Ophthalmic plastic and reconstructive surgery
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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.
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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.
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Ophthal Plast Reconstr Surg · Mar 1994
Case ReportsMedical and surgical management of chemosis after blepharoplasty.
Chemosis--conjunctival edema--occurs frequently after direct surgical or accidental trauma. In most cases, it resolves spontaneously. We report three patients with a spectrum of persistent chemosis after lower blepharoplasty. Etiologic factors are presented, and the management is reviewed.
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Ophthal Plast Reconstr Surg · Dec 1993
Case ReportsPneumomediastinum following blowout fracture of the medial orbital wall: a case report.
An unusual case of cervical emphysema and pneumomediastinum following a blowout fracture of the medial orbital wall is presented. Severe pulmonary distress did not occur, and the trapped air rapidly absorbed. The source of the emphysema and its progression is discussed considering the anatomic relations of the facial and cervical subcutaneous space and the mediastinum. To our knowledge, this complication is rare and has been documented only once before in an isolated blowout fracture of the orbit.
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Ophthal Plast Reconstr Surg · Jan 1986
Control of lacrimal secretion after sphenopalatine ganglion block.
Tear secretion with topical anesthesia ("Basal secretion") was measured in 10 normal subjects using Schirmer's tear strips before and after a sphenopalatine ganglion block. In an additional three normal subjects, tear turnover was determined with an objective fluorophotometer both before and after sphenopalatine ganglion block. The sphenopalatine ganglion block was obtained by the injection of the lidocaine (2%) into the sphenopalatine fossa. ⋯ Tear secretion with topical ocular anesthesia was reduced substantially by sphenopalatine block, as measured by either Schirmer's strips or objective fluorophotometry. The more exact fluorophotometric method recorded a complete cessation of tear turnover flow following ganglion block. These findings support other reports, suggesting that all tear secretion is under neurologic control and dependent on reflex stimulation.