Ophthalmic plastic and reconstructive surgery
-
Ophthal Plast Reconstr Surg · Jun 1994
Comparative StudyEfficacy of lateral canthotomy and cantholysis in orbital hemorrhage.
Emergent orbital decompression in tense orbital hemorrhage with compromised ophthalmic blood flow may be achieved with lateral canthotomy, defined as incision of the lateral canthal tendon, and cantholysis, defined as canthotomy combined with disinsertion of at least the inferior crus of the lateral canthal tendon. This study was performed to determine which procedure, canthotomy, canthal tendon disinsertion, or cantholysis, produced the largest reduction in intraocular pressure after simulated orbital hemorrhage in 10 closed ruminant orbits with retrobulbar injections of normal saline. Intraocular pressure (IOP) reductions were measured after canthotomy in five orbits, after lateral canthal tendon disinsertion in five orbits, and after completion of cantholysis in all 10 orbits. ⋯ Canthal tendon disinsertion (CTD) produced a mean IOP reduction of 19.2 mm Hg. Cantholysis produced a mean IOP reduction of 30.4 mm Hg, a significantly (p < 0.05) greater reduction in IOP than that produced by canthotomy or canthal tendon disinsertion alone. Cantholysis in acute orbital hemorrhage may produce significantly greater reduction in IOP, and thus in intraorbital pressure, and allow better perfusion of orbital tissues than either lateral canthotomy or CTD.
-
Ophthal Plast Reconstr Surg · Jun 1994
Case ReportsCicatricial ectropion in ichthyosis: a novel approach to treatment.
Four kinds of ichthyosiform dermatoses have been described. Only lamellar ichthyosis or ichthyosis congenita is associated with the development of ectropion and subsequent eye symptoms. Conservative treatments have been tried but surgical correction of the ectropion was ultimately required for symptomatic relief. ⋯ A circumcision was performed and the foreskin divided into four separate full-thickness skin graft triangles to treat the four-lid ectropion. There was successful resolution of the eye symptoms and a watertight closure. To our knowledge, this is a unique case in which penile foreskin has been used to correct cicatricial ectropion.