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Upper Eyelid (upper + eyelid)
Kinds of Upper Eyelid Selected AbstractsUpper Eyelid Full-Thickness Skin Graft in Facial ReconstructionDERMATOLOGIC SURGERY, Issue 1 2005Dogan Tuncali MD Background The potentially available upper eyelid skin, as an alternative donor site, deserves more attention in clinical use. Objective The objective of this study was to prospectively evaluate the clinical behavioral characteristics of upper eyelid full-thickness skin grafts in facial reconstruction. Methods Sixteen patients who concluded the 12-month follow-up period were included in the study. Graft dimensions were measured in place before the graft harvest. Defect sizes were measured following lesion excision and postgrafting. Graft sizes were measured postoperatively at 1, 3, 6, and 12 months. Results The largest and smallest grafts were 46 × 22 mm and 40 × 15 mm (average 43.1 × 19.3 mm) in size, respectively. The largest and smallest defect dimensions were 33 × 23 mm and 17 × 9 mm (average 22.6 × 15.6 mm), respectively. The average postgrafting size was 21.1 × 14.6 mm. Grafts and donor sites healed very well. Generally, an acceptable to good texture and color match was observed beyond 6 months. Wound bed contraction was not observed beyond the first month (p < .05). Conclusion Special characteristics of hairless skin, good color and texture matching, and inconspicuous and hidden donor scar make the upper eyelid a good alternative donor site for small- to medium-sized facial skin defects. The main disadvantages that limit its clinical use are the age of the patient, a lack of adnexal structures, comparatively limited sun exposure, and possible insufficient thickness, especially when deep defects are of concern. DOGAN TUNCALI, MD, LEVENT ATES, MD, AND GÜRCAN ASLAN, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Sebaceous Carcinoma of the Eyelid: Analogy to Extramammary Paget's DiseaseJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005J.B. Lee We present a 69-year-old woman with a sebaceous carcinoma of the left upper eyelid, which originated from the Meibomian gland of the tarsal plate. The intraepidermal extension involved not only the conjunctival epithelium but also the overlying skin with subsequent extension into the dermis. The discussion will include diagnostic, both clinical and microscopic, considerations along with comparison to mammary Paget's disease. Just as mammary Paget's disease, which originates from the glands in the dermis eventuating in the seeding of the overlying epidermis, so too does sebaceous carcinoma of the eyelid. Accordingly, just as mammary Paget's disease is often misdiagnosed as an inflammatory condition, so too is sebaceous carcinoma. [source] Peribulbar blockade with a short needle for phacoemulsification surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2009W. RIAD Background: Peribulbar blockade is still widely used for phacoemulsification surgery. The potential complications of this technique include central spread, globe perforation and retrobulbar hemorrhage. The 25 mm needle is the most common needle used to perform the block. The aim of this study was to demonstrate the efficacy of a 12.5 mm needle in performing peribulbar blockade for phacoemulsification surgery. Methods: After obtaining the hospital research and the Human Ethics Committees' approval, 200 patients undergoing the phacoemulsification procedure under local anesthesia were enrolled in this descriptive study. Peribulbar blockade was performed with a 27 G, 12.5-mm-long needle. The needle was inserted transcutaneously through the lower eyelid into the inferotemporal quadrant. Digital pressure was applied by the thumb and index fingers around the needle hub during injection. After negative aspiration, a local anesthetic solution was injected until total drop of the upper eyelid was achieved. Ocular akinesia was assessed 10 min after the block using the simple akinesia score. A score of 3 or less was accepted to provide adequate analgesia for the surgical procedure to be performed. If the block was inadequate for surgery after 10 min, supplementary anesthesia was provided using the same needle. Results: Adequate analgesia after the first injection was reported in 90.5% of the patients while 9.5% required supplementary anesthesia. There were no major sight or life-threatening complications. Conclusion: Using a 12.5-mm-long needle for peribulbar blockade produced satisfactory results. This technique is effective for phacoemulsification surgery. [source] Radiosurgery versus carbon dioxide laser for dermatochalasis correction in Asians,LASERS IN SURGERY AND MEDICINE, Issue 2 2007Carol S. Yu MBBS (Hons), MRCS (Edin) Abstract Background and Objectives Carbon dioxide (CO2) laser and radiosurgery are techniques commonly employed in oculoplastic surgery. However, there is no literature comparing their results in blepharoplasty. Study Design/Materials and Methods Twenty Chinese patients with dermatochalasis underwent radiosurgery in one upper eyelid and CO2 laser in the contralateral eyelid. Intraoperative time, hemorrhage, and pain control were assessed. Subjects were evaluated at postoperative 1 hour, 1 week, 1 month, and 3 months for hemorrhage and wound healing by a masked assessor. Results All patients reported minimal pain with either technique. A significantly shorter operative time was achieved with CO2 laser, with better intraoperative hemostasis. There was no significant difference in postoperative hemorrhage and wound swelling between radiosurgery and CO2 laser. No significant intraoperative complications were noted. Conclusions Both radiosurgery and CO2 laser are equally safe and effective for upper lid blepharoplasty. CO2 laser achieves shorter operative time with superior intraoperative hemostasis. Lasers Surg. Med. 39:176,179, 2007. © 2007 Wiley-Liss, Inc. [source] Video-Assisted Thoracoscopic Sympathectomy for Congenital Long QT SyndromesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 4p1 2003JIANFENG LI LI, J., et al.: Video-Assisted Thoracoscopic Sympathectomy for Congenital Long QT Syndromes. The feasibility, safety, and effectiveness of video-assisted thoracoscopic sympathectomy (VATS) for congenital long QT syndrome were assessed in four patients who had frequent syncopal events before the surgeries. Under general anaesthesia, the pleural cavity was entered via two small incisions in the left third and fifth intercostal spaces at the mid-axillary line. The left thoracic sympathetic chain was identified and resected from T2-T5. The lower one third of the left stellate ganglion was also resected. VATS resulted in a significant shortening in corrected QT intervals (QTc) in three patients, the average QTc of the four patients immediately before and after VATS was538 ± 76and512 ± 57 ms, respectively(P = 0.047). The heart rate remained unchanged after the VATS (67 ± 4vs69 ± 4 beats/min, P > 0.05). There were no major perioperative complications apart from mild ptosis of the left upper eyelid in one patient who recovered in the following days. There was no recurrence in syncopal events after a 3-month follow-up. VATS is a safe and effective technique for left cardiac sympathectomy in patients with congenital long QT syndromes. (PACE 2003; 26[Pt. I]:870,873) [source] 4361: Management of orbital tumours with adjuvant iodine brachytherapy using "inverted" plaquesACTA OPHTHALMOLOGICA, Issue 2010T KIVELÄArticle first published online: 23 SEP 2010 Purpose To describe our experience in using "inverted" iodine plaques as adjuvant treatment after resection of orbital tumours. Methods Between 1999 and 2007, three patients (ages 17-48 years) underwent resection of an lacrimal gland tumour followed by application of an "inverted" iodine plaque manage any microscopic infiltration, i.e. a gold plaque carrying iodine-125 seeds on its convex rather than concave surface. In a fourth instance, the seeds were placed on the convex surface of a ruthenium rather than a gold plaque to manage an eye with a late extraocular recurrence of an irradiated uveal melanoma following resection of the extension. Results The diameter of the plaque was 20 mm. It was sutured to the sclera so that when the eye was in primary position the lacrimal fossa was targeted. When the eye moved, the irradiated volume naturally enlarged. A 40-56 Gy dose was calculated to the depth of 10 mm, and the dose at 5 mm was then calculated as 80-134 Gy. Treatment time was 59-154 hours. In one case, the iodine seeds were placed asymmetrically to limit radiation damage to the eyelid skin. In two patients, transient erythema of the upper eyelid developed, which resolved in a few months time. In case of the extraocular melanoma, dose was the same. Recurrent tumours have not developed. Conclusion An "inverted" iodine plaque is one option for adjuvant irradiation of the orbit which shields the eye from radiation damage. [source] The application of temperature measurement of the eyes by digital infrared thermal imaging as a prognostic factor of methylprednisolone pulse therapy for Graves' ophthalmopathyACTA OPHTHALMOLOGICA, Issue 5 2010Shyang-Rong Shih Abstract. Purpose:, Graves' ophthalmopathy (GO) involves autoimmune process resulting in proptosis, congestion, oedema and diplopia. Werner's NOSPECS classification and clinical activity score (CAS) of GO cannot objectively describe the inflammatory status. Digital infrared thermal imaging (DITI) detects local temperature and may reflect the degree of orbital inflammation. The aim of this study was to evaluate the clinical application of the eye temperature measured by DITI. Methods:, Forty-six patients with GO receiving intravenously methylprednisolone pulse therapy (MPT) were included in this study. Local temperatures of the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid and cornea were measured with DITI before and after MPT. CAS, proptosis, eye movement (EOM) and diplopia were also recorded. Improvement of CAS was defined as at least one point decrease at either side of the eye, which was 0.5 score decrease as to the average of bilateral CAS. Results:, Local temperatures of the eyes decreased after MPT. The mean value of temperature (MT) of 12 points including the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva and lower eyelid of both eyes before MPT was 32.65°. The mean change of MT after MPT (,T) was ,0.22°. ,T significantly negative-correlated with basal MT (correlation coefficient = ,0.54, p = 0.004). Higher baseline MT and CAS before MPT correlated with higher possibility of improvement of CAS after MPT (p = 0.013 and 0.012, respectively). Baseline MT and CAS together correlated with improvement of CAS after MPT better than baseline CAS alone could do (area under the receiver operating characteristic curve: 82.81% and 66.63%, respectively). Conclusions:, Basal temperature of the eyes measured by DITI was an objective indicator of inflammation of GO. Combining CAS and MT could better predict the outcome of MPT than CAS alone. [source] Granular cell tumour of the lacrimal glandACTA OPHTHALMOLOGICA, Issue 2009SL VON HOLSTEIN Purpose To report the clinical and histopathological characteristics of a patient with a granular cell tumour (GCT) of the lacrimal gland. Methods Surgical excision and histological examination. Results A 38-year old male presented with a painful swelling located temporally in the right upper eyelid. Clinical examination revealed proptosis and displacement of the right eye and a tumour was palpated at the site of the lacrimal gland. MRI scan revealed a solid tumour in the lacrimal fossa. The tumour was excised. Microscopically the tumour was composed of tumour cells with coarsely granular cytoplasm. The tumour cells were arranged in clusters and ribbons separated by collagen bundles and no necrosis or mitosis were present. The granules were PAS positive, diastase resistant and the tumour cells expressed focal staining for S100. Electron microscopy showed numerous secondary lysosomes. The diagnosis is consistent with a GCT. Conclusion This case presents for the first time a GCT of the lacrimal gland. [source] Rosacea lymphoedema of the eyelidACTA OPHTHALMOLOGICA, Issue 6 2004Tze Foon Lai Abstract. Purpose:,To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis. Methods:,A 51-year-old white man presented with a 12-month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed. Results:,The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect. Conclusion:,Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist. [source] Capillary haemangioma of the eyelids and orbit: a clinical review of the safety and efficacy of intralesional steroidACTA OPHTHALMOLOGICA, Issue 3 2003Michael O'Keefe Abstract. Purpose:, To describe the presenting features, investigations, treatment and outcome of a series of patients with capillary haemangioma of the eyelids and orbit. Methods:, A retrospective analysis of 21 patients, presenting between the years 1985 and 2000. Effectiveness of treatment was determined by final visual acuity and cosmetic result. Results:, Lesions were more common in females and the upper eyelid was a definite site of predilection. A total of 87.5% of lesions presented within 6 weeks of birth. Intralesional steroid injections were received by 79% of patients. Amblyopia was a definite complication. No local or systemic complications were associated with intralesional steroid injection. Surgery and laser treatment were reserved for persistent lesions. Conclusion:, Early recognition and prompt treatment with intralesional steroid prevents early occlusion amblyopia, but follow-up and management of refractive amblyopia with glasses and patching is necessary in the longer term. In this series, intralesional steroid proved to be a safe effective treatment. [source] A pearly nodule on the upper eyelidCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2010R. Verdolini No abstract is available for this article. [source] Haemangioendothelioma on the conjunctiva of the upper eyelidCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 8 2006Sang Hyoung Cho MD Abstract A 62-year-old man visited the authors' clinic complaining of a mass on the palpebral conjunctiva of the right upper eyelid. The 2.0 cm × 1.2 cm sized, red and painless mass underwent incision and biopsy for histopathological examination. The mass was confirmed to be Kaposiform haemangioendothelioma characterized by densely packed spindle cells. These cells were positive to vimentin, CD31 and factor VIII-related antigen by immunohistochemical stain. The mass was completely resolved by oral steroid therapy and has not recurred through the presentation. Kaposiform haemangioendothelioma generally occurs in infant and adolescent periods and is characterized by rapid progression and invasion to adjacent tissue. Herein, an unusual case of Kaposiform haemangioendothelioma affecting the conjunctiva of the upper eyelid on a middle-aged man is reported. [source] Cicatricial ectropion: repair with myocutaneous flaps and canthopexyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 7 2006Kiran Manku FRANZCO Abstract Background:, To evaluate the effectiveness of myocutaneous upper eyelid flaps combined with canthopexy to treat cicatricial lower eyelid ectropion. Methods:, A prospective non-comparative case series undertaken in a private practice setting. Consecutive patients with moderate lower eyelid cicatricial ectropion and upper eyelid dermatochalasis underwent transfer of a bipedicle or monopedicle flap from the upper eyelid combined with canthopexy. The main outcome measures included the occurrence of complications, eyelid position and cosmesis. Results:, Sixty-two consecutive cases of cicatricial ectropion repair using myocutaneous flaps and canthopexy. After a mean follow up of 20 months, 58 (93.5%) of the cases had the lower lid punctum facing posterosuperior into the tear lake, showed lid globe apposition and satisfactory eyelid position. There was mild recurrence of cicatricial ectropion in four patients (6.5%). There were no cases of graft failure or granuloma formation. Conclusion:, The use of a myocutaneous flap from the upper eyelid combined with a canthopexy suspension suture for repair of cicatricial ectropion may offer good eyelid position and function. This technique has the advantage of avoiding full thickness blepharotomy and was associated with a low incidence of early recurrence. [source] Sebaceous gland carcinoma of the eyelid presenting as a conjunctival papillomaCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2005Jwu Jin Khong MB BS (Hons) Abstract An unusual presentation of sebaceous carcinoma of the eyelid is described in a 96-year-old man who presented with a large papillomatous palpebral conjunctival lesion in the left upper eyelid. The patient underwent a shave excision of the lesion, followed by a full thickness excision with paraffin section margin control. Histopathology revealed a sebaceous gland carcinoma with no evidence of pagetoid spread. Although rare, sebaceous gland carcinoma should be considered in the differential diagnosis of a conjunctival papilloma. [source] Levator palpebrae superioris muscle in human fetuses: Anatomical findings and their clinical relevanceCLINICAL ANATOMY, Issue 7 2005J. Plock Abstract Accessory medial muscular bellies of the levator palpebrae superioris muscle and broad lateral insertion of its aponeurosis into tissue near the lacrimal gland have been reported as rare variations in adults. The anatomy of this muscle was studied in orbits of ten human fetuses between the 5th and 10th months of gestation. In each of the dissected orbits, the levator palpebrae superioris muscle had a broad lateral insertion into the capsule of the lacrimal gland or the periorbita, in this period of development. In addition, medial accessory muscles of the levator or singular muscle fibers within fibrous bands that inserted near the trochlear region and the medial portion of the upper eyelid were present in 70% of the fetuses, either unilaterally or bilaterally. These findings demonstrate new unreported aspects of levator palpebrae superioris development and morphology. Our findings suggest that an initial broad anterior primary anlage of the muscle is followed by secondary atrophy of lesser used marginal portions of this muscle, which are replaced by delicate connective tissue. These findings might force new considerations about diagnostic and therapeutic approaches to congenital mobility disorders of the levator palpebrae superioris muscle, such as blepharoptosis or eyelid retraction. The clinical relevance of our results are discussed along with a review of the embryogenesis of extraocular muscles and soft tissue of the orbit. Clin. Anat. 18:473,480, 2005. © 2005 Wiley-Liss, Inc. [source] Fishing Down Under: case report and review of management of a fishhook injury of the eyelidCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 5 2008AJ Kreis A 21-year-old man presented to the emergency department of the Royal Victorian Eye and Ear Hospital with a fishhook embedded in his unprotected left upper eyelid. The fishhook was removed after exploration of the left eye by vertical eyelid incision. Subsequent eyelid reconstruction by lid margin adaptation was performed. Management of these injuries depends on type of hook, the involved ocular structure and location of the hook. This is an update on management options, where triage and surgical approaches are discussed. This case illustrates the risk to the eyes while fishing. Persons with an interest in fishing should be advised to wear eye protection. [source] Novel Pretrichial Browlift Technique and Review of Methods and ComplicationsDERMATOLOGIC SURGERY, Issue 9 2009COURTNEY S. McGUIRE BS BACKGROUND The upper third of the face is integral to our perception of youth and beauty. While the eyelids anchor this facial cosmetic unit, the eyebrows and forehead are intrinsically linked to the upper eyelids, and their position and texture play an important role in creating pleasing eyes as well as conveying mood and youth. The most common browlifts are performed with endoscopic visualization. Yet, this technique requires special equipment and a prolonged learning curve. OBJECTIVE To demonstrate a novel pretrichial technique and to review different browlift methods and their potential adverse effects. METHODS Case series and review of the literature. RESULTS The pretrichial browlift results in a mild to moderate browlift with secondary smoothing of the forehead topography. Aside from bruising and swelling, it results in minimal adverse effects. Other techniques are also effective but may create a larger scar such as a direct browlift, may be more difficult in terms of approach such as the browpexy, or require endoscopes. CONCLUSION Browlifts are an important procedure in rejuvenating the upper third of the face and improving the overall facial aesthetic appearance. The pretrichial browlift is a less invasive open technique that is safe and effective for the appropriate patient. [source] Improvement of Dermatochalasis and Periorbital Rhytides With a High-Energy Pulsed CO2 Laser: A Retrospective StudyDERMATOLOGIC SURGERY, Issue 4 2004Tina S. Alster MD Background. Upper eyelid dermatochalasis is typically treated with excisional blepharoplasty. The role of the CO2 laser previously had been confined to that of a vaporizing, incisional, or hemostatic tool. Over the past several years, however, ablative CO2 laser skin resurfacing has been popularized as an adjunctive treatment to blepharoplasty to minimize periorbital rhytides through its vaporizing as well as skin-tightening action. Objective. To evaluate the safety and efficacy of a high-energy pulsed CO2 laser as a stand-alone treatment for dermatochalasis and periorbital rhytides. Methods. Sixty-seven patients (skin phototypes I,IV) with mild-to-severe upper eyelid dermatochalasis and periorbital rhytides received periocular CO2 laser skin treatment. Global assessment scores of dermatochalasis and rhytides were determined by a side-by-side comparison of periocular photographs preoperatively and 1, 3, and 6 months postoperatively. In addition, caliper measurements of upper eyelids before and 1, 3, and 6 months after treatment were obtained. Results. Both dermatochalasis and periorbital rhytides were significantly improved after periocular CO2 laser skin resurfacing. Patients with more severe dermatochalasis and rhytides showed greater improvement after CO2 laser treatment than did those with mild or moderate involvement. Side effects were limited to erythema and transient hyperpigmentation. No scarring, hypopigmentation, or ectropion were observed. Conclusions. Periocular skin resurfacing with a CO2 laser can safely and effectively improve upper eyelid dermatochalasis and periorbital rhytides. [source] Numerical analysis of interferograms for evaluation of tear film build-up timeOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2009Dorota H. Szczesna Abstract The lateral shearing interferometer was applied to the in vivo dynamic investigation of the external surface of the pre-corneal tear film after an eye blink. Sequences of interferograms were recorded at a sampling frequency of 25 Hz. Immediately after every eye blink, a bright pattern was observed under the interference fringes. This disappeared after a short time interval (around 0.5,2 s): smooth interference fringes were then observed, corresponding to the creation of a smooth anterior optical surface over the cornea. The purpose of this study is to describe in detail the kinetics of pre-corneal tear film stability and to propose quantitative measures of the stabilisation process in healthy eyes during the 3 s period after a blink. Two methods of quantitative assessment of the tear film build-up time are presented. The first is based upon the evaluation of the inhomogeneity of the background of the interferogram; the second evaluates the orientation of the structure of the background by the analysis of the zero order of the Fast Fourier Transform (FFT) spectrum. The quasi-vertically oriented bright line patterns observed in interferograms immediately after a blink and the mirror-symmetry of their tilts for right and left eyes indicate that the pattern is related to the wiping movements of the upper eyelids during the eye blink. [source] | ||||||||||