{"title":"Myxoma: An Unusual Aggressive Orbital Lesion.","authors":"Clare Quigley, Jessica Y Tong, Gelareh Farshid, Fiona Bonar, Dinesh Selva","doi":"10.1097/IOP.0000000000002771","DOIUrl":"10.1097/IOP.0000000000002771","url":null,"abstract":"<p><p>Myxoma is a rare tumor that can be challenging to diagnose, with imaging findings that can be nonspecific. We present a case of a 21-year-old man who presented with a subacute history of right visual deterioration and proptosis. Imaging showed a large right superomedial orbital mass of 43 × 31 × 24 mm, which enhanced heterogeneously and was eroding the adjacent orbital roof and medial wall. An excisional biopsy was performed via a lid crease approach under transorbital endoscopic guidance. We review the clinical, radiological, and histological characteristics of myxoma. In addition, we highlight important associations with genetic syndromes including Carney complex and Mazabraud syndrome.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e2-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086138","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}
Rachel L Chu, Kerilyn Godbe, Harrison D Sciulli, Sara J Krachmalnick, Maryam Abdo, Jason A Sokol
{"title":"More Than Under-Eye Bags: Treatment of Formidable Festoons.","authors":"Rachel L Chu, Kerilyn Godbe, Harrison D Sciulli, Sara J Krachmalnick, Maryam Abdo, Jason A Sokol","doi":"10.1097/IOP.0000000000002769","DOIUrl":"10.1097/IOP.0000000000002769","url":null,"abstract":"<p><p>A 64-year-old male with no medical care over the last decade was transferred from his local emergency room to a level 1 trauma center following an unwitnessed fall. Upon ophthalmic evaluation, he was noted to have significant lethargy and bilateral large festoons with secondary ectropion. Laboratory workup revealed severe hypothyroidism, consistent with myxedema coma, and his lethargy improved with medical treatment. The festoons were surgically removed to address the ectropion, and the patient was satisfied with the results following a single procedure. This case report features the largest reported festoons to date in the literature and emphasizes the importance of balancing cosmesis with function during surgical excision and correction of ectropion.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e1-e2"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086136","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}
Stephen Dryden, Ryan Gabbard, George Salloum, Andrew Meador, Jacquelyn Laplant, Aleksandr Kruglov, Brian Fowler, Matthew Wilson, James Fleming
{"title":"Reply Re: \"Marginal Full Thickness Blepharotomy for Management of Orbital Compartment Syndrome\".","authors":"Stephen Dryden, Ryan Gabbard, George Salloum, Andrew Meador, Jacquelyn Laplant, Aleksandr Kruglov, Brian Fowler, Matthew Wilson, James Fleming","doi":"10.1097/IOP.0000000000002858","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002858","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 1","pages":"113"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927622","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}
James O Robbins, Irene T Lee, Avital L Okrent, Christopher R Dermarkarian, Julie A Woodward
{"title":"A Proposed Protocol for the Acute Management of Palpebro-Orbital Myiasis: Case Report and Review of the Literature.","authors":"James O Robbins, Irene T Lee, Avital L Okrent, Christopher R Dermarkarian, Julie A Woodward","doi":"10.1097/IOP.0000000000002808","DOIUrl":"10.1097/IOP.0000000000002808","url":null,"abstract":"<p><p>Periocular and orbital myiasis are rare, vision-threatening conditions characterized by the infestation of dipterous fly larvae into periorbital and orbital tissues. While it has been primarily reported in tropical and subtropical regions where the climate is ideal for fly larval breeding, any patient with inadequate wound care regardless of geography may be predisposed. Infestations can progress rapidly over the course of several days with significant risk of life-threatening intracranial extension. Despite this, there is a paucity of oculoplastic literature describing protocols to treat periocular and orbital myiasis in the acute setting. Here, the authors present a case of periocular and orbital myiasis seen at the Duke University Hospital in Durham, North Carolina (U.S.A.), and describe a protocol that was effective in the eradication of the infestation without surgical tissue debridement.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e32-e35"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740186","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":"Autologous Platelet-rich Fibrin as a Three-dimensional Structural Scaffold in the Healing of Contracted Orbital Sockets.","authors":"Kasturi Bhattacharjee, Vatsalya Venkatraman, Deepak Soni, Sonali Gaikwad","doi":"10.1097/IOP.0000000000002714","DOIUrl":"10.1097/IOP.0000000000002714","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of platelet-rich fibrin as an adjuvant in surface healing of contracted orbital sockets.</p><p><strong>Methods: </strong>Prospective, interventional, and comparative study of 25 patients with moderate to severe contracted sockets conducted over 2 years (February 2020-February 2022). Group 1 underwent a dermis-fat graft with fornix forming sutures supplemented by a platelet-rich fibrin membrane, while group 2 received a dermis-fat graft with fornix forming sutures only. Patients over 18 years were evaluated as per prefixed inclusion and exclusion criteria. Assessments were conducted at 1, 3, and 12 months postsurgery, focusing on wound evaluation, socket epithelialization, postoperative pain, prosthesis rehabilitation, and complications, if any. Wound evaluation and pain intensity were assessed utilizing the wound evaluation score and visual analog scale, respectively. Socket epithelization was documented clinically at every visit.</p><p><strong>Results: </strong>The study showed a mean age of 38.8 ± 8.8 years, with a 2:1 male-to-female ratio. Group 1 consistently scored higher on wound evaluation score than group 2 at all follow-up points. In group 1, 81.8% achieved a maximum wound evaluation score at 4 weeks and 100% at 3 and 12 months, compared to group 2's 42.8%, 50%, and 57.1%, respectively ( p < 0.05). Postoperative contracture occurred in 3 group 2 patients at the final follow-up, with 6 showing unsatisfactory appearance. Group 1 demonstrated significantly lower pain intensity on postoperative day 1 ( p = 0.03), and greater epithelization at 4 weeks.</p><p><strong>Conclusion: </strong>platelet-rich fibrin appears to be an effective solution for enhancing wound healing during socket reconstruction, attributed to its sustained release of growth factors and mesenchymal stem cells.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"52-60"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082196","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}
Madison E Weiss, Brittany M Perzia, John H Sinard, Thuy T Tran, Michelle M Maeng
{"title":"Primary Treatment of Eyelid Conjunctival Melanoma with Immunotherapy: A Case Report.","authors":"Madison E Weiss, Brittany M Perzia, John H Sinard, Thuy T Tran, Michelle M Maeng","doi":"10.1097/IOP.0000000000002776","DOIUrl":"10.1097/IOP.0000000000002776","url":null,"abstract":"<p><p>Conjunctival melanoma is a rare, life- and sight-threatening ocular malignancy sharing molecular features with cutaneous and mucosal melanoma. Despite current clinical approaches, high recurrence rates and frequent metastases pose significant challenges in management. Immune checkpoint inhibitors such as ipilimumab and nivolumab have revolutionized cutaneous melanoma treatment, but their efficacy in conjunctival melanoma remains largely unexplored. Herein, the authors present the case of metastatic palpebral conjunctival melanoma in a 59-year-old male successfully treated with a first-line combination of ipilimumab and nivolumab without adjuvant therapies or local surgeries. Local disease resolution was achieved after only 7 months of treatment, and the immune checkpoint inhibitor regimen was well-tolerated with limited systemic adverse effects and no ocular side effects.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e12-e15"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140705","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}
Hirohiko Kakizaki, Jose Miguel Ambat, Jonnah Kristina Teope, Munekazu Naito, Yasuhiro Takahashi
{"title":"Lymphatic Channel Distribution in Comparison With Blood Vessels in the Upper Eyelid.","authors":"Hirohiko Kakizaki, Jose Miguel Ambat, Jonnah Kristina Teope, Munekazu Naito, Yasuhiro Takahashi","doi":"10.1097/IOP.0000000000002799","DOIUrl":"10.1097/IOP.0000000000002799","url":null,"abstract":"<p><strong>Purpose: </strong>To examine microscopically the distribution of the lymphatic channels in comparison with the blood vessels in the upper eyelid.</p><p><strong>Methods: </strong>Central sagittal sections of 13 upper eyelids (8 right, 5 left) from 11 Japanese cadavers, aged 36 to 87 years old (average age: 66.6 years), were histologically examined. The specimens were fixed in 10% formalin. Staining with D2-40 for lymphatic channels and with the antibody for α-smooth muscle actin for blood vessels was utilized.</p><p><strong>Results: </strong>The lymphatic channels were mainly distributed superficially, just under the skin, but the blood vessels were situated deeper, and diffusely spread throughout the upper eyelid.</p><p><strong>Conclusion: </strong>The positional predispositions of the lymphatic channels and the blood vessels were different. The former is mainly superficial and the latter is deeper and diffuse.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"101-104"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392138","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}
Delaram Mirzania, Zhenyang Zhao, Denise S Kim, Vinay K Aakalu, Christine C Nelson
{"title":"Umbilical Amniotic Tissue Graft as an Alternative Approach for Eyelid Reconstruction After Necrotizing Fasciitis Debridement.","authors":"Delaram Mirzania, Zhenyang Zhao, Denise S Kim, Vinay K Aakalu, Christine C Nelson","doi":"10.1097/IOP.0000000000002793","DOIUrl":"10.1097/IOP.0000000000002793","url":null,"abstract":"<p><p>A 54-year-old female with myelodysplastic syndrome on chemotherapy presented with 10 days of periocular erythema and edema worsening on oral antibiotics. Computed Tomography scan showed periorbital soft tissue swelling without postseptal extension or abscess. Intravenous broad-spectrum antibiotics were administered. However, she developed necrosis of the upper eyelid requiring aggressive debridement. Nine days after debridement, the defect measuring 5.5 × 3 cm was covered using an umbilical amniotic tissue graft (AmnioGuard, BioTissue, Miami, FL). At postoperative week 4, 5-fluorouracil was injected to prevent the shortening of anterior lamella. At postoperative week 20, the graft had dissolved and been replaced by regenerated skin. Final eyelid exam demonstrated normal eyelid elevation and minimal lagophthalmos. Herein, we present a case of umbilical amniotic membrane as a substrate graft to support the healing of the eyelid defect by secondary intention.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e18-e22"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896554","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}