Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"USP6-FISH Negative Nodular Fasciitis: Benign Impostor of the Orbit.","authors":"Kashviya Suri, April Lee, Neha Seth, Allison Coombs","doi":"10.1097/IOP.0000000000003291","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003291","url":null,"abstract":"<p><p>Nodular fasciitis (NF) is a benign, rapidly growing myofibroblastic proliferation that can closely mimic sarcoma clinically, radiographically, and histologically, posing a significant diagnostic challenge. We report a case of an 11-year-old boy presenting with a painless but progressively enlarging periorbital mass initially suspected to be a dermoid cyst. Although his ultrasound was reassuring, MRI showed an enhancing lesion concerning for neoplasm, prompting surgical excision. Histopathologic evaluation revealed spindle-cell proliferation within a myxoid stroma consistent with NF. However, the USP6 fluorescence in situ hybridization analysis was negative. Further genomic analysis identified a rare USP6-PAFAH1B1 fusion. This case highlights a diagnostically challenging subset of NF in which conventional USP6 fluorescence in situ hybridization testing may be negative, necessitating next-generation sequencing for a definitive diagnosis. Increased awareness of NF and its clinical, histologic, genetic, and radiographic presentation is essential to avoid misdiagnosis and to guide appropriate management.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945489","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":"Occult Lacrimal Pathology in Young Versus Older Patients With Presumed Primary Acquired Nasolacrimal Duct Obstruction: Implications for Preoperative Imaging.","authors":"Steffie Arès, Charlotte Lussier, Olivia Serhan, Myriam Belaiche, Evan Kalin-Hajdu","doi":"10.1097/IOP.0000000000003275","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003275","url":null,"abstract":"<p><strong>Purpose: </strong>Approximately 50% of ASOPRS surgeons consider young age to be an indication for imaging in patients with nasolacrimal duct obstruction. This practice is rooted in the assumption that young age confers a higher risk of clinically occult disease. This study examines whether young age is, in fact, associated with clinically occult lacrimal pathology.</p><p><strong>Methods: </strong>A retrospective multicenter chart review was conducted at the Université de Montréal on consecutive patients with clinically presumed primary acquired nasolacrimal duct obstruction who underwent dacryocystorhinostomy with intraoperative tissue biopsy.</p><p><strong>Results: </strong>A total of 457 sides from 413 patients were analyzed, including 64 sides in patients ≤50 years (group 1) and 393 in patients >50 years (group 2). Expected lacrimal histopathology (nonspecific inflammation) was observed in 90.6% of group 1 and 89.1% of group 2 (p = 0.71). No malignant or potentially malignant pathologies occurred in group 1, compared with 2.8% in group 2 (p = 0.18). On logistic regression, young age was neither a predictor of occult pathology (B = -0.002. p = 0.82) nor occult malignancy/potential malignancy (B = 0.004. p = 0.81). Preoperative imaging was obtained in a subset of 96 dacryocystorhinostomies (34 group 1, 62 group 2) and did not detect a clinically occult pathology in any case; however, 7 patients with normal imaging ultimately had unsuspected pathologies on dacryocystorhinostomy, including 4 malignant/potentially malignant lesions.</p><p><strong>Conclusion: </strong>Young age was not associated with an increased likelihood of clinically occult lacrimal pathology in patients presumed to have primary acquired nasolacrimal duct obstruction, and routine imaging failed to detect all clinically silent pathologies. Available evidence therefore does not support the practice of preferentially imaging young patients with clinically presumed primary acquired nasolacrimal duct obstruction.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881442","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":"WSOPRAS and ITEDS Consensus Statement on the Assessment and Management of Thyroid Eye Disease.","authors":"Andrea L Kossler, Ashok K Grover, Antonio A V Cruz, Lelio Baldeschi, Michael Kazim, Timothy J Sullivan","doi":"10.1097/IOP.0000000000003277","DOIUrl":"10.1097/IOP.0000000000003277","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a globally applicable consensus statement for the assessment and management of thyroid eye disease (TED).</p><p><strong>Methods: </strong>The World Society of Ophthalmic Plastic Reconstructive and Aesthetic Surgery council selected a 6-member, geographically diverse TED task force to develop a consensus statement on the assessment and management of TED. Consensus was achieved through monthly meetings from January to July 2025, alongside an analysis of the literature in terms of relevance, level of evidence, and global versus local applicability. A draft document was circulated to all World Society of Ophthalmic Plastic Reconstructive and Aesthetic Surgery constituent societies for feedback. Using a modified Delphi approach, the expert panel convened over 6 additional virtual sessions from July 2025 to March 2026 to review the submitted feedback, incorporating comments with agreement from at least 5 of 6 experts. The final statement was approved by both the World Society of Ophthalmic Plastic Reconstructive and Aesthetic Surgery council and the International Thyroid Eye Disease Society board of directors.</p><p><strong>Results: </strong>Consensus was achieved regarding methods, TED definitions, assessment, medical and surgical management, and safety recommendations. The consensus statement delineates acceptable standards, workup, and evaluation time points for basic-, intermediate-, and advanced-level assessment tailored to diverse global contexts, as well as tiered medical and surgical interventions, recommended for the different phases and severities of TED.</p><p><strong>Conclusions: </strong>The World Society of Ophthalmic Plastic Reconstructive and Aesthetic Surgery-International Thyroid Eye Disease Society consensus statement on TED, developed by oculoplastic and orbital surgeons, provides a global framework for the standardized assessment and management of TED to improve TED care and enhance patient outcomes.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881384","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 Extranodal Marginal-Zone Lymphoma and Crystal-Storing Histiocytosis Related to a Longstanding Silicone Scleral Buckle.","authors":"Lawrence Langley, Alan Ramsay, Kaveh Vahdani, Geoffrey E Rose","doi":"10.1097/IOP.0000000000003284","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003284","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881423","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":"Early Diagnosis of Upper Eyelid Pyoderma Gangrenosum Using the PARACELSUS Score and Tissue-Sparing Management With Adjunctive Hypochlorous Acid Therapy: A Case Report.","authors":"Anil Akdeniz, Görkem Polat, Safiye Aktaş, Meryem Altin Ekin","doi":"10.1097/IOP.0000000000003283","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003283","url":null,"abstract":"<p><p>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that may cause rapid tissue destruction when it involves the periocular region. We report a 17-year-old patient with ulcerative colitis who developed progressive upper eyelid ulceration initially treated as preseptal cellulitis and later suspected necrotizing infection. Despite broad-spectrum antibiotics, the lesion worsened. Clinical findings, sterile cultures, associated cutaneous lesions, and a PARACELSUS score of 17 strongly supported the diagnosis of PG, prompting immediate systemic corticosteroid therapy before histopathologic confirmation. Adjunctive wound care included topical hypochlorous acid therapy and ophthalmic antibiotic ointment. Histopathology subsequently confirmed PG. Complete re-epithelialization was achieved within 3 weeks without eyelid malposition, functional sequelae, or recurrence during 8 months of follow-up. This case highlights the value of the PARACELSUS score in facilitating early diagnosis of periocular PG and supports prompt tissue-preserving management to prevent irreversible eyelid damage.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881439","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":"Prospective Analysis of Blink Dynamics and Ocular Surface Changes After Levator Aponeurosis Advancement.","authors":"Anil Ağaçkesen, Derya Çepni Çakir, Murat Oklar","doi":"10.1097/IOP.0000000000003285","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003285","url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively evaluate changes in blink dynamics following unilateral ptosis surgery and to assess their relationship with ocular surface parameters.</p><p><strong>Methods: </strong>Sixteen patients (10 female, 6 male; mean age 56.0 ± 13.2 years) undergoing unilateral levator aponeurosis advancement were enrolled. Incomplete blink percentage and blink rate were assessed using slow-motion smartphone videography. Noninvasive tear break-up time, meibomian gland area loss, palpebral fissure height, and margin reflex distance 1 were measured bilaterally at baseline and at a postoperative visit between day 45 and 60. Ocular surface symptoms were assessed with the Ocular Surface Disease Index.</p><p><strong>Results: </strong>Incomplete blink percentage increased markedly in the operated eye following surgery (12.0% [0.0-50.8] vs. 67.5% [49.0-90.0], p = 0.001), with patients demonstrating ≥50% incomplete blink rates rising from 37.5% to 75.0%. Meibomian gland area loss also increased significantly (29.2% [17.9-42.1] vs. 36.9% [24.9-47.0], p = 0.016). Blink rate, noninvasive tear break-up time, and Ocular Surface Disease Index did not change significantly. No eye-specific parameter changed in the contralateral eye. A negative correlation was found between preoperative incomplete blink percentage and magnitude of postoperative change (r = -0.606, p = 0.013).</p><p><strong>Conclusions: </strong>Levator aponeurosis advancement produces a marked and selective increase in incomplete blink percentage accompanied by increased meibomian gland area loss, without affecting blink rate or the contralateral eye. Blink incompleteness may represent a clinically underrecognized consequence of ptosis surgery with long-term ocular surface implications.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881415","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":"Re: Lash Lamination as a Nonsurgical Approach to Lash Ptosis.","authors":"","doi":"10.1097/IOP.0000000000003281","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003281","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881462","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":"Subcutaneous Tocilizumab in Thyroid Eye Disease: What Can Orbital Surgeons Learn From Borrowed Blueprints?","authors":"Ayushi Agarwal, James Slattery, Pravin Hissaria, Dinesh Selva","doi":"10.1097/IOP.0000000000003286","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003286","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881407","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":"Expulsion of Lacrimal Sac Dacryolith During Cone-Beam Computed Tomography-Dacryocystography (3D CBCT-DCG).","authors":"Rafal Nowak, Mohammad Javed Ali","doi":"10.1097/IOP.0000000000003201","DOIUrl":"10.1097/IOP.0000000000003201","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e252"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227533","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":"Radiation Therapy and Nivolumab with Relatlimab-rmbw Achieved a Complete Response in Metastatic Cutaneous Melanoma to the Orbit.","authors":"Brandon T Sellers, Amina Chaudhry, Devarati Mitra, Kim Learned, Oded Sagiv","doi":"10.1097/IOP.0000000000003162","DOIUrl":"10.1097/IOP.0000000000003162","url":null,"abstract":"<p><p>We present a patient with left orbital metastasis of cutaneous melanoma, treated with 30 Gy in 10 fraction radiation therapy followed by a combination of programmed death-1 inhibitor, nivolumab, and lymphocyte-activation gene inhibitor, relatlimab. The patient achieved a complete response to treatment, with no evidence of recurrence of the orbital mass, 17 months after treatment initiation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e215-e219"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966557","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}