Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ECTROPION”

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 739 records · Page 41Linked to original sources
PubMed1990

The ophthalmic manifestations and treatment of the amniotic band syndrome.

The amniotic band syndrome is an unusual cause of craniofacial deformities. The syndrome, which is initiated by rupture of the amnion, results in an unpredictable combination of compression deformities of the fetus, construction or amputation defects of the extremities, and craniofacial clefting deformities. The type and extent of ophthalmic abnormalities are dependent on the band location and timing. They include a combination of bony orbital clefts or hypertelorism; lid anomalies such as colobomas, ptosis, and ectropion; lacrimal outflow obstruction; and globe involvement. We review the clinical course of 14 patients diagnosed with, or suspected as having, this syndrome and describe the methods of treatment. In most instances, multiple surgical procedures were required to restore function. Satisfactory cosmesis proved more difficult to obtain.

Amniotic Band Syndrome↗
PubMed1990

The successful treatment of a divided nevus on a young patient using a modified Kunhnt-Szymanowski procedure.

A 16-year-old boy underwent excision of a congenital divided nevus on his left eyelids. The defect of the lower eyelid was repaired utilizing a modified Kuhnt-Szymanowski procedure, and the part of the nevus on the upper eyelid was removed by simple horizontal excision and suture. The symmetry of both of his eyelids was successfully preserved without ectropion or conspicuous scars. This procedure is especially effective even in a young patient when removing a lesion extending to the lower ciliary border.

Adolescent↗
PubMed1997

Floppy eyelid syndrome and obstructive sleep apnea.

Floppy eyelid syndrome (FES) usually affects middle-aged obese men, presenting as a unilateral or bilateral chronic papillary conjunctivitis. The upper eyelid is lax, floppy, and easily everted. The laterality corresponds to the side the patient sleeps on. An association with obstructive sleep apnea (OSA) has been suggested. A personal series of 17 new cases is presented, and 79 previously reported cases are reviewed to give a detailed description of the syndrome. In addition to the classical presentation, patients may present with upper lid ptosis, lash ptosis or trichiasis, lower lid ectropion or rarely entropion, or corneal complications. Eight patients with FES were investigated for OSA. Twenty other patients with known OSA were examined for FES and other possibly associated ocular features. All eight patients referred for sleep studies were found to have OSA. One of the 20 patients with known OSA was found to have FES, and two had features of early asymptomatic FES. One patient with FES and OSA had normal tension glaucoma. Patients with FES should be considered for sleep studies because of the known morbidity of OSA. Simple screening of patients with OSA may detect FES and avoid late corneal complications that can compromise vision.

Adolescent↗
PubMed1997

The role of second-intention healing in periocular reconstruction.

Second-intention healing is a time-honored method of wound management. Its role in periocular reconstruction, however, is currently controversial. The objectives of this thesis are threefold: to evaluate carefully the outcomes in a cohort of patients treated by this technique, to provide a comprehensive review of published reports, and to formulate recommendations and guidelines for appropriate application in selected patients. Eyelid and periorbital defects after excision of periocular tumors were allowed to heal by second intention in 59 patients. The locations of the wounds were the medial canthus (n = 32), lower eyelid (n = 20), upper eyelid, (n = 4), glabella (n = 2), and nasojugal fold (n = 1). Five excised areas involved the eyelid margin, and in three patients the defect included the canalicular system. The size of the defects ranged from 3 x 3 mm to 22 x 27 mm. The average duration of follow-up was 19 months (range, 6 months to 8 years). The functional and cosmetic results were satisfactory in 49 patients (83%). Complications occurred in 10 patients and included ectropion, medial canthal webbing, trichiasis, eyelid notching, and hypertrophic scarring. Only two patients, however, required secondary repair. Healing by second intention is a safe, effective, and inexpensive alternative to surgical reconstruction after tumor excision in selected patients.

Adult↗
PubMed1998

The arrowhead skin-muscle flap in the closure of lower eyelid defects.

Lower-lid defects can arise from many sources, but they are often the result of excision of lower-lid tumors. The excision of the lesion is often performed by means of a pentagonal wedge resection. After repair of the tarsus and reapproximation of the lid margin, the skin and orbicularis are usually closed in a vertical fashion, which is perpendicular to relaxed skin tension lines and may extend further down the lid than is optimal as a result of a dog-ear excision. The authors propose a new method for closure of skin and orbicularis muscle in repair of lower eyelid marginal defects. This method is simple and has several advantages over vertical closure: it follows relaxed skin tension lines, allows closure of the anterior lamella in the opposite direction from the posterior lamella, and leaves an infraciliary scar rather than a vertical scar extending down the cheek. This method has been used in over 100 patients during the past 8 years, and no significant complications have occurred. Potential disadvantages of the technique include increased vertical tension and a tendency for the lid to be pulled downward. For these reasons, the arrow-head flap would not be the best choice in patients with preexisting lower eyelid retraction, cicatricial ectropion, or vertically tight lower-lid skin.

Dermatologic Surgical Procedures↗
PubMed1998

Eyelid changes in long-standing leprosy.

To describe eyelid changes in ocular leprosy, 74 patients (148 eyes or 296 eyelids) were examined, focusing on eyelid abnormalities. The adnexal examination included evaluation of the upper eyelid crease pattern, qualitative assessment of the orbicularis oculi muscle function, measurement of the distance between the corneal reflex and the upper eyelid margin (margin reflex distance), and slit-lamp biomicroscopy of the eyelashes and tarsal conjunctiva. Eyelash ptosis was a common finding associated with a multiple upper eyelid crease pattern and trichiasis. In the past, eyelash ptosis has probably been diagnosed as upper eyelid entropion or trichiasis, but in this series entropion was not observed. The distinction between eyelash ptosis, trichiasis, and upper eyelid entropion is important because the surgical management for each is different. Other true leprotic abnormalities of the eyelids are lagophthalmos and lower lid ectropion.

Adult↗
PubMed2000

Complications of laser resurfacing and their management.

PURPOSE: To describe complications associated with laser resurfacing along with specific treatment recommendations. METHODS: The authors' experiences with laser resurfacing complications are discussed in conjunction with a review of published reports. Current preoperative and postoperative regimens are also presented. RESULTS: Postoperative erythema occurs in all patients and is considered a transient side effect, not a complication. Postinflammatory hyperpigmentation, hypopigmentation, scarring, wound infections, milia, ectropion, pain, acneiform eruptions, pruritus, and contact dermatitis are reported by multiple authors. Specific interventions combined with the passage of time allow most of these complications to resolve, leaving the patient with an acceptable final result. CONCLUSIONS: Although laser resurfacing is a safe and effective method of facial rejuvenation, the cosmetic surgeon must be aware of the various complications that may be encountered. Prompt recognition of complications and appropriate management provide the best opportunity for an acceptable aesthetic outcome.

Anti-Bacterial Agents↗
PubMed2001

The maximal Hughes procedure.

PURPOSE: To describe the use of oblique medial and lateral periosteal flaps with the Hughes tarsoconjunctival flap for the repair of maximal defects of the lower eyelid. METHODS: A small prospective case series of eight patients requiring lower eyelid reconstruction following with maximal defect of the lower eyelid. The patients underwent a Hughes tarsoconjunctival advancement combined with oblique medial and lateral periosteal flaps, and were assessed for aesthetic outcome and surgical complications. RESULTS: All patients had uncomplicated surgery. Outcomes assessed included corneal protection, eye closure, lower eyelid retraction, complications, and patient satisfaction. Eyelid contour and protection was excellent in all patients. Postoperatively, one patient had mild lower eyelid retraction, and in a second patient, medial ectropion with mild lower eyelid retraction developed that required subsequent revision. CONCLUSIONS: The maximal Hughes procedure is a safe and effective procedure that may be performed with patients under local anesthesia and may avoid the need for more extensive techniques for surgical repair of maximal defects of the lower eyelid.

Adult↗
PubMed2001

Differential section of the seventh nerve as a tertiary procedure for the treatment of benign essential blepharospasm.

PURPOSE: To examine the efficacy of differential section of the seventh nerve in treatment of patients with blepharospasm refractory to botulinum toxin and eyelid protractor myectomy. METHODS: A retrospective noncomparative interventional case series consisting of a cohort of 228 patients with benign essential blepharospasm followed from 1987 to 1997 in a university ophthalmic plastic surgery referral practice. Patients were treated with botulinum toxin injections, eyelid protractor myectomy, and differential section of the seventh nerve in stepwise fashion as needed for symptomatic control. RESULTS: Thirty-four patients (15% of total) underwent eyelid protractor myectomy during this period. Eyelid protractor myectomy failed to control blepharospasm in 7 (21%) of these 34 patients, who then underwent differential section of the seventh nerve an average of 2 years after myectomy. Patients were followed up for an average of 36 months, with a success rate of 42% (3 of 7). The remaining 4 patients had repeat differential section of the seventh nerve with a 50% success rate, which brought the overall success rate from differential section of the seventh nerve to 71%. Lower eyelid ectropion requiring surgical repair complicated 27% of differential section of the seventh nerve procedures. CONCLUSIONS: Differential section of the seventh nerve is a reasonable alternative in the treatment of patients who have persistent disability despite treatment with botulinum toxin injections and eyelid protractor myectomy.

Adult↗
PubMed2001

Involutional entropion repair with fornix sutures and lateral tarsal strip procedure.

PURPOSE: To evaluate the long-terrm effectiveness of fornix suture placement combined with a lateral tarsal strip procedure in correcting involutional entropion. Published reports regarding various surgical techniques and results are reviewed. METHODS: This retrospective study reviewed 119 patients with involutional lower eyelid entropion who underwent surgical repair between January 1987 and May 1999 at the Bascom Palmer Eye Institute. Exclusion criteria included follow-up duration of less than 6 months, previous lower eyelid blepharoplasty, previous conjunctival surgery other than chalazion removal, or cicatricial entropion. The three surgical subsets were (1) combined lateral tarsal strip and fornix sutures: (2) fornix sutures alone; and (3) lateral tarsal strip procedure alone. The chart review was complemented by a telephone questionnaire to assess the long-term clinical outcome, complications, and patient satisfaction. RESULTS: One hundred fifty-two eyelids in 119 patients were included. One hundred twenty-five eyelids had combined surgery (lateral tarsal strip with fornix sutures), 9 eyelids had only fornix suture repair, and 18 eyelids had repair with only the lateral tarsal strip procedure. The recurrence rate in these three surgical subsets was 1.6%, 33%, and 22%, respectively, with average follow-up of 36 months. One case of incisional cellulitis was encountered. Postoperative ectropion was not seen in the group having the combined lateral tarsal strip and fornix suture procedure. CONCLUSIONS: Suture advancement of the lower eyelid retractors in conjunction with a lateral tarsal strip procedure is a simple, quick, physiologic, and effective approach in achieving long-lasting correction for involutional entropion.

Aged↗
PubMed2002

Congenital upper eyelid coloboma and cryptophthalmos.

PURPOSE: To discuss the relation between congenital upper eyelid coloboma and cryptophthalmos and to present a new grading for both conditions. METHODS: Observational case series study. Twenty-six children (age range, one day after birth to 15 years old) were included in the study: 19 with upper eyelid coloboma, 4 with classic cryptophthalmos, and 3 with both eyelid coloboma and cryptophthalmos. RESULTS: Of the 19 cases of upper eyelid coloboma, 5 occurred in isolation, 11 were associated with facial deformities, and 3 were part of a first arch syndrome (according to the Mustardé classification). All cases of classic cryptophthalmos were sporadic and nonsyndromic. All patients with coloboma with facial deformities, cryptophthalmos, and both eyelid coloboma and cryptophthalmos had similar associated facial abnormalities. CONCLUSION: Upper eyelid colobomas with facial deformities and cryptophthalmos can be considered as one anomaly. A new grading for this anomaly has been suggested. Grade 1: Coloboma without cryptophthalmos. Grade 2: Coloboma with abortive cryptophthalmos. Grade 3: Coloboma with complete cryptophthalmos. Grade 4: Classic cryptophthalmos (absence of all eyelid structures and the eye is completely covered with skin). Grade 5: Severe cryptophthalmos (with severe deformity of the nose and ectropion of the upper lip).

Adolescent↗
PubMed2001

Epiphora caused by conjunctivochalasis: treatment with transplantation of preserved human amniotic membrane.

PURPOSE: To present our experience with the use of preserved human amniotic membrane on patients with epiphora caused by conjunctivochalasis. METHODS: Twelve patients, seven women and five men, ages ranging from 56 to 72 years (mean, 61 years) were referred to our Cornea Service with chronic epiphora. In all patients, no punctal ectropion was present, the lacrimal pathway was patent, and the dye disappearance test was abnormal. All patients had already undergone various therapies including multiple irrigations of the lacrimal system, antibiotic drops, steroid drops, and artificial tear drops. In all patients, conjunctivochalasis, which was not previously diagnosed, was evident on slit-lamp examination. After surgical removal of the excess conjunctiva, preserved human amniotic membrane was placed over and sutured with 10-0 nylon continuous suture to the free conjunctival edges. During the postoperative period, artificial tear drops and steroid/antibiotic drops were applied. RESULTS: Improvement of the epiphora was evident from the first postoperative day. After removal of the suture 10 to 15 days (mean, 12 days) after surgery, no patient complained of epiphora. The dye disappearance test was normal. During the follow-up period, which ranged from 6 to 11 months (mean, 8 months), no patient complained of epiphora and no conjunctivochalasis was detected in the area in which human amniotic membrane was transplanted. CONCLUSION: In our experience, transplantation of preserved human amniotic membrane greatly improved symptoms of epiphora caused by conjunctivochalasis. Continued education of the general ophthalmologists concerning this condition is required.

Aged↗
PubMedDate not supplied

Assessment of cosmetic and functional results of conservative versus surgical management of facial burns.

This study was undertaken to determine whether tangential excision and thick split-thickness skin grafting (STSG) of deep facial burns give a better cosmetic and functional result than conservative management. Forty patients (28 adults, 12 children) treated for facial burns between July 1989 and July 1991 were evaluated in follow-up (mean 18.3 +/- 8.3 months). The patients were categorized into the following groups according to depth and management of their facial burns: (A) healed without surgery in less than 21 days (n = 13), (B) healed without surgery in 21 days or more (n = 11), (C) early debridement and thick STSG in 18 days or less after the burn (n = 6), and (D) delayed debridement and thick STSG in more than 18 days after the burn (n = 10). Facial esthetics were evaluated by use of a modified scar assessment scale [range 0 (normal) to 16 (multiple abnormalities)], and functional problems of the face and neck were evaluated by use of physical examination. Group A patients had a significantly better overall rating on the scar assessment scale (2.1 +/- 2.9) than the patients in the other groups that required more than 21 days to heal, B (8.0 +/- 2.7), C (7.3 +/- 2.9), and D (5.7 +/- 2.5) (p < 0.01, analysis of variance). Also, skin-grafted areas in the surgically treated groups C and D had a significantly better scar rating than wounds that healed spontaneously in group B (5.7 +/- 4.0 vs 8.0 +/- 2.7, p < 0.05; and 5.1 +/- 2.6 vs 8.0 +/- 2.7, p < 0.05). There was no significant difference among groups B, C, and D when the total number of persistent functional problems after treatment were compared. The most common functional problems for these patients were microstomia (17/27) and eyelid ectropion (17/27). Patients with superficial facial burns that heal in less than 21 days appear to heal with generally very acceptable cosmetic and functional results. However, in those patients with deep facial burns that require prolonged periods for spontaneous wound healing, tangential excision of the wound and resurfacing with thick STSG appear to give better cosmetic results than conservative management, with no greater incidence of functional complications.

Adult↗
PubMedDate not supplied

Facial mutilation after an assault with chemicals: 15 cases and literature review.

Facial mutilation after an assault with chemicals is rarely discussed in the literature even though it is a devastating injury that occurs worldwide and is not prohibited or punished by special laws. It is our purpose to describe the devastating outcome of facial mutilation after an assault with chemicals and to draw attention to this injury as a worldwide problem. We studied fifteen patients who sustained facial mutilation with chemicals. The common story was that the patient's spouse was the perpetrator, that sulfuric acid was used, and that the deed occurred after marital or financial discord. All victims were disfigured severely and most became reclusive and rarely left their homes. Six patients (40%) had total bilateral blindness and one suffered partial loss of vision. Lower eyelid ectropion (14), microstomia (12), cervical flexion contracture (10), ear deformity (8), and nostril stenosis (6) were common. Few of the perpetrators were prosecuted. We reviewed the literature and found that the problem has been described all over the world, and that the outcome is similar to that which we described. The problem deserves worldwide recognition and attention.

Adolescent↗
PubMed1976

Pseudomonas ulceration of the cornea following major total body burn: a clinical study.

If periorbital or facial areas are involved in burn injury, the eyes must be given prophylactic care. The importance of these cases is not to point out the danger of corneal injury as a direct result of thermal trauma; rather, it is to emphasize the seriousness of corneal abrasions and the danger of subsequent Pseudomonas infection during convalescence of the postburn patient. Once the corneal epithelium is damaged, ulceration rapidly occurs and when infected with Pseudomonas aeruginosa presents one of the most difficult ophthalmologic situations. The convalescent burn patient is in jeopardy of corneal abrasion during general anesthesia for grafting or debridement. Neither of the patients who underwent anesthesia was noted to have corneal abrasion. Nor did either ectropion or lid contracture develop in the three patients described herein. Lid contracture may lead to corneal exposure and should be corrected by expeditious lid tarsorrhaphy. Once ulceration has occurred, as with these patients, corneal transplantation may be indicated.

Adult↗
PubMed2002

Orbital preservation in surgical management of sinonasal malignancy.

OBJECTIVE: To determine the oncological and functional outcome when applying defined criteria for orbital preservation during surgical treatment of sinonasal malignancy encroaching on the orbital structures. STUDY DESIGN: Retrospective consecutive review of patients in tertiary care center setting. METHODS: Analysis of 66 patients undergoing surgical treatment for sinonasal malignancy encroaching on the orbit. Orbital preservation was performed in all patients with tumor extension up to and including resectable periorbital involvement. Minimum follow-up was 2 years. Detailed analysis of oncological and functional outcomes is included. RESULTS: Of 66 tumors abutting or invading into the orbit, 54 were amenable for surgical treatment with orbital preservation and the remaining 12 underwent orbital exenteration. Histopathological findings were divided into five subgroups: squamous cell carcinoma, adenomatous carcinomas, sinonasal undifferentiated carcinoma, sarcoma, and other. Squamous cell carcinoma represented the largest subgroup (24 patients), and 5-year overall actuarial survival was not statistically different (P = 1.4; relative risk, 0.713) between patients treated with orbital preservation (53%) versus those undergoing exenteration (46%). Similarly, no difference in survival was found in the adenomatous carcinoma subgroup. Within the orbital preservation group as a whole, local recurrence occurred in 30% patients (16 of 54) compared with 33% patients (4 of 12) treated with orbital exenteration. Of note, eye-sparing surgery was associated with local recurrence at the original site of orbital involvement in only 7.8% of cases (4 of 54). Overall eye function was graded as functional without impairment in 54% of patients (29 of 54), functional with impairment in 37% (20 of 54), and nonfunctional in 9% (5 of 54). The most common abnormality was globe malposition (enophthalmos or hypophthalmos) that was seen in 34 patients (63%) and was associated with the lack of adequate rigid reconstruction of subtotal or total orbital floor or multisegment orbital defects. However, enophthalmos was asymptomatic in the majority of cases, and persistent diplopia occurred in only five patients (9%). Various ocular sequelae were present in 20 of the 49 patients (41%) with functional eyes. Radiation therapy increased the risk of ocular complications, in particular, optic atrophy, cataract formation, excessive dryness, and ectropion. CONCLUSIONS: Selective orbital preservation is oncologically safe and is a worthwhile undertaking in attempting to maintain a functionally useful eye with surgical management of sinonasal malignancy encroaching on the orbit. Consideration should be given to rigid orbital reconstruction in larger defects resulting from subtotal or total orbital floor resection or resections involving two or more orbital walls.

Adolescent↗
PubMed1976

Resurfacing large cheek defects with rotation flaps from the neck.

A neck flap based on the midline many provide excellent cover for large cheek defects. The technical aspects of planning and replacement, with emphasis on positioning to prevent ectropion of the lower lid, are presented. Alone, or in conjunction with the multiple excision technique, this flap can produce a superior cheek surface.

Cheek↗