Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Surgical Techniques and Outcomes in the Management of Pediatric Eyelid Burns: A Systematic Review.","authors":"Lixin Ji, Pranali N Gandhi, Bryan S Torres","doi":"10.1097/IOP.0000000000002842","DOIUrl":"10.1097/IOP.0000000000002842","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the surgical techniques used in the management of eyelid burns among pediatric patients below 18 years old, focusing on the timing of interventions and patient outcomes.</p><p><strong>Methods: </strong>This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A comprehensive literature search was performed using PubMed, Embase, and Web of Science, targeting studies published between January 2000 and August 2024. Search terms included \"burn,\" \"injury,\" \"release,\" \"scar,\" \"children,\" \"pediatric,\" \"eyelid,\" \"contracture,\" and \"reconstruction.\" A total of 51 studies were identified, of which 6 met the inclusion criteria and were selected for detailed review. All focused on pediatric patients with severe eyelid burns.</p><p><strong>Results: </strong>The review identified a range of surgical techniques, including antegrade foreheadplasty, Double Frost Suture technique, and early versus delayed surgical release. Antegrade foreheadplasty was effective in addressing upper eyelid contracture deformities, providing significant functional and aesthetic improvements. The Double Frost Suture technique was successful in preventing graft retraction and enhancing graft stability. The timing of surgical intervention was found to be crucial, with early release showing better outcomes in terms of ocular protection and faster recovery compared with delayed interventions.</p><p><strong>Conclusions: </strong>The findings underscore the importance of a tailored approach in the surgical management of pediatric eyelid burns, with careful consideration of the timing and technique. While early surgical release generally yields better outcomes, the choice of technique should be guided by the specific needs of each patient. Further research is needed to refine these techniques and to better understand the long-term outcomes, particularly in complex cases involving extensive burns.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"245-249"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922511","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: \"Treatment of Thyroid Eye Disease-Associated Ophthalmopathy and Myopathy With Intraorbital Injection of 5-Fluorouracil and Triamcinolone Acetonide\".","authors":"Maya T Harrington, Rachel K Sobel","doi":"10.1097/IOP.0000000000002954","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002954","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 3","pages":"351"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040670","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":"Surgical Timing for Patients With Thyroid Eye Disease Treated With Teprotumumab: A Collaborative Multicenter Study.","authors":"Hannah L Walsh, Kevin D Clauss, Benjamin I Meyer, Emanuil Parunakian, Cigdem Yasar, Carolina A Chiou, Thomas E Johnson, Shoaib Ugradar, Andrea L Kossler, Suzanne K Freitag, Raymond S Douglas, Sara T Wester","doi":"10.1097/IOP.0000000000002839","DOIUrl":"10.1097/IOP.0000000000002839","url":null,"abstract":"<p><strong>Purpose: </strong>To compare regression rates, characteristics, and surgical outcomes of thyroid eye disease patients who underwent orbit, strabismus, or eyelid surgery at various times during or after teprotumumab treatment.</p><p><strong>Design: </strong>Multicenter, retrospective, observational cohort study.</p><p><strong>Participants: </strong>Adult patients (age >18) with a minimum of 4 infusions of teprotumumab treatment for thyroid eye disease who had had eye surgery during or after treatment.</p><p><strong>Methods: </strong>Two groups were formed based on surgery timing: group 1 (G1) (<180 days since last infusion) and group 2 (G2) (≥180 days since last infusion).</p><p><strong>Main outcome measures: </strong>The primary outcome was postoperative regression rates. Secondary outcomes were postoperative regression characteristics, regression treatment, and orbital decompression proptosis reduction.</p><p><strong>Results: </strong>This study evaluated 53 patients (81% female) who underwent 78 surgeries. G1 comprised 24 individuals with 34 surgeries, while G2 comprised 29 patients with 44 surgeries. Regression rates did not significantly differ between G1 and G2 (20.8% vs. 14.7%, p = 0.611). Compared with G1 patients, patients in G2 who regressed showed a significant mean increase in Clinical Activity Score (4.2 vs. 6.1, p = 0.027) and a nonsignificant yet measured increase in proptosis when compared with those in G1 (2.9 vs. 4.25, p = 0.298) at the time of regression. Compared with G1 patients, G2 patients who regressed were equally likely to undergo a repeat course of teprotumumab as group 1 ( p = 0.14) but underwent a higher number of additional surgical procedures ( p = 0.057). Thyroid stimulating immunoglobin levels uptrended more often in patients who regressed.</p><p><strong>Conclusion: </strong>Our study suggests that while the rate of regression may not differ significantly, the severity, clinical impact, and need for additional surgery might be more pronounced for patients who have surgery more than 6 months after their last teprotumumab dose.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"320-328"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801924","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":"Nasolacrimal Duct Obstruction in a Patient With Sotos Syndrome.","authors":"Tom Kornhauser, Abdelrahman M Elhusseiny, Raghu H Ramakrishnaiah, John D Pemberton","doi":"10.1097/IOP.0000000000002847","DOIUrl":"10.1097/IOP.0000000000002847","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e108"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896516","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 Granulomas of Orbital Sarcoidosis Often Show Foci of Necrosis: A Retrospective Observational Study.","authors":"Hursuong Vongsachang, Natalie Wolkow, Anna M Stagner","doi":"10.1097/IOP.0000000000002819","DOIUrl":"10.1097/IOP.0000000000002819","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the frequency and extent of necrosis within granulomas among patients diagnosed with orbital sarcoidosis on biopsy.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients diagnosed with orbital sarcoidosis at a single institution from 2018 to 2024. Histopathology slides were re-reviewed for evidence of any necrosis or infection. Demographic, laboratory, histopathologic, and radiographic data were gathered for these patients. All findings were presented using descriptive statistics.</p><p><strong>Results: </strong>There were 19 total cases of orbital sarcoidosis in the study timeframe. The majority were female (15, 78.9%) with a median age of 49 (range: 11-85) presenting with a unilateral, mass-occupying orbital lesion (n = 16, 84.2%). The lacrimal gland and orbital fibroadipose tissue were the most frequently involved and biopsied. Biopsies from 13 patients (68.4%) had granulomas containing varying amounts of necrosis on histopathology on retrospective review. No fungal or acid-fast microorganisms were detected with special stains; a subset of patients had additional molecular genetic-based microbiologic studies which were also unrevealing.</p><p><strong>Conclusions: </strong>Although the histopathology of sarcoidosis is classically described as a \"non-necrotizing (noncaseating) granulomas,\" granulomas with varying extents of necrosis are more frequently seen in orbital sarcoidosis than previously recognized, or than reported in biopsies from patients with sarcoidosis at other anatomic sites. The presence of necrosis within sarcoidal granulomas should not exclude a diagnosis of sarcoidosis at this site, given that infection is adequately excluded.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"289-292"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668560","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":"Management of Pediatric Traumatic Nasolacrimal Duct Obstruction and Predictors for Surgical Outcomes.","authors":"Lunhao Li, Leilei Zhang, Yimin Li, Wodong Shi, Mohammad Javed Ali, Caiwen Xiao","doi":"10.1097/IOP.0000000000002850","DOIUrl":"10.1097/IOP.0000000000002850","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the clinical features, surgical treatments, and outcomes of pediatric post-traumatic nasolacrimal duct obstructions and predictors for surgical outcomes.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients under the age of 18 years with the diagnosis of traumatic nasolacrimal duct obstructions during an 11-year period from a tertiary referral center. The clinical data were reviewed and analyzed. A binary logistic regression was performed to establish a predictive model for surgical failure after treatment.</p><p><strong>Results: </strong>Eighty-three eyes of 80 consecutive patients were included in the study. Anterior displacement of the lacrimal sac was noted in 71.1% (59/83) cases. Medial canthus deformities were observed in 79.5% (63/83) cases. External dacryocystorhinostomy and endoscopic dacryocystorhinostomy were performed on 65 and 18 cases, respectively. At a mean follow-up of 28 months following stent removal, anatomical and functional success rate was noted in 83.1% (69/83). The presence of orbital fractures involving the rim, gross skin scaring, lacrimal sac displacement, and fracture fragments in the vicinity of the lacrimal sac were found to be significant predictors for surgical failure. The area under the raw current curves of the predictive model was 0.888.</p><p><strong>Conclusion: </strong>This large series of post-traumatic pediatric nasolacrimal duct obstructions showed that sac-duct junction was the most common site of obstruction and anterior displacement of the lacrimal sac and bony fragments in the lacrimal sac area were significant predictors of failures. Medial canthal deformities can be addressed simultaneously with good outcomes.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"335-340"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864917","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":"Linear Scleroderma En Coup de Sabre: A Case Series With Eyelid Involvement and Management.","authors":"Li Teng Kok, Mohsan Malik, Tessa Fayers, Konstantina Sorkou, Alia Issa, Daniel G Ezra","doi":"10.1097/IOP.0000000000002843","DOIUrl":"10.1097/IOP.0000000000002843","url":null,"abstract":"<p><p>Linear scleroderma en coup de sabre is a rare subtype of localized scleroderma. It is typically characterized by linear sclerosis and atrophy of the skin and underlying dermis affecting the frontoparietal region above the brow. The linear sclerotic lesions rarely extend into the upper eyelid. In this case series, the authors describe the presentation of 3 en coup de sabre cases, in particular the associated eyelid and adnexal findings which include upper eyelid skin fibrosis, sulcus hollowing, and eyelid retraction. The authors also describe the range of reconstructive treatment options in the remission phase with a combination of autologous fat transfer, injectable filler, eyelid retraction repair, and contralateral ptosis repair to improve facial symmetry and cosmesis of en coup de sabre lesions on the forehead, brow and eyelid region.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e80-e85"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801824","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 Ominous Sign: Bilateral Symmetric Enlargement of All Extraocular Muscles.","authors":"Sarah S Brassaloti, Mariana N Aidar, Fernando Chahud, Antonio A V Cruz","doi":"10.1097/IOP.0000000000002790","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002790","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 3","pages":"e107"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984567","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 Orbitomalar Ligament: A Cleavage Plane in Oculofacial Trauma.","authors":"Michael T Kryshtalskyj, Mina Mina, Carson D Schell, Kian M Madjedi, Ryan Nugent, Don O Kikkawa, Michael E Ashenhurst, Karim G Punja","doi":"10.1097/IOP.0000000000002865","DOIUrl":"10.1097/IOP.0000000000002865","url":null,"abstract":"<p><p>The authors describe an oculofacial injury phenotype manifesting as a cleavage plane following the orbitomalar ligament in 5 cases. Across these cases, curvilinear wounds followed the course of the orbitomalar ligament, running clean planes through orbicularis oculi down to the infraorbital rim and arcus marginalis. One case involved bilateral orbitomalar ligaments, and 1 case involved the inferior canaliculus. Associated craniofacial injuries included orbital floor fracture, orbital hemorrhage, and zygomaticomaxillary complex fractures. Moderate-to-severe globe injuries were encountered, including hyphema, commotio retinae, retinal hemorrhages, cyclodialysis cleft, lens dislocation, and globe rupture. Wound closure included deep polyglactin sutures to recreate mid-facial support from the disrupted orbitomalar ligament; 1 case that did not receive deep, layered closure was associated with lower eyelid ectropion. These cases illustrate how orbitofacial ligaments may influence trauma phenotypes and inform subsequent repair.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e99-e104"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864965","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":"Identifying Minimum Single Dose of Recombinant Human Hyaluronidase for In Vitro Dissolution of Twenty-Two Hyaluronic Acid Fillers.","authors":"Rasika Sudharshan, Shaili S Davuluru, Alena J Shen, Shreya Gupta, Nikta Saeedi, Julie Woodward, Wendy W Lee, Femida Kherani, Jill A Foster, Sandy X Zhang-Nunes","doi":"10.1097/IOP.0000000000002941","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002941","url":null,"abstract":"<p><strong>Purpose: </strong>As the use of hyaluronic acid fillers continues to increase for clinical and aesthetic purposes, associated complications continue to rise as well. Excess hyaluronidase is often used to dissolve filler, which has its own set of adverse effects. This study analyzes 22 commercially available fillers to delineate the lowest single dose of recombinant human hyaluronidase (RHH) required to fully dissolve each filler within 6 hours across 3 trials.</p><p><strong>Methods: </strong>0.2 ml aliquots of each of 22 hyaluronic acid fillers were placed in wells. A single dose of RHH, titrated to a minimum volume of 0.45 cc, was administered to the center of the aliquot, to a maximum of 140 units. RHH amounts were as follows: 0, 2.5, 5, 10, 20, 40, 60, 80, 100, 120, or 140 units RHH. Bird's eye and lateral photographs were taken to monitor dissolution progress at several time points over the 6-hour period to monitor aliquot height and appearance changes. Filler aliquots were left undisturbed for 6 hours, after which dissolution was confirmed by stirring the aliquot on video recording. This process was repeated 3 times per filler to determine the minimum dose of RHH required to consistently dissolve each aliquot.</p><p><strong>Results: </strong>For each of the 22 fillers, the minimum dose of RHH required for dissolution was identified with consistent results across 3 trials, demonstrating reliability. Juvéderm Volbella, Juvéderm Vollure, Juvéderm Skinvive, Restylane-L, Restylane Lyft, and Restylane Silk were identified as the least resistant fillers, requiring ≤20 units to dissolve. Resilient hyaluronic acid (RHA) 2, RHA 3, RHA 4, Belotero Volume, Juvéderm Ultra XC, Juvéderm Volux, Restylane Kysse, and Revanesse Versa were classified as most resistant, requiring ≥120 units to dissolve.</p><p><strong>Conclusions: </strong>This study identifies the minimum single dose of RHH from 2.5 units/0.2 ml to 140 units/0.2 ml for dissolution of 22 different hyaluronic acid fillers over 6 hours. These results paired with previous studies help elucidate the dissolution profiles of each filler in the context of their rheological properties, further informing physicians on how to optimally dissolve different hyaluronic acid fillers in a clinical setting.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026101","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}