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At least 37 records · Page 2Linked to original sources
PubMed2001

Spontaneous eyelid expansion after full thickness eyelid resection and direct closure.

BACKGROUND/AIMS: Direct closure of eyelid defects gives excellent functional results but is usually restricted to defects measuring less than a quarter of the eyelid length for fear of distorting the palpebral aperture and compromising lid function. The authors have used direct closure in larger defects. The aim of this study was to establish the effects of direct closure of full thickness eyelid margin defects under tension on the palpebral aperture dimensions. METHODS: A consecutive series of patients who had undergone one eyelid, full thickness lid resection repaired by direct closure were identified and invited to have both eyes photographed. The palpebral apertures of both eyes were measured from the photographs by a masked observer. The amount of eyelid resected was recorded from the operation notes. The unoperated palpebral aperture was used as the control. The result were analysed using a paired samples t test. RESULTS: The photographs of 18 patients were included in the analysis. The mean width of excised full thickness lid tissue was 15 mm (range 7-26 mm). The mean vertical palpebral aperture height was 9.2 (SD 1.4) mm in the operated eye as opposed to 9.3 (SD 1.2) mm in the non-operated eye. The mean horizontal palpebral aperture width was 26.1 (SD 1.9) mm in the operated eye as opposed to 26.4 (SD 1.8) mm in the non-operated eye. There was no statistically significant difference between the operated and unoperated horizontal and vertical palpebral measurements. CONCLUSIONS: Direct closure of large full thickness eyelid defects is possible in selected patients with excellent functional and cosmetic results. Eyelid tissue expansion occurs spontaneously following direct eyelid defect closure under tension, restoring the palpebral aperture dimensions.

Adult↗
PubMed1986

The management of eyelid laxity during lower eyelid blepharoplasty.

Lower eyelid and lateral canthal angle malposition or frank ectropion are the most common complications of lower eyelid blepharoplasty. Although these complications may result from excessive skin excision, from surgical imbrication of the orbital septum or lower eyelid retractors, or from scar formation within the eyelid, failure to correct preexisting lower eyelid laxity is the most common cause. Recently published data have established laxity at the lateral canthus as the primary cause of involutional lower eyelid laxity. We review the pathophysiology of lower eyelid laxity and present an anatomic approach for the correction of lower eyelid laxity during blepharoplasty.

Aging↗
PubMed2003

Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion.

PURPOSE: To describe a system of post-Mohs reconstruction that addresses lower eyelid susceptibility to unopposed tractional, cicatricial, and gravitational forces. Large flaps are anchored to fixed tissue to avoid transmitting flap tension to the eyelids. METHODS: This is a retrospective, cohort study drawn from approximately 40 patients with post-Mohs defects of the nonmarginal lower eyelid, cheek, and lateral canthus. Surgical intervention involved horizontally oriented, relaxed skin tension line-designed advancement flaps, usually with eyelid margin stabilization. The use of anchoring sutures and any requirement for flap-graft combinations were based on defect size and the elasticity of adjacent tissues. RESULTS: Anchoring eyelid and cheek flaps to underlying periosteum permitted broad flap dissection and advancement without distortion, as the semimobile eyelid and canthi were protected from the resulting flap tension. Anticipated defect size limits for flap reconstruction often were exceeded. Defects too broad for flap reconstruction alone could be downsized, leaving a relatively small area for graft resurfacing. CONCLUSIONS: Anchored cheek flaps extend recognition of the continuity of the lower eyelid and midface to the primary reconstruction of tumor-free defects, and they address the relation by restoring deep attachments that minimize eyelid and canthal dystopia.

Basal Cell Carcinoma↗
PubMed1999

[Prevention and treatment of eyelid retraction and ectropion following lower eyelid blepharoplasty with tarsal tuck procedure].

OBJECTIVE: To prevent or decrease eyelid retraction and ectropion following lower eyelid blepharoplasty. METHODS: The tarsal tuck procedure was performed during lower eyelid blepharoplasty to tighten the lower eyelid. This method had been used since 1991. RESULTS: After the operation, the lower eyelid was tensional and steady. The complications of eyelid retraction and ectropion were diminished. CONCLUSION: The pathologic basis of the eyelid bag is that the supporting tissues become lax so that the lower eyelid and lateral canthus move downwards. The exact aim of the tarsal tuck procedure is to correct these pathologic changes.

Blepharoplasty↗
PubMed1991

Multilevel full-thickness eyelid resection for the correction of severe acquired ptosis in the poorly functioning eyelid.

Six eyelids (4 patients) with severe myogenic (4 eyelids), neurogenic (1 eyelid), or mechanical (1 eyelid) ptosis underwent surgical correction with a multilevel full-thickness resection of eyelid tissue combined with a plication of the levator aponeurosis-Müller's muscle complex. All eyelids had poor levator function, fair to poor orbicularis function, and a poor Bell's phenomenon. In all cases, the upper eyelids were elevated to an acceptable functional level without exposure keratopathy. This resection procedure preserves orbicularis function while allowing correction of severely ptotic eyelids with poor levator function, providing an acceptable alternative to other techniques for correcting this problem.

Adult↗
PubMed1995

Morphogenetic study of the eyelids in NC-eob mice fetuses with an open-eyelid malformation at birth.

The NC-eob mice are mutants having open eyelids at birth with complete penetrance. Detailed scanning electron microscopy and light microscopy for study of the eyelid development of NC-eob embryos/fetuses were performed at days 13 to 17 of gestation and compared with normal NC mice, with the aim of investigating the etiopathogenesis of the open eyelids at birth. No difference was observed between NC and NC-eob embryos by scanning electron microscopy and histologic examination at days 13 and 14 of gestation. At day 15 the epithelium at the tip of the eyelids had 2 to 3 layers, and clumps of round periderm cells appeared on the outer surface of the margin of the lids in NC and NC-eob embryos. However, these clumps in NC-eob embryos were not as remarkable in number and in size compared with NC embryos. At day 16 the eyelids of NC fetuses extended over the cornea and began to fuse. The epithelium at the tip of the eyelids consisted of 4 to 5 layers with the following elongated area. The surface of the tip of the elongated epithelium was covered with a large number of round periderm cells. In NC-eob fetuses the epithelium remained stationary at 2 to 3 layers. Only a small number of round cells were noted at the tip of the eyelids, and fusion did not occur. At day 17, although the upper and lower eyelids of NC fetuses were entirely fused, no change occurred in NC-eob fetuses, either in the periderm or in the epithelium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Primary infratarsal lower eyelid retractor lysis to prevent eyelid retraction after inferior rectus muscle recession.

PURPOSE: To evaluate a procedure to prevent lower eyelid retraction, which may occur after inferior rectus muscle recession surgery as a direct consequence of the intimate anatomic connections between the inferior rectus muscle and lower eyelid retractors. METHODS: We evaluated the technique of primary infratarsal lower eyelid retractor lysis on 12 eyelids of ten patients undergoing inferior rectus muscle recession of 3 mm or more. Indications for surgery included restrictive strabismus related to Graves' ophthalmopathy, orbital blowout fracture, and orbital fibrosis syndrome. RESULTS: For the 12 eyes, inferior rectus muscle recession ranged from 3 to 10 mm (mean, 5.3 mm). Postoperatively there was no significant change in mean lower eyelid position (P > .82), and no patient developed inferior scleral show. CONCLUSION: Primary infratarsal eyelid retractor lysis is an effective technique for preventing lower eyelid retraction after inferior rectus muscle recession strabismus surgery.

Aged↗
PubMed1988

Paralyzed eyelids reanimated with a closed-eyelid spring.

Implantation of gold weights and open wire springs to close the eyelid have provided good corneal protection in selected patients with eyelid paralysis. These techniques, however, do not overcome lower eyelid drooping. The closed-eyelid spring technique was developed to address this problem, and, to date, the author has implanted 27 closed-eyelid springs. This technique has reestablished a voluntary blink, provided corneal protection, and effectively held the lower lid in a relatively normal position in 25 of 27 patients. This report describes patient selection, surgical technique, and results of implanting closed-eyelid springs to reanimate paralyzed eyelids.

Eyelid Diseases↗
PubMed2006

Full-thickness eyelid reconstruction with a single upper eyelid orbicularis oculi musculocutaneous flap.

Eyelid tumors affecting the eye in general prove to be highly challenging to plastic surgeons. Reconstruction must be precisely detailed when dealing with lesions that primarily affect the skin but progressively the eyelid margin. Conjunctiva invasion damage is estimated to one-third or less in size when compared with the damage caused on the anterior wall of the eyelid. Although serial techniques for extent and location of full-thickness eyelid reconstruction have been detailed, the orbicularis oculi muscle can be easily raised as an island musculocutaneous flap. The eyelid's bilaminar wall is recreated by folding the flap on itself and full-thickness eyelid reconstruction is achieved sacrificing minimal accessory tissue. The small cutaneous section in contact with the globe becomes tolerable. As no single method for full-thickness eyelid reconstruction applies to extent and location to a wide range of defects, the proposed flap is safe, reliable, and beneficial to oculoplastic surgery.

Aged↗
PubMed1990

Lower eyelid reconstruction with the upper eyelid rotation flap.

A new technique of lower eyelid reconstruction was developed by using an ipsilateral upper eyelid rotation flap. After resection of a tumor in the lower eyelid, it is possible to replace the defect by a full-thickness upper eyelid rotation flap. Knowledge of exact eyelid anatomy is necessary to perform this kind of operation. In addition to the well-known techniques, the rotation flap constitutes a complete anatomic reconstruction of the lower eyelid with no functional loss of the upper eyelid.

Aged↗
PubMed2000

[Operation of the floppy eyelid. Symptomatic cases require surgical eyelid stabilization].

BACKGROUND: Floppy Eyelid is a rare condition causing chronic papillary conjunctivitis and chronic corneal disorders (superficial punctate keratitis, epithelial and stromal ulcers). It is characterized by an extremely enlarged and "floppy" upper eyelid which can be easily everted by slight elevation. Usually obese men are affected who use to sleep face down either on the right or on the left side. Pushing the eyelid against the pillow, the lid is intermittently everted at sleep. This lagophthalmus with rubbing of the exposed eye and lid structures causes all pathologic disorders. Shielding the eye at night may help temporarily. PATIENTS: We performed surgery on 7 men with symptomatic floppy eyelid in the age of 42 to 61 years. The patients had been symptomatic between 1 month and 4 years prior to the definite diagnosis. Follow-up time has been 7 months to 4.5 years. RESULTS: In all cases surgery achieved improvement. CONCLUSIONS: Cases of unclear conjunctival or corneal damage and inflammation should led consider Floppy Eyelid as a possible cause. The typical clinical findings make diagnosis easy. As complete stopping of eyelid-rubbing by changing the patient's sleeping habits is mostly not easily possible, for acute therapy of threatening damages to cornea and conjunctiva a surgical shortening of the lid is necessary which stabilizes the lid in order to avoid nightly spontaneous eversion for a long time.

Adult↗
PubMed2002

[Correction of lower eyelid retraction following lower eyelid blepharoplasty].

OBJECTIVE: To investigate the ideal methods for correction of lower eyelid retraction following lower eyelid blepharoplasty. METHODS: Transcanthal canthopexy was used in 5 patients (8 eyes) with mild lower eyelid retraction. Transcanthal canthopexy combined with Hamra's lower blepharoplasty was used in 15 patients (27 eyes) with severe lower lid retraction. RESULTS: 14 patients (25 eyes) were followed up for 6-12 months. Of them, 13 patients achieved satisfactory results; one patient had undercorrection of retraction. CONCLUSION: Transcanthal canthopexy is a simple and effective method for correction of mild lower eyelid retraction following lower eyelid blepharoplasty. Transcanthal canthopexy combining Hamra's lower blepharoplasty may be an ideal choice for correction of severe lower eyelid retraction.

Adult↗
PubMed1994

MRI findings of the upper eyelid and their relationship with single- and double-eyelid formation.

Before the invention of magnetic resonance imaging (MRI), it was impossible to observe an architectural deformation of the eyelid because of its movement. The authors observed MRI films of 15 eyelids in both closed and opened positions and obtained new information on the architecture of the upper eyelid and also the mechanism of single and double eyelids, and sunken eye formation. (1) Orbital fat is transposed when the lid moves. If the fat can not return into the orbit when the lid opens, it droops and interferes with the fold formation of the lid. (2) The thickness of the eyelid skin is associated with double-eyelid formation. The skin fold is observed at the junction between thick skin with subcutaneous fat and thin skin without it. (3) We could not confirm Doxanas and Anderson's assertion that septal insertion was lower in Orientals. However, we observed pretarsally drooped or herniated orbital fat in many slit-eye Orientals. (4) There are three angles at the tarso-levato-aponeurotic line: one at the junction with transverse ligament, one at the point of septal insertion, and another at the aponeurotic terminal on the tarsus.

Adipose Tissue↗
PubMed1992

Cosmetic eyelid surgery and the problem eyelid.

The human eyelid is an amazingly complex structure that is responsible for protecting, moisturizing, and reconstituting the external surface of the eye. Compromise of any of the tarsoligamentous supporting structures of the eyelids can result in eyelid malposition, corneal compromise, and even blindness. Failure to recognize these abnormalities in patients seeking cosmetic eyelid surgery can lead to disastrous results. The most common structural eyelid abnormalities encountered in patients seeking cosmetic eyelid surgery and prophylactic and reconstructive surgical techniques to deal with these difficult problems are discussed.

Eyelids↗
PubMed1993

Lateral canthal tendon resection with conjunctiva preservation for the treatment of lower eyelid laxity during lower eyelid blepharoplasty.

Lower eyelid laxity is a problem commonly encountered in patients undergoing lower eyelid blepharoplasty. Two problems associated with the numerous surgical procedures used for the management of this condition are (1) postoperative alteration of the shape of the palpebral fissure and lateral canthal angle and (2) difficulty with appropriate suture positioning or placement when reattaching the resected lateral canthal tendon. To address these problems, the surgical technique of lateral canthal tendon resection was modified by preserving the lateral conjunctiva, thus maintaining normal anatomic landmarks and ensuring proper suture placement. To date, this technique has been performed effectively on 50 patients who demonstrated mild to moderate eyelid laxity during preoperative evaluation for lower eyelid blepharoplasty. The only complication encountered has been undercorrection in one patient. The benefits of this procedure have been prevention of alteration of the palpebral fissure or canthal angle shape, greater ease and more accurate suture placement when reattaching the lateral canthal tendon, and avoidance of the need for full-thickness eyelid resection.

Aged↗
PubMed1992

Eyelid anatomy revisited. Dynamic high-resolution magnetic resonance images of Whitnall's ligament and upper eyelid structures with the use of a surface coil.

We used a new radiofrequency surface coil and complementary software in eyelid magnetic resonance imaging. This custom-designed coil allows visualization of the eyelid structures in submillimeter resolution, providing detailed delineation of such structures as the orbital septum, levator aponeurosis, Müller's muscle, and orbital septa. The effect of Whitnall's ligament on the levator aponeurosis can be observed as a "tenting" of the aponeurosis; the change in vector force is persistent in upgaze and downgaze. This technology will allow accurate dynamic studies of eyelid anatomy in patients with various anatomically based eyelid diseases, before and after surgery, making it possible to test in vivo longstanding theories of normal and pathologic eyelid physiology.

Eyelids↗
PubMed2004

Pig eyelid as a teaching model for eyelid margin repair.

A surgical model was created to teach eyelid margin repair to ophthalmology residents. On gross and histopathologic examination, the pig eyelid was found to be similar to the human eyelid. Using the pig eyelid mounted on an easy-to-construct model, eyelid margin repair was effectively taught at a surgical workshop.

Animals↗
PubMed1978

[Congenital ectropion of the upper eyelids due to an anomaly of the eyelids in down's syndrome (author's transl)].

A 5-months-old female baby with Down's Syndrome developed an intermittent spastic ectropion of the upper eyelids. The reasons for this are thought to be the flaccidity of the connective tissue, which is typical in Down's Syndrome, and a little anomaly of the eyelids, the tarsus was too short horizontally and very weak and the upper eyelids were somewhat larger than normal and elongated. Suturing Bangerter's lid-sheets on the upper eyelids for 15 days resulted in a scarring of the tarsus with the lax connective tissue of the upper eyelids. The ectropion disappeared and did not recur.

Congenital Abnormalities↗