Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Successful Neoadjuvant Treatment Using Trastuzumab Emtansine (Kadcyla) for Locally Advanced and Metastatic Lacrimal Gland Adenocarcinoma.","authors":"Agni Kakouri, Matthew J Debnam, Renata Ferrarotto, Tracy Lu, Bita Esmaeli","doi":"10.1097/IOP.0000000000002967","DOIUrl":"10.1097/IOP.0000000000002967","url":null,"abstract":"<p><p>A 25-year-old man presented with a locally advanced lacrimal gland adenocarcinoma with parotid metastasis. The lesion was strongly HER-2 positive (3+) on immunohistochemistry. The patient was treated with neoadjuvant trastuzumab emtansine, an antibody-drug conjugate targeting HER-2. The patient had an excellent response to neoadjuvant therapy trastuzumab emtansine, with a significant decrease in the size of the lacrimal gland carcinoma, making eye-sparing surgery a viable option for the patient. Furthermore, there was nearly complete resolution of the parotid metastasis; thus, radical neck dissection and parotidectomy were avoided.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e183-e187"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040662","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":"Juvenile Trabecular Ossifying Fibroma of the Orbit.","authors":"Jonathan Siktberg, Yash J Vaishnav, Aleksandar Krbanjevic, Reena Singh, Louise A Mawn","doi":"10.1097/IOP.0000000000002952","DOIUrl":"10.1097/IOP.0000000000002952","url":null,"abstract":"<p><p>An 11-year-old male presented to the hospital with severe headache, nausea, and proptosis of the OD. Imaging revealed a 4 × 3 × 1 cm mass originating in the right orbital roof with adjacent bony remodeling, a calcific rim along the inferior extent of the lesion, and a heterogenous central component with hyper- and hypo-dense components. An orbitotomy with biopsy with near-total resection was performed, which yielded a diagnosis of juvenile trabecular ossifying fibroma, a tumor rarely found in the orbit. Two months later, given the concern for residual/recurrent disease based on increased signal abnormality on MRI, resection of the residual mass was achieved via bifrontal craniotomy.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e179-e183"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333644","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 Role of Perforator Island Flaps for the Reconstruction of Midfacial and Periorbital Large and Deep Defects.","authors":"Antonio Augusto Velasco E Cruz, Juliana Albano de Guimarães, Sarah Soares Brassaloti, Roque Souza Lima, Mariana Nadais Aidar","doi":"10.1097/IOP.0000000000002925","DOIUrl":"10.1097/IOP.0000000000002925","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a single-hospital experience with the reconstruction of broad and deep periorbital defects with perforator island flaps (PIFs).</p><p><strong>Methods: </strong>Twenty cases of reconstruction of complex defects in the periocular region using PIF were selected and revised. All cases were performed in the university hospital of the University of São Paulo, Ribeirão Preto, Brazil, from September 2018 to July 2024. Data collected included intraoperative and postoperative photographic documentation, lesions diagnoses, defect sizes and locations, PIF sizes and axes of mobilization, postoperative follow-up duration, and complications.</p><p><strong>Results: </strong>All patients underwent periorbital reconstruction with PIF after tumor resection. In 7 cases, the defects involved the lower lid cheek junction, and in 10 cases, they extended into the medial canthus, including 3 cases of orbital exenteration. The lateral periorbital region was affected in 2 patients. The mobilization of the flaps was from the lower cheek toward the lower eyelid in 7 patients, toward the medial canthal area in 10 patients, and horizontally to cover defects in the medial and temporal regions in 2 cases. The size of the resultant defect averaged 7.9 cm 2 . The mean follow-up time was 40 months. The flap remained viable in 100% of cases.</p><p><strong>Conclusion: </strong>PIFs are a versatile option for reconstructing large periorbital defects and extended exenterations, and this technique should be included in the repertoire of procedures for managing midfacial tumors.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"593-598"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625573","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":"Efficacy of Silicone Gel Versus Placebo for Postsurgical Scars of the Eyelids: A Randomized, Controlled, Double-Blinded Study.","authors":"Troy S Karanfilian, Tobin Thuma, Tiffany Cheng, Ricky Paramo, Jee-Young Moon, Sruti Akella, Anne Barmettler","doi":"10.1097/IOP.0000000000002913","DOIUrl":"10.1097/IOP.0000000000002913","url":null,"abstract":"<p><strong>Purpose: </strong>While silicone has been shown to be effective on scars on the sternum, foot, and other areas with thicker skin, the effect of silicone on scars in the thin periocular skin has not yet been evaluated in a prospective, randomized, and double-blinded fashion.</p><p><strong>Methods: </strong>This prospective, randomized, double-blinded study enrolled patients undergoing bilateral upper eyelid blepharoplasty or bilateral upper eyelid ptosis repair. Subjects were randomized to apply silicone gel to 1 eyelid incision site and placebo (petrolatum ointment) to the other side twice daily postoperatively. Outcome measures were physician-graded scar erythema, elevation, and pigmentation, as well as patient-reported satisfaction, itching, pain, and firmness. These were assessed postoperatively at 1 week, 1 month, 3 months, and 6 months.</p><p><strong>Results: </strong>Of 192 eyelids from 96 patients, there were no significant ( p ≤ 0.05) differences in any outcomes between silicone gel and placebo across any measure or time point. Patient satisfaction and blinded doctor and patient appearance preferences did not show any significant difference between the 2 treatments at any time point. Average follow-up was 11 weeks (range: 1-136 weeks).</p><p><strong>Conclusions: </strong>This clinical trial suggests that topical silicone may not offer significant advantages over petrolatum ointment in improving eyelid scar healing. Overall results indicate similar efficacy between treatments. These results underscore the importance of evidence-based medicine in choosing beneficial and cost-effective interventions.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"555-559"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414303","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":"Inflammatory Markers as Predictors of Orbital Infection Severity.","authors":"Alison Gibbons, Elliot Cherkas, Mannat Kaur, Shazia Dharssi, Radwa Elsharawi, Davin C Ashraf, Emily Li","doi":"10.1097/IOP.0000000000002903","DOIUrl":"10.1097/IOP.0000000000002903","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the utility of inflammatory marker levels in defining orbital cellulitis (OC) severity.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at 2 tertiary care centers using a medical record search of billing codes from January 1, 2000, to January 1, 2023. Patients were categorized into 2 cohorts-uncomplicated OC and OC with complication [subperiosteal abscess (SPA), orbital abscess (OA), or cavernous sinus thrombosis (CST)]. Values at presentation of the following markers were recorded: absolute neutrophil count (ANC), white blood cell count (WBC), platelet count, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR). Logistic regression, controlled for immunosuppression and age, compared levels between patients with uncomplicated OC versus OC with complication, surgical versus nonsurgical management, and abnormal versus normal presenting and final vision.</p><p><strong>Results: </strong>A total of 785 patients-413 uncomplicated OC (52.6%) and 372 OC with complication (47.4%) (272 SPA [73.2%], 85 OA [22.8%], and 15 CST [4.0%])-met criteria. The sample was majority male (58.2%) and White (65.9%), with a mean age of 31.6 ± 26.4 years. Platelet count, ANC, WBC, and NLR levels were significantly higher in patients with complicated OC (p < 0.001). Levels of ANC, WBC, CRP, and NLR were significantly higher in surgical patients (p < 0.001). Higher levels of NLR and ANC were associated with worse visual acuity and an relative afferent pupillary defect at presentation (p = 0.006 and p = 0.032, respectively) but not at the final follow-up.</p><p><strong>Conclusions: </strong>Levels of NLR, ANC, and WBC at presentation may have clinical utility in identifying severe orbital infections and may aid management.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 5","pages":"530-534"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015970","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":"Atypical Optic Nerve Sheath Meningioma With Postbiopsy Ophthalmic Artery Occlusion.","authors":"Maryam Eghtedari, William G Mitchell, Thomas G Hardy","doi":"10.1097/IOP.0000000000002938","DOIUrl":"10.1097/IOP.0000000000002938","url":null,"abstract":"<p><p>The authors present the case of a 44-year-old female with progressive optic neuropathy secondary to an atypical posterior intraconal tumor who underwent incisional biopsy complicated by severe postoperative vision loss secondary to ophthalmic artery occlusion. Histology showed a fibroblastic meningioma WHO grade 1. Here, the authors discuss the clinical and radiologic findings, in particular, the exophytic \"globular\" configuration of the tumor, and perform a review of the literature.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e167-e171"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736095","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 and Ocular Venous Congestion: A Rare Manifestation of Hypervascular Paget Disease of the Bone.","authors":"Melissa Yuan, Carolina A Chiou, Jennifer C W Hu, Seyedeh Maryam Zekavat, Dean Eliott, Aman B Patel, Daniel R Lefebvre","doi":"10.1097/IOP.0000000000002909","DOIUrl":"10.1097/IOP.0000000000002909","url":null,"abstract":"<p><p>A 73-year-old male with a history of incidentally diagnosed Paget disease of bone affecting the skull and left orbit 2 years prior presented with 3 months of vision loss, proptosis, and periorbital swelling of the OS. Examination showed best-corrected Snellen visual acuity of 20/150 in the affected eye, intact motility, 7 mm of relative proptosis, significant dilated and tortuous \"corkscrew\" conjunctival vessels, serous choroidal and retinal detachments, optic nerve hyperemia, and venous tortuosity and dilation. Although the bony lesions in the left orbit were stable from 1 year prior on imaging, the diagnostic angiogram demonstrated osseous blush and hypervascularity of the lesion. It was thus determined that the abnormal bone of the left orbit with enhanced blood flow was adversely affecting the blood flow in the orbit and eye. The patient underwent coil embolization of the feeding vessels and external blood supply to the lateral orbital wall and hyperostotic Paget lesion via coil embolization of the left internal maxillary artery and left middle meningeal artery with improvement of the choroidal effusions and subretinal fluid, followed by bony orbital decompression with improvement in the proptosis. This is a novel case of orbital and ocular vascular congestion due to Paget disease.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e154-e157"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009203","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":"Reproducibility of the Unaided Subjective Assessment of Orbital Computed X-Ray Tomographic Features in Thyroid Eye Disease.","authors":"Isobel Landray, James Carpenter, Kaveh Vahdani, Katherine Miszkiel, Lakshmi A Ratnam, Geoffrey E Rose","doi":"10.1097/IOP.0000000000002929","DOIUrl":"10.1097/IOP.0000000000002929","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the reproducibility of subjective interpretation of computed x-ray tomography for 8 features associated with thyroid eye disease.</p><p><strong>Methods: </strong>Patients with confirmed thyroid eye disease had 3 distinct orbital computed x-ray tomography sections presented as anonymized montages to 3 masked observers (#1 orbital radiologist, #2 general radiologist, and #3 orbital surgeon). Eight features were graded: superior orbital fissure clarity, degree of orbital fat prolapse through the superior orbital fissure, loss of fat space at the apex, muscle enlargement, increase in orbital fat volume, vascular congestion, superior ophthalmic vein size, and lamina papyracea bowing. Thirty montages were randomly triplicated within the completed image-testing-file.</p><p><strong>Results: </strong>Each observer provided 3296 assessments of montages from 146 patients (68% female). Observer #2 had the highest rate of \"indeterminate\" gradings (13.3%), while #1 had the lowest (6.7%). For intraobserver agreement, the kappa statistics were \"substantial\" to \"almost perfect\" for apical crowding, muscular enlargement, and medial bowing, whereas orbital fat expansion and vascular congestion showed only \"slight\" to \"moderate\" agreement. Excluding superior ophthalmic vein size (where indeterminacy was too great for statistical analysis), there was a wide and statistically significant interobserver variation for the other 7 features, with no consistent ranking of observer scores.</p><p><strong>Conclusions: </strong>Subjective interpretation of computed x-ray tomography images for patients with thyroid eye disease has high variability, particularly for interobserver comparisons. Only the assessment of apical crowding, muscular enlargement, and bowing of the lamina papyracea showed fairly consistent intraobserver gradings. The results suggest that variability in the interpretation of such images might only be improved with the use of objective measures applied to the computed x-ray tomography images.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"576-583"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625567","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 Epidemiology and Treatment Outcomes of Facial Nerve Palsy Using a Population-Based Method.","authors":"Christopher J Hwang, Sarah Alshami, David O Hodge, Elizabeth A Bradley","doi":"10.1097/IOP.0000000000002912","DOIUrl":"10.1097/IOP.0000000000002912","url":null,"abstract":"<p><strong>Purpose: </strong>To update the epidemiological patterns of facial nerve palsy (FNP) in Olmsted County, Minnesota.</p><p><strong>Methods: </strong>A retrospective chart review using the Rochester Epidemiology Project database was conducted. Patients aged ≥18 years receiving a diagnosis of FNP within the Rochester Epidemiology Project database from the years 2000 to 2010 were included in the study. Data collected included age, gender, cause of FNP, degree of paralysis, medical and/or surgical management, and outcomes. Overall incidence rates were determined using gender-specific population figures for Olmsted County. Incidence trends were compared with previous Rochester Epidemiology Project studies.</p><p><strong>Results: </strong>The most common cause for FNP was Bell palsy (70.3% of cases). The overall incidence rate for Bell palsy in Olmsted County from 2000 to 2010 was 39.9 (95% CI, 36.1-43.7) per 100,000 person-years. This is an absolute increase of 14.9 per 100,000 person-years and a 60% relative increase in Bell palsy compared with a previous study performed at Mayo Clinic using the Rochester Epidemiology Project database population data from 1968 to 1982. Patients were infrequently evaluated by an ophthalmologist (8.4% of cases), and surgical intervention to address ophthalmic sequelae was rare (1.7% of cases).</p><p><strong>Conclusions: </strong>The incidence of Bell palsy has increased dramatically over previous studies, which has occurred in the setting of declining herpes simplex virus type 1 seropositivity trends and increasing herpes zoster incidence in the United States. Few patients with FNP are referred to ophthalmologists, which may represent a gap in care for both acute and long-term ophthalmic sequelae.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"549-554"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009204","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":"Ophthalmic Manifestations of Angiolymphoid Hyperplasia with Eosinophilia: A Systematic Review and Pooled Analysis of 86 Cases.","authors":"H Shafeeq Ahmed, Chinmayee J Thrishulamurthy, Shwetha Venkatesh, Vidhya Eshwaran, Thara Mary James, Ramya Boregowda Siddegowda, Dayananda S Biligi","doi":"10.1097/IOP.0000000000002880","DOIUrl":"10.1097/IOP.0000000000002880","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to consolidate evidence on ophthalmological manifestations of angiolymphoid hyperplasia with eosinophilia, focusing on its presentation, diagnosis, and management.</p><p><strong>Methods: </strong>Preferred reporting items for systematic reviews and meta-analyses-adherent systematic review was conducted across 3 databases from inception until September 2024. Case reports and series detailing angiolymphoid hyperplasia with eosinophilia in ocular structures were included. Data on demographics, clinical presentation, diagnostic methods, and treatment outcomes were extracted and analyzed.</p><p><strong>Results: </strong>A total of 86 patients from 52 case reports/series were included. The median age was 41 years (IQR: 22-54), with a slight male predominance (51.16%, n = 44/86). The majority of patients (94.18%, n = 81/86) presented with unilateral eye involvement. The orbit was the most frequently involved location (45.35%, n = 39/86), followed by the upper eyelid (27.91%, n = 24/86). Clinical symptoms included proptosis (36.04%, n = 31/86), ptosis (26.74%, n = 23/86), and diplopia (11.67%, n = 10/86). Surgical excision was performed in 54.65% (n = 47/86) of cases, with biopsy done for diagnostic purposes in all patients. Recurrence occurred in 13.95% (n = 12/86), with risk factors including incomplete excision and prior angiolymphoid hyperplasia with eosinophilia in the same or opposite eye. Steroid therapy was used in 18.6% (n = 16/86) but showed limited success. Newer treatment strategies with propranolol showed efficacy in recurrent cases, with no recurrence reported in patients receiving this therapy.</p><p><strong>Conclusion: </strong>Angiolymphoid hyperplasia with eosinophilia in ocular structures presents diagnostic and therapeutic challenges. Surgical excision remains the mainstay of treatment, though recurrence is common. Therapeutic strategies with propranolol may offer alternative management options in recurrent cases.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"487-494"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882572","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}