Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Canalicular Coronary Stent Recanalization: First Experience in Human Patients, Surgical Techniques and Outcomes.","authors":"Mohammad Javed Ali","doi":"10.1097/IOP.0000000000003047","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003047","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the feasibility of implanting a drug-eluting cobalt-chromium alloy coronary stent in patients with extensive canalicular obstructions.</p><p><strong>Methods: </strong>The pilot study was carried out in 4 canaliculi of 4 patients with extensive canalicular obstructions in a setting of earlier failed dacryocystorhinostomy. All patients underwent preoperative dacryoendoscopy to characterize the canalicular obstruction. This was followed by full-length canalicular trephination and balloon dacryoplasty along with a revision dacryocystorhinostomy. Sirolimus-eluting coronary stents of 2 mm in diameter (when fully expanded) and 12 mm in length, mounted on balloon catheters, were used. The balloon catheters were introduced into the canaliculi under endoscopy guidance. The stents were delivered following dilatation of the balloon to 12 atmospheres and secured in a locked (spring-out) position. The balloon was then deflated, securely removed, and the stent position was reconfirmed with a dacryoendoscopy. Postoperative monitoring of the implanted stent was performed using dacryoendoscopy, nasal endoscopy, CT scans, and MRI imaging to assess its stability, outcomes, and complications.</p><p><strong>Results: </strong>The drug-eluting cobalt-chromium alloy coronary stents could be delivered and secured at a desired position within the canaliculi. The trephined canaliculi were uniformly dilated 360 degrees with a wide and uniform lumen. Intraoperatively, the edges and intervening patches of the freshly trephined canalicular lumen were uniformly distributed in spaces between the stent rings without any influence on the already expanded lumen. CT-dacryocystography (DCG) and MRI provided additional information on the stent position, angulation, and dye conductance through the stent. At 6 weeks, 2 of the canaliculi reoccluded, 1 partially reoccluded, and 1 was patent. The postoperative course provided several new learnings that would help further modify the procedure. The surgical learning curve is shallow if the surgeon is adept with canalicular trephination and balloon dacryoplasty techniques.</p><p><strong>Conclusion: </strong>Drug-eluting cobalt-chromium alloy coronary stents can be precisely deployed and secured within a well-trephined canaliculus. The study is the first to demonstrate the surgical technique of canalicular coronary stent recanalization in human patients with canalicular obstructions. While there were some frustrating failures, this pilot study, nevertheless, lays the foundations of prophylactic or therapeutic techniques that have the potential to maintain canalicular patency in a wide range of canalicular disorders.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963763","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":"Periocular Reconstruction Utilizing the Integra Dermal Regeneration Template.","authors":"Liane O Dallalzadeh, Anne L Bennett, Mikaela Kislevitz, Phillip A Tenzel, Ronald Mancini, Kamel Itani, James F Thornton","doi":"10.1097/IOP.0000000000003042","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003042","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the use of the Integra dermal regeneration template (DRT) for periocular reconstruction following Mohs micrographic or surgical excision of cutaneous malignancy.</p><p><strong>Methods: </strong>This is a retrospective study of adult patients who underwent periocular reconstruction using DRT from 2017 to 2023 at a single academic institution. All patients had a postexcision defect involving at least 1 periocular subunit, including brow, temple, cheek, nasal sidewall, medial and/or lateral canthal areas. The primary outcome measure was the incidence of postoperative cicatricial eyelid malposition.</p><p><strong>Results: </strong>Sixteen patients were included (62.5% male, 70.6 ± 11.3 years old [mean ± SD]). Mean postexcision defect measured 27.0 ± 21.4 cm2, with 13 patients (81.3%) having a defect that involved more than 1 periocular subunit, with medial canthal area and nasal side wall being most common (37.5%). DRT was chosen for staged reconstruction for 4 cases where the final stage of excision reached periosteum/bone, 3 cases awaiting clearance of margins, 2 cases of perineural invasion, and 3 cases medically unfit to undergo general anesthesia, when specified. Re-epithelialization occurred 34 ± 8 days following DRT placement with either full thickness or split thickness skin graft, or adjacent tissue transfer. Nine patients (56.3%) developed cicatricial eyelid malposition, with the brow and nasal side wall having the greatest incidence. Means of re-epithelialization was not significantly associated with the incidence of malposition (p = 0.87).</p><p><strong>Conclusions: </strong>This series demonstrates DRT's utility in the reconstruction of large periocular defects following excision of cutaneous malignancy, particularly cases that lack pathological clearance at the time of reconstruction. The incidence of subsequent eyelid malposition is not insignificant and merits preoperative discussion.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963786","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":"Orbital Synovial Sarcoma: Novel Case Report and Review of the Literature.","authors":"Samantha X Xing, Lauren B Yeager, Carlos A Pagan, Shifali Dumeer, Brian P Marr","doi":"10.1097/IOP.0000000000003038","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003038","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical, histologic, and molecular features of a rare case of orbital synovial sarcoma and to provide a comprehensive literature review.</p><p><strong>Methods: </strong>We present a case report and up-to-date literature review of orbital synovial sarcoma. Variables analyzed included patient demographics, clinical presentations, imaging findings, histopathologic features, molecular diagnostics, treatment, and outcomes.</p><p><strong>Results: </strong>A 25-year-old female presented with a left orbital mass causing swelling, tearing, and mild vision impairment. Imaging identified a mass in the inferior orbit, which was subsequently confirmed by pathology as a monophasic spindle cell synovial sarcoma. Notably, initial fluorescence in situ hybridization testing for the SS18 rearrangement was negative; however, next-generation sequencing later identified an SS18-synovial sarcoma X breakpoint protein 2 fusion. The patient underwent complete surgical resection, followed by proton beam radiotherapy and chemotherapy. A PubMed and Medline search revealed 10 prior cases of orbital synovial sarcoma. Most patients were female (90.9%) and presented with painless swelling, lacrimation, and headaches. All tumors were localized at diagnosis. Surgical resection was the primary treatment in 81% of cases, with adjuvant radiation or chemotherapy each administered in 36% of cases. No recurrence or metastasis was observed on follow-up (average 11.6 months).</p><p><strong>Conclusions: </strong>Orbital synovial sarcoma is rare and typically localized at diagnosis. This is the first reported orbital synovial sarcoma with an SS18-synovial sarcoma X breakpoint protein 2 fusion identified by next-generation sequencing after negative fluorescence in situ hybridization. The case underscores the diagnostic value of molecular profiling when standard testing is inconclusive.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963820","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":"Outcomes and Risk Factors for Complications of Dermis-Fat Graft as Primary Orbital Implant.","authors":"Anna Schuh, Nicolas Pensel, Franziska Reinking, Siegfried Priglinger, Christoph Hintschich","doi":"10.1097/IOP.0000000000003032","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003032","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate outcomes after dermis fat graft (DFG) as primary orbital implants after enucleation, complication rates, and possible risk factors for complications.</p><p><strong>Methods: </strong>Retrospective analysis of all primary DFG (DFG I°) performed at the University Eye Hospital of Ludwig-Maximilians-University Munich from 2013 to 2022.</p><p><strong>Results: </strong>A total of 257 sockets of 257 patients were reconstructed after enucleation with a DFG I°. 222 eyes with sufficient follow-up were included for analysis. Almost 59.9% (n = 133) of patients were male and 40.1% (n = 89) female. Median age at surgery was 60 years (range 10-93). The most common surgical indications were painful blind eye (148, 66.7%), malignancy (55, 24.8%), treatment-refractory perforated corneal ulcer (9, 4.0%), and disfiguring blind eye (5, 2.2%). Median time of follow-up was 10.6 months (range 0.7-123.2). Median time to fitting of the first prosthesis was 1.2 months (range 0.6-22.8). Prosthesis fitting was excellent in the majority of patients (156/168; 93%), as was prosthesis motility (119/158; 75%). Patient satisfaction was excellent in 81% (123/151). Complications were as follows: complete necrosis 1.8% (4/222), partial necrosis 2.7% (6/222), severe atrophy 1.8% (2/111), postoperative hemorrhage 0.5% (1/222), contracted socket 4.5% (5/111). Older age at surgery was statistically significantly associated with necrosis (p = 0.049), contracted socket (p = 0.042), and atrophy (p = 0.039).</p><p><strong>Conclusions: </strong>DFG is a safe and effective technique for primary socket reconstruction after enucleation, yielding favorable outcomes with rarely major complications. Older age at surgery was the sole significant risk factor identified for DFG necrosis, atrophy, and contracted socket.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963839","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":"Nonneural Granular Cell Tumor of the Eyelid in a 10-Year-Old Boy.","authors":"Kelsey L Walsh, Kevin Whitehead, Matthew H McCartney, Gary Quagliotto, Timothy J Sullivan","doi":"10.1097/IOP.0000000000003008","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003008","url":null,"abstract":"<p><p>Nonneural granular cell tumors are rare neoplasms and their histogenesis remains incompletely understood. While these tumors share morphological similarities with conventional granular cell tumors, they are thought to represent a distinct entity owing to their lack of S100 protein expression. We report the first published case of pediatric eyelid nonneural granular cell tumors - only the third known eyelid presentation case described to date. This case highlights the importance of accurate histopathological diagnosis and contributes to the limited body of literature guiding the surgical management of these rare tumors.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855946","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":"Assessment of Differential Diagnoses for Oculoplastics Cases Produced by Large Language Models.","authors":"Jeffrey C Peterson, Sruti S Rachapudi, Sasha Hubschman, Kevin Heinze, Thomas Oetting, Sean M Rodriguez, Pete Setabutr, Ann Q Tran","doi":"10.1097/IOP.0000000000002984","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002984","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the accuracy of different large language models (LLMs) in generating differential diagnoses for oculoplastic cases.</p><p><strong>Methods: </strong>Differential diagnoses were generated for 20 oculoplastic cases sourced from University of Iowa EyeRounds.org using 6 LLMs: Chat Generative Pre-Trained Transformer (ChatGPT) 3.5, ChatGPT 4.0, OcuSmart/EyeGPT, Google Gemini 1.5, Claude 3.5, and Microsoft CoPilot. Outputs were compared against the EyeRounds expert-curated differentials examining (1) top diagnosis match rate (2) inclusion of the correct diagnosis within the generated list, as well as (3) recall and (4) precision, calculated to assess the overlap and conciseness of LLM outputs.</p><p><strong>Results: </strong>OcuSmart/EyeGPT achieved the highest top diagnosis match rate (85 ± 36%), while Claude 3.5 demonstrated the highest rate of inclusion of correct diagnosis in differential, as well as recall rate (100 ± 0% and 55 ± 27%, respectively). Google Gemini produced the most precise differentials at 43 ± 24%. Claude 3.5 generated the largest but least concise lists. LLM performance varied by case; for example, idiopathic orbital inflammation cases yielded highest recall and top diagnosis match across all models, while floppy eyelid syndrome cases demonstrated lowest performance.</p><p><strong>Conclusions: </strong>LLMs show promising potential in diagnosing oculoplastic cases, with OcuSmart/EyeGPT and Claude 3.5 performing best for determining the case diagnosis and recall, and ChatGPT 3.5, OcuSmart/EyeGPT, and Gemini generating concise and relevant differentials. However, further research and development are necessary to validate LLMs' capabilities and integrate them into the clinical workflow.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817192","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":"Elastic Fiber Characteristics of Lacrimal Tracts to Aging and Inflammation.","authors":"Hirohiko Kakizaki, Mohammad Javed Ali, Deepak P Edward, Blanche Xiao Hong Lim, Yasuhiro Takahashi","doi":"10.1097/IOP.0000000000003009","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003009","url":null,"abstract":"<p><strong>Purpose: </strong>To microscopically examine elastic fiber characteristics of the lacrimal tracts in relation to aging and inflammation.</p><p><strong>Materials and methods: </strong>Histological evaluation of 8 lacrimal canaliculi from 6 East Asian cadavers (age range: 36-87 years) and 14 lacrimal sacs and nasolacrimal ducts from 9 East Asian cadavers (age range: 52-98 years) was performed. The specimens were fixed in 10% formalin and stained with Elastica van Gieson. Elastic fiber characteristics were observed across age groups, and the ratio of flexible and fragmented-thickened-curved elastic fibers (f/ftc) was subjectively estimated using a 4-point scale.</p><p><strong>Results: </strong>In the lacrimal canaliculi, the f/ftc ratios ranged from 3/1 to 4/0 in the third and fourth decades of life. By the seventh decade, approximately half of the elastic fibers were either fragmented, thickened, or curved. In the eighth decade, the f/ftc ratio dropped to 0/4. In the lacrimal sacs and nasolacrimal ducts, the youngest 52-year-old left specimen showed the f/ftc ratio of 3/1 both in the lacrimal sac and nasolacrimal duct. A majority of the specimens from the seventh, eighth, and ninth decades of life demonstrated the f/ftc ratio of either 1/3 or 0/4 in the lacrimal sac and the nasolacrimal ducts. The 87-year-old male's canalicular specimens (right 2/2, left 0/4) and the 77-year-old male's sac specimens (right 0/4, left 1/3) exhibited asymmetrical findings between sides. Three lacrimal sacs in old age demonstrated inflammation with a decreasing number of elastic fibers.</p><p><strong>Conclusion: </strong>Elastic fibers in the lacrimal tracts progressively fragment, thicken, and curve with age. Inflammation decreased the number of elastic fibers.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817196","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":"Endoscopic Dacryocystorhinostomy in a Patient With Hemi-Arrhinia.","authors":"Zachary Kelly, Eelam Adil, Edith R Reshef","doi":"10.1097/IOP.0000000000003001","DOIUrl":"10.1097/IOP.0000000000003001","url":null,"abstract":"<p><p>Congenital arrhinia and hemi-arrhinia can present with varying degrees of nasal hypoplasia. There are significant anatomical consequences to the lacrimal system, and treatment of epiphora in these cases is challenging, with few reports of successful external dacryocystorhinostomy or combined endoscopic and external dacryocystorhinostomy. A 12-year-old girl with left hemi-arrhinia presented with left-sided epiphora and chronic dacryocystitis due to an incompletely formed nasolacrimal system. She underwent a left endoscopic dacryocystorhinostomy via a right-sided transnasal approach in conjunction with otorhinolaryngology, with complete resolution of symptoms postoperatively. This is the first reported case in the literature demonstrating that epiphora in the setting of hemi-arrhinia may be successfully treated in a completely endoscopic fashion with a multidisciplinary team and stereotactic navigation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817197","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":"Subjective Assessment of Eight CT Features in the Prediction of Dysthyroid Optic Neuropathy.","authors":"Isobel Landray, Kaveh Vahdani, James Carpenter, Katherine Miszkiel, Lakshmi A Ratnam, Geoffrey E Rose","doi":"10.1097/IOP.0000000000003007","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003007","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the subjective assessment of 8 orbital CT features for predicting dysthyroid optic neuropathy (DON).</p><p><strong>Methods: </strong>Scan montages from 137 orbits without DON and 121 with DON were each graded independently by 3 observers for 8 imaging features: namely, degree of apical crowding, extraocular muscle enlargement, expansion of orbital fat, clarity of the superior orbital fissure, fat prolapse through the superior orbital fissure, medial wall bowing, general orbital vascular congestion, and dilation of the superior ophthalmic vein. Gradings were analyzed individually and also averaged across observers. Associations with DON were assessed using univariate and multivariate logistic regression, and performance of the latter was assessed using area under the receiver-operating-characteristic curve, sensitivity, specificity, and calibration plots.</p><p><strong>Results: </strong>Unadjusted models showed apical crowding (p < 0.001), extraocular muscle enlargement (p < 0.001), vascular congestion (p = 0.001), and medial wall bowing (p < 0.001) were each associated with DON, across all observers. Models for observers 1 and 3 included only apical crowding, with a 1-unit grading-increase giving, respectively, a 2.88-fold and 3.04-fold increase in DON odds (p < 0.001). The observer 2 model included extraocular muscle enlargement (odds ratio: 2.95; p < 0.001) and vascular congestion (odds ratio: 2.57; p = 0.023). The \"averaged-score\" model for all observers included only apical crowding, with a 3.76-fold increased odds per unit increase in grading (p < 0.001). The models showed borderline-acceptable discrimination (area under the receiver-operating-characteristic curve: 0.68-0.75) and good calibration, with the averaged-score model performing best.</p><p><strong>Conclusions: </strong>Apical crowding, extraocular muscle enlargement, vascular congestion, and medial wall bowing are key predictors of DON, with apical crowding being the most influential.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817201","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":"Visual Improvement in a Child With Periorbital Plexiform Neurofibroma Treated With Selumetinib: Case Report and Literature Review.","authors":"Abdulrahman S Alhadlag, Hatim H Najmi, Faisal A Altahan, Fatimah A AlHammad","doi":"10.1097/IOP.0000000000003011","DOIUrl":"10.1097/IOP.0000000000003011","url":null,"abstract":"<p><p>We describe a case of a 4-year-old girl with neurofibromatosis type 1 and a large, inoperable periorbital plexiform neurofibroma involving the right trigeminal nerve treated with selumetinib, highlighting significant tumor reduction, visual improvement, and lightening of café-au-lait macules. The patient showed significant clinical and radiological improvements within 8 months of selumetinib therapy. Tumor volume decreased by approximately 70% with marked proptosis resolution and extraocular motility restoration. The visual acuity of the affected eye improved from 20/100 to 20/40, and the intraocular pressure was stabilized without surgical intervention. Adverse effects were mild and included transient elevations in creatine phosphokinase levels and mild hair loss, with no dose adjustment required. This case highlights selumetinib as a potential first-line treatment for inoperable periorbital plexiform neurofibromas in pediatric patients with neurofibromatosis type 1, achieving functional and visual improvements. Future studies should explore the long-term efficacy and safety of mitogen-activated protein kinase inhibitors in similar cases.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817166","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}