treatment of all cases of primary and recurrent entropion to minimize recurrences. Between 1983 and 1989, 127 consecutive eyelids with involutional entropion in 97 patients were operated by the senior author (R.P.C.) using the procedure described in this paper. Of these eyelids, 39% (49) had previous surgery and 22% (28) had more than one previous procedure. Although occasional minor postoperative problems occurred, they were readily managed, and there have been no known recurrences of entropion with an average follow-up of 33 months.
Explore the source record for details and available documents.
Tracing Medicare peer review from its inception to the present day, this article focuses on the Texas problems with the state's peer review organization and the solutions brought about by the Texas Medical Association Physician-Patient Advocacy Committee. The author traces his personal involvement in the process to illustrate what impact can be made by any physician in the state through involvement in organized medicine. Lessons learned and messages for the future cap off this overview of peer review in Texas.
This report describes the characteristics and treatment of a syndrome in which the predominant ophthalmic defect is a congenital malposition of the medial canthal tendon. The syndrome is illustrated by 3 patients, each of whom had associated nasal deformities on the ipsilateral side. These congenital anomalies most likely resulted from an arrest in development during the second month of embryonic life. A combined effort by the ophthalmic plastic surgeon, the general plastic surgeon, and the otolaryngologist has been found useful in the management of these patients.
A perforation of the left orbit by a five-inch knife blade was sustained by a 30-year-old woman. In spite of the knife's course through a myriad of vital structures, the only significant injury was a laceration of the lateral canthal tendon. Following surgical repair the patient recovered with no residual problems.
Explore the source record for details and available documents.
A 15-cm orbital floor elevator was used to lift orbital contents, and to reposition and remove bony fragments during orbital floor repair procedure.
Many ophthalmic plastic surgical problems are ignored because the patient seems to be ""getting along." Frequently physicians are only vaguely aware of the constant daily discomfort their patients experience from seemingly minor problems such as endocrine exophthalmos, an ill-fitting prosthesis or baggy eyelids. As a result, too often the patient is unaware of the treatment possibilities that are available to relieve and often eliminate his problem. These conditions are often first seen by the family physician.
Rubeosis iridis developed in the right eye of a 10-year-old boy with Marfan's syndrome. This eye had a chronic retinal detachment which we could study adequately only after coreoplasty of the iris was carried out with the argon laser. The purpose of this paper is to describe our experience using the argon laser for coreoplasty, and to report the unique pinwheel configuration of the iris neovascularization that developed around the laser lesions. We believe the rubeosis iridis was most likely a sequelae of the chronic retinal detachment, and that the atrophic laser lesions probably acted as templates for the neovascularization, giving rise to its peculiar configuration.