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PubMed2006

Effect of age on upper and lower eyelid saccades.

To study the effect of age on the metrics of upper and lower eyelid saccades, eyelid movement of two groups of 30 subjects each were measured using computed image analysis. The patients were divided on the basis of age into a younger group (20-30 years) and an older group (60-91 years). Eyelid saccade functions were fitted by the damped harmonic oscillator model. Amplitude and peak velocity were used to compare the effect of age on the saccades of the upper and lower eyelid. There was no statistically significant difference in saccade amplitude between groups for the upper eyelid (mean +/- SEM; upward, young = 9.18 +/- 0.32 mm, older = 8.93 +/- 0.31 mm, t = 0.56, P = 0.58; downward, young = 9.11 +/- 0.27 mm, older = 8.86 +/- 0.32 mm, t = 0.58, P = 0.56) However, there was a clear decline in the peak velocity of the upper eyelid saccades of older subjects (upward, young = 59.06 +/- 2.34 mm/s, older = 50.12 +/- 1.95 mm/s, t = 2.93, P = 0.005; downward, young = 71.78 +/- 1.78 mm/s, older = 60.29 +/- 2.62 mm/s, t = 3.63, P = 0.0006). In contrast, for the lower eyelid there was a clear increase of saccade amplitude in the elderly group (upward, young = 2.27 +/- 0.09 mm, older = 2.98 +/- 0.15 mm, t = 4.33, P < 0.0001; downward, young = 2.21 +/- 0.10 mm, older = 2.96 +/- 0.17 mm, t = 3.85, P < 0.001). These data suggest that the aging process affects the metrics of the lid saccades in a different manner according to the eyelid. In the upper eyelid the lower tension exerted by a weak aponeurosis is reflected only on the peak velocity of the saccades. In the lower eyelid, age is accompanied by an increase in saccade amplitude which indicates that the force transmission to the lid is not affected in the elderly.

Adult↗
PubMedDate not supplied

Comparison of cosmetic results in frontalis sling operations: the eyelid crease incision versus the supralash stab incision.

PURPOSE: In addition to ptosis, the lack of eyelid crease is one of the main cosmetic problems of patients with poor levator function. In this study, we aimed to evaluate the effect of the incision site on ptosis correction and eyelid crease formation in frontalis sling operations. MATERIALS AND METHODS: Photographs and charts of 27 patients (45 eyelids) who underwent frontalis sling operations were retrospectively reviewed. All patients had congenital ptosis with poor levator function ranging from 0 to 4 mm. In group I (15 eyelids), 3 supralash eyelid skin incisions were performed and the sling material was threaded along the tarsal surface. In group 11 (30 eyelids), the eyelid crease approach was used with the suturing of the sling material directly to the tarsus. RESULTS: Although lid contour and lid crease symmetry were good in 46.6% of the cases in group I, eyelid crease formation was not satisfactory in any of the cases. Lid contour and lid crease symmetry were good in 76.6% of the cases in group II. CONCLUSION: Our results indicated that the eyelid crease approach provided better functional and cosmetic results than did the supralash stab incision in frontalis sling operations. The passage of the sling material behind the orbital septum by direct visualization in the eyelid crease approach is one of the main factors affecting the surgical success of the frontalis sling operation.

Adolescent↗
PubMed1992

Eyelid avulsion: a clinical and experimental study.

Traumatic eyelid avulsion is reported infrequently. We cared for an 18-year-old man who lost > 75% of his right upper eyelid. The tissue was recovered 10 h following the initial trauma. Successful surgical reimplantation resulted in a functional upper eyelid with extensive madarosis. An experimental study was undertaken to attempt to determine the optimal method for preservation of avulsed eyelid tissue. Experimental surgery was performed to simulate repair of eyelid avulsion. The postoperative changes in experimentally reimplanted eyelids parallel those noted in the clinical example of eyelid avulsion. This clinical example and experimental study suggested the following management principles for handling avulsed eyelid tissue: eyelid tissues should not be immersed in saline; avulsed eyelid tissues should be stored at 4 degrees C; if reimplantation time is < 6 h, storage in a cold moist environment is adequate.

Adolescent↗
PubMed2005

[Incidence of benign and malignant lesions of eyelid and conjunctival tumors].

PURPOSE: To examine the incidence of benign and malignant eyelid lesions and conjunctival tumors. SUBJECTS AND METHODS: One-hundred-and twenty-eight cases (131 eyes) which were treated during the period from January 1990 to February 2004 were histopathologically diagnosed for eyelid or conjunctival tumors (87 cases of eyelid tumors and 41 cases of conjunctival tumors) in retrospective evaluations. The incidence of benign or malignant lesions, the pathological classification, age, sex, and clinical diagnostic accuracy were all investigated. RESULTS: Sixty-four (73%) of the tumors were found to be benign eyelid tumors. The common benign eyelid tumors were 14 nevocellular nevi, 9 seborrheic keratosis, 7 epidermoid cysts, and 6 papillomas. Twenty-four (27%) eyelid tumors were malignant. These included 9 basal cell carcinomas, 9 sebaceous gland carcinomas, 4 malignant lymphomas, and 2 metastatic tumors. Thirty-four (79%) conjunctival tumors were benign, and the common benign conjunctival tumors were 9 nevocellular nevi and 7 papillomas. Nine (21%) conjunctival tumors were malignant, comprising 7 malignant lymphomas and 2 squamous cell carcinomas. The mean ages of malignant eyelid and conjunctival tumor patients were significantly older than those of benign tumor patients. Clinical accuracy in predicting basal cell carcinoma and sebaceous gland carcinoma was 11.1% and 44.4%, respectively. CONCLUSIONS: Approximately 70 approximately 80% of all eyelid and conjunctival tumors are benign. Clinicians should suspect that the lesions are malignant when seeing elderly patients with eyelid or conjunctival tumors. Excised eyelid lesions should be submitted for histopathologic confirmation because there are some cases where clinical diagnosis does not match pathological diagnosis.

Aged↗
PubMed2005

[Tumors and tumor-like lesions of eyelids collected at Department of Pathological Anatomy, Wroclaw Medical University, between 1946 and 1999].

PURPOSE: To determine the histopathological, epidemiological and clinical characteristics of benign, malignant and tumor-like lesions of the eyelid collected in Department of Pathological Anatomy, Wrocław Medical University. MATERIAL AND METHODS: Department of Pathological Anatomy, Wrocław Medical University, has been collecting data of all tumors and tumor-like lesions of the eye and ocular adnexa diagnosed at the department during the 54-year interval from 1946 through 1999. Retrospective analysis of all eyelid biopsy specimens submitted to the department between January 1, 1946, and December 31, 1999 were performed. RESULTS: There were 4818 cases of the eye and ocular adnexa lesions diagnosed at the department since 1946 and 1999, what made up 0.262% of all diagnosed cases. Of 4818 total number of cases there were 2416 women and 2392 men. In 10 cases sex was unknown. The eyelids were the most common localization of malignant tumors (39.9% cases of all eye regions). The incidence cohort of all eyelid lesions included 2031 cases what made up 42.15% of all diagnosed lesions within the eye and it's adnexa. Benign tumors were the most common lesions (n=1262; 62.2%). Among all them papillomas were the most commonly found (n=659; 52.3%). Malignant tumors constituted 21,3% (n=433). Of the 433 malignancies, 314 were basal cell carcinomas (72.5%). Malignant tumors developed most commonly on the lower eyelid (n=303; 70%) but involved the right and left sides with equal frequency. Almost 2/3 of all tumor-like lesions in both genders were cysts including atheromas. CONCLUSIONS: Benign eyelid tumors compose the majority of all eyelid lesions. The eyelids are the most common localization of malignant tumors within the eye and it's adnexa. Basal cell carcinoma is the most common malignant eyelid tumor. The lower eyelid is the most frequent site of origin in cases of malignant tumors. Men and women are equally affected.

Carcinoma↗
PubMed2005

Eyelid tumors in Siriraj Hospital from 2000-2004.

OBJECTIVES: To determine the relative incidence of eyelid lesions seen in Siriraj Hospital from January 2000-April 2004. STUDY DESIGN: Retrospective charts review MATERIAL AND METHOD: Two hundred and ninety-seven cases of eyelid lesions seen in Siriraj Hospital from 2000 to 2004 were analyzed. RESULTS: There were 53 (17.8%) inflammatory conditions, 212 (71.4%) benign eyelid tumors and 32 (10.8%) malignant eyelid tumors. These 32 malignant eyelid tumors included 13 sebaceous gland carcinomas, 12 basal cell carcinomas, 3 malignant melanomas, 2 squamous cell carcinomas, 1 apocrine adenocarcinoma and 1 metastatic carcinoma. Various flaps techniques or primary closures were used for reconstruction in 20 cases. Six cases needed exenteration. CONCLUSION: The majority of eyelid lesions were benign eyelid tumors while malignant eyelid tumors contributed 10.8% of the total eyelid lesions. Sebaceous gland carcinoma was the most common eyelid tumor found in their present study that was consistent with other studies from Asian countries.

Adolescent↗
PubMed1997

Local injections of corticotropin releasing factor reduce doxorubicin-induced acute inflammation in the eyelid.

PURPOSE: Doxorubicin chemomyectomy is an effective alternative treatment option for patients with blepharospasm and hemifacial spasm. One side effect of the use of doxorubicin in localized injections is the development of acute inflammation and skin injury at the injection site. Corticotropin releasing factor (CRF) was reported to reduce inflammation after acute inflammatory injuries due to other causes and at other sites. This study was performed to assess the potential of CRF to prevent the development of skin injury and eyelid soreness after local doxorubicin injection. METHODS: Rabbits received lower eyelid injections of either 75 or 150 micrograms CRF followed by injection of either 0.5, 1, or 2 mg doxorubicin or doxorubicin alone. Eyelids were assessed for changes in acute inflammation by immunohistochemical localization of macrophages and monocytes using anti-CD11, an antibody specific for these cell types. Short-term alterations in vascular permeability were assessed using an Evans blue assay. Additional eyelids were followed daily for changes in the skin over the injection site to determine day of onset of skin injury and the total duration of skin injury. After 1 month, the eyelids were processed histologically for morphometric analysis of muscle fiber loss. Monkey eyelids also were examined for the effect of CRF and doxorubicin injections. RESULTS: Doxorubicin alone produced an acute inflammatory reaction in the treated eyelids, with a large influx of macrophages and monocytes throughout the connective tissue at 1 and 2 days. Corticotropin releasing factor pretreatment significantly reduced this influx of inflammatory cells into the connective tissue. Doxorubicin produced a large increase in vascular permeability in the treated eyelids, with resultant edema. Corticotropin releasing factor did not alter this change in vascular permeability, indicating that CRF appears to have a specific effect on migration of inflammatory cells rather than just a generalized effect on vascular permeability. Corticotropin releasing factor and doxorubicin cotreatments delayed the onset of skin injury and decreased the total duration of injury to the skin compared to doxorubicin alone. The effectiveness of doxorubicin chemomyectomy was maintained; muscle loss was significant at all doses of CRF combined with doxorubicin. CONCLUSIONS: Corticotropin releasing factor dramatically decreased the acute inflammatory reaction that results in the eyelid from local doxorubicin injections. Not only did CRF reduce the acute influx of monocytes and macrophages, but it protected the skin overlying the injection site, substantially reducing the extent of skin injury. The efficacy of doxorubicin-induced muscle toxicity was maintained. A treatment protocol that combines myotoxicity with antiinflammatory activity in the treated eyelids may lead to a more effective patient treatment by increasing patient acceptance. The potential should be explored that CRF may be of clinical use in limiting tissue injury when administered immediately after extravasation during cancer chemotherapy.

Animals↗
PubMed2005

Transconjunctival Müller muscle recession with levator disinsertion for correction of eyelid retraction associated with thyroid-related orbitopathy.

PURPOSE: To evaluate the efficacy of transconjunctival Müller muscle recession and graded levator disinsertion for eyelid retraction in patients with thyroid-related orbitopathy (TRO). DESIGN: Retrospective consecutive case series. METHODS: Medical record review of 78 TRO patients (107 eyelids) who underwent surgery for upper eyelid retraction in a 5-year period was performed. Main outcome measures were anatomic and functional success, minimal reflex distance (MRD), lagophthalmos, eyelid asymmetry, and patient discomfort. RESULTS: One hundred seven eyelid retraction surgeries were performed on 78 TRO patients (63 women, mean age 49 years); mean follow-up time was 16.7 months. Upper eyelid position, lagophthalmos, exposure keratopathy, and patients' discomfort markedly improved after surgery (P < .001). Marginal reflex distance (MRD1) decreased an average of 2.6 mm from 6 mm pre-operatively to 3.4 mm post-operatively (P < .001); lagophthalmos decreased an average of 0.6 mm from 1.3 mm pre-operatively to 0.4 mm post-operatively (P = .006) Failure rate was 8.4%, most improved with a second surgery. Overcorrection was noticed in three cases (2.8%). Eyelid asymmetry improved from a mean of 1.0 mm pre-operatively to 0.4 mm post-operatively (P = .001); more than 80% of patients showed eyelid asymmetry of 1 mm or less. CONCLUSION: Transconjunctival Müller muscle and levator recession is safe and effective in correction of mild, moderate, or severe eyelid retraction in TRO patients. The failure rate is less than 10% and may be addressed by a second surgery.

Conjunctiva↗
PubMed1993

Medial canthotomy and cantholysis in eyelid reconstruction.

Combined medial canthotomy and cantholysis is a quick, technically simple, single-stage reconstructive technique for use in the reconstruction of the upper or lower eyelid. This technique, which transects one lacrimal canaliculus, provides up to 20% of the horizontal eyelid dimension for closure. Medial canthotomy and cantholysis is most frequently used in combination with other eyelid reconstructive techniques for difficult reconstructions, which would otherwise require more extensive surgical procedures. The surgical technique is readily performed with the patient under general anesthesia and entails the transection of one lacrimal canaliculus, lysis of one crus of the medial canthal tendon, and lateral advancement of the medial eyelid stump. We used medial canthotomy and cantholysis in the reconstruction of 29 eyelid defects (21 upper eyelids and eight lower eyelids) over a 12-year period with adequate reconstructive results in all cases. Eleven of the patients underwent simultaneous lateral canthotomy and cantholysis. Complications of the medial canthotomy and cantholysis technique include anterior displacement of the medial portion of the eyelid, epiphora, notching of the medial portion of the eyelid, medial ectropion, and blepharoptosis. If used with appropriate case selection, this technique allows an optimal reconstructive result to be achieved with a minimum of operative time and morbidity.

Eyelid Neoplasms↗
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

Upper eyelid gold weight implantation in the Asian patient with facial paralysis.

Patients with facial paralysis may develop ophthalmic complications. Poor eyelid closure and lagophthalmos place the patient at increased risk for the development of corneal problems such as epithelial defects, stromal thinning, bacterial infection, and even perforation. Initial treatment should be conservative and include the use of ocular lubricants, moisture chambers, and taping of the lower eyelid into proper position. Surgical intervention may be required in patients who have failed medical therapy or in whom the facial paralysis is not expected to improve. Gold weight implantation in the upper eyelid has become a popular procedure to correct upper eyelid retraction and to improve corneal coverage. Previous descriptions of gold weight placement in the upper eyelid have focused on Caucasian eyelid anatomy. However, there are distinct anatomic differences between the Caucasian and Asian eyelids, which dictate the overlying aesthetic differences. We describe our technique for placement of a gold weight in the Asian upper lid, with attention to the maintenance of symmetric eyelid creases. We reviewed the charts of six Asian patients with facial paralysis who underwent gold weight placement in the upper eyelid for the correction of lid retraction. All patients did well functionally and aesthetically, and none developed an extrusion of the implant with this approach.

Adult↗
PubMed1995

Repair of upper eyelid retraction: a comparison between adjustable and non-adjustable sutures.

BACKGROUND: The challenge with the surgical repair of upper eyelid retraction is to obtain a more predictable and satisfactory postoperative eyelid contour and height, and to minimise the need for further surgery. METHODS: A retrospective analysis was performed on all patients treated surgically for eyelid retraction at Moorfields Eye Hospital over a 13 year period. RESULTS: In this study good postoperative results were obtained in 10 of 13 (77%) eyelids using adjustable sutures, compared with 56 of 148 (38%) eyelids using non-adjustable sutures (p < 0.01). With non-adjustable sutures, good results were achieved more often for non-thyroid compared with thyroid related eyelid retraction (26/55 versus 31/93 eyelids respectively, p < 0.05). Previous eyelid surgery did not affect outcome. CONCLUSION: We recommend the use of adjustable sutures for the repair of upper eyelid retraction, particularly in patients with thyroid disease.

Adolescent↗
PubMed1984

Oriental eyelids. An anatomic study.

Dissection of the eyelids and sagittal sections of the orbital blocks identified the anatomic features of the oriental eyelids responsible for their unique appearance. The basic distinction involves the formation of the eyelid crease and fold. In the occidental eyelid, the orbital septum fuses with the levator aponeurosis below the superior tarsal border. However, in the oriental eyelid, the orbital septum fuses with the levator aponeurosis below the superior tarsal border. The accompanying preaponeurotic or orbital fat is allowed to proceed to the anterior tarsal surface, resulting in a full or thickened eyelid. The inferior extension of the orbital septum, beyond the superior tarsal border, prevents anterior aponeurotic fibers from fanning toward the subcutaneous tissues to produce the normal eyelid crease. Appreciation of the unique anatomic features of oriental eyelids is important for those persons who evaluate or surgically explore these eyelids.

Asian People↗
PubMed2000

Gaping lids, gp, a mutation on centromeric chromosome 11 that causes defective eyelid development in mice.

In mammals, during fetal development, the eyelids grow and flatten over the eyes and temporarily fuse closed. Failure of this normal developmental process in mice leads to the defect, open-eyelids-at-birth. Nearly all newborns of the GP/Bc strain, homozygous for the spontaneous recessive mutation, gaping lids (gp), have bilateral open eyelids at birth, with essentially no fusion between the upper and lower eyelids. Histological sections and scanning electron microscopy of GP/Bc eyes during the normal period of eyelid growth and fusion indicate that gp/gp mutant fetuses have deficient upper and lower eyelids; surface periderm cells that appear to have some role in eyelid growth and fusion are present, but lack a normal "streaming pattern toward the fusion zone. No other defects due to the gaping lids mutation were detected. A genetic analysis based on outcrosses of GP/Bc to various linkage marker stocks and to CBA/J and ICR/Bc normal strains was done. Penetrance in F(2) segregants, but not in BC1 segregants, was usually significantly less than 100%, was strongly affected by the identity of the normal strain used, ranging from 44% to 92%, and indicated a potential complexity of modifiers. Forty-one affected F(2) and 120 BC(1) segregants from the outcross of GP/Bc to CBA/J, and 23 affected F(2) segregants from the outcross to ICR/Bc, were used to map gp to proximal Chr 11 between the centromere and D11Dal1 (Camk2b), an interval previously defined as less than 1 cM. Sets of whole F(2) litters from the crosses to CBA/J (n = 106) and ICR/Bc (n = 65) strains were typed for informative SSLPs near gp (D11Mit62 and D11Mit74, respectively) and demonstrated that the segregation ratios in the region are Mendelian. The known genes in the interval, Nf2 and Lif, do not seem to be obvious candidate genes for gp. An Egfr-null allele was used to confirm the previously reported map position of the potential candidate locus, Egfr, to a more distal interval, between D11Mit62/226 and D11Mit151, from which gp had been excluded. Tests for allelism showed that the Egfr mutation and the gp mutation complement each other, and therefore also indicate that they are at different gene loci. Open-eyelids-at-birth is associated with several mutations at other loci with variable penetrance owing to modifiers and in other more complex genetic liabilities in inbred strains, and the genetics of this trait is a model for other genetically complex developmental threshold traits. The gaping lids mutation identifies a previously unknown locus on proximal Chromosome (Chr) 11 that has a strong role in fetal eyelid growth.

Alleles↗
PubMedDate not supplied

Eyelid fusion and epithelial differentiation at the ocular surface during mouse embryonic development.

PURPOSE: To investigate epithelial differentiation at the ocular surface of the developing mouse eye by examining temporal and spatial changes in the expression of specific keratins. METHODS: Ocular tissues, including the entire eyeball, conjunctiva, and eyelid, of mouse embryos at embryonic day (E) 12.5 to E18.5 as well as of adult mice were examined by hematoxylin-eosin staining and by immunohistochemistry with antibodies to keratins K4, K10, K12, and K14. RESULTS: Hematoxylin-eosin staining revealed that eyelid fusion occurred at E17.5. Keratin immunohistochemistry demonstrated that: (1) K4 was expressed before K12, which in turn was expressed before K10; (2) expression of K4, K12, and K14 was spatially heterogeneous in the epithelia of the eyelid invaginations before eyelid fusion, but thereafter was continuous and homogeneous in the entire conjunctival epithelium, corneal epithelium, and basal cell layer of the surface epithelia, respectively; and (3) K10 immunoreactivity was not detected before eyelid fusion but was apparent in the epidermis of the eyelid thereafter. CONCLUSIONS: Eyelid fusion is a critical period for differentiation of the ocular surface ectoderm into the epithelia of the conjunctiva, cornea, and eyelid skin. The conjunctival epithelium differentiates before the corneal epithelium, which in turn differentiates before the eyelid epidermis.

Animals↗
PubMed2005

Visual evaluation of fade in response to facial nerve stimulation at the eyelid.

STUDY OBJECTIVE: The aim of this study is to investigate the probability of visual detection of fade in response to train-of-four (TOF) stimulation, double-burst stimulation3,3 (DBS(3,3)), or DBS(3,2) at the eyelid in comparison to that at the thumb. DESIGN: This is a randomized single-blinded study. SETTING: The study took place at the University hospital. PATIENTS AND MEASUREMENTS: Sixty adult patients underwent general anesthesia. INTERVENTIONS AND MEASUREMENTS: Patients were randomly divided into either the eyelid group (n = 30) or the thumb group (n = 30). In the eyelid group, at the varying degrees of neuromuscular block caused by vecuronium, TOF, DBS(3,3), or DBS(3,2) were given at the temporal branch of the facial nerve, and the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was determined at the eyelid. Similarly, in the thumb group, the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was examined at the thumb. MAIN RESULTS: When the true TOF ratios were 0 to 0.60, the probability of detection of TOF fade in the eyelid group was significantly lower than in the thumb group (P < .05). At the true TOF ratios of 0.31 to 0.70, the probability of visual detection of DBS(3,3) fade in the eyelid group was significantly less than in the thumb group (P < .05). When the true TOF ratios were 0.81 to 1.00, the probability of detection of DBS(3,2) fade in the eyelid group was significantly higher than in the thumb group (P < .05). CONCLUSION: The probability of visual detection of fade in response to TOF or DBS(3,3) is lower at the eyelid than the thumb. In contrast, DBS(3,2) fade tends to be seen more frequently at the eyelid than at the thumb.

Adult↗
PubMed2001

Management of eyelid anomalies associated with Blepharo-cheilo-dontic syndrome.

PURPOSE: To describe the previously unreported management of the eyelid anomalies associated with blepharocheilo-dontic syndrome. Blepharo-cheilo-dontic syndrome is a syndrome of congenital cleft lip/palate, oligodontia, euryblepharon, eyelid ectropion, and lagophthalmos. METHODS: Case report. A 3-month-old male presented with bilateral upper and lower eyelid ectropion with eyelid retraction, marked euryblepharon, severe lagophthalmos, and a right side cleft lip/palate. Lateral tarsal strips, lower eyelid retractor disinsertion, myocutaneous advancement of the cheek and eyelids, and lateral tarsorrhaphy were performed. RESULTS: Correction of the ectropion, eyelid retraction, euryblepharon, and marked improvement in his lagophthalmos were achieved postoperatively. No recurrence of the ectropion or euryblepharon has been noted after 6 months of follow-up. CONCLUSION: Appropriate reconstructive surgery of the eyelids reduces the morbidity associated with the eyelid anomalies and provides an excellent cosmetic result for patients with blepharo-cheilo-dontic syndrome.

Cleft Lip↗
PubMed1992

Merkel cell carcinoma of the eyelid and periocular tissues.

Five patients had eyelid and periocular Merkel cell carcinoma. The tumor was located on the left lower eyelid in two patients, the left upper eyelid in one patient, the right upper eyelid in one patient, and was metastatic to the right outer canthus in one patient. The mean duration of symptoms was approximately four months. The diagnosis of Merkel cell carcinoma was not suspected clinically in any of the four primary eyelid cases, but was only established on histopathologic examination of biopsy specimens. Light microscopy disclosed carcinoma with small primitive cells in all five tumor biopsy specimens. Immunohistochemical studies showed neuron-specific enolase and keratin and transmission electron microscopy demonstrated neurosecretory granules typical for Merkel cell carcinoma. All five patients in this study were treated with wide surgical excision of the eyelid tumors with intraoperative frozen-section monitoring of the margins of resection. The left lower eyelid Merkel cell carcinoma spread to the preauricular lymph node in one patient. This patient subsequently died of metastatic Merkel cell carcinoma. One patient with metastatic right outer canthus Merkel cell carcinoma received radiotherapy (6,550 cGy). Eyelid Merkel cell carcinoma has the potential for recurrence and metastatic spread. We recommend lifetime follow-up for patients treated for eyelid Merkel cell carcinoma.

Aged↗