Ophthalmic plastic and reconstructive surgery
-
Ophthal Plast Reconstr Surg · Mar 2013
Bleeding complications in both anticoagulated and nonanticoagulated surgical patients.
This study was performed to ascertain the incidence of anticoagulant use in oculoplastic surgical patients and the reliability of patient medication disclosure. Differences in perioperative bleeding complications among patients continuing anticoagulants, those who withheld the medications, and those not anticoagulated were investigated. ⋯ Forty percent of patients undergoing oculoplastic procedures were using anticoagulants; yet, many patients failed to disclose their medication usage. The decision to operate and whether to discontinue these medications must be individualized considering the nature of the procedure and the patient's medical condition. It may be appropriate to continue anticoagulants in certain patients at increased risk for a vascular event, ensuring adequate hemostasis throughout the procedure.
-
A 20-year-old woman presented with self-inflicted pencil wounds to her bilateral orbits. CT angiography revealed penetration of pencils through optic canals into temporal lobes. Examination revealed bilateral no light perception, fixed dilated pupils, complete ptosis, and complete ophthalmoplegia. The patient was admitted to the psychiatric ward and her vision and cranial nerve deficits did not improve.
-
A 48-year-old man was seen in the Wills Eye Institute emergency room for pain and decreased vision after having a diesel engine fuel cylinder explosion in his face. Clinical examination showed proptosis, decreased extraocular motility, and increased intraocular pressure; CT scan imaging revealed hypodense areas within the orbit. ⋯ The patient ended up losing vision from an intense chemical cellulitis with subsequent orbital compartment syndrome and optic neuropathy. This case highlights the severity of orbital chemical injuries and their variable prognoses despite aggressive management.
-
The aim of this article was to report the clinical presentation, radiography, culture results, treatment modalities, and outcomes of periocular abscesses associated with brow epilation. ⋯ Periocular abscess formation after brow epilation has been previously described in only a single case report in the literature. The authors believe this entity is underreported given their current report describing 26 such cases. Given the high prevalence of cosmetic brow epilation in females, the authors believe a careful history regarding brow epilation in any patient presenting with a periocular abscess or preseptal cellulitis is essential to explore the possible cause of their infection. The majority of patients in the current study's cohort had methicillin-resistant Staphylococcus aureus-related abscesses, and treatment with antibiotics with methicillin-resistant Staphylococcus aureus coverage may be a prudent first line choice in such patients.