Lateral Tarsoconjunctival Flap Suspension Treatment of Post Blepharoplasty Lower Eyelid Retraction

29 Nov 2020

Jordan R Conger, Seanna R Grob, Roberto M Limongi, Jeremiah P Tao

Journal : OPRS

Ref : Lower eyelid Retraction Oculoplastics Tarsoconjunctival Flap

Radiofrequency-Assisted Endofistulectomy: Treating Coexisting Lacrimal Fistulae During Endoscopic Dacryocystorhinostomy

29 Nov 2020

Nandini Bothra, Mohammad Javed Ali

Purpose:

To assess the efficacy of radiofrequency-assisted endofistulectomy in patients with lacrimal fistulae communicating with the lacrimal sac.

Methods:

Retrospective interventional case series of patients undergoing endoscopic dacryocystorhinostomy with endofistulectomy from June 2016 to January 2020 were studied. The indications of endoscopic dacryocystorhinostomy were associated refractory complex congenital nasolacrimal duct obstructions and primary-acquired nasolacrimal duct obstruction. The communication of the fistulae with the lacrimal sac was ascertained. Specific surgical parameters and technique were used, and the variables assessed include patient demographics, clinical presentation, indications, surgical technique, recurrences, and outcomes.

Results:

Six eyes of 6 patients with mean age of 23.33 years underwent radiofrequency-assisted endofistulectomy. The surgical technique was found to be minimally invasive, easy to perform with multiple advantages like absence of a skin incision, targeting of the complete extent of the fistula, and complete closure of the external and internal openings of the fistulae. At 4 weeks, dacryocystorhinostomy ostium was well mucosalized and patent with a dynamic common canalicular opening. The fistula site had healed well with no epiphora or discharge or residual scarring.

Conclusion:

Radiofrequency-assisted endofistulectomy is a minimally invasive and viable alternative to incisional fistulectomy in select group of patients of congenital or acquired fistulae which communicate with the lacrimal sac.

https://journals.lww.com/op-rs/Abstract/2020/11000/Radiofrequency_Assisted_Endofistulectomy__Treating.17.aspx

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Journal : OPRS

Ref : lacrimal Lacrimal fistula

Free Tarsal Graft and Free Skin Graft for Lower Eyelid Reconstruction

29 Nov 2020

John G Bortz, Sameer Al-Shweiki

Purpose:

To determine whether reconstruction of lower eyelid defects involving the eyelid margin with a free tarsal graft and an overlying free skin graft, without retention or provision of any vascular support, would yield acceptable functional and cosmetic results.

Methods:

We present here a clinical series of 4 patients treated between April 2019 and September 2019 who underwent reconstruction of large postcarcinoma excision, eyelid-margin-inclusive eyelid defects. Surgery was performed by the same surgeon (J.G.B.) at the Westchester Medical Center, Department of Ophthalmology and Dobbs Ferry Hospital in New York. Without retaining a conjunctival pedicle (modified Hughes procedure), and without a myocutaneous or other vascularized flap, the lower eyelids were reconstructed with a free tarsal graft and a separate overlying free skin graft. The primary outcomes measured were eyelid apposition to the globe, margin reflex distance 2 at least 6 months postoperatively, ocular surface integrity, and patient comfort and patient satisfaction with the procedure.

Results:

The patients included in the clinical series ranged in age from 73 to 82, 3 were men and 1 women. Each had recent Moh’s excision of carcinoma (3 basal; 1 squamous) resulting in large tissue defects of the lower eyelids. All carcinomas were T1N0M0. The mean postoperative margin reflex distance 2 of the reconstructed eyelids was 5.5 mm, range 5–7.5 mm. Two of the 4 patients underwent a secondary revision within 2–3 weeks following initial reconstruction for lateral ectropion or dehiscence. All eyelids were well-opposed to the globes after revision (except for the nasal eyelid in patient number 2 who had a preexisting ectropion from prior carcinoma excision in the same eyelid). Functional and esthetic results were on par with those of the modified Hughes procedure. All 4 patients were pleased that they had chosen to undergo the procedure being discussed.

Conclusion:

In this clinical series of 4 patients, reconstruction of lower eyelid defects with a free tarsal graft and overlying free skin graft resulted in an acceptable functional and esthetic lower eyelid suggesting that retention of or provision of vascular support in either the anterior or posterior lamella may not be necessary

https://journals.lww.com/op-rs/Abstract/2020/11000/Free_Tarsal_Graft_and_Free_Skin_Graft_for_Lower.16.aspx

Journal : OPRS

Ref : Eyelid reconstruction Oculoplastics

Normative Exophthalmometry Measurements Vary Among Ethiopian Adults and the Major Ethiopian Ethnic Groups

29 Nov 2020

Curtis J Heisel, Philip S Garza, Cherinet M Fashe, Asrat Sime, Christine Nelson

Purpose:

Periocular and orbital anthropometric values vary among races. No studies have established normative exophthalmometry values for Ethiopians or the many Ethiopian ethnic groups. This study established a set of normative anthropometric values for exophthalmometry, and further evaluated whether these measurements differed based on sex or ethnic group.

Methods:

A cross-sectional study was performed in the ophthalmology department at St. Paul’s Hospital in Addis Ababa, Ethiopia. Two hundred ninety-six participants were recruited for the study. Sex, primary Ethiopian ethnic subgroup, and exophthalmometry measurements were recorded. Differences between ethnicities and sexes were evaluated using independent samples t test.

Results:

Average proptosis for the total cohort was 15.88 ± 2.49 mm, with 582 eyes measured. Females (15.87 ± 2.53, n = 286) and males (15.89 ± 2.49, n = 296) were not significantly different in their proptosis measurements. Within the 3 largest ethnic groups measured, Amhara (16.12 ± 2.67, n = 204), Oromo (15.43 ± 2.51, n = 172), and Gurage (16.23 ± 2.59, n = 98), the difference in proptosis measurement was significant between the Amhara and Oromo groups (p = 0.01), and the Oromo and Gurage groups (p = 0.01). The only ethnic group that was significantly different between sexes was Gurage, of which average female proptosis was 15.51 ± 2.74 (n = 54), while male proptosis was 17.13 ± 2.11 (n = 44) (p < 0.01).

Conclusions:

Mean Ethiopian proptosis values vary across ethnicities, are similar to those measured in other African populations, but are lower than those established in African-American populations. This study provides an important resource that Ethiopian ophthalmologists can use when evaluating patients with suspected ophthalmic and orbital disease.

https://journals.lww.com/op-rs/Abstract/2020/11000/Normative_Exophthalmometry_Measurements_Vary_Among.15.aspx

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Journal : OPRS

Ref : Orbit

Subperiosteal Masqueraders as Compared to Subperiosteal Abscess: Contrasting Clinical Presentation and Radiographic Densities

29 Nov 2020

Jenny C Dohlman, Larissa A Habib, Mary E Cunnane, Michael K Yoon

Journal : OPRS

Ref : Orbit Subperiosteal abscess

Newly Designed Universal Trans-punctal Rigid Lacrimal Microendoscope

29 Nov 2020

Masashi Mimura, Audrey C Ko 1 3, Ramzi M Alameddine, Bobby S Korn, Don O Kikkawa, Hidehiro Oku, Bunpei Sato, Tsunehiko Ikeda

Journal : OPRS

Ref : lacrimal

Building Your Brand: Analysis of Successful Oculoplastic Surgeons on Social Media

29 Nov 2020

Sally S E Park , Sruti S Akella, Jee-Young Moon, Bryan Zarrin, Sheel Patel, Hiten Doshi, Anne Barmettler

Purpose:

To determine the impact of social media content from oculoplastic surgeon-held accounts on public engagement.

Methods:

This study analyzed successful Instagram accounts (defined by >500 followers as of May 2019) held by American Society of Ophthalmic Plastic Reconstruction Surgery members. Each account’s 20 most and 20 least successful posts (based on number of likes) were characterized by the post’s subject, location, media type, and tag usage. Posts were then analyzed using a web-based application that calculates the engagement level of Instagram users with the selected post.

Results:

A total of 4,812 posts were analyzed from 37 Instagram accounts. Of these American Society of Ophthalmic Plastic Reconstruction Surgery members, the majority were men (67.6%, n = 25) in private practice solely (70.3%, n = 26). Numerous post characteristics, like content and media type, impacted success in a statistically significant manner; for example, public engagement rose when featuring the posting doctor, especially when smiling and wearing a white coat. Meanwhile, posts featuring an office procedure had a negative effect. Formatting was also found to contribute to success. For example, photographs were preferred over videos, while multiple images were best presented sequentially as a carousel (with the viewer swiping through the series) rather than in a large collage. Use of tags (hashtags, accounts, and locations) were associated with increased engagement.

Conclusions:

Social media is an important communication and marketing tool, especially in esthetic fields like oculoplastics. Guidelines for success are presented in this study; content, location, subject, media type, and tags statistically significantly impact public engagement.

The influence of social media is rapidly growing and can be strategically harnessed by oculoplastic surgeons to educate both patients and healthcare providers, collaborate with colleagues, and for referrals and marketing.

https://journals.lww.com/op-rs/Abstract/2020/11000/Building_Your_Brand__Analysis_of_Successful.12.aspx

Journal : OPRS Uncategorized

Ref : aesthetics