Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Pediatric Ocular Adnexal Lymphoma: Past, Present, and Future.","authors":"Kelsey L Walsh, Matthew H McCartney, Christopher J Fraser, Timothy J Sullivan","doi":"10.1097/IOP.0000000000003176","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003176","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the clinical, imaging, and pathological spectrum of pediatric ocular adnexal lymphomas tumors (OAL), including both primary and secondary lesions, using contemporary World Health Organization Haematolymphoid (5th edition) classification.</p><p><strong>Methods: </strong>This retrospective case series included patients <18 years with biopsy-proven lymphoma of the orbit or ocular adnexa managed by a single oculoplastic surgeon over a 30-year period. Demographic, clinical, imaging, histopathological, treatment, and outcome data were collected. Lesions were categorized as primary (confined to ocular adnexa with or without regional lymph nodes) or secondary (ocular adnexa involved as part of systemic lymphoproliferative disease).</p><p><strong>Results: </strong>Eleven patients (median age 11 years; 6 male) were identified. Five (45%) had precursor B-cell lymphoblastic leukemia/lymphoma, and 3 (27%) had mature B-cell tumors, including 2 extranodal marginal zone lymphomas and 1 diffuse large B-cell lymphoma. Three (27%) had mature natural killer/T-cell neoplasms, including 1 primary cutaneous anaplastic large cell lymphoma, 1 anaplastic large cell lymphoma, and 1 extranodal natural killer/T-cell lymphoma, nasal type. Six patients (55%) presented with ocular adnexal involvement secondary to systemic disease, most commonly in the orbit. Periorbital swelling, proptosis, and palpable masses were the predominant ocular signs. Management ranged from surgical excision or topical interferon to systemic chemotherapy, radiotherapy, and hematopoietic stem-cell transplantation. At the last follow-up, outcomes varied with histological subtype and disease stage.</p><p><strong>Conclusions: </strong>Pediatric ocular adnexal lymphomas displays striking clinicopathologic heterogeneity, with a predominance of precursor lymphoblastic neoplasms and a notable proportion of high-grade mature B- and T/NK-cell lymphomas. Recognizing both primary and secondary lesions and applying accurate histopathological classification are critical for timely diagnosis and to guide modern targeted therapies. This series expands the evidence base for a rare disease and underscores the importance of integrating ophthalmic assessment with contemporary World Health Organization diagnostic frameworks.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966603","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":"Upper Eyelid Retraction: An Atypical Sign of Orbital Conjunctival Inclusion Cyst.","authors":"Aline Ramos da Silva, Renata Fernandes Cunha, Fernando Chahud, Antonio Augusto Velasco E Cruz","doi":"10.1097/IOP.0000000000003180","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003180","url":null,"abstract":"<p><p>Orbital conjunctival inclusion cysts are uncommon lesions that may develop as congenital choristomatous rests or as a result of traumatic or iatrogenic implantation of conjunctival epithelium. Depending on their size and location, they can be asymptomatic or cause proptosis, diplopia, mechanical ptosis, and ocular motility disturbances. We report a rare case of a 63-year-old female patient who developed marked upper eyelid retraction due to a conjunctival inclusion cyst associated with a retinal detachment procedure performed 20 years before presentation. A literature review did not disclose any case of upper eyelid retraction associated with orbital conjunctival inclusion cysts.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966626","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":"Involutional Entropion: Demographics, Presenting Findings, Surgical Management.","authors":"Philip L Custer, Julia B Huecker","doi":"10.1097/IOP.0000000000003155","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003155","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the demographics, presentation, and anatomic features associated with involutional entropion, offering insight into the etiology of the condition. Surgical techniques and results are presented.</p><p><strong>Methods: </strong>A retrospective chart/photographic review was performed on patients treated between 2005 and 2024.</p><p><strong>Results: </strong>Demographic analysis was limited to 405 patients without prior surgery. Incidence increased with age, with only 1.7% ≤60 years old. Males were more frequently affected than predicted using population data. Unilateral right (57%, p = 0.015) was more common than left entropion. Unilateral entropion was associated with an ipsilateral larger or inferiorly positioned orbit, findings more common on the right. Throughout the study, 30.6% of patients showed signs of bilateral disease.Five hundred nineteen procedures (612 eyelids) were performed. Most included a lateral tarsal strip and posterior retractor attachment. Twenty-one percent of lids had insufficient laxity for a standard lateral tarsal strip. Recurrent cases more commonly involved males (63%, p = 0.018) and the right side (63%, p = 0.047). Postoperative ectropion was more frequent after anterior (p < 0.001) and chemosis after posterior surgery (p < 0.001). Recurrence developed in 8 study eyelids (1.3%). Preoperative ipsilateral ptosis (≥1 mm) was present in 33.4% of unilateral cases and often improved after repair.</p><p><strong>Conclusions: </strong>Incidence of involutional entropion increases with age and is greater in males and on the right. Enophthalmos, retractor laxity, and canthal instability are likely predisposing anatomic factors. Significant horizontal laxity is seldom present. The lateral tarsal strip reestablishes canthal stability, and when combined with posterior retractor attachment to tarsus and orbicularis is highly effective. Complications are uncommon and usually apparent soon after surgery.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966605","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":"Elastase-Treated Auricular Cartilage: Feasibility as a Substitute for Native Tarsus.","authors":"Elana Meer, Kendall Goodyear, Joseph Park, Somaye Jafari, Kanish Mirchia, Joseph Demer, Justin Karlin","doi":"10.1097/IOP.0000000000003103","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003103","url":null,"abstract":"<p><strong>Purpose: </strong>Reconstruction of upper eyelid defects is challenging due to paucity of fungible local tissue and a lack of adequate tarsal substitutes. Cartilage is too stiff to be directly implanted in the posterior lamella due to the risk of corneal damage with blinking. Since elastin is a key structural element in elastic cartilage, we hypothesized that elastase treatment of cartilage may reduce cartilage's stiffness sufficiently to make it a feasible posterior eyelid lamella substitute.</p><p><strong>Methods: </strong>Porcine auricular cartilage was treated with elastase or buffer control. Histopathology, electron microscopy, and mechanical testing were performed. Young's modulus was calculated using the Hertzian method for mechanical indentation testing at baseline, 2, and 24 hours. Group 1 (buffer control auricular cartilage), Group 2 (elastase-treated auricular cartilage), and Group 3 (native tarsus) were compared.</p><p><strong>Results: </strong>Grossly, elastase treatment increased cartilage flexibility, and microscopically increased chondrocyte lacunae and decreased the density of the interterritorial matrix, relative to controls. Electron microscopy revealed elastin fiber degradation with empty channels preplacing elastin fibers. At 2 hours, cartilage stiffness showed minimal differences between Groups 1 and 2 for both instantaneous modulus (1.34 vs. 1.37 MPa; p = 0.92) and equilibrium modulus (0.31 vs. 0.36 MPa; p = 0.71). By 24 hours, the equilibrium modulus of elastase-treated cartilage (0.055 MPa) resembled native tarsus (0.016 MPa; p = 0.76).</p><p><strong>Conclusions: </strong>Grossly, elastase treatment increased cartilage flexibility and, microscopically, increased chondrocyte lacunae and decreased the density of the interterritorial matrix, relative to controls.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966542","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":"A Case of Periocular Factitious Dermatitis in an Adult.","authors":"Katerina Tori, Michael Han, Hui Bae Harold Lee","doi":"10.1097/IOP.0000000000003169","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003169","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912560","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":"A Rare Case of Metastatic Papillary Thyroid Carcinoma Presenting as an Invasive Orbital Mass.","authors":"Natalie A Chen, Teresa H Chen, Sean Yuan, Maria Del Valle Estopinal, Jeremiah P Tao","doi":"10.1097/IOP.0000000000003168","DOIUrl":"10.1097/IOP.0000000000003168","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912540","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":"Periphlebitis of the Superior Ophthalmic Vein in Noninflammatory Thyroid Eye Disease.","authors":"Antonio Augusto Velasco E Cruz, Guilherme Montenegro, Maria P S Facchin, Victória H Rocha","doi":"10.1097/IOP.0000000000003142","DOIUrl":"10.1097/IOP.0000000000003142","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934535","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":"Accessory Extraocular Muscle With Inflammatory Enlargement: A Rare Presentation.","authors":"Josiane França John, Diego André Eifer, João Pedro da Silveira Dalla-Bona, Fernando Procianoy","doi":"10.1097/IOP.0000000000003178","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003178","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912530","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":"Review of the Management of Periocular Cutaneous Squamous Cell Carcinoma With Perineural Spread Over the Last Decade.","authors":"Sarinee Juntipwong, Mehriban Alizada, Kirsten Simmon, Almila Sarigul Sezenoz, Victor M Elner, Denise S Kim, Christine C Nelson, James Alan Hayman, Paul Loren Swiecicki, Francis Paul Worden, Hakan Demirci","doi":"10.1097/IOP.0000000000003010","DOIUrl":"10.1097/IOP.0000000000003010","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy of various treatment modalities for periocular cutaneous squamous cell carcinoma (pcSCC) with perineural spread (PNS), including immunotherapy, targeted therapy, radiation therapy (RT), and observation.</p><p><strong>Methods: </strong>A retrospective review of 21 patients with pcSCC and PNS treated with immunotherapy, targeted therapy, RT, or observation over the past decade at a single center.</p><p><strong>Results: </strong>Twelve cases were treated with immunotherapy: 6 patients received cemiplimab, 1 pembrolizumab, and 5 combined with chemotherapy/epidermal growth factor receptor (EGFR) blocker/RT (mean follow-up 32 months). MRI showed improvement in 92% of patients (complete response 42% and partial response 50%). Trigeminal neuralgia improved in 92%. Motor and sensory nerve recovery were noted in 50%. Survival rates were 100% in 1 year, 88% in 2 years, and 75% in 3 years. Three patients received EGFR blocker (cetuximab) with RT: 2 patients experienced clinical regression, and 1 had stable disease (mean follow-up 31 months). Neuropathic pain improved in all cases, but no motor or sensory nerve recovery was observed. Survival rates were 100% at 1 year, and 33% at 2 years. Four patients received RT-only (3 had progressive disease, 1 stable disease) and 2 patients opted for observation. No clinical improvement or nerve function recovery was observed in both groups. Both mean survivals were less than 2 years. The 2-year survival rates were 88% in the immunotherapy group, 33% in the EGFR + RT group, and 0% in the RT-only and observation groups.</p><p><strong>Conclusions: </strong>Immunotherapy demonstrated superior clinical outcomes in pcSCC with PNS, improving symptoms, nerve function, MRI findings, and survival rates compared to other treatment modalities.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"79-85"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732580","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":"Endoscopic Dacryocystorhinostomy in a Patient With Hemi-Arrhinia.","authors":"Zachary Kelly, Eelam Adil, Edith R Reshef","doi":"10.1097/IOP.0000000000003001","DOIUrl":"10.1097/IOP.0000000000003001","url":null,"abstract":"<p><p>Congenital arrhinia and hemi-arrhinia can present with varying degrees of nasal hypoplasia. There are significant anatomical consequences to the lacrimal system, and treatment of epiphora in these cases is challenging, with few reports of successful external dacryocystorhinostomy or combined endoscopic and external dacryocystorhinostomy. A 12-year-old girl with left hemi-arrhinia presented with left-sided epiphora and chronic dacryocystitis due to an incompletely formed nasolacrimal system. She underwent a left endoscopic dacryocystorhinostomy via a right-sided transnasal approach in conjunction with otorhinolaryngology, with complete resolution of symptoms postoperatively. This is the first reported case in the literature demonstrating that epiphora in the setting of hemi-arrhinia may be successfully treated in a completely endoscopic fashion with a multidisciplinary team and stereotactic navigation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e21-e24"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817197","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}