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At least 271 records · Page 15Linked to original sources
PubMed2004

Treatment of atopic eyelid disease using topical tacrolimus following corticosteroid discontinuation in a patient with open-angle glaucoma.

PURPOSE: To report a case of atopic eyelid disease treatment using topical tacrolimus in a patient with open-angle glaucoma following corticosteroid discontinuation. DESIGN: Interventional case report. METHODS: A 59-year-old white man with a history of treated open-angle glaucoma (latanoprost 0.005%) was referred to our department for atopic eyelid disease. The patient had received previous treatment with topical corticosteroid ointments (hydrocortisone acetate 1%/dexamethasone 0.1% ointments) that, even though they were effective in controlling atopic eyelid disease, were complicated by markedly elevated intraocular pressure (IOP) (steroid responder). Topical steroids were discontinued while other treatment modalities (such as eyelid hygiene, artificial tears, topical antihistamine drugs, topical mast cell stabilizers, or topical/oral antibiotics) were proven ineffective. RESULTS: Topical tacrolimus 0.03% ointment (Protopic; Fujisawa, Dublin, Ireland) was applied to the eyelid skin twice daily. An improvement of eyelid inflammation was observed while eczematous skin lesions and erosions were resolved within 15 days. After 6 months of continued topical tacrolimus treatment, there was no evidence of atopic dermatitis recurrence. During this period IOP remained controlled without any evidence of deregulation. CONCLUSIONS: Treatment of atopic eyelid disease with topical tacrolimus, following corticosteroid discontinuation in a steroid responder patient with open-angle glaucoma, seems to be an effective alternative treatment to corticosteroids without the risk of IOP increase.

Administration, Topical↗
PubMed2003

Graft contraction: a comparison of acellular dermis versus hard palate mucosa in lower eyelid surgery.

PURPOSE: To compare graft contraction rates of acellular dermis versus hard palate mucosa when used as free spacer grafts in lower eyelid surgery and to provide clinical outcome data. METHODS: A prospective, nonrandomized clinical trial involving the placement of 19 spacer grafts in the lower eyelids of 14 patients was performed. Indications for spacer graft placement included lower eyelid retraction and mildly contracted socket. Patients with lower eyelid retraction also underwent an endoscopic subperiosteal midface lift. For all procedures, the height of each graft was measured during and after surgery. The amount of contraction was measured for each graft, and a mean was calculated for each spacer material. The clinical success was evaluated for all procedures, based on improvement of the functional concern being addressed. RESULTS: The mean graft contraction rate was 57% for the acellular dermis and 16% for the hard palate mucosal grafts (P <0.005). Of the 7 procedures using acellular dermis for lower eyelid retraction, 6 were considered a success, and 1 was considered a partial success. Of the 6 procedures using hard palate for lower eyelid retraction, 5 were considered a success, and 1 was considered a failure unrelated to the graft. Of the 5 procedures with acellular dermis used for mildly contracted socket, 2 were considered a success, 2 were considered a partial success, and 1 was considered a failure because of graft contraction. The one case using hard palate for mildly contracted socket was considered a success. CONCLUSIONS: Acellular dermis contracts significantly more than hard palate mucosa when used as a lower eyelid spacer graft. Acellular dermis and hard palate mucosa were both associated with a high rate of clinical success in all categories except for patients with a mildly contracted socket who received acellular dermis; more than 60% of these patients (n=5) had only partial success or failure caused by graft contraction.

Adult↗
PubMed2003

Upper eyelid skin grafting: an effective treatment for lagophthalmos following blepharoplasty.

Patients who have undergone upper blepharoplasty occasionally develop anterior lamellar insufficiency, which can result in lagophthalmos, corneal decompensation, and even blindness. Historically, skin grafts in the upper eyelid have been considered a last-resort procedure because of poor cosmetic outcomes. Poor cosmetic outcomes result from the traditional practice of placing the skin graft above the eyelid crease. This article describes a surgical technique for upper eyelid skin grafting in which the graft is placed in a supraciliary position. Presented are results of a retrospective study of 20 patients (31 eyelids) who underwent supraciliary upper eyelid skin grafting. The postoperative results were evaluated by examining the improvement in lagophthalmos, the improvement of keratopathy and comfort of the patient, and the cosmetic appearance of the graft. Upper eyelid skin grafting using this surgical technique is an effective and cosmetically acceptable method to improve corneal integrity and comfort in patients who have corneal exposure from insufficient anterior lamella after upper eyelid or eyebrow surgery.

Aged↗
PubMed2004

Adipose compartments of the upper eyelid: anatomy applied to blepharoplasty.

Many authors have indicated the presence of ectopic or accessory upper eyelid fat pads, but the effective rate of eyelid fat variations and the corresponding clinical features are still unclear. The purpose of this study was to evaluate the variability of upper lid fat and to define the anatomical landmarks of the adipose pockets of the upper lid. From January of 1998 to January of 2002, the authors investigated the upper eyelid fat compartments of 47 patients who underwent upper blepharoplasty. To support surgical findings, 11 fresh cadavers were also investigated; the anatomy of the intraorbital fat and of the upper eyelid fat compartments was reviewed. Ten patients (21.3 percent) showed an accessory fat pad in the upper lid, which was found on both sides in nine cases. In all patients, the third fat pad was situated lateral to the two classic compartments described by Castanares, behind the orbital septum. Surgical dissections demonstrated that this fat pad derived from the preaponeurotic fat. Anatomical dissections in three cadavers demonstrated an accessory fat compartment protruding under the inferior border of the lacrimal gland. This protruding fat derived from the preaponeurotic fat in all cases and might justify the clinical appearance of a bulge or fullness in the lateral third of the upper eyelid. In the authors' experience, the presence of an accessory upper eyelid fat pad was a frequent finding during blepharoplasty; it could be found and actually resected in about 21 percent of all cases. Surgical and experimental findings put this element as a lateral physiological extension of the preaponeurotic fat that can anteriorly protrude under the inferior border of the lacrimal gland toward the orbital septum. The clinical appearance may be a bulge or fullness in the upper eyelid, and its resection can better define the lateral one third of the supratarsal fold.

Adipose Tissue↗
PubMed1992

Lower eyelid blepharoplasty.

BACKGROUND: Lower eyelid blepharoplasty is a frequently performed procedure to reverse partially gravitational aging effects on eyelid tissues. Careful planning, proper execution, and appropriate management of potential postoperative complications will generally result in a happy and satisfied patient. However, in any surgical procedure that is primarily aesthetic in nature, the surgeon needs to be constantly aware of factors that may compromise the functional integrity of the eyelid. A patient with altered visual function or ocular discomfort is no longer primarily concerned about the final aesthetic appearance of even the most perfectly executed, technically correct blepharoplasty procedure. OBJECTIVE: To describe the preoperative evaluation, surgical technique, and postoperative complications of lower eyelid blepharoplasty. Specific attention will be given to lower eyelid retraction and ectropion following blepharoplasty. CONCLUSION: Successful lower eyelid blepharoplasty surgery can be a source of both patient and physician satisfaction. As long as patient expectations are consistent with realistic surgical goals, lower eyelid blepharoplasty is an important aspect of overall facial aesthetic surgery.

Eyelid Diseases↗
PubMed2004

Eyelid sebaceous carcinoma masquerading as in situ squamous cell carcinoma.

BACKGROUND: Sebaceous carcinoma (SC) accounts for 1% to 5.5% of all eyelid malignancies. Diagnosis is often delayed because of its ability to masquerade as other periocular lesions both clinically and histologically. OBJECTIVE: To promote a high index of suspicion among Mohs surgeons for SC when managing biopsy-proven in situ squamous cell carcinoma (SCC) of the eyelid, particularly the upper eyelid. METHODS: This is a retrospective case review. RESULTS: A 77-year-old woman and a 71-year-old man were referred for Mohs micrographic surgery with a diagnosis of upper eyelid in situ SCC on biopsy. Intraoperatively, the presence of clear cell differentiation, in addition to extensive conjunctival involvement, leads to the correct diagnosis of SC. One case was subsequently found to have Muir Torre syndrome. CONCLUSION: Early diagnosis of eyelid SC leads to a better outcome and a higher survival rate. Hence, when managing in situ SCC of the eyelids, particularly the upper eyelid, Mohs surgeons should be aware of the possibility of SC and actively look for sebaceous cell differentiation or extensive conjunctival spread.

Adenocarcinoma, Sebaceous↗
PubMed2003

Relative contributions of eyelid and eye-retraction motor systems to reflex and classically conditioned blink responses in the rabbit.

Early compensatory mechanisms between eyelid and eye-retraction motor systems following selective nerve and/or muscle lesions were studied in behaving rabbits. Reflex and conditioned eyelid responses were recorded in 1). controls and following 2). facial nerve section, 3). retractor bulbi muscle removal, and 4). facial nerve section and retractor bulbi muscle removal. Animals were classically conditioned with a delay paradigm by using a tone (350 ms, 600 Hz, 90 dB) as conditioned stimulus, followed 250 ms later by an air puff (100 ms, 3 kg/cm(2)) as unconditioned stimulus. Conditioned eyelid responses generated in the absence of the facial motor system (i.e., by the almost sole action of the retractor bulbi motor system) presented a wavy profile, due to the succession of eye-retraction movements. Learned eyelid responses generated in the absence of the eye-retraction motor system (i.e., by the almost exclusive action of the facial motor system) were similar to those of controls, but were reduced in amplitude and peak velocity. Finally, the isolated action of the extraocular recti muscle produced very small eyelid movements during both reflex and learned eyelid responses. Although each of these motor systems could act independently of the others, the motor result of their joint action did not coincide with the simple addition of their separate actions. Both facial and eye-retraction motor systems appear to be necessary for normal eyelid closure during blinking in rabbits. Central reorganization to compensate for loss of either of these systems may explain why the response of each system in isolation cannot be added linearly to obtain normal blink response magnitudes and profiles.

Animals↗
PubMed2005

Upper and lower eyelid saccades describe a harmonic oscillator function.

PURPOSE: To determine whether experimentally measured upper and lower eyelid saccades can be fitted to a mathematical function. METHODS: A charge-coupled device video camera connected to a personal computer was used to record upper and lower eyelid saccades accompanying 20 degrees and 40 degrees of vertical eye rotation in 19 normal adult subjects. Movement analysis was performed with software that calculated the center of a blue spot in each frame. The damped harmonic oscillator model was used to fit all saccadic functions obtained. RESULTS: All downward and upward saccades of both upper and lower eyelids were fitted with the underdamped solution of the model with correlation coefficients ranging from 0.980 to 0.999 (mean = 0.995). It was possible to measure maximum velocity at any time, amplitude, and duration of the saccade movements. For the upper eyelid, downward saccades were faster than upward saccades, a difference that was not observed for the lower eyelid. For both the upper and lower eyelids, the velocity of upward and downward movements reached a peak at approximately 0.05/0.06 second and then decreased. For both the upper and lower eyelid saccades, there was good linear correlation between amplitude and velocity. Overshoots were detected in the downward saccades of both lids. CONCLUSIONS: Normal upper and lower saccades are described by functions that are extremely well fitted by the underdamped solution of the harmonic oscillator model. Overshooting is a typical feature of normal downward saccades and can be explained by the elastic properties of the tissues.

Adult↗
PubMed2004

Squamous cell carcinoma of the eyelid treated with photodynamic therapy.

The ocular tissues can be the site of a number of malignant tumors in adults. Approximately 5% to 10% of all skin tumors occur in the eyelid. Incidence studies indicate that basal cell carcinoma is the most frequent malignant eyelid tumor (90%) followed by squamous cell carcinoma (9%). A 55-year-old man presented a squamous cell carcinoma (SCC) of 8 mm diameter, localized in the middle third of the lower eyelid, 3 mm under the eyelid margin on the eyelids. The histopathologic examination of a biopsy specimen showed the typical features of squamous cell carcinoma. Photodynamic therapy (PDT) with topical 5-aminolevulic acid (ALA) after Frost suture was employed. Very good results were obtained with rapid healing, without invasiveness, and without anesthesia. There was no evidence of scar formation and no signs of recurrence at 6 months follow-up. Many therapeutic methods have been suggested for squamous cell carcinoma of the eyelid. We consider photodynamic treatment of eyelid skin malignancies to be of great interest and it may represent an interesting future perspective for their management especially when surgical intervention cannot be tolerated by the patient.

Aminolevulinic Acid↗
PubMed2006

[Tearing and eyelid laxity with no ectropion: is tarsal strip always effective?].

PURPOSE: To verify whether the tarsal strip procedure improves epiphora of patients with eyelid laxity but no ectropion. METHODS: A retrospective study was done with a sample of epiphora patients with lax eyelids in normal position and no nasolacrimal obstruction who were operated on with the tarsal strip technique. Fourteen lower eyelids, in 11 patients, were included in the study. RESULTS: Epiphora in ten eyes (71.4%) completely or significantly improved after a follow-up of three months. Eyelid laxity disappeared in all cases. CONCLUSION: In patients with epiphora, lax eyelids and patent lacrimal ducts, the tarsal strip procedure can significantly improve epiphora in most cases. As laxity ceased to exist in all eyelids, an assumption can be made that in some of the failures there may be other causes, concomitant with eyelid laxity, to explain perseverance of epiphora.

Aged↗
PubMed2006

[Eyelid reconstruction with Fricke's flap: report of two cases].

Skin cancer is the most common neoplasm in human beings and among them, basal cell carcinoma is the most prevalent. This report shows two cases with this tumor, located in the lateral canthus, affecting both the superior and inferior eyelids. The first case was a female, 72 years old, with amaurosis of the right eye. One year ago, she noted a tiny papule at the left lateral canthus. The CT scan revealed that the tumor had compromised about 80% of the left superior eyelid, 70% of the inferior eyelid and showed superficial invasion of the lateral orbital wall. The histopathological test diagnosed basal cell carcinoma, with clear margins. The reconstruction of both eyelids was done with Fricke's flap. The second patient was a female, 68 years old, who had an accident with multiple scars at the left side of her face two years before. One year later, she noted a small lesion at the left side of the lateral canthus. The CT scan showed that the tumor had affected about 90% of the left superior eyelid, 65% of the inferior eyelid and showed superficial invasion of the lateral orbital wall. The histopathological test diagnosed basal cell carcinoma, with clear margins. The reconstruction of both eyelids was done with Fricke's flap. The authors believe that although this flap is not the first choice for a reconstructive procedure, it should not be forgotten because in some patients, it would be the only possible choice.

Aged↗
PubMed2004

Three ligaments reinforce the lower eyelid.

This study was performed to elucidate the ligamentous structures in the lower eyelid other than the Lockwood ligament. Ten lower eyelids (right 5, left 5) of 5 Oriental post-mortems were dissected. The orbital septum was incised along the orbital rim, and then turned over toward the eyelid margin. The orbital fat was exposed and removed as much as possible without injuring the ligamentous structures. The ligamentous structures in the lower eyelid were then investigated macroscopically. There were two other ligaments in the lower eyelid in addition to the Lockwood ligament. All three ligaments originated from the posterior lacrimal crest, but went in different directions. The superior ligament ran on the junction of the orbital septum and the capsulopalpebral fascia, and in the lateral area, it ran on the posterior aspect of the orbital septum and attached to the periosteum of the lateral orbital rim. The inferior ligament went toward the posterior aspect of the inferior oblique muscle after separating from the Lockwood ligament. Ligaments other than the Lockwood ligament were revealed in the lower eyelid. These ligaments are thought to reinforce the fragility of the lower eyelid.

Aged↗
PubMed2005

Eyelid incision for dacryocystorhinostomy in Asians.

PURPOSE: Dacryocystorhinostomy via an eyelid incision has been described in Western literature. This study was undertaken to confirm that eyelid incision for dacryocystorhinostomy is suitable in Asians, because Asians have anatomic features that differ from those of Westerners. METHODS: We performed dacryocystorhinostomy with an eyelid incision along skin wrinkles or relaxed skin tension lines in 57 eyelids of 49 patients from July 2003 to December 2004. The medical records of the patients were reviewed retrospectively. RESULTS: Postoperative scars were easily camouflaged by wrinkles or relaxed skin tension lines of the eyelid without major complications. CONCLUSIONS: An eyelid incision can be used for dacryocystorhinostomy in Asians, regardless of the lack of a definite lower eyelid crease and the presence of epicanthus.

Adolescent↗
PubMedDate not supplied

Etiology of eyelid retraction in children: a retrospective study.

Eyelid retraction in an adult occurs usually secondary to Graves' ophthalmopathy, but in children the diagnosis is often obscure. To our knowledge, there are no reports reviewing the relative frequency of the various etiologies of eyelid retraction in children. We reviewed the records of our Pediatric Service from 1976 to 1991 and identified 16 children with eyelid retraction. The eyelid retractions were unilateral in 11 cases and bilateral in five cases, and were the result of five different identifiable causes. Unilateral eyelid retraction was associated with congenital aberrant innervation of the third nerve (3), levator fibrosis (2), hemangioma (1), hyperthyroidism (1), craniosynostosis (1) and Down syndrome (1). Bilateral eyelid retraction was associated with either hyperthyroidism (2) or bilateral optic nerve anomalies with vertical nystagmus (2). Seven of our 11 patients with unilateral retraction had an identifiable etiology, and the remaining four patients had incomplete evaluations. Imaging studies were diagnostic in four of nine patients so studied. Based on our findings, we recommend thyroid studies in all patients with eyelid retraction without aberrant innervation, and neuroimaging if thyroid function is normal.

Child, Preschool↗
PubMed1999

Effects of eyelid scrubbing on the lid margin.

PURPOSE: To compare the effects of eyelid scrubbing with an eyelid cleansing solution (ECS) to eyelid scrubbing with ECS and the addition of antibacterial or anti-inflammatory pharmaceuticals on the clinical appearance, microbial status, tissue histology, and the inflammatory cell profile of the normal eyelid margin. METHODS: Eyelid scrubbing was performed twice daily using ECS; ECS with the antibacterial sulfacetamide (ECS+); and ECS with sulfacetamide and prednisolone acetate (ECS++) over a 21 day period on three groups of 16 rabbits with clinically normal eyelids. RESULTS: Significant hyperemia of the margin occurred in all three groups over the 3 week period; however, the degree of hyperemia was less with ECS+ (P<0.05) and ECS++ (P<0.05). Chemosis, tearing, mucus discharge, and the microbial status were not significantly different than controls. There were no marked histologic differences in the tissues, except for increased red blood cell packing in the small vessels near the lid margins in scrubbed eyelids, consistent with hyperemia. The inflammatory cell profile showed minimal changes that were not statistically significant in any of the three groups, except that >50% of mast cells showed evidence of degranulation. CONCLUSIONS: Use of ECS with an antibiotic, or an antibiotic and steroid solution, resulted in less inflammation than scrubbing with ECS alone.

Administration, Topical↗
PubMed2003

[Early repair of full layer eyelid defect caused by chemical burn].

OBJECTIVE: To investigate the optimal time and method of the early repair of the full layer eyelid defect caused by chemical burn. METHODS: Free nasal septum mucosal cartilage flap with muscle flap, skin grafting, or skin flap were performed in 18 cases (19 eyelids) with chemical burn within 4 postburn weeks. Eyelid reconstruction and corneal transplantation were performed at the same time in 4 patients. RESULTS: All the reconstructed eyelids and transplanted cornea survived. The incidence of severe complications, such as exposure keratitis, corneal ulcer and eyeball perforation decreased. CONCLUSION: Full layer eyelid defect caused by chemical burn should receive early reconstruction and repair, including timely reconstruction of eyelid for the sake of protecting the eyesight and of alleviating the inflammatory reactions, and the corneal transplantation should be done at the same time to avoid corneal perforation. Nasal septum mucosal cartilage flap could be ideal for the eyelid reconstruction.

Adult↗
PubMed2004

Telomerase expression in sebaceous carcinoma of the eyelid.

BACKGROUND: In humans telomerase is expressed in most cancers and immortal cell lines, and activation of telomerase may play important roles in tumorigenesis and immortalization. This study was to investigate the roles of telomerase activity (TA) and human telomerase RNA (hTR) in sebaceous carcinoma of the eyelid. METHODS: The telomerase repeated amplification protocol (TRAP) was used to demonstrate telomerase activity in 12 cases of sebaceous carcinoma of the eyelid. In situ hybridization (ISH) was used to demonstrate the expression of hTR in 55 cases of paraffin-embedded sebaceous carcinoma of the eyelid, and the results were compared with the proliferative index determined by Mib-1 immuno-labeling, histological patterns and recurrence of the tumor. RESULTS: Different telomerase activity was shown in the 12 cases of sebaceous carcinoma of the eyelid. The positive expression of hTR was 85.5% (47/55) in tumor cells, but not in the adjacent tissues. The positive expression of hTR was correlated with the proliferative activity (as assessed by Mib-1 immunolabelling, r = 0.942, P < 0.001) and the differentiation of sebaceous carcinoma of the eyelid (chi(2) = 17.621, P < 0.001), but not significantly related to tumor recurrence. The level of hTR expression increased with the decrease of differentiation of sebaceous carcinoma of the eyelid. CONCLUSIONS: The results suggest that the up-regulation of telomerase expression plays some roles in tarsal gland carcinogenesis, and the expression of hTR is a useful marker for malignant degree of sebaceous carcinoma of the eyelid.

Biomarkers, Tumor↗
PubMed2006

[A new method for medial canthoplasty combined double eyelid formation].

OBJECTIVE: In order to explore a new method to perform the medial canthoplasty applied with upper eyelid fold formation in a single procedure. METHODS: According to the principles to correct the deformity of the medial canthus, a new method was designed to fetch up the skin defect of the medial side of upper eyelid, minimize the skin scarring around the medial canthus, and form upper eyelid fold. RESULTS: The 86 cases, which mild or moderate epicanthus without upper eyelid fold, were treated with this technique and long-term follow-ups above 6 months were made. The 67 cases were given the follow-ups. The appearances of upper eyelid fold and medial canthus were evaluated. The appearances of eyelid fold were paralleled type. The epicanthus was corrected completely or in major. CONCLUSIONS: This new canthoplastic method with upper eyelid fold formation may be suitable to all the medial epicanthus except inverse epicanthus. All of the patients were satisfied with the final results.

Adolescent↗