Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Ophthalmic Outcomes of Transorbital Endoscopic Skull Base Surgery.","authors":"Quillan M Austria, Shanlee M Stevens, Allison Coombs, Gary J Lelli, Theodore H Schwartz, Kyle J Godfrey","doi":"10.1097/IOP.0000000000003091","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003091","url":null,"abstract":"<p><strong>Purpose: </strong>Transorbital endoscopic approaches to the skull base provide minimally invasive access with decreased surgical morbidity in appropriately selected cases. This study expands on the current understanding of transorbital neurological surgery by expanding the cohort, duration of follow-up, detailed ophthalmologic outcomes, and analysis.</p><p><strong>Methods: </strong>A retrospective consecutive case review was performed. Included subjects underwent lateral transorbital endoscope-assisted surgical approaches at a single center between 2016 and 2024. Subjects were stratified into 4 groups based on pathology (and/or) location: intradural, extradural, cavernous sinus and Meckel cave, and sphenoid wing meningiomas ± hyperostosis. Demographic information and ophthalmologic data were collected.</p><p><strong>Results: </strong>Thirty-five subjects were included: intracranial intradural (n = 8), intracranial extradural (n = 8), cavernous sinus and Meckel cave (n = 11), and sphenoid wing meningioma (n = 8). On average, visual acuity (VA) trended toward improvement in all groups except sphenoid wing meningioma; however, this trend did not reach statistical significance (p = 0.39). Fifteen patients completed preoperative and postoperative Humphrey visual field testing. Overall, mean deviation scores trended toward improvement from -3.59 ± 4.28 to -1.82 ± 2.82 dB; however, this trend did not reach statistical significance (p = 0.35). A similar trend was seen in all groups except the extradural group. There were statistically significant improvements in diplopia (p = 0.01), extraocular motility (p = 0.04), and exophthalmos (p = 0.04) in all groups. Dyschromatopsia trended toward a decrease from 23% to 10% and, however, did not reach statistical significance (p = 0.06). Transient diplopia, ptosis, and extraocular motility deficits were common but generally resolved; however, 66% of subjects had persistent postoperative V1 or V2 hypoesthesia.</p><p><strong>Conclusions: </strong>Visual outcomes were stable or improved in almost all patients. However, patients should be alerted to the possibility of persistent facial hypoesthesia. These results provide evidence that lateral transorbital endoscope-assisted approaches may have favorable ophthalmological morbidity profiles when performed by expert, multidisciplinary teams in carefully selected cases.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192352","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":"Primary Orbital Cryptococcosis in an Immunocompetent Child: A Case Report.","authors":"Rana Shebl, Mai Soliman, Rania A Ahmed","doi":"10.1097/IOP.0000000000003092","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003092","url":null,"abstract":"<p><p>Orbital fungal infections are initially misdiagnosed, typically only considered in immunocompromised patients, and may be empirically treated with systemic corticosteroids-potentially exacerbating disease progression. We report the third case described in medical literature of Cryptococcus neoformans invading the orbit in an immunocompetent host and the first in a child with bilateral presentation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192318","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":"Effects of Glucagon-Like Peptide-1 Receptor Agonist on Facial Landmarks.","authors":"Teresa H Chen, Joy Li, Dylan Hellbusch, Jeremiah P Tao","doi":"10.1097/IOP.0000000000003070","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003070","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effects of glucagon-like peptide-1 (GLP-1) receptor agonist on facial landmarks.</p><p><strong>Methods: </strong>A retrospective case-control study with age-, sex-, ethnicity-, and diagnosis-matching of patients in one institution under the care of one oculofacial plastic surgeon from 2022 to 2024. Inclusion criteria were patients over 18 years old with high-resolution frontal full-face photographs. Exclusion criteria were prior oculofacial aesthetic or reconstructive procedures, trauma, paresis, or thyroid eye disease. These facial landmarks were measured: total face, upper-facial, mid-facial and lower-facial heights, palpebral fissure width and height, upper eyelid height, nasal width and height, palpebral fissure slant, philtrum width and height, upper and lower lip heights, upper and lower vermillion heights, mouth width, and upper and lower vermillion angles.</p><p><strong>Results: </strong>Eighteen patients taking GLP-1 agonists and 18 matched patients not taking GLP-1 agonists (control) were identified. The average age was 68 ± 11 years for both groups. There were 8 males and 10 females in each group. Half had a diagnosis of bilateral upper eyelid blepharoptosis, and half had bilateral upper eyelid dermatochalasis. Average duration of GLP-1 agonist use was 324 days, with an average change in weight -3.4 kg and change in body mass index -1.5. There was no statistically significant difference in body mass index in the GLP-1 agonist group (29.6 ± 7.6) and the control group (28.2 ± 7.1) (p = 0.57). Patients taking GLP-1 agonists had statistically significantly increased philtrum width, upper vermillion height, lower lip height, and mouth width (p ≤ 0.05).</p><p><strong>Conclusions: </strong>Patients taking GLP-1 agonists had statistically significant increases in orolabial measurements.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192334","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":"Dermal Matrix Templates in Periocular and Orbital Reconstructive Surgery.","authors":"Peter Garside, Joseph Pearman, Priya Bhatt","doi":"10.1097/IOP.0000000000003065","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003065","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this article is to provide a concise literature review highlighting the current clinical applications of dermal matrix templates in periocular and orbital reconstructive surgery. We include well-established surgical techniques as well as novel applications reported on individual patients or small case series. The hope is that this review will give the reader a better understanding of the biological properties of dermal matrix templates and their emerging uses within the field of oculoplastic and reconstructive surgery.</p><p><strong>Methods: </strong>Literature search. A PubMed search was performed using the search terms \"dermal matrix AND periocular,\" \"dermal matrix template AND orbital,\" \"dermal matrix AND eyelid,\" \"integra AND eyelid,\" \"acellular dermal AND eyelid.\" A full review of the literature using the PubMed database was conducted up until January 11, 2025. The articles used were written in English, with all articles accessed in full. Both review articles and original articles were used for this review.</p><p><strong>Results: </strong>Current applications of dermal matrix templates within periocular and orbital reconstruction include in periocular tissue loss, eyelid surgery, conjunctival surgery, and in socket reconstruction following exenteration. Novel uses include anophthalmic socket augmentation, orbital wall reconstruction, nasolacrimal duct reconstruction, and lower lid blepharoplasty.</p><p><strong>Conclusions: </strong>Dermal matrix templates are a useful addition to the oculoplastic surgeon's armamentarium, offering an alternative to traditional reconstructive techniques utilizing local tissue flaps or skin grafts.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138215","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":"The Use of Hypochlorous Acid in the Treatment of Periorbital Necrotizing Fasciitis.","authors":"Jonathan Siktberg, Louise A Mawn","doi":"10.1097/IOP.0000000000003061","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003061","url":null,"abstract":"<p><p>Periorbital necrotizing fasciitis (PONF) is a severe skin and soft tissue infection that corrupts the body's natural immune response, leading to extensive tissue necrosis that can result in exenteration or death. Reactive oxygen species, such as hypochlorous acid, are among the elements employed by the immune system in fighting bacterial infection. In necrotizing fasciitis this immune response is thwarted, as the responsible pathogens produce enzymes that eliminate these reactive oxygen species. The host immune response can be augmented by the external application of hypochlorous acid to severely infected tissues. This manuscript presents a case series of 18 orbits from 15 patients treated with a novel treatment approach in the orbit-local administration of hypochlorous acid-in addition to traditional treatment with surgical debridement and intravenous antibiotics. Patients in this series were diagnosed with periorbital necrotizing fasciitis and received local hypochlorous acid administration via an orbital catheter and a Penrose drain to allow for flow-through of the bacterial toxins. Hypochlorous acid was well tolerated in all patients. Zero patients underwent exenteration, and zero patients died. Further investigation into hypochlorous acid treatment in periorbital necrotizing fasciitis is warranted.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131469","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":"The Recognizability of Cropped Unilateral Upper Face Photographs.","authors":"Edsel B Ing, Brendan K Tao, Michael Balas, Daisy Liu, Kenneth Chang, Georges Nassrallah, Ahsen Hussain, Navdeep Nijhawan","doi":"10.1097/IOP.0000000000003074","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003074","url":null,"abstract":"<p><strong>Purpose: </strong>Facial photographs are invaluable medical teaching tools, but patient privacy must be respected. The degree to which unilateral cropped upper face photos are recognizable is not known.</p><p><strong>Methods: </strong>Oculofacial surgeons were canvassed on a societal email to participate in an online study in February 2025. The surgeons were shown 4 famous individuals. Each of the 4 celebrities was presented initially as a cropped unilateral periorbital photograph with an iris mask, then without an iris mask, and then finally as a full face photograph. For each photograph, the surgeons were asked to identify the celebrity and rate how confident they were in the identification.</p><p><strong>Results: </strong>Eighty-seven surgeons completed the study with a response rate of 62%. Overall, the cropped, unilateral upper face photographs of famous celebrities were correctly identified on average 4.9% of the time, with a mean prediction confidence level of 69 ± 15%. Unmasking the iris did not improve recognition. Mistaken identification of the cropped, iris-masked, unilateral upper face photographs occurred approximately 20% of the time. On average, there was a 16.8-fold increase in recognition of the full face of famous celebrities compared with the cropped unilateral upper face photo.</p><p><strong>Conclusion: </strong>In the vast majority of cases, the identity of cropped unilateral periorbital photos is not discernible. Notwithstanding, patient informed consent remains mandatory to obtain and use photos for publication.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125184","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 of Punctal Dilatation With Monocanalicular Stent for the Treatment of Punctal Stenosis.","authors":"Nandini Bothra, Giannis A Moustafa, Roman Shinder, Mohammad Javed Ali","doi":"10.1097/IOP.0000000000003077","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003077","url":null,"abstract":"<p><strong>Purpose: </strong>To discuss the outcomes of nonincisional punctal dilatation and monocanalicular stent intubation in patients with acquired punctal stenosis.</p><p><strong>Methods: </strong>Retrospective interventional study of patients with symptomatic punctal stenosis over a study period of 4 years (July 2018-July 2022). All patients underwent nonincisional punctal dilation with monocanalicular stenting at 2 tertiary institutes in India and the United States. Procedures were performed as an office procedure with local anesthesia. Topical antibiotics and tapering doses of topical steroids were prescribed in the postoperative period. Stent extubation was done at 4 to 6 weeks. A minimum follow-up of 6 months postoperatively was required to be included in the study. Anatomic success was defined as a patent grade 3 punctum, while functional success was defined as absent or only occasional epiphora (Munk ≤ 1).</p><p><strong>Results: </strong>A total of 198 puncta of 163 patients were included in the study. About 71.8% of patients were women, and the mean age was 53 years (range: 12-82 years). At a mean follow-up of 9.1 months (range: 6-60 months), a significant postoperative improvement in the Munk score (3.71-1.49, p < 0.01) was noted. At postoperative month 6, anatomic success was achieved in 189 (95.5%) puncta, and functional success was achieved in 185 (93.4%) puncta. Recurrent stenosis was noted in 16 (8%) puncta.</p><p><strong>Conclusion: </strong>Nonincisional punctal dilation with a monocanalicular stent demonstrates high anatomical and functional success rates and low restenosis rate, while preserving the punctal integrity and lacrimal pump function.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125242","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":"Chronic Dacryocystitis With Elevated IgG4-Plasma Cells in a Patient With Rubinstein-Taybi Syndrome: An IgG4-Related Disease?","authors":"Nikolaos Gkalapis, Marie Elisabeth Burghardt, Christin Busse, Arne Viestenz, Mohammad Javed Ali, Jens Heichel","doi":"10.1097/IOP.0000000000003071","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003071","url":null,"abstract":"<p><p>Rubinstein-Taybi syndrome (RTS) is a rare congenital neurodevelopmental disorder associated with several ocular and lacrimal anomalies. A 40-year-old female patient with RTS presented with persistent right-sided epiphora following an earlier unsuccessful endoscopic dacryocystorhinostomy performed elsewhere. The patient underwent revision external dacryocystorhinostomy with fistulectomy and intubation. Intraoperatively, a focal polypoidal lacrimal sac lesion was noted, and histological analysis revealed significant immunoglobulin G4 (IgG4)-plasma cell infiltration. However, the diagnostic criteria for IgG4-related ophthalmic disease were not fulfilled. The revision external surgery was anatomically and functionally successful. To the best of the authors' knowledge, this is the first report of IgG4-plasma cell infiltration in the lacrimal apparatus of a patient with RTS.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125188","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":"Ex Vivo Biomechanical Comparison of Silicone Sling Securing Methods for Frontalis Ptosis Repair.","authors":"Ziki Gurney, Meydan Ben Ishai, Chris Schulz, Saul Rajak","doi":"10.1097/IOP.0000000000003073","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003073","url":null,"abstract":"<p><strong>Purpose: </strong>In silicone sling frontalis suspension surgery, the sling is secured by passing both ends through a tight sleeve. Slippage of the silicone sling through the sleeve is likely a major reason for surgical failure. This ex vivo study compared different securing methods to improve the security of the sling in the sleeve.</p><p><strong>Methods: </strong>This quantitative laboratory study compared 6 methods of securing the sling and sleeve to the control: 1) sutures to join the sleeve and sling, 2) 2-throw and 3) 3-throw square knots with the sling, 4) ligaclips, 5) cyanoacrylate surgical glue, and 6) a heat-shrink polyolefin sleeve. Tensile strength in Newtons (N) was measured to determine the force required to either initiate tail slippage or cause complete breakage of the silicone sling.</p><p><strong>Results: </strong>The securing methods, ranked by tensile strength, were: 3-throw square knot (4.3 N ±0.3), 2-throw square knot (3.7 N ±0.4), sutures (2.7 N ±0.5), ligaclips (1.3 N ±0.3), heat-shrink (1.1 N ±0.4), glue (0.6 N ±0.1), and control (0.2 N ±0.0). All methods, except glue, were significantly more effective than the control group.</p><p><strong>Conclusions: </strong>Multiple methods can greatly improve the security of the sling within the sleeve in these laboratory tests. However, further in vivo exploration is needed to assess other factors such as biocompatibility, risk of extrusion, adjustability, and prominence under the brow. The aim is to develop a quick and easy method to apply while allowing for safe removal or loosening to adjust lid height without introducing additional risks.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125247","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":"Association Between Area Deprivation Index and Periocular Basal Cell Carcinoma Treated With Mohs Micrographic Surgery.","authors":"Kiara M Corcoran Ruiz, Cory Shoshany, Karla L Valdes Morales, Daniela Frankel, Mara Trifoi, Christopher J Miller, Jeremy R Etzkorn, Jocelyn He, Gui-Shuang Ying, César A Briceño","doi":"10.1097/IOP.0000000000003066","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003066","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the association of neighborhood-level disadvantage with periocular basal cell carcinoma (BCC) sizes and time to surgery for patients treated with Mohs micrographic surgery (MMS).</p><p><strong>Methods: </strong>Periocular BCC treated with MMS were identified from a prospectively maintained database from a single institution over 17 years. The Area Deprivation Index (ADI) was used to rank neighborhoods by socioeconomic disadvantage with higher national ADI scores indicative of greater neighborhood-level deprivation. Primary outcomes included pre- and postoperative defect size and time to surgery from diagnosis date.</p><p><strong>Results: </strong>Our study included a total of 1,592 patients. There were greater percentages of non-White (p < 0.001) and Hispanic or Latino (p < 0.001) patients in the higher ADI quartiles. Higher ADI was associated with larger preoperative BCC size (p < 0.001), larger postoperative BCC size (p < 0.001), and longer time between diagnosis to surgery (p < 0.001).</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to analyze associations between periocular BCC treated with MMS and neighborhood-level deprivation in the United States. Disparities in tumor sizes at presentation and delays in surgery for patients with periocular BCC, provide opportunities for further study to promote timely diagnosis and treatment of periocular cutaneous malignancies.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125065","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}