Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"CADS as a Decision-making Tool: Developing an Oculoplastic Management Algorithm for Facial Nerve Palsy.","authors":"Anthony Yao, Nirodha Jayawickrema, Raman Malhotra","doi":"10.1097/IOP.0000000000002748","DOIUrl":"10.1097/IOP.0000000000002748","url":null,"abstract":"<p><strong>Purpose: </strong>The Cornea, Asymmetry, Dynamic, Synkinesis (CADS) score is a validated grading score for periocular involvement in facial nerve palsy (FNP). The authors conducted a retrospective review of FNP cases, including initial CADS scores and subsequent ophthalmic interventions. The results were used to inform the development of an oculoplastic management algorithm for FNP.</p><p><strong>Methods: </strong>Single-center retrospective cohort study of patients with FNP referred to a tertiary unit between 2016 and 2022. Data collected included demographic data, etiology of FNP, treatment initiated, and CADS grading at each visit. Adult patients with ≥6 months of follow-up were included, and cases were excluded if ocular surface or oculoplastic procedures were performed elsewhere prior to the initial review by the unit.</p><p><strong>Results: </strong>Of 408 consecutive new patients with FNP, 80 fulfilled inclusion criteria (mean age 57 years, range 21-83 years). Presentations of FNP were unilateral in 98.8% (79/80), with an underlying preganglionic etiology in 75.0% (60/80). At the initial review, surgery was recommended for 61.3% (49/80) of cases. Subgroup analysis of surgical cases for each CADS domain showed 46.9% (23/49) had C-score ≥2, which was predictive of upper lid surgery requirement (e.g., upper lid platinum segment chain; levator recession). About 63.2% (31/49) had an A-score ≥1 which predicted for lower lid surgery requirement (e.g., retractor recession, lower lid sling, medial canthal tendon plication, and lower lid full thickness skin graft) as well as a brow lift. Almost 79.6% (39/49) had a D-score ≥2, which was associated with both upper lid and lower lid surgery requirements. Also, 59.2% (29/49) had an S-score of ≥1 however, this was not associated with the surgical requirement, highlighting a different approach compared with the other CADS domains.</p><p><strong>Conclusion: </strong>This study represents a large cohort of patients followed up with a validated ophthalmic-specific FNP grading scale. This was utilized to develop a CADS-based management algorithm to help guide decision-making for surgical intervention versus medical management in FNP.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"143-147"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Atypical Case of Orbital Wall Infarction Secondary to Sickle Cell Disease in an Adult and Review of Literature.","authors":"Li Teng Kok, Branka Marjanovic, Mohsan Malik","doi":"10.1097/IOP.0000000000002831","DOIUrl":"10.1097/IOP.0000000000002831","url":null,"abstract":"<p><p>Sickle cell disease is known to cause painful vaso-occlusive crises in long bones with large marrows. Orbital infarction is a rare complication of sickle cell disease and usually presents in children and adolescents with acute onset periocular swelling mimicking orbital cellulitis. The authors describe an atypical case of a 38-year-old man with homozygous sickle cell disease who presented with isolated, complete ptosis of his OD with minimal swelling. He described brow aches on the same side, with no features of proptosis, ophthalmoplegia, or compressive optic neuropathy. Orbital imaging revealed infarction in the right frontal bone and orbital roof, with inflammatory soft tissue swelling. His condition resolved completely after 4 days with conservative medical therapy alone.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e60-e63"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Cannabis Usage on Thyroid Eye Disease.","authors":"Amanda M Zong, Anne Barmettler","doi":"10.1097/IOP.0000000000002770","DOIUrl":"10.1097/IOP.0000000000002770","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to investigate the association between cannabis usage and thyroid eye disease (TED) in patients with autoimmune hyperthyroidism. While the association between cigarette smoking and TED is well established, the effect of cannabis on TED is unclear.</p><p><strong>Methods: </strong>This cohort study examined data from TriNetX, an electronic health record platform, for patients with autoimmune hyperthyroidism between December 1, 2003, and December 1, 2023. Primary outcomes were TED presentation (exophthalmos, eyelid retraction, eyelid edema, orbital edema, strabismus, and optic neuropathy) and treatment (teprotumumab, methylprednisolone, tarsorrhaphy, and orbital decompression) in cannabis users, nicotine users, and control patients. Propensity matching was performed to control for characteristics such as age, sex, race, prior thyroidectomy, and/or radio ablation. Relative risk between cohorts was calculated for each outcome in 6-month, 1-year, and 2-year intervals following diagnosis of autoimmune hyperthyroidism.</p><p><strong>Results: </strong>Of 36,186 patients with autoimmune hyperthyroidism, 783 were cannabis users, 17,310 were nicotine users, and 18,093 were control patients without cannabis or nicotine usage. Compared with control patients, cannabis users were more likely to be younger, male, and Black/African American and have anxiety or depression. After propensity matching, cannabis users were 1.9 times more likely to develop exophthalmos ( p = 0.03) and 1.6 times more likely to develop any TED presentation ( p = 0.049) in the 1-year interval although these differences did not remain statistically significant in the 2-year interval.</p><p><strong>Conclusions: </strong>Cannabis users had a significantly increased risk for TED outcomes in the 1-year interval. Further research is needed to inform TED management.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"179-185"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Eyelid Entropion: A Historical Review.","authors":"Philip L Custer","doi":"10.1097/IOP.0000000000002784","DOIUrl":"10.1097/IOP.0000000000002784","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to review the long history of entropion, with emphasis on its significance to the specialty of ophthalmology, and the numerous methods developed to treat cicatricial and involutional forms of the condition.</p><p><strong>Methods: </strong>An extensive medical literature review was performed, identifying publications containing information on entropion and associated conditions. Foreign language manuscripts were translated using online resources.</p><p><strong>Results: </strong>A total of 920 manuscripts published between 1505 and 2023 were reviewed. While the majority were written in English, 38.5% were foreign language works. For much of history, both cicatricial and involutional entropion were managed by shortening the anterior lamella. Horizontal eyelid margin or posterior tarsal incisions were often added for cicatricial disease. Later, different tissues were grafted into the defects created by these incisions. A variety of measures were used to temporize in patients with involutional entropion. Surgical treatment of this condition evolved to include methods of suture rotation, orbicularis weakening or redirection, tarsal stabilization, lid margin shortening, and eyelid retractor repair.</p><p><strong>Conclusions: </strong>Entropion and its management are described throughout recorded history. For much of this time, cicatricial entropion was the most common form of the disease, in great part secondary to the prevalence of trachoma. The social impact of these conditions was a primary factor in the establishment of ophthalmology as a medical specialty and the creation of dedicated eye hospitals. Publications describing the treatment of involutional entropion appear with increasing frequency after the mid-19th century. Arguably, more procedures have been described for entropion than for any other ophthalmic condition.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"125-133"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic Nerve Sheath Fenestration: A Retrospective Review of Its Safety, Efficacy, and Impact on Optical Coherence Tomography.","authors":"Lalita Gupta, Paras Vora, Max Benningfield, Emily A Altman, Padmaja Sudhakar, Peter J Timoney","doi":"10.1097/IOP.0000000000002792","DOIUrl":"10.1097/IOP.0000000000002792","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the safety and efficacy of optic nerve sheath fenestration using visual acuity, perimetry, and optical coherence tomography.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent an optic nerve sheath fenestration at an academic center between 2016 and 2021 was performed with institutional review board approval. Outcome measures included visual acuity, perimetric mean deviation, optic disc edema grade, improvement in symptoms, and intraoperative and postoperative complications. Optical coherence tomography data collected included macular ganglion cell volume and thickness, as well as retinal nerve fiber layer thickness. Preoperative baseline data and 1-, 6-, and 12-month postoperative data were collected. Repeated measures with a mixed-effects model were used for continuous data, and linear regression analyses were performed.</p><p><strong>Results: </strong>A total of 55 patients (86 eyes) underwent optic nerve sheath fenestration, via a medial transconjunctival approach by the same orbital surgeon. After 12-month follow-up, visual acuity ( P < 0.05), perimetric mean deviation ( P < 0.05), and optic disc edema ( P < 0.001) improved in the operative eye. Retinal nerve fiber layer thickness decreased from a mean of 165 to 92 µm ( P < 0.001). Macular ganglion cell volume was found to have a small decrease from baseline and correlated well with visual acuity, contrast sensitivity testing, and perimetric mean deviation ( P < 0.001).</p><p><strong>Conclusions: </strong>Optic nerve sheath fenestration performed via a medial transconjunctival approach is a safe and effective method to preserve vision in patients with papilledema, particularly in cases of fulminant or progressive idiopathic intracranial hypertension. Quantitative measurements of the macular ganglion cell layer can serve as a useful adjunct to other diagnostic testing.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"213-220"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply Re: \"Peri-Levator Betamethasone Versus Triamcinolone Injection in Management of Thyroid Eye Disease-Related Upper Eyelid Retraction Without Proptosis\".","authors":"Rawda A Awad, Ahmad A Awad, Abd El-Nasser A Mohammad","doi":"10.1097/IOP.0000000000002919","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002919","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 2","pages":"234"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rosai-Dorfman Disease of the Lacrimal Sac.","authors":"Nandini Bothra, Dilip K Mishra, Mohammad Javed Ali","doi":"10.1097/IOP.0000000000002811","DOIUrl":"10.1097/IOP.0000000000002811","url":null,"abstract":"<p><p>Extranodal Rosai-Dorfman disease involving the orbit and sinuses is well documented in the literature. However, those involving the lacrimal drainage system alone are rare. A woman presenting with Rosai-Dorfman disease involving the lacrimal drainage system, masquerading as a lacrimal sac malignancy, and its treatment is highlighted in the report described. Minimally invasive treatment for lacrimal drainage system involving Rosai-Dorfman disease in the form of intralesional steroids can be a safe and effective option.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e40-e41"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcome of Conjunctival Transposition Flaps for Contracted Sockets.","authors":"Kaveh Vahdani, Geoffrey E Rose","doi":"10.1097/IOP.0000000000002755","DOIUrl":"10.1097/IOP.0000000000002755","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy, and reintervention rate, of a conjunctival transposition technique in the treatment of contracted fornices in anophthalmic sockets.</p><p><strong>Methods: </strong>Retrospective case-note review of patients with contracted anophthalmic sockets who received a novel conjunctival mucosal transposition flap for augmentation of socket lining. Contracted anophthalmic sockets were categorized as grade 1 (minimal contraction), grade 2 (inferior and/or superior fornix), grade 3 (advanced scarring of the entire upper and lower fornices), and grade 4 (severe palpebral phimosis, recurrent cases, and irradiated sockets).</p><p><strong>Results: </strong>Of 32 patients (56% male), 53% had mild-to-moderate contracted anophthalmic sockets (grades 1 or 2). The transposition flap was combined with secondary ball implantation (3 cases), ball exchange (1 case), primary orbital floor (1 case), or revisional floor (3 cases) implantation. By an average follow up of 9.2 years, 16% (5 cases with grade 3 or 4) required additional relining, with another patient declining further surgery; this yielding an overall anatomic success of 81% (100% in grades 1 and 2; 60% in grades 3 and 4). At the last follow up, 91% of patients had adequate socket lining and 94% reported a comfortable socket with stable prostheses.</p><p><strong>Conclusions: </strong>Having results similar to free grafting but without remote donor-site morbidity, this novel transposition flap satisfactorily addresses mild-to-moderate fornix contracture, and most patients achieve stable and comfortable prosthetic wear. Some patients with severe contracted anophthalmic sockets required further autologous grafting: this generally arose because the transposition flap included tissue from above the socket's horizontal raphé (with later contracture of the upper fornix).</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"148-155"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Changes in Hand Tactile Sensitivity After Glabellar Botulinum Toxin Treatment.","authors":"Johnson T Hoang, Renata M Maia, Cat N Burkat","doi":"10.1097/IOP.0000000000002764","DOIUrl":"10.1097/IOP.0000000000002764","url":null,"abstract":"<p><strong>Purpose: </strong>The authors aimed to assess behavioral changes in tactile sensitivity in patients receiving cosmetic glabellar botulinum toxin-A injections.</p><p><strong>Methods: </strong>In this prospective cohort study, the authors conducted quantitative sensory testing on 20 patients receiving 15 to 35 units of glabellar botulinum toxin-A treatment between October 1, 2022 and March 8, 2023. The authors used modified Von Frey filaments to exert forces between 0.25 mN and 512 mN to the dorsal hand just prior to botulinum toxin-A injections. Filament tips were uniform, rounded, and 0.5 mm in diameter to prevent nociceptor activation. This process was repeated 4 to 6 weeks after injection to assess for any change in minimal mechanical detection thresholds.</p><p><strong>Results: </strong>Minimal mechanical detection thresholds decreased (patients detected smaller amounts of force) overall, in patients with prior botulinum toxin-A treatment, and in patients without prior botulinum toxin-A treatment: 5.34 mN to 4.33 mN ( p = 0.22), 6.43 mN to 5.97 mN ( p = 0.31), and 4.44 mN to 3.00 mN ( p = 0.53), respectively.</p><p><strong>Conclusions: </strong>The authors' results suggest that the plastic changes observed in previous studies do not necessarily result in clinically significant manifestations when utilizing small to moderate amounts of botulinum toxin-A for aesthetic correction of glabellar lines, thus highlighting the safety of botulinum toxin-A for this indication. Further research is required to gain a comprehensive understanding of whether hand-associated cortical activity is altered after aesthetic amounts of botulinum toxin are injected.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"161-165"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting Extraocular Motility in a Patient With Burkitt Lymphoma.","authors":"Ryan P Nolan, Daniel A Rodriguez, Abraham J Mathew, Lucy I Mudie, Michael T Yen","doi":"10.1097/IOP.0000000000002791","DOIUrl":"10.1097/IOP.0000000000002791","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e76"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}