Essential blepharospasm is an incurable disease for which many treatment modalities fave been tried. The author has performed the Anderson's muscle stripping procrdure involving the meticulous extirpation of all eyelid protractors and reinrorcement or the retractors in three patients with essential blerharospasm withgratifying results.
Adult ; Aged ; Blepharospasm/*surgery ; Eyelid Diseases/*surgery ; Female ; Humans ; Middle Aged ; Oculomotor Muscles/*surgery

Objective: To report the epidemiology of canalicular lacerations and surgical outcomes of canalicular laceration repair with Mini-Monoka® (FCI Ophthalmics, Issy-les-Moulineaux, Cedex, France) intubation. Methods: This is a retrospective interventional case series of patients who underwent Mini-Monoka® intubation in the repair of canalicular laceration from 2010 to 2015 at a tertiary state-owned hospital in Manila, Philippines. Patient demographics, surgical outcomes, and complications were analyzed. Results: Fourteen patients (12 males and 2 females) underwent Mini-Monoka® intubation for monocanalicular laceration. The mean age at presentation was 27 years (range, 16-47 years). The mean duration of follow-up was 2.92 years (range, 1.28-6.15 years). Canalicular patency was achieved in 12 out of the 14 patients (86%). None of the 12 patients experienced epiphora following stent removal resulting in a functional success rate of 100%. Two patients had punctal slitting (14%). Premature stent loss occurred in 2 out of the 14 patients (14%). Conclusion Mini-Monoka® intubation is effective in maintaining the long-term anatomical patency of the lacerated canaliculus. It is a simple and minimally invasive procedure making it a safe and reasonable alternative to the traditional methods of canalicular repair.
Lacerations ; Eyelid Diseases

BACKGROUND: The most common surgical treatment for paralytic lagophthalmos is the placement of a weight implant in the upper eyelid; however, this technique confers the risks of implant visibility, implant extrusion, and entropion. In this study, we present a new technique of placing platinum weight implants between the levator aponeurosis and inner septum to decrease such complications. METHODS: A total of 37 patients with paralytic lagophthalmos were treated between March 2014 and January 2017 with platinum weight placement (mean follow-up, 520.1 days). After dissecting through the orbicularis oculi muscle, the tarsal plate and levator aponeurosis were exposed. The platinum weights (1.0–1.4 g) were fixed to the upper margin of the tarsal plate and placed underneath the orbital septum. RESULTS: Five patients could partially close their eye after surgery. The average distance between the upper eyelid and the lower eyelid when the eyes were closed was 1.12 mm. The rest of the patients were able to close their eye completely. Three patients patient developed allergic conjunctivitis after platinum weight insertion, which was managed with medication. None of the patients complained of discomfort in the upper eyelid after surgery. Visibility or extrusion of the implant were observed in three patients. CONCLUSIONS: Postseptal weight placement is a safe and reproducible method in both primary and secondary upper eyelid surgery for patients with paralytic lagophthalmos. It is a feasible method for preventing implant visibility, implant exposure, and entropion. Moreover, platinum is a better implant material than gold because of its smaller size and greater thinness.
Conjunctivitis, Allergic ; Entropion ; Eyelid Diseases ; Eyelids* ; Facial Paralysis ; Follow-Up Studies ; Humans ; Methods ; Orbit ; Platinum* ; Prostheses and Implants ; Thinness ; Weights and Measures

OBJECTIVETo screen mutations in the forkhead transcriptional factor 2 gene (FOXL2) in six Chinese families with blepharophimosis, ptosis, and epicanthus inversus syndrome(BPES).

METHODSPCR amplification and direct sequencing of the FOXL2 coding region in genomic DNA were performed in affected patients and 80 healthy controls. BLAST analysis of the sequence was made on Internet.

RESULTSA novel 951-953(delC) was found in the two affected patients of a Chinese family with BPES. No mutations were found in the healthy controls. The 951-953(delC) may cause a frameshift mutation after codon 238 that exists downstream of the forkhead domain, resulting in the production of truncated proteins.

CONCLUSIONThese findings indicated that the 951-953(delC) deletion mutation in the two patients resulted in truncated proteins and hence led to their BPES. To the authors' knowledge, the 951-953(delC) in FOXL2 has not been previously reported.

Amino Acid Sequence ; Base Sequence ; Blepharophimosis ; genetics ; Blepharoptosis ; genetics ; China ; Eyelid Diseases ; genetics ; Family Health ; Female ; Forkhead Box Protein L2 ; Forkhead Transcription Factors ; genetics ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Sequence Alignment

Thirty-nine patients with blepharospasm were treated with botulinum A toxin. Twenty-six patients had essential blepharospasm, and thirteen had a hemifacial spasm. A total of 113 injections were given, and the average follow-up was 14.6 months. The mean preinjection spasm intensity was 2.9+ and the mean postinjection spasm intensity was 0.7+. The mean interval between injections was 4.4 months. The treatment was effective, although transient, in all patients with essential blepharospasm and hemifacial spasm. The toxin had a prolonged effect on the patients who had previously undergone muscle stripping procedure. The side effects were mild, transient, and local.
Adult ; Aged ; Blepharospasm/*drug therapy ; Botulinum Toxins/*therapeutic use ; Eyelid Diseases/*drug therapy ; Female ; Humans ; Male ; Middle Aged ; Time Factors

PURPOSE: To investigate the surgical results of an ear cartilage graft and supplemental procedures for correcting lower lid retraction combined with entropion in anophthalmic patients. METHODS: We reviewed retrospectively the medical records of 7 anophthalmic patients with lower lid retraction and entropion, who received a posterior lamellar ear cartilage graft and one or both of lateral tarsal strip or eyelash-everting procedure between March 1998 and March 2003. Preoperative and postoperative lid and socket statuses were also investigated. RESULTS: Ear cartilage grafts were performed in all 7 patients, lateral tarsal strips in 6, and eyelash-everting procedures in 5. Postoperative follow-up durations ranged from 4 to 28 months (average 12.6 months). Retractions were corrected during follow-up in all patients. There were no cases of entropion immediately after surgery. However, the eyelashes of the lower lid returned to an upright position in 4 patients, but not so severe as to touch the ocular prosthesis, and thus did not require surgical correction during follow up. CONCLUSIONS: Lower lid retraction combined with entropion in anophthalmic patients can be corrected effectively using an ear cartilage graft with selective, supplemental procedures.
Retrospective Studies ; Male ; Humans ; Female ; Eyelid Diseases/*etiology/*surgery ; Entropion/*etiology/*surgery ; Ear Cartilages/*transplantation ; Child, Preschool ; Child ; Anophthalmos/*complications ; Adult

A 39-year-old man with poliosis of his lower eyelid lashes visited our clinic. He reported that his symptoms began with a few central lashes and then spread along the adjacent lashes during the ensuing 2 weeks. A pigmented nevus, approximately 4 mm in diameter, was identified just above the white lashes without surrounding skin depigmentation. No specific findings were identified with regard to the patient's general health or serologic and radiologic testing. Excisional biopsy of the pigmented nevus was performed. On histopathologic examination, infiltration of the dermis by numerous lymphocytes and melanophages was observed. The poliosis was ultimately diagnosed as a presenting sign of the halo phenomenon in the regressive stage of a melanocytic nevus.
Adult ; Biopsy ; Diagnosis, Differential ; Eyelashes/*pathology ; Eyelid Neoplasms/*diagnosis ; Hair Diseases/*diagnosis ; Humans ; Hypopigmentation ; Male ; Nevus, Halo/*diagnosis

OBJECTIVETo observe the clinical effectiveness of meibomian gland tube massage in treating meibomian gland dysfunction (MGD).

METHODSAll patients were divided into medicine group (tropically administered with corticosteroid eye ointment and artificial tears)and massage group (meibomian gland tube massage in addition to these drugs) using random numbers. At different period(before treatment and after treatment 2,4 weeks), the slip-lamp microscopy and intraocular pressure measurement were performed. Ocular symptoms were evaluated by questionnaire of ocular surface disease index (OSDI), and corneal fluorescein staining scores (CFS) was used for checking the epithelial integrity,tear film breakup time (TBUT), and tear secretion (Schirmer I test,SIt).

RESULTSBefore the treatment, the OSDI score,TBUT, CFS, and SIt showed no statistical significance between these two groups (all P>0.05). After the treatment, the symptoms, damage of corneal epithelium, quality of tear film,tear secretion were significantly improved in both groups(P<0.05), and were significantly superior in the massage group than in the medicine group (all P<0.01; but CFS t4w=6.60,P>0.05).

CONCLUSIONThe meibomian gland tube massage in combination with drug therapy can improve the treatment effectives for MGD.

Cornea ; Eyelid Diseases ; Fluorescein ; Humans ; Meibomian Glands ; Surveys and Questionnaires ; Tears

During the course of meibomian gland dysfunction (MGD) treatment, meibomian gland massage is an effective auxiliary method. Based on an extrusion method using anti-phase massage rollers and a theory on envelope plane, a massage mechanism was proposed in this paper for the defect of the traditional mechanical assist massage structure to discharge obstruction of Meibomian gland more smoothly and to enlarge massage coverage. Meanwhile, for the case that the power of motor was significantly limited by size, an evaluation, about the input, output and loss, was carried out to initially verify the feasibility of the designed mechanism.
Eyelid Diseases ; therapy ; Humans ; Massage ; instrumentation ; Meibomian Glands

The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.
Amblyopia ; Astigmatism ; Blepharophimosis ; Blepharoptosis* ; Entropion ; Heart Septal Defects, Ventricular ; Hernia, Inguinal ; Humans ; Hyperopia ; Myopia ; Reoperation ; Strabismus ; Tongue ; Visual Acuity