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At least 307 records · Page 17Linked to original sources
PubMed1993

Repair of the tarsoligamentous sling in New Zealand white rabbits using polytetrafluoroethylene graft material.

Repair of large full-thickness lower lid defects requires reconstruction of the tarsoligamentous sling. This may necessitate either a tarsus sharing technique or a skin flap with a free cartilage graft. Obtaining tarsus or cartilage in these procedures has the disadvantage of requiring a second surgical site, which may cause further scarring and deformity. Polytetrafluoroethylene (PTFE) is a nonantigenic, inert, highly biocompatible, mechanically strong synthetic material that has been successfully utilized as a vascular and soft tissue patch since the 1970's. PTFE has been used in ophthalmic surgery to wrap orbital implants and as an interpositional graft for the correction of lower lid retraction. We evaluated the usefulness of PTFE in the reconstruction of the tarsoligamentous sling in 24 lids of 12 New Zealand white rabbits. PTFE with internodal spacings of 10 and 30 microns were used initially. Despite a lack of tissue inflammation, the PTFE grafts were uniformly extruded by 2 weeks postoperatively. Four additional lids were reconstructed using PTFE (30 and 60 microns) coated with a biological substrate. This graft material was also extruded. These results suggest that PTFE material may not be satisfactory for reconstruction of the tarsoligamentous sling.

Animals↗
PubMed1994

Irradiated homologous aorta in eyelid reconstruction. Part II. Human data.

Reconstruction of posterior lamellar eyelid defects requires a tissue substitute that is either identical to the tissue lost (i.e., surrounding or nearby tarsus) or donor tissue that serves the same supportive role. With extensive lid defects, at times an alternative tissue to tarsus may be required. Irradiated homologous aorta is available as a posterior lamellar substitute. It provides a structural framework for the surrounding lid tissues to grow on and is incorporated into the normal eyelid anatomy. It is available to the reconstructive ophthalmic surgeons as an alternative donor tissue in the presence of extensive lid defects.

Adenocarcinoma↗
PubMed1998

Tarsal kinking after Hughes flap.

A retrospective review of 45 patients undergoing the Hughes tarsoconjuctival flap procedure for lower eyelid reconstruction detected three individuals who developed kinking of the tarsus and upper eyelid margin. This unusual complication became apparent at the time of flap division. A horizontal band of fibrosis at the superior border of the remaining upper eyelid tarsus was appreciated in two of the patients. Excision of the fibrotic tissue resulted in an immediate improvement of the deformity.

Adenocarcinoma, Sebaceous↗
PubMed2001

Eyelids and eye socket reconstruction using the expanded forehead flap and scapha composite grafting.

After trauma or excision of malignant tumor, it is difficult to achieve satisfactory results when reconstructing deformed eyelids and the socket for an ocular prosthesis. The authors demonstrate examples of successful reconstruction for a prosthetic eye that provided adequate and aesthetic soft-tissue support achieved by applying a three-step surgical procedure of reconstruction of the eye socket, the eyelids, and the tarsus and eyelid margin. Because it is highly vascularized and its distal end can be divided into two or three portions for easy three-dimensional reconstruction, the expanded forehead flap alone, with a galea flap, or with a free rectus abdominis muscle perforator flap was used. The expanded forehead flap also provides excellent thin upper lid contour and good color-matching with a recipient site. For the eye socket, sufficient volume of tissue was provided from the expanded forehead flap with or without a galea or a free rectus abdominis muscle perforator flap, and a deep and convex fornix was formed. This resulted in a good fit and in stability of the ocular prosthesis. The surface and the inner lining of the eyelids were reconstructed using portions of the expanded forehead flap. For the tarsus and eyelid margin, conventional reconstruction techniques use cartilage of the concha, which has limitations of length and which does not fit the shape of the tarsal margin. The authors used the scapha composite graft, and a natural shape and good elasticity resulted.

Adult↗
PubMed2005

In vivo findings of the bulbar/palpebral conjunctiva and presumed meibomian glands by laser scanning confocal microscopy.

OBJECTIVE: To report in vivo laser scanning confocal microscopic findings of the normal human conjunctiva and presumed meibomian glands and to investigate the potential application of this confocal microscope (HRT II Rostock Cornea Module) as a diagnostic device for normal and abnormal ocular surface structures. METHOD: Four healthy volunteers (51-, 49-, 31-, and 30-year-old men) participated in this study. The temporal bulbar conjunctiva, approximately 5 mm away from the limbus, and the upper tarsus conjunctiva of each patient were examined in vivo by a laser confocal microscope. Also, presumed meibomian glands beneath the tarsal conjunctiva were examined. RESULTS: In all subjects, the in vivo laser confocal microscope obtained similar images. In the superficial epithelial cell layer of the bulbar conjunctiva, numerous bright nuclei were observed. We also observed many Langerhans cells with characteristic dendritic morphology and goblet cells with relatively homogeneous brightness in the bulbar conjunctiva. Most interestingly, the palpebral conjunctival epithelium with invaginations or crypts was observed. In addition, weblike structures, presumably meibomian glands, were observed beneath the palpebral conjunctival epithelium. CONCLUSIONS: These results indicate that in vivo laser confocal microscopy can be used not only to visualize the bulbar conjunctiva but the upper tarsus conjunctiva and possibly subconjunctival meibomian glands. Further investigations of conjunctival and meibomian gland pathologies may further elucidate the potential of this device in clinical ophthalmology.

Adult↗
PubMed2003

Trisomy 13: a rare case of congenital tarsal kink.

We describe the management of the eyelid anomaly associated with Patau syndrome. Trisomy 13 is the genotype of the syndrome's phenotype. The eyelid anomaly was a tarsal kink, a congenital malformation of the tarsus that causes entropion. A 2-month-old white girl presented with unilateral upper eyelid entropion and central corneal ulceration. To correct this condition, two 6-0 polyglactin sutures were passed through the gray line of the upper and lower eyelids and tied. Correction of the entropion and improvement in the corneal condition were achieved after surgery. No recurrence of the entropion or corneal ulceration was noted after 2 months of follow-up. This simple technique, which corrected the eyelid malposition, providing an excellent cosmetic result without incision of the tarsus, has been previously reported in other cases of tarsal kink but not in a patient with Patau syndrome.

Abnormalities, Multiple↗
PubMed2005

Retinoid receptor subtypes in sebaceous cell carcinoma of the eyelid.

PURPOSE: To study retinoid receptor expression in sebaceous cell carcinoma of the eyelid. METHODS: Expression of retinoid receptors (RAR alpha, beta, and gamma and RXR alpha, beta, and gamma) in tumor specimens from 10 patients with sebaceous cell carcinoma of the eyelid and in 3 normal incidental tarsus specimens from healthy adults without cancer was studied immunohistochemically by using antiretinoid receptor antibodies. RESULTS: In all 3 specimens of normal tarsus, all 6 retinoid receptors were expressed. RARalpha expression was absent in 3 tumors and was decreased in 3 tumors compared with expression in the control tissues. RARbeta expression in carcinomas was primarily perinuclear; 6 tumors showed increased RARbeta expression compared with controls. RARgamma expression was absent in 4 tumors and was decreased in 2 tumors compared with controls. RXRalpha nuclear expression was decreased compared with controls in 5 tumors. RXRbeta expression was low in 7 tumors. RXRgamma expression was absent in 6 tumors. CONCLUSIONS: Aberrant expression of retinoid receptors in sebaceous cell carcinoma of the eyelid might play a role in the pathogenesis and progression of this carcinoma.

Adenocarcinoma, Sebaceous↗
PubMedDate not supplied

Secondary tarsoconjunctival flap after previous lower eyelid Hughes repair.

PURPOSE: To describe a secondary, two-stage eyelid-sharing tarsoconjunctival flap advancement technique for the repair of full-thickness lower eyelid defect, using the remaining upper eyelid marginal tarsus that was spared in a previously performed Hughes procedure. METHODS: A computerized database search was performed on all cases of Hughes repair of the lower eyelid performed over a 10-year period (1995 to 2005) to identify patients who required a secondary tarsoconjunctival flap repair. In two cases of tumour recurrence at the lower eyelid margin, an eyelid-sharing, two-stage tarsoconjunctival flap repair of the lower eyelid using the remaining 4 mm of marginal tarsus that was spared in the original Hughes procedure was performed. Case reports of these 2 patients are presented together with their postoperative results. RESULTS: The incidence rate of the described secondary tarsoconjunctival flap procedure was 2 cases per 240 cases (0.8%) of primary Hughes procedure performed over a 10-year period. The postoperative courses in the 2 patients were uncomplicated with excellent surgical results at 6 months' follow-up. CONCLUSIONS: The secondary tarsoconjunctival flap advancement procedure is an effective reconstructive technique for the repair of the full-thickness lower eyelid defect in an eyelid that has already undergone a previous Hughes repair.

Aged↗
PubMed2004

Surgery without skin resection for eyelid entropion.

The previously reported surgical methods for eyelid entropion are basically manipulations of the skin or the conjunctival surface. When entropion is marked, manipulations also involve the tarsus. In the most widely used method, the eyelashes are directed outward by horizontal wedge resection of an appropriate amount of the excessive skin in the ciliary vestibule. This method is simple and effective but sometimes causes recurrences, conspicuous scars due to tension of the resection site, or lagophthalmos due to excessive resection. We speculated that partial swelling of the orbicularis muscle at the front of the tarsus is one of the main causes of pediatric eyelid entropion and found that correction of entropion is possible by partial resection of this muscle without skin resection. Eight patients with congenital entropion were treated by this method, and good results were obtained.

Child, Preschool↗
PubMed2006

The relationship of capsulopalpebral fascia with orbital septum of the lower eyelid: an anatomic study under magnification.

The aim of this study is to elucidate each insertion of the capsulopalpebral fascia (CPF) and orbital septum (OS) in the lower eyelid. Fifteen eyelid specimens were obtained from 15 Korean male adult cadavers for the study. Three parasagittal sections were made apart at medial limbus, midpupillary line and lateral limbus. The specimens were cut in 10-mum sections, stained with Masson-trichrome and observed under light microscopy. The head of the CPF split open superiorly and inferiorly wrapping around the inferior oblique muscle and met anteriorly. CPF inserted to the inferior border of the tarsus, merging the anterior border of the inferior tarsal muscles. OS blended with CPF most closely at 3.7-5.4 mm beneath the lower tarsal border: and differently at 3.7 +/- 0.7 mm on the medial limbus line, 4.3 +/- 0.8 mm on the midpupillary line and 5.4 +/- 1.0 mm on the lateral limbus line. The blending level is closer to the tarsus at the medial side than the lateral side. The closest distance between the lower tarsal border and the first identifiable smooth muscle nuclei of the inferior tarsal muscle was 2.1-2.7 mm, and differently 2.7 +/- 0.7 mm on the medial limbus line, 2.7 +/- 0.7 mm on the midpupillary line and 2.1 +/- 0.9 mm on the lateral limbus line. Precise anatomical understanding of OS and CPF may be conducive to the lower eyelid surgery.

Aged↗
PubMed1994

Age-related medial ectropion of the lower eyelid.

BACKGROUND: A simplified procedure is proposed for the repair of medial lower eyelid age-related ectropion. METHODS: A posterior horizontal incision is made in the medial half of the lower eyelid at the inferior border of tarsus. The lower eyelid retractors are exposed and then plicated to the tarsus without excision of posterior lamellae or the use of everting sutures. The lid is then shortened horizontally with excision of a pentagonal section or lateral tarsal strip procedure. RESULTS: The procedure was performed in six patients successfully without complication. CONCLUSIONS: This is an effective method for repair of lower lid medial age-related ectropion.

Age Factors↗
PubMedDate not supplied

Comparison of three methods for arthrodesis of the distal intertarsal and tarsometatarsal joints in horses.

OBJECTIVE: To evaluate the effects of diode laser surgery (LS), surgical drilling (SD), and intraarticular sodium monoiodoacetate (MIA) as methods for fusing the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses. STUDY DESIGN: Experimental study. ANIMALS: Adult horses (15) without radiographic signs of osteoarthritis (OA) of the DIT and TMT joints. METHODS: Group 1 (n=3) had LS performed bilaterally on DIT and TMT joints; 1 horse was evaluated for 1 week and 2 horses were evaluated for 2 weeks. Group 2 (n=6) had LS on DIT and TMT joints of 1 tarsus and MIA administration into the contralateral DIT and TMT joints and were evaluated for 6 months. Group 3 (n=6) had LS performed on DIT and TMT joints of 1 tarsus and SD of the contralateral DIT and TMT joints and were evaluated for 12 months. Postoperative comfort, lameness, radiography, microradiography, and histology scores were compared using repeated measures ANOVA, and paired or 2 sample t-tests; significance was set at P<.05. RESULTS: LS caused the least postoperative morbidity. In group 2, horses were less lame in 4 LS-treated limbs and 2 MIA-treated limbs at 6 months when compared with the contralateral limb. In group 3, horses were less lame in 5 LS-treated limbs and 1 SD-treated limb at 6 and 12 months compared with the contralateral limb. On microradiography, 11 MIA joints and 2 LS joints had bone bridging the joint at 6 months whereas 8 SD joints and 5 LS joints had bone bridging at 12 months. Significantly more joint space was bridged by bone in MIA- (51.4%) and SD (46.2%)-treated joints compared with LS joints at 6 (30.6%) and 12 (28.5%) months, respectively (P<.05). CLINICAL RELEVANCE: SD and MIA resulted in more bone bridging of the distal 2 tarsal joints, than LS. However, LS seemingly caused less pain and discomfort to horses in the immediate postoperative period; horses were generally less lame in the LS limb. More laser energy may need to be applied to these joints to promote fusion; however, it may also have beneficial effects beyond fusion. Further research on horses with OA of the distal 2 tarsal joints is needed to determine whether LS can cause soundness without facilitating bony fusion.

Animals↗
PubMedDate not supplied

Evaluation of different projections for radiographic detection of tarsal degenerative joint disease in Icelandic horses.

Radiographs from 196 tarsi in 98 Icelandic horses were evaluated to compare the accuracy of four different projections in detecting radiographic signs of degenerative joint disease in the distal tarsus. The extent and localization of tarsal degenerative joint disease found in one projection when reading all four projections of the same tarsus together was compared with the combined findings from all four projections. The results of reading individual radiographic projections without knowledge of the other three projections was also evaluated. Degenerative joint disease was detected most frequently in the plantarolateral-dorsomedial oblique (P1L-DMO) projection. The location with the highest relative frequency of radiographic findings was the dorsolateral aspect of the centrodistal and tarsometatarsal joints respectively. Radiographic signs of active bone remodelling was detected in 30 (33%) and periarticular osteophytes in 51 (56%) of 91 tarsi with degenerative joint disease.

Animals↗
PubMed2002

Hindlimb net joint energies during swing phase as a function of trotting velocity.

Net joint powers and energies have been described in walking horses during the swing phase of the stride in the fore- and hindlimb (Clayton et al. 2001). During trotting, swing phase net joint powers have been described in the forelimb but not in the hindlimb. The effects of velocity on power profiles and energy patterns are important in relation to locomotor energetics. The objective of this study was to evaluate velocity-dependent changes in hindlimb net energy profiles of the swing phase during trotting. Inverse dynamic analysis was used to calculate net joint energies at the hindlimb joints of 6 horses trotting overground at velocities ranging from 2.27-5.17 m/s. At all velocities, there was net energy generation at the hip and tarsus and net energy absorption at the stifle, fetlock and coffin joints. Velocity-dependent bursts of energy generation at the hip actively protracted the limb in early swing and initiated retraction in late swing. Synchronous with the bursts of energy generation at the hip were velocity-dependent bursts of energy absorption across the stifle that acted to control flexion in early swing and extension in late swing. The distal limb was raised and lowered by velocity-dependent bursts of energy generation that flexed the tarsus in early swing and extended it in late swing. The energy bursts in early swing increased linearly with velocity, whereas the energy bursts in late swing increased as a function of the square or cube of velocity. The results contribute to understanding the mechanisms used to accelerate and decelerate the limbs more rapidly as velocity increases, which is an important consideration in racing and sporting performance.

Animals↗
PubMed1988

Extratarsal chalazia.

Three cases of atypical, extratarsal chalazia are presented. All three patients initially presented with a history of an inflammatory mass close to the lid margin. Inferior migration subsequently occurred, with loss of connection to the tarsus, causing confusion in the diagnosis. The basis for this migration is postulated to be the anatomical relationships of the tarsus, postorbicular fascia, and lower eyelid retractors. A good response was obtained with standard surgical therapy.

Adult↗
PubMed1993

Rhythmic patterns evoked in locust leg motor neurons by the muscarinic agonist pilocarpine.

1. When an isolated metathoracic ganglion of the locust was superfused with the muscarinic cholinergic agonist pilocarpine, rhythmic activity was induced in leg motor neurons. The frequency of this induced rhythm increased approximately linearly from 0 to 0.2 Hz with concentrations of pilocarpine from 10(-5) to 10(-4) M. Rhythmic activity evoked by pilocarpine could be completely and reversibly blocked by 3 x 10(-5) M atropine, but was unaffected by 10(-4) M d-tubocurarine. 2. For each hemiganglion, the observed rhythm was characterized by two main phases: a levator phase, during which the anterior coxal rotator, levators of the trochanter, flexors of the tibia, and common inhibitory motor neurons were active; and a depressor phase, during which depressors of the trochanter, extensors of the tibia, and depressors of the tarsus were active. Activity in depressors of the trochanter followed the activity of the levators of the trochanter with a short, constant interburst latency. Activity in the levator of the tarsus spanned both phases. 3. The levator phase was short compared with the period (0.5-2 s, or 10-20% of the period) and did not depend on the period. The interval between the end of a levator burst and the beginning of the following one thus increased with cycle period. The depressor phase was more variable, and was usually shorter than the interval between successive levator bursts. 4. Motor neurons in a same pool often received common discrete synaptic potentials (e.g., levators of trochanter or extensors of tibia), suggesting common drive during the rhythm. Coactive motor neurons on opposite sides (such as left trochanteral depressors and right trochanteral levators), however, did not share obvious common postsynaptic potentials. Depolarization of a pool of motor neurons during its phase of activity was generally accompanied by hyperpolarization of its antagonist(s) on the same side. 5. Rhythmic activity was generally evoked in both hemiganglia of the metathoracic ganglion, but the intrinsic frequencies of the rhythms on the left and right were usually different. The activity of the levators of the trochanter on one side, however, was strongly coupled to that of the depressors of the trochanter on the other side. 6. The locomotory rhythm was weakly coupled to the ventilatory rhythm such that trochanteral levator activity on either side never occurred during the phase of spiracle opener activity corresponding to inspiration. 7. The rhythmic activity observed in vitro bears many similarities to patterns of neural and myographic activity recorded during walking. The similarities and differences are discussed.

Animals↗
PubMed2000

The cutler-beard bridge flap technique with use of donor sclera for upper eyelid reconstruction.

We evaluated the Cutler-Beard bridge flap technique with the use of donor sclera for upper eyelid reconstruction. The right upper eyelid of a 22-year-old man (case 1) was bitten by a dog. A mass in the left upper eyelid of an 85-year-old man (case 2) was excised. Major full-thickness defects of the eyelid with small loss of tarsus were reconstructed with the use of donor sclera. Good cosmetic results were obtained. Major full-thickness defects of the upper eyelid with small loss of tarsus may be effectively reconstructed by the Cutler-Beard technique with use of donor sclera.

Adult↗
PubMed1991

The development of the sensory neuron pattern in the antennal disc of wild-type and mutant (lz3, ssa) Drosophila melanogaster.

The development of the sensory neuron pattern in the antennal disc of Drosophila melanogaster was studied with a neuron-specific monoclonal antibody (22C10). In the wild type, the earliest neurons become visible 3 h after pupariation, much later than in other imaginal discs. They lie in the center of the disc and correspond to the neurons of the adult aristal sensillum. Their axons join the larval antennal nerve and seem to establish the first connection towards the brain. Later on, three clusters of neurons appear in the periphery of the disc. Two of them most likely give rise to the Johnston's organ in the second antennal segment. Neurons of the olfactory third antennal segment are formed only after eversion of the antennal disc (clusters t1-t3). The adult pattern of antennal neurons is established at about 27% of metamorphosis. In the mutant lozenge3 (lz3), which lacks basiconic antennal sensilla, cluster t3 fails to develop. This indicates that, in the wild type, a homogeneous group of basiconic sensilla is formed by cluster t3. The possible role of the lozenge gene in sensillar determination is discussed. The homeotic mutant spineless-aristapedia (ssa) transforms the arista into a leg-like tarsus. Unlike leg discs, neurons are missing in the larval antennal disc of ssa. However, the first neurons differentiate earlier than in normal antennal discs. Despite these changes, the pattern of afferents in the ectopic tarsus appears leg specific, whereas in the non-transformed antennal segments a normal antennal pattern is formed. This suggests that neither larval leg neurons nor early aristal neurons are essential for the outgrowth of subsequent afferents.

Animals↗