Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EYELIDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1995

Treatment of facial palsies with external eyelid weights.

PURPOSE: Because ocular exposure is a major complication of facial paralysis, an external gold eyelid load weight was evaluated for effectiveness in the treatment of this problem. METHODS: We prospectively studied 12 patients with unilateral facial paralysis who were treated with the external eyelid weights. Follow-up examinations included corneal exposure, amount of artificial tear usage, patient comfort, and complications associated with the weights. Treatment end points were the patient's decision to undergo a canthoplasty or placement of an implanted weight or resolution of the facial paresis to better than House's grade IV/VI. RESULTS: Of the 12 patients studied, ten had decreased corneal exposure on the affected side, with a coincident decrease in artificial tear drop use and increased comfort. One patient had no improvement in a corneal defect, and one was unable to apply the weight. Five patients had some difficulty in positioning the weight, which was related to upper eyelid dermatochalasis in four of the five. Only two weights were lost in over two years of total wearing time. CONCLUSIONS: External eyelid weights are useful in the treatment of ocular exposure associated with facial paralysis. The weights decreased corneal exposure, decreased reliance on artificial tear drops, and increased patient comfort. The weights were helpful as a trial before implantation of eyelid weights and as a longer-term treatment for ocular exposure in patients with temporary facial paralysis. Loose upper eyelid skin may limit their usefulness in some patients.

Adult↗
PubMed1988

Combined viable composite grafting and eyelid sharing techniques to prevent blepharoptosis after extensive tumor excision.

Five patients underwent tumor excision involving either the entire upper eyelid and temporal lower eyelid (three patients) or the entire lower eyelid and temporal upper eyelid (two patients), followed by reconstruction with an eyelid sharing procedure combined with viable composite grafting to the upper eyelid and a temporal semicircular flap. None of the five patients developed postoperative blepharoptosis, and all had excellent functional and cosmetic results. Follow-up ranged from 23 to 94 months.

Blepharoptosis↗
PubMed1981

The use of sclera in the treatment of dysthyroid eyelid retraction.

The use of sclera for correcting dysthyroid lid retraction is described. Forty-three procedures on 14 patients are reviewed. Of these 43 procedures, 18 were for upper eyelid retraction, and 25 were for lower eyelid retraction. A tapered graft, larger temporally, was used for the upper eyelid. An eliptical graft of uniform vertical height was used for lower eyelid. Moderately predictable results were obtained; 66% of patients were corrected to within 1 mm of desired positions after the first operative procedure. Only 13% of patients required additional surgery. When secondary procedures were required, the eyelids were corrected to the desired location. Complications were minimal. Sclera proved to be an excellent graft material for dysthyroid eyelid retraction.

Adult↗
PubMed1985

The use of tarsus as a free autogenous graft in eyelid surgery.

This is a report of the use of autogenous tarsus as a free graft in 121 eyelid surgical procedures. Seventy-three operations were for reconstruction of full-thickness defects and 30 were for repair of eyelid retraction. The remainder were for repair of cicatricial entropion, symblepharon, distichiasis, and irregularity of the eyelid margin. No grafts failed. There were three complications to a donor eyelid. It is believed that donor eyelid complications are less likely when the graft is harvested so as to include the upper tarsal margin. The free autogenous tarsal graft was found to be effective in repairing a variety of eyelid defects.

Ankle↗
PubMed2001

An animal model of lower eyelid spacer grafting with acellular dermis.

PURPOSE: Lower eyelid retraction is common in patients with dysthyroid orbitopathy and is seen less commonly in other conditions. Treatment typically requires vertical augmentation of the posterior eyelid lamella with an interpositional graft. Several autologous, homologous, and alloplastic materials have been used. We investigated the gross and microscopic in vivo histology of acellular homologous dermis used as a structural interpositional graft in the lower eyelids of Yucatan minipigs. METHODS: This prospective, experimental study was designed as follows: Surgery was performed on the left lower eyelid of 4 Yucatan minipigs in accordance with the Massachusetts General Hospital Subcommittee on Research Animal Care guidelines. A 4 x 20-mm strip of acellular porcine dermis was prepared and sutured into place between the tarsus and conjunctiva/lower lid retractors. Tissues were harvested at 6 and 12 weeks and were evaluated histologically. RESULTS: Gross examination revealed vertical elongation of the palpebral conjunctival surface. Histologic evaluation was performed with hematoxylin and eosin and Verhoeff elastin stains. Serial sections demonstrated incorporation of grafted dermal matrix into native tissues without evidence of inflammation. Definitive differentiation between grafted dermis and native dermis was not possible with light microscopy. Portions of the graft appeared to be epithelialized, whereas other histologic regions showed poorly adhesive epithelium. Inflammatory infiltrates including lymphocytes and polymorphonuclear leukocytes were not seen. No epithelioid or giant cells were identified in the sections examined. CONCLUSIONS: Acellular homologous dermis produced no measurable untoward effects when implanted as an interpositional graft in the lower eyelid of Yucatan minipigs. On the basis of its material characteristics, it appears to be suitable for this purpose: It is readily available, easily stored, easy to manipulate, and produces minimal inflammation. Long-term persistence, early postoperative histology, and clinical eyelid elevation in humans remain to be evaluated.

Animals↗
PubMed1982

The use of mucosa-lined flaps in eyelid reconstruction: a new approach.

In this paper, a review is given of the conditions that should be fulfilled for optimal eyelid reconstruction and of the principles on which modern techniques are based. A new approach to upper-eyelid reconstruction using a bipedicled flap from the lower eyelid that is lined with a mucosal graft but has no cartilaginous support is described. Also introduced is the use of similarly lined monopedicled flaps for the reconstruction of lower-eyelid defects. With these procedures, eyelid reconstruction has become less complicated. Flaps taken from forehead or cheek are scarcely ever necessary, and problems with reconstruction can be restricted to patients who have had radiotherapy or to the rare patients in whom defects in both eyelids have to be closed.

Basal Cell Carcinoma↗
PubMedDate not supplied

New corticosteroid-eluting porous polyethylene implant for the management of lower eyelid retraction: a pilot study.

PURPOSE: Lower eyelid retraction after trauma presents a challenging management problem. We postulated that a porous polyethylene (pPE) eyelid spacer coated with a polyvinyl alcohol (PVA) and triamcinolone acetonide (TA) matrix could deliver corticosteroid locally over extended periods and modulate inflammation and scar formation. We designed a pPE corticosteroid-eluting implant and evaluated its characteristics in vitro and in vivo. METHODS: The release characteristics of pPE implants coated with a PVA/TA matrix of low, intermediate, and high doses of TA were studied in vitro. The implants were then placed in the posterior lamella of lower eyelids of Dutch Belted rabbits for 12 weeks. Clinical events were recorded and eyelids were examined for gross and histologic features, including capsular thickness and degree of vascularity, fibrovascular ingrowth, and inflammatory response. RESULTS: In vitro, implants coated with the intermediate and high doses of TA released the drug at a steady rate for at least 78 days. In rabbits, the PVA and PVA/TA coating prevented fibrovascular ingrowth, except where breaks in the PVA/TA coat were present. Implants with PVA/TA coating demonstrated less inflammation and capsule vascularity. An inverse correlation between TA dose and capsule thickness was noted. CONCLUSIONS: We describe a novel drug-release pPE eyelid implant. The corticosteroid-eluting implant demonstrated antiangiogenic and anti-inflammatory properties, which could prove beneficial in the treatment of lower eyelid retraction.

Animals↗
PubMed2006

Upper and lower eyelid reconstruction: the year in review.

PURPOSE OF REVIEW: Depending on the size, location, and extent of defects, a myriad of surgical approaches may be utilized to repair the eyelids. An understanding of the principles of lid reconstruction as well as orbital and periorbital anatomy is essential when approaching the repair of eyelid defects. While principles of eyelid reconstruction have been established, achieving good functional and aesthetic reconstruction remains challenging. This review examines the methodology of reconstructing eyelid defects, as reported over the last year. RECENT FINDINGS: Eyelid reconstruction continues to encompass a wide range of reconstructive options. Reports range from simple modifications of traditional techniques to the use of complex flaps and grafts. SUMMARY: While set algorithms have been proposed regarding eyelid reconstruction, the method of choice will ultimately depend on a combination of factors, including availability of tissues, and a surgeon's experience with the available modes of reconstruction.

Eyelid Neoplasms↗
PubMed2005

Combined hard palate spacer graft, midface suspension, and lateral canthoplasty for lower eyelid retraction: a tripartite approach.

BACKGROUND: Eyelid retraction is an unfortunate consequence of cosmetic surgery, trauma, and disease states. It is frequently symptomatic and may be associated with dry eye syndrome and corneal compromise. The pathophysiology of lower eyelid retraction usually involves some degree of lateral canthal tendon laxity, middle lamella scarring, and malar descent. The authors describe for the first time a series of patients whose lid retraction was treated with a tripartite procedure that addresses all three pathophysiologic components simultaneously and rehabilitates the patients cosmetically and functionally. METHODS: The authors retrospectively reviewed the records of 17 patients (24 eyelids) operated on between 1999 and 2003 by one senior surgeon. The age of the patients ranged from 26 to 77 years (mean, 50.3 years), and all presented with significant scleral show (average, 2.0 mm) and symptomatic corneal exposure from a variety of causes. Preoperatively, all patients were noted to have a combination of lower eyelid laxity, middle lamellar contracture, and malar descent. Preoperative and postoperative examinations included Shirmer's test, a measurement of scleral show, and a slit-lamp examination. Mean follow-up time was 13 months. All patients underwent a triad of hard palate spacer grafting, lateral canthal suspension, and midface elevation. RESULTS: All 17 patients (representing 24 retracted eyelids) had complete resolution of scleral show (2.5-mm average correction) and were uniformly satisfied with their cosmetic and functional outcome at last follow-up. Preoperative dry eye symptoms resolved in all patients in the series. There were no major complications and only two minor complications (corneal irritation from graft sutures in one patient and an oronasal palatal fistula in another), both of which resolved in the early follow-up period. CONCLUSIONS: The combination of hard palate spacer grafting, lateral canthoplasty, and midface suspension is an effective, aesthetic, and functional treatment for moderate to severe lower eyelid retraction resulting from multiple causes. This tripartite procedure is associated with predictable results, a low morbidity rate, and high patient satisfaction.

Adult↗
PubMed2006

Hemicrania with massive autonomic manifestations and circumscribed eyelid erythema.

OBJECTIVES: To describe a unilateral headache that in addition to the typical shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea (SUNCT) syndrome - traits with excessive and ipsilateral autonomic phenomena - had circumscribed eyelid erythema and adjacent ocular redness. OBSERVATIONS: A 60-year-old female had excessive, right-sided lacrimation and local pain at 15 years of age. Due to steadily increasing discomfort, with lacrimation and swelling over the outer part of the upper eyelid, the right lacrimal gland was removed at 20 years of age, with a suspicion of lacrimal gland adenoma. Preoperatively, symptomatic side mild-degree eyelid erythema/rhinorrhea were integral parts of the attack. After years with minor complaints, she, in the mid-twenties, experienced more long-lasting pain attacks, and pain soon became the main problem. A marked, distinct erythema on the lateral part of the right-sided eyelids and marked, localized 'eye redness' in the adjacent area were main ingredients of the attacks together with eyelid edema and viscous rhinorrhea. There were visible vessels below the eye, and telangiectasia of the upper eyelid. CONCLUSIONS: This headache has many similarities with SUNCT - but has several, grossly deviating traits: the temporal aspects, excruciatingly intense pain attacks, and above all marked, lateral eye-lid erythema, and adjacent, massive ocular reddening. This constellation probably alienates it from SUNCT.

Anticonvulsants↗
PubMed2006

Clinical analysis of benign eyelid and conjunctival tumors.

PURPOSE: To assess the relative frequency and clinicopathologic characteristics of benign conjunctival tumors. METHODS: A retrospective study of 80 consecutive patients admitted to our hospital with benign eyelid and conjunctival tumor between April 2000 and November 2002 was undertaken, and clinical records including age, sex and involved site of tumors and pathology slides of the patients were reviewed retrospectively. RESULTS: Twenty-three males and 33 females presented with benign eyelid tumors and 12 males and 12 females with conjunctival tumors. Mean age was 42.3 and 29.7 years, respectively. The lower eyelid was involved in 27 (48.2%) of eyelid tumors and the medial conjunctiva in 14 (58.3%) of conjunctival tumors. The most frequent tumor was intradermal nevus (44.6%), seborrheic keratosis (16.1%) and compound nevus (10.7%) in eyelid tumors, and compound nevus (29.2%) and intradermal nevus (25.0%) in conjunctival tumors. CONCLUSION: This report will provides a basic analysis of benign eyelid and conjunctival tumors.

Adult↗
PubMedDate not supplied

Eyelid hyperlaxity and obstructive sleep apnea (O.S.A.) syndrome.

PURPOSE: An association between the floppy eyelid syndrome and the obstructive sleep apnea syndrome (O.S.A.) has been reported. We studied eyelid tissue elasticity and other ophthalmologic findings in a large number of patients with sleep disorders. MATERIAL AND METHODS: Sixty-nine patients with sleep disorders were evaluated. Two thirds were found to have O.S.A., and one third was treated at night by nasal continuous positive airway pressure (nasal C.P.A.P.). Slit lamp examination, eyelid measurements and Schirmer test were performed. RESULTS: Eyelid hyperlaxity was increased in patients with O.S.A. The floppy eyelid syndrome (associated papillary conjunctivitis), however, was rare. Associated corneal lesions were rare, and most patients were asymptomatic. In some cases, ocular irritation was due to air leaks from nasal C.P.A.P. A significant proportion of patients required treatment for primary open angle glaucoma. CONCLUSIONS: Our study of 69 patients found an association between O.S.A. and eyelid hyperlaxity.

Adult↗
PubMed2003

Physiology of the eyelid motor system.

The eyelid motor system represents an excellent experimental model for the study of reflex and learned motor responses. Eyelid responses can be recorded quantitatively with the search coil in a magnetic-field technique. Stimuli able to evoke reflex blinks (air puffs, flashes of light, tones) can also be controlled quantitatively. Eyelid movements can be classified as spontaneous, passive (such as those following eye saccades), reflex, and acquired with classical conditioning procedures. Information is available regarding the firing activity of brainstem motoneuronal pools (abducens, accessory abducens, and facial motoneurons) involved in these types of eyelid response. In particular, facial motoneurons present different encoding properties for the generation of reflex against learned eyelid responses. In cats, accessory abducens motoneurons are involved only in reflex (but not in learned) blinks. The recent description of the complete organization of premotoneuronal pathways related to eyelid motorics opens new experimental possibilities for the study of this particular motor system.

Abducens Nerve↗
PubMedDate not supplied

Lichen planus affecting eyelid alone: a rare entity.

Lichen planus of the eyelid alone is a rarely reported condition with just about 11 cases reported so far in the international literature. We report a case of lichen planus of single lower eyelid with characteristic histopathologic findings on eyelid biopsy. It is unusual to encounter a usually characteristic and often widespread entity like lichen planus occurring at only one site like an eyelid. Lichen planus of the eyelid should be included in the differential diagnosis of eyelid dermatitis.

Aged↗
PubMed1999

Clinical use of a new axial chondro-mucosal flap in wide full-thickness eyelid reconstructions.

BACKGROUND AND OBJECTIVE: Full thickness reconstruction of more than half of an eyelid, mainly of the upper one, is a challenge for the surgeon. In 1992, for the first time, the authors reported the use of an axial chondro-mucosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 18 patients operated on using the above technique during the period June 1991-March 1997. PATIENTS AND METHODS: Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, length of the palpebral rim, rim opening, levator function, an aesthetic balance of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months. RESULTS: The axial chondro-mucosal flap was clinically viable in all patients. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm. levator function (mean 13 mm) was shown. CONCLUSION: The authors discuss their complications and results and feel that this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstruction, for wide defects when the use of other flaps is compromised.

Adult↗
PubMed2003

Graded full-thickness anterior blepharotomy for upper eyelid retraction.

PURPOSE: A chief morbidity of Graves' eye disease (GED) is upper lid retraction that results in exposure keratopathy and cosmetic deformity. This study was conducted to assess the efficacy of graded anterior blepharotomy to treat upper lid retraction. METHODS: Fifty eyelids of 32 patients with GED-associated upper lid retraction causing symptomatic ocular exposure were treated with graded, transcutaneous, full-thickness, anterior blepharotomy. Preoperative and postoperative ocular exposure symptoms, upper lid position, lagophthalmos, and keratopathy were compared. RESULTS: At an average of 8.5 +/- 8.1 months (range, 2 to 35 months) follow-up, more than 90% of preoperative symptoms resolved or improved. Upper eyelid position (P < .00001), lagophthalmos (P < .0001), and keratopathy (P < .01) were significantly improved. Mild contour abnormalities (all < or = 1 mm) occurred in 7 of 50 eyelids. Eyelid crease recession or asymmetry occurred in 4 of 22 patients with postoperative lid crease measurements. Complications of ptosis, wound dehiscence, and full-thickness hole each occurred once. The average time for performing the procedure was 31.5 +/- 8.9 minutes per eyelid. CONCLUSIONS: Graded anterior blepharotomy for upper lid retraction is a safe and highly effective surgical treatment for symptomatic GED-associated upper eyelid retraction. This technique achieves excellent functional and cosmetic outcomes.

Adult↗
PubMedDate not supplied

[The possibilities for surgical correction in the combined treatment of patients with cicatricial deformities of the eyelids].

A total of 217 patients with posttraumatic cicatricial deformations of the eyelids were treated. The authors resort to a functional approach when assessing posttraumatic injuries of the eyelids and propose their own anatomic and functional classification of cicatricial deformations of the eyelids, based on the principle of anatomic and functional entity of the eye and its defense system. This classification specifies the basic functions of the eyelids as components of the defense mechanism of the eye, offers criteria for assessing the cicatrices proper, and presents the basic characteristics of combined cicatricial deformations of the eyelids and complications thereof. The authors used this classification to plan the treatment strategy, scope of surgical intervention, and order of stages, and to define the indications for the use of various methods of blepharoplasty in patients with cicatricial deformations of the eyelids.

Adult↗
PubMed1998

Four-eyelid sebaceous cell carcinoma following irradiation.

BACKGROUND: Sebaceous cell carcinoma is a distinctive tumor of the eyelid associated with a high rate of metastasis and mortality. Involvement of both upper and lower lids has been described; however, involvement of all 4 eyelids is extremely rare. OBJECTIVE: To describe the evaluation and diagnosis of the clinicopathologic features in a 74-year-old patient with 4-eyelid sebaceous carcinoma and a history of whole face irradiation for eczema. METHODS: Bilateral eyelid, conjunctiva, map, and fine needle biopsy of enlarged, submandibular lymph node specimens were stained with hematoxylin-eosin and oil-red-O for light microscopy and fresh-frozen sections were evaluated by electron microscopy. RESULTS: The biopsy specimens from the eyelids and conjunctiva showed sebaceous carcinoma cells in the meibomian glands and scattered within the conjunctival epithelium. The cells were moderately well differentiated. Similar cells stained with oil-red-O were found in the submandibular lymph nodes. CONCLUSIONS: The appearance of bilateral sebaceous carcinoma supports the concept of simultaneous occurrence of multiple primaries in specific patients, especially after radiation therapy. Patients with a history of facial irradiation and atypical eyelid lesions should be evaluated for malignant tumors such as sebaceous carcinoma.

Adenocarcinoma, Sebaceous↗