Ophthalmic plastic and reconstructive surgery
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Ophthal Plast Reconstr Surg · May 1999
Case ReportsRepair of orbital floor fractures with hydroxyapatite block scaffolding.
To determine the efficacy of using a scaffold of hydroxyapatite blocks within the maxillary sinus to treat patients with large orbital floor fractures and secondary vertical globe dystopia. ⋯ Hydroxyapatite block scaffolding is a useful alternative to metallic floor implants and autologous bone grafts in the reconstruction of large traumatic orbital floor defects associated with vertical globe dystopia.
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Ophthal Plast Reconstr Surg · Mar 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of three modified lidocaine solutions for use in eyelid anesthesia.
To compare pain on injection and the efficacy of anesthesia of three modified lidocaine solutions for use in eyelid surgery: 1) 2% lidocaine with 1:100,000 epinephrine, 2) 2% lidocaine with 1:100,000 epinephrine buffered 9:1 with 8.4% sodium bicarbonate, and 3) 2% lidocaine with 1:100,000 epinephrine diluted 1:9 with 0.9% bacteriostatic saline solution (with benzyl alcohol). ⋯ For local anesthesia in eyelid surgery, bacteriostatic saline modified solution provides more comfort on injection than either buffered or unmodified lidocaine-epinephrine solution and provides an adequate level of anesthesia that does not differ significantly from either the buffered or unmodified solutions.
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Ophthal Plast Reconstr Surg · Jan 1999
Role of local amphotericin B therapy for sino-orbital fungal infections.
Sino-orbital fungal infections are serious complications of diabetes and immunosuppression. Standard treatments include surgical debridement of the involved tissues with possible orbital exenteration, intravenous antifungal therapy, and improvement of the host's immunocompetence and metabolic state, when possible. The role of conservative orbital debridement combined with local amphotericin B irrigations in the treatment of these patients was evaluated. ⋯ Conservative orbital debridement with local amphotericin B irrigations is an effective adjunct in the control of sino-orbital fungal infections, especially in patients with reversible immunosuppression and good preoperative visual acuities.
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To describe the clinical features of patients with unusual orbital foreign bodies. ⋯ An orbital foreign body may be overlooked because a small penetrating wound may be accompanied by minimal or no signs of inflammation early in the clinical course. A careful history and physical examination, imaging studies, and a strong suspicion are helpful for establishing the diagnosis of an orbital foreign body.
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Ophthal Plast Reconstr Surg · Nov 1998
Case ReportsIntervention within days for some orbital floor fractures: the white-eyed blowout.
Management of blowout fractures involving the orbital floor has been controversial over the past several decades. One school of thought recommends conservative treatment for 4 to 6 months while another recommends a 'wait and watch' period of 2 weeks before intervention. ⋯ We advocate surgery within the first few days after injury as it may help to avoid permanent motility restriction. The authors have termed this entity 'the white-eyed blowout fracture.'