Biomedical subjects
Publications and source records attributed to S Morax.
In the anophthalmic socket, the deep superior eyelid sulcus is a quite common syndrome; sometimes with ptosis of the upper eyelid and laxity of the lower eyelid. The treatment by a silicone prosthesis in the deep sulcus fills eyelid volume. The main advantages of this procedure are simplicity and relative harmlessness. The authors relate their technique and the results about 15 cases. The indications are discussed.
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Functional and cosmetic ophthalmic complications of Graves' (1835) disease are dysthyroid optic neuropathy, exophthalmos, eyelid retraction and oculomotor disturbances. This paper describes and elaborates on the surgical procedures used when these complications are present. In severe exophthalmos and optic neuropathy we use an orbital decompression of the orbital floor sometimes combined with the medial wall, via an anterior approach. In eyelid retraction, we perform a recession of the levator muscle with scleral graft implantation. In concomitant strabismus, surgery is usually limited to recessions of the involved muscles, most of the surgery is directed to the inferior and medial rectus, as these are the most commonly affected muscles. The indications depend on the status of the patient at the time of referral. For severe exophthalmos with true retraction of the upper eyelid, we begin by treatment of the retraction and if this is not sufficient, we perform orbital decompression. For severe exophthalmos with oculomotor disturbances, we perform orbital decompression and later, the strabismus surgery. For oculomotor disturbances with eyelid retraction, we perform the strabismus surgery at the first and the eyelid retraction at the second stage. When there is a combination of exophthalmos, eyelid retraction and oculomotor disturbance, the indications and the choice of treatment are difficult and depend on numerous factors. If orbital decompression is indicated, it will be done first, followed by the strabismus surgery and at a later stage, the eyelid retraction. If only the eyelid retraction is treated, it will be done after the strabismus surgery. The chronological order of treatment depends on the modification we observe on the other components of the ophthalmopathy.
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Acquired conjunctival implantation cysts of the orbit after oculo-orbital and palpebral surgery are benign tumors. The term (terminology) implies "mis-placement" of the conjunctival epithelium into the orbit. Till now they have been described after "enucleation surgery". In fact, they can follow "any kind" of oculo-orbital-palpebral surgery, our series shows. We report here seven cases of acquired implantation orbital cysts; we discuss pathogeny, diagnosis, and the different investigations. We insist upon curative and above all preventive treatment.
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The authors present four cases of Merkel cells tumor of the eyelid. These cases conform to the standard clinical and histological criteria specified in the dermatological literature. Immuno-histochemical studies have been performed (specific neuron enolase, cytokeratin KL 1). Il the last case an ultrastructural study has made evident the characteristic neurosecretory granulations and intermediate filaments. Various hypothesis concerning the origin of this tumor are discussed in light of anatomical evidence.
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Dermis fat graft as a movable implant within the muscle cone is considered. The graft's survival depends mainly on its early vascularization which is bound to dermis, quality of the socket and suture of the recti muscles. The results of the twenty three first grafts emphasize two types of indications: Essential indications for the treatment of enophthalmos and for the treatment of migrated or extruded orbital implants. Relative indications: primary grafts and dermis-fat implantation for the treatment of contracted sockets.
The Müller's muscle-conjunctival resection procedure is a relatively simple technique for mild ptosis, with good levator function and phenylephrine test positive. The advantages are: preservation of tarsus, very good and predictable results.
Twenty seven frontalis sling procedures were performed with use of autogenous fascia-lata. The choice of this procedure was performed sometimes at the first stage for severe ptosis with poor levator function: isolated congenital ptosis, blepharophimosis syndrome, Marcus Gunn Jaw-Winking ptosis, ptosis with severe myopathy, some traumatic ptosis. This procedure was also performed in a second stage after failure of the useful procedures (levator resection) and after verification that the levator was not exploitable. Sometimes the choice of the procedure is done during the exploration of the eyelid and the levator because there is not always "parallelism" between the levator function and his anatomy. So operative technique must always be performed by a complete anterior palpebral approach, the surgeon can passed the suspensory material from the tarsus to the roof of the orbit, just anterior to the levator aponeurosis, and then out above the eyebrow. The pulley this created by the periosteum of the superior orbital margin prevents vertical traction lines. The skin crease is created with sutures which pick up the tarsus and the lid retractors. If, during the explorations the levator is "exploitable", a super maximum levator resection will be performed at the first stage, the frontalis suspension will be maintained in case of failure of the levator resection.
Functional and cosmetic ophthalmic complications of Graves' disease are exophthalmos, eyelid retraction and oculomotor disturbances. This paper describes and takes over the surgical procedures used when these complications are associated. In severe exophthalmos, we used an orbital decompression of the orbital floor sometimes combined with the medial wall by an anterior approach. In eyelid retraction, we perform a recession of the levator muscle with scleral graft implantation. In incomitant strabismus, surgery is usually limited to recessions of the involved muscles, most of the surgery is directed to the inferior rectus and medial rectus, as these are the most commonly affected muscles. The indications depend on the status of the patient at the time of referral. For severe exophthalmos with true retraction of the upper eyelid, we begin at the first stage by treatment of the retraction and if it is not sufficient, we perform an orbital decompression at the second stage. For severe exophthalmos with oculomotor disturbances, we perform at the first stage the orbital decompression and at the second stage the strabismus surgery. For oculomotor disturbances with eyelid retraction, we perform the strabismus surgery at the first stage and the eyelid retraction at the second stage. When there is the association of exophthalmos, eyelid retraction and oculomotor disturbances, the indication and the choice of treatment are difficult and depend on numerous factors. If an orbital decompression is indicated, it will be done first, followed by the strabismus surgery and at a later stage, the eyelid retraction. If only the eyelid retraction is treated, it will be done after the strabismus surgery. The chronology of the treatment depends on the modification we observed on the other components of the ophthalmopathy when one stage treatment is performed on one component: for example orbital decompression can modify the oculomotor disturbance and oculomotor surgery can modify eyelid retraction.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.