Ophthalmic plastic and reconstructive surgery
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Ophthal Plast Reconstr Surg · Sep 1998
Case ReportsDeep transorbital approach to the apex and cavernous sinus.
Tumors of the orbital apex are difficult to approach through a standard lateral orbitotomy exposure. The transcranial approach has been described, but it requires an open craniotomy as well as dissection through the annulus of Zinn in its tight superior segment to reach intraconal and inferior lateral tumors. It is well recognized that the transcranial approach is optimal only for tumors of the superomedial orbital apex. ⋯ By use of the deep orbital apex approach described, all four tumors were successfully exposed and removed. Visual and motor function was unchanged or improved in all four patients, with the exception of one tumor that incorporated the inferior division of the third cranial nerve; in that patient, the transected nerve was anastomosed microscopically, and partial return of function was noted. The transorbital ophthalmic approach to tumors of the inferolateral orbital apex has significant potential advantages in comparison with a frontal craniotomy approach.
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Ophthal Plast Reconstr Surg · Jan 1998
ReviewRAND study: workforce requirements and provider supply relevant to oculoplastic and orbital surgery.
The 1995 RAND study Estimating Eye Care and Workforce Requirements analyzes the United States' supply, demand, and need for eyecare providers. Portions of the RAND study were prepared along traditional ophthalmic specialty lines. ⋯ The RAND study results indicate a significant current and very probable future oversupply of oculoplastics workforce personnel. This oversupply is further exacerbated when a RAND study underestimate of the number of new fellowship-trained oculoplastic surgeons is corrected.
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Ophthal Plast Reconstr Surg · Sep 1996
Combined paresis and restriction of the extraocular muscles after orbital fracture: a study of 16 patients.
Sixteen patients with combined paresis and restriction of extraocular muscle(s) orbital fracture repair were studied before and after in order to determine the clinical features and management of such patients. All 16 patients showed limited ductions of the involved eye in the field of action of the entrapped, paretic muscle and of the antagonist muscle after orbital fracture. Single extraocular muscles (13 patients) and two extraocular muscles (three patients) were demonstrated adjacent to the fracture site on orbital computed tomography (CT). ⋯ Six patients with significant deviations required prisms (three patients) or strabismus surgery (three patients). The latter three patients had two muscles involved. Results of this study demonstrate that the ophthalmologist must appropriately diagnose patients with paresis and restriction of an extraocular muscle and counsel them that "new" diplopia may occur after orbital fracture repair and that this diplopia may require additional therapy.
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Ophthal Plast Reconstr Surg · Jun 1995
Case ReportsOrbital emphysema following remote skull trauma.
In an unusual case of orbital emphysema following nose blowing, a reliable patient history and examination demonstrated no direct trauma to the orbit. Blunt posterior skull trauma was sustained several hours before the development of the orbital emphysema. A "seismic" transmittal of force to the orbital walls is postulated.
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Ophthal Plast Reconstr Surg · Dec 1994
Argon green laser photoepilation in the treatment of trachomatous trichiasis.
We describe the treatment of focal trachomatous trichiasis with argon green laser. We treated 70 eyelashes in 17 patients with 80% success and found this treatment modality convenient both for the patient and the practitioner.