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Palpebral Aperture (palpebral + aperture)
Selected AbstractsThe Effect of Full-Face Broadband Light Treatments Alone and in Combination With Bilateral Crow's Feet Botulinum Toxin Type A ChemodenervationDERMATOLOGIC SURGERY, Issue 3 2004Jean Carruthers MD Background. Broadband light (BBL; Intense Pulsed Light; Lumenis Ltd., Yokneam, Israel) is a powerful, nonablative, light-based technology that targets melanin and hemoglobin and stimulates the formation of collagen and elastin. Botulinum toxin type A (BTX-A; BOTOX; Allergan Inc., Irvine, CA) treatment of the lateral periocular region relaxes the vertical fibers of the orbicularis oculi and results in softening of the lateral orbital crow's feet rhytides and widening of the palpebral aperture. Objective. To compare the effects of full-face BBL in combination with BTX-A and BBL alone in female subjects with Fitzpatrick I,III skin types, Glogau II,III rhytides, and significant associated facial lentigines and telangiectasia. Methods. This was a prospective, randomized study of 30 women with moderate to severe crow's feet rhytides. Half of the subjects were treated with BTX-A and BBL and the other half with BBL alone. Their response was assessed clinically and photographically. Skin biopsies of the temporal skin were taken from two subjects in each group and were stained with Masson trichrome. Results. Patients treated with a combination of BTX-A and BBL experienced a better response to treatment, both at rest and on maximum smile, as well as a slightly improved response in associated lentigines, telangiectasia, pore size, and facial skin texture compared with patients who received BBL treatment alone. Skin biopsies showed an increase in dermal collagen in each group. Conclusions. The patients in this study benefited from both treatments. Although BBL led to a remarkable improvement in full-face telangiectasias, lentigines, and skin texture, the improvement increased in all categories with combination therapy. In addition, an added improvement in the full-face aesthetic with both BTX-A and BBL therapy combined was obvious. These results suggest that both treatments,although evidently complementary,may also act synergistically to produce optimal clinical effects, revolutionizing the treatment of facial aging. [source] Botulinum-A Toxin Treatment of the Lower Eyelid Improves Infraorbital Rhytides and Widens the EyeDERMATOLOGIC SURGERY, Issue 8 2001Timothy Corcoran Flynn MD Botulinum-A exotoxin (BTX-A) can be used cosmetically to improve rhytides, particularly of the upper one-third of the face. In this study, fifteen women had BTX-A (BOTOX, Allergan, Inc.) injected into the orbicularis oculi muscle. One lower eyelid received two units just subdermally in the midpupillary line three millimeters below the ciliary margin. The opposite periocular area received two units BTX-A in the lower eyelid with 12 units BTX-A injected into the lateral orbital ("crow's foot") area. Three injections of four units each were placed 1.5 cm from the lateral canthus, each 1 cm apart. Patients and physicians independently evaluated the degree of improvement (grade 0 = no improvement, grade 1 = mild improvement, grade 2 = moderate improvement, and grade 3 = dramatic improvement). An independent photographic analysis was performed. Patients reported a grade of 0.73 when two units were injected alone into the lower lid, and a grade of 1.9 when the lower eyelid and the lateral orbital areas were injected. Physician assessment was grade 0.7 with injection of the eyelid alone and grade 1.8 with injection of the lower eyelid and lateral orbital area. Single investigator photographic analysis demonstrated that 40% of the subjects who had injection of the lower eyelid alone had an increased palpebral aperture (IPA), while 86% of the subjects who had injection of the lower eyelid and lateral orbital area had an IPA. Subjects receiving two units alone had an average 0.5 mm IPA and a mean 1.3 mm IPA at full smile. Concomitant treatment of the lateral orbital area produced a mean 1.8 mm IPA at rest and a mean 2.9 mm IPA at full smile. The results were more notable in the Asian eye. Two units of BTX-A injected into the lower eyelid orbicularis oculi muscle improves infraorbital wrinkles, particularly when used in combination with BTX-A treatment of the lateral orbital area. [source] Tear-film lipid layer morphology and corneal sensation in the development of blinking in neonates and infantsJOURNAL OF ANATOMY, Issue 3 2005John G. Lawrenson Abstract The aim of the study was to evaluate the role of lipid layer thickness and corneal sensation in the development of blinking in neonates. The study group comprised sixty-four neonates and infants (mean age 27.5 ± 15 (sd) weeks, range 3.4,52) whose mothers were attending a general practice healthy baby clinic. Spontaneous eye-blink activity was determined from digital videographic recordings; tear film lipid layer morphology wasexamined using interference patterns produced by the Keeler TearscopeÔ Plus over a five-point grading scale (higher grades are associated with thick and stable lipid films); corneal sensation threshold was assessed with the Non-Contact Corneal Aesthesiometer (NCCA), using the eye-blink response as an objective indication that the cooling stimulus had been felt; palpebral aperture dimensions were measured using calibrated digital still images of the eye in the primary position. The overall mean spontaneous blink-rate was found to be 3.6 (± 0.3) blinks min,1, and the mean interblink time was 21.6 (± 2.8) s. The lowest blink-rates were observed in the 0,17-week age group (average 2 blinks min,1). The blink-rate showed a highly significant correlation with age (r = 0.46, P < 0.01). The overall mean lipid layer grading was 3.6 (± 0.2 SE) arbitrary units. Higher grades were found in the newborn and the mean grading score reduced with age (P < 0.01). The mean sensation threshold to blink (TTB) was 0.69 (0.04 SE) mbar, which did not differ from a control group of older subjects (P > 0.05). There was a rapid increase in palpebral aperture length and width from birth to 1 year old, with surface area increasing by 50% over the same period. We concluded that the low rate of spontaneous eye blink activity in neonates is associated with a thick stable lipid layer that may be a function of a small palpebral aperture. Furthermore, neonates appear to have the capacity to detect ocular surface cooling, which is a major trigger for spontaneous blinking. [source] Management of oculoplastic problems in the OOKP eyeACTA OPHTHALMOLOGICA, Issue 2009A GOMAA OOKP surgery (either stage 1 or 2) can result in complex oculoplastic complications. The majority of these are mucous membrane graft-related, including graft thinning, ulceration and infection or overgrowth onto the anterior optical cylinder. However, lid malposition, forniceal shortening and widening of the palpebral aperture may also occur. Appropriate timely surgical intervention of these is crucial to protect the underlying OOKP lamina. In addition, correcting over-exposure of the globe aids in improved comfort for the patient. Adjustments of the lid and forniceal abnormalities can enhance comfort, cosmesis and prosthetic shell stability. Retrospective case note analysis of all patients treated 1996 , 2009 at the Sussex Eye Hospital, Brighton, UK, was performed. This study reports the prevalence and type of oculoplastic complications found and describes the surgical management for each. [source] | ||||||||||