Blepharoplasty ; Eyelids ; abnormalities ; injuries ; Humans ; Surgical Flaps

PURPOSE: To evaluate the usefulness of a polypropylene non-woven sheet as a spacer graft for the correction of lower lid retraction METHODS: Fifteen New Zealand white rabbits were randomized into three groups. Polypropylene non-woven sheets were implanted between the tarsus and lower lid retractor via a transcutaneous approach (Group 1), a transconjunctival approach (Group 2), or a transconjunctival approach with amniotic membrane transplantation (Group 3). Numerous large pores were made in the sheet with a 21-gauge needle before implantation. Rabbits were sacrificed serially after 1, 2, 4, 6, and 8 weeks in each group. Gross and histologic examinations were performed. RESULTS: In Group 1, the polypropylene sheets stayed in place well, without any exposure on gross observation except at 2 weeks. In Group 2, the conjunctival wound was not healed on the polypropylene sheet, and the sheet was exposed to the ocular surface and extruded gradually. In Group 3, the conjunctival wound was well healed on the surface of polypropylene sheet, and the sheet remained stationary at 4, 6, and 8 weeks on gross examination. Histologic examinations showed gradual fibrovascular ingrowth into the polypropylene sheets in Groups 1 and 3, but not in Group 2, in which only severe inflammatory infiltrations were observed. CONCLUSIONS: The polypropylene non-woven sheet is a good candidate for a spacer material in lower lid retraction operation, and either the transcutaneous approach or the use of an amniotic membrane is necessary for best postoperative outcome.
Amnion ; Ankle ; Eyelids* ; Needles ; Polypropylenes* ; Rabbits ; Transplants* ; Wounds and Injuries

PURPOSE: The aim of this study was to analyze the effects of using the nonincisional, double fold formation method with three small incisions and two-stitches. METHODS: This study included 39 patients who underwent double eyelid operation by a nonincisional technique and who were followed up for more than 6 months. On the desired double eyelid line, three points 6 mm apart were marked and three stab incisions made. A small amount of subcutaneous tissue was removed through the incisions, and orbital fat was removed through the lateral wound site-if necessary. Using double-armed 7-0 nylon or prolene, two buried sutures of 6 mm width were made. Sixteen patients also underwent surgery for epiblepharon, and three patients with unilateral double eyelid due to trauma had a contralateral eyelid operation for asymmetry correction. Five patients also had epicanthoplasty. RESULTS: Two patients lost their folds completely and reoperations were performed. Two patients showed cysts due to suture material and so the suture knots were removed; the double fold remained afterwards, so no other procedures were needed. In one case, the suture was seen subcutaneously, so suture removal and reoperation were performed. CONCLUSIONS: To minimize double fold loss, which is a disadvantage of the nonincisional double fold formation technique, we removed a portion of pretarsal tissue, muscle, and/or orbital fat and made two wide slings. Also, we corrected asymmetry due to traumatic unilateral double eyelid and epicanthal fold. In conclusion, we expect that our method could extend the applicability of nonincisional double fold formation.
Eyelids ; Humans ; Nylons ; Orbit ; Polypropylenes ; Reoperation ; Subcutaneous Tissue ; Sutures ; Wounds and Injuries

PURPOSE: The aim of this study was to analyze the effects of using the nonincisional, double fold formation method with three small incisions and two-stitches. METHODS: This study included 39 patients who underwent double eyelid operation by a nonincisional technique and who were followed up for more than 6 months. On the desired double eyelid line, three points 6 mm apart were marked and three stab incisions made. A small amount of subcutaneous tissue was removed through the incisions, and orbital fat was removed through the lateral wound site-if necessary. Using double-armed 7-0 nylon or prolene, two buried sutures of 6 mm width were made. Sixteen patients also underwent surgery for epiblepharon, and three patients with unilateral double eyelid due to trauma had a contralateral eyelid operation for asymmetry correction. Five patients also had epicanthoplasty. RESULTS: Two patients lost their folds completely and reoperations were performed. Two patients showed cysts due to suture material and so the suture knots were removed; the double fold remained afterwards, so no other procedures were needed. In one case, the suture was seen subcutaneously, so suture removal and reoperation were performed. CONCLUSIONS: To minimize double fold loss, which is a disadvantage of the nonincisional double fold formation technique, we removed a portion of pretarsal tissue, muscle, and/or orbital fat and made two wide slings. Also, we corrected asymmetry due to traumatic unilateral double eyelid and epicanthal fold. In conclusion, we expect that our method could extend the applicability of nonincisional double fold formation.
Eyelids ; Humans ; Nylons ; Orbit ; Polypropylenes ; Reoperation ; Subcutaneous Tissue ; Sutures ; Wounds and Injuries

There are many clinical reports on implant exposure as a complication of hydroxyapatite orbital implantation, but relatively small number of reports have concerned full range of complications that can occur with hydroxyapatite orbital implants. The authors analyzed all the complications associated with the 110 hydroxyapatite orbital implants performed by one surgeon at the department of ophthalmology, Presbyterian Medical Center between January 1993 and June 1998, and discussed the management and progression of them. There were 8 kinds, 40 cases of soft tissue problems, 3 kinds, 20 cases of eyelid problems, and 7 kinds, 27 cases with prosthesis and pegging.Most of them were improved with conservative management and surgical treatments were required in 2 cases with conjunctival wound disruption, 5 cases with implant exposure, 3 cases with overgrowth of subconjunctival granulation tissue, 3 cases with ptosis, 1 case with eyelid laxity, 2 cases with peg extraction, and 4 cases with poor peg position. Surgeons and patients who want to use hydroxyapatite as an orbital implant would be more satisfied with thorough knowledge on many possible complications and their etiology, proper prevention and management.
Durapatite* ; Eyelids ; Granulation Tissue ; Humans ; Ophthalmology ; Orbit* ; Orbital Implants* ; Prostheses and Implants ; Protestantism ; Wounds and Injuries

In Korea, lateral canthoplasty, along with medial epicanthoplasty, has become popular over the past years to widen the horizontal length of the palpebral fissure. However, the effect of the surgery differs greatly depending on the shape and structure of the eyes. If over-widened, complications such as eversion, scarring, and conjunctival exposure may occur. Thus, the author of this study suggests a more effective and safe method for lateral canthal lengthening that causes minimal complications. A total of 236 patients underwent lateral canthoplasty between July 2007 and December 2015. For each patient, a triangular flap 4-5 mm away from the lateral canthus was elevated and rotated 45 degrees laterally while the continuity of the lower eyelid gray line was maintained. A new lateral canthus was created by fixating the rotation flap to the lateral orbital rim with minimal skin trimming and tension-free sutures, preventing relapse and maintaining a triangular shape. In more than 95% of cases, effective and satisfactory extension was achieved. On average, a 3 mm extension of the lateral canthus was achieved. There were minor complications such as wound dehiscence, webbing, and scarring, which were easily corrected. The author not only extended the lateral canthus 3-4 mm laterally but also maintained the continuity of the gray line on the lower lid as a more natural-looking triangular shape, while minimizing complications such as webbing and conjunctival exposure.
Cicatrix ; Eyelids ; Humans ; Korea ; Lacrimal Apparatus ; Methods ; Orbit ; Recurrence ; Skin ; Sutures ; Wounds and Injuries

1,072 cases of ocular injuries, including 271 cases of in-patients, who visited department of ophthalmology of Chungnam National University Hospital from January 1,1981 to December 31, 1985, were clinically analyzed. The results were as follows: 1. The incidence of ocular injuries was 8.1% of all eye patients and 16.0% of all patients admitted to this ophthalmologic department. 2. The incidence was more common in male(82.0%) and in the age of 3rd to 4th decades(53.7%). 3. Monocular injuries accounted for 90.4% of ocular injuries. There was no significant difference in the incidence between the right and left eye. 4. Tho ocular injuries were more common in the spring(27.4%), but in children the incidence was higher during the vacation. 5. The patients who visited this hospital within 24 hours after injury accounted for 89.8%. 6. The most common cause of ocular injuries was fist or finger(15.9%), followed by iron products(12.6%) and traffic accident(10.9%), but the injuries by iron products(32.1%) were most common in the admitted patients. 7. The most common ocular injury was eyelid laceration (15.3%), followed by subconjunctival hemorrhage(12.5%) and conjunctival foreign body(8.6%). In the cases of in-patients, corneal laceration(21.2%) was most common, followed by corneoscleral laceration(14.9%) and lens perforation(10.2%). The corneal perforation was 52.1% of all perforating eye injuries. 8. Surgical procedure included corneal suture(21.1%), lensectomy(12.5%), enucleation or evisceration(11.2%), and others. 9. Visual acuity was improved in most cases by treatment, but the corrected vision after treatment was less than 0.1 in 33.2%, which was mainly due to the perforating eye injuries. 10. The most common complication of ocular injuries after treatment was corneal opacity(36.3%), followed by secondary glaucoma(14.6%) and traumatic cataract(6.4%).
Child ; Chungcheongnam-do ; Corneal Perforation ; Eye Injuries ; Eyelids ; Humans ; Incidence ; Iron ; Lacerations ; Ophthalmology ; Visual Acuity

The 1,783 patients with eye injuries, including the 234 in-patients, who visited the Department of Ophthalmology, Seoul Adventist Hospital from Jan. 1, 1987 to Dec. 31, 1988 were clinically analyzed. The results were as follows: 1. The incidence of ocular injuries was 4.7% of all eye patients, and 25.5% of all patients admitted to this ophthalmologic department. 2. The incidence was more common in male(76,8%)and in the age of 3rd to 4th decades(47.0%). 3. The ocular injuries were more common in the spring(27.3%), and in March. 4. The most common cause of ocular injuries was sand or dust or iron piece(29.8%), followed by fist or finger(12.2%) and traffic accident(12.5%), but the injuries by iron products(20.1%) were the most common in the admitted patients. 5. The most common ocular injury was conjunctival foreign body(23.7%), followed by subconjunctival hemorrhage (20.6%) and (9.5%). In the cases of in-patients, hyphema(24.2%) was the most coommon, followed by corneal lacera tion(12.2%) and eyelid laceration(11.2%). 6. Surgical procedure included corneal suture(18.3%), primary closure of eyelid and face(22.2%). 7. Visual acuity was improved in most cases by treatment, but the corrected vision after treatment was less than 0.1 in 20.5%, which was mainly due to the perforating eye injuries. 8. The most common complication of ocular injuries after treatment was corneal opacity(34.1%), followed by vitreous opacity(9.4%).
Dust ; Eye Injuries ; Eyelids ; Hemorrhage ; Humans ; Hyphema ; Incidence ; Iron ; Ophthalmology ; Seoul ; Silicon Dioxide ; Visual Acuity

Skull base surgeons are frequently required to operate in close proximity to the facial nerve, making facial nerve paresis or paralysis the possible result of resection of skull base tumors. Serious functional problems can result following eyelid paralysis. The inability to blink and lubricate the eye can lead to exposure keratitis, corneal abrasions, and even blindness. Thus, management of paralysis following facial nerve injury should include provision of adequate corneal coverage. In the cases where the surgeon is certain that the facial nerve has been left intact and return of function is expected, methods are needed to meliorate the temporary paresis or paralysis of the eyelids. If the lower lid is in proper position, adequate eyelid closure can be achieved with placement of the gold weight alone in the upper eyelid. These weights also could be removed once facial nerve function returns normal. Presented is a report of the satisfactory outcome that we have achieved from gold implantation into the upper lid in temporary paralysis of the eyelids in facial nerve paralysis.
Blindness ; Eyelids* ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis* ; Keratitis ; Paralysis ; Paresis ; Skull Base ; Weights and Measures

Lagophthalmos creates functional deficits, exposed keratitis, and corneal ulcer that may lead to blindness. Thus, managment of paralysis following facial nerve injury should include provision of adequate corneal coverage. Tarsorrhaphy has been the classic method of providing corneal protection in patients with facial nerve paralysis. However, tarsorrhaphy is cosmetically unsatisfactory, limits vision, and provides poor corneal protection. Reanimation of the paralyzed eyelids with a gold implantation has overcome these limitations. We had a good result from gold implantation into the upper lid in a lagophthalmic patient of facial nerve paralysis.
Blindness ; Corneal Ulcer ; Eyelids ; Facial Nerve ; Facial Nerve Injuries ; Humans ; Keratitis ; Paralysis