Grade I ankyloblepharon following chemical burn.
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The derivation of the different phenol formulas for facial rejuvenation is traced. The method of action of phenol and the formula additives is discussed and an improved technique is described with which deep as well as superficial wrinkles of the face can be removed. Phenol chemosurgery is a proper alternative to the surgical face lift in properly selected patients. The potential complications of the procedure should not detract from the benefits.
Oculoplastic procedures well within the capabilities of most ophthalmic surgeons are described. Only those conditions most commonly encountered are discussed and the corrective surgery is illustrated. If required, all procedures described may be carried out under local anaesthesia in a minor operations room. The operative techniques described are those used by the author.
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BACKGROUND: Medial canthal tendon laxity is a common cause of epiphora and ocular irritation. It is difficult to treat due to the proximity of the lower canaliculus and punctum to the tendon. METHODS: The results of a prospective series of patients with involutional medial canthal tendon laxity between 1997 and 2002 were reviewed. Symptoms and measured laxity were recorded before and after medial canthal tendon repair. The medial canthal tendon was routinely repaired through a cut along the lid margin extending from the punctum medially. This avoids a vertical cut onto the anterior lamella of the eyelid, which is useful if a skin graft is required. RESULTS: Twenty lower eyelid medial canthal tendon repairs were performed on 17 patients. Preoperatively, the lower punctum in all patients was able to be distracted to the medial limbus or further and in 50% of cases, the lower lid punctum was able to be distracted to the pupil midline or further. Postoperatively all patients had reduction of their medial canthal tendon laxity. Postoperatively in 85% of cases the lower punctum was not able to be distracted beyond the medial limbus; however, 15% of cases still had significant residual laxity. Eighty-five per cent of patients reported improvement in symptoms. CONCLUSIONS: This is an effective procedure in the majority of patients with moderate to severe medial canthal tendon laxity; however, residual lower lid laxity persisted in some patients.
PURPOSE: To identify external ophthalmic abnormalities in multiple endocrine neoplasia type 2B (MEN2B), which may facilitate early detection and prophylactic thyroidectomy to prevent medullary thyroid carcinoma. METHODS: Three patients with MEN2B were examined by an oculoplastic surgeon and external ophthalmic findings were recorded. RESULTS: All patients had prominent corneal nerves, thickened eyelids, mild ptosis and eversion of the upper eyelids. Two patients displayed eyelid nodules and one exhibited lower lid margin eversion. CONCLUSION: Ptosis and lower lid margin eversion are previously unreported findings in patients with MEN2B. Medullary thyroid carcinoma is the most serious consequence of MEN2B and has a high mortality if untreated. Early diagnosis and prophylactic thyroidectomy may be lifesaving. Gene mutations can be identified but the sporadic tendency of the syndrome emphasizes the importance of early clinical detection. MEN2B is one of a number of systemic malignancies with ophthalmic manifestations. Ophthalmologists should be aware of the external features of this rare but lethal malignancy.
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BACKGROUND: Botulinum toxin is a safe, helpful adjunct to many other treatments for facial rejuvenation. Used together, the final result is more polished and refined. In addition, botulinum toxin can be used to maintain the surgical laser results by preventing dynamic facial muscular action re-establishing expressive wrinkles and folds. OBJECTIVES: We describe the facial areas best treated with botulinum toxin and our adjunctive techniques so that the cosmetic physician can easily incorporate these into their practice. RESULTS: The aesthetic results are improved with the combination of botulinum toxin and the surgical or laser procedure over either modality alone. CONCLUSIONS: We believe that there are many new treatment options for combined therapy with botulinum toxin, laser resurfacing, and surgical procedure in periocular and facial rejuvenation that the aesthetic physician can easily incorporate into their practice.
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All Swedish cases with the Sjögren-Larsson syndrome (SLS) i.e. 35 patients were studied. Glistening dots of unknown nature were seen round the foveola. These foveal and parafoveal changes seem to be a cardinal sign of SLS together with congenital ichthyosis, spastic di/tetraplegia and mental deficiency.
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