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

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

Eyelid Diseases ; diagnosis ; immunology ; pathology ; Facial Dermatoses ; diagnosis ; immunology ; pathology ; HIV Infections ; complications ; immunology ; Humans ; Immunocompromised Host ; Male ; Middle Aged ; Molluscum Contagiosum ; complications ; diagnosis ; immunology ; pathology

Most people think that ophthalmology only treat diseases of the eyeball, but there are also many diseases of the accessory organs around the eyeball. Oculoplasty is a field of ophthalmology that deals with diseases of the eyelids, lacrimal system, and orbit. These accessory organs play important roles in protecting the eyes and supporting their function. Sometimes, diseases of these organs cause cosmetic problems, as well as functional problems. In the past, this field was considered rather indifferently and was not well recognized, so the treatment of these diseases was not specialized. However, concomitantly with recent improvements in quality of life and the increased desire of patients for these diseases to be treated, the importance of this field is increasing and many oculoplastic specialists are being trained. In the oculoplastic field, wide range of diseases are treated. In this report, the author provides a brief overview of the most important and common oculoplastic diseases.
Eyelid Diseases ; Eyelids ; Humans ; Lacrimal Apparatus Diseases ; Ophthalmology ; Orbit ; Orbital Diseases ; Quality of Life ; Specialization

BACKGROUNDDry eye patients suffer from all kinds of symptoms. Sometimes, the clinical signs evaluation does not disclose any obvious difference in routine examination; in vivo confocal microscopy (IVCM) is a powerful tool for ocular surface disease. This study aimed to clarify meibomian gland (MG) alterations in dry eye patients with different symptoms and to compare the findings using IVCM.

METHODSA total of sixty patients were recruited, all subjected to Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ), and questionnaires for the assessment of dry eye symptoms before clinical sign examinations were given to the patients. Finally, IVCM was applied to observe MG's structure. Statistical analysis was performed using the t-test, Mann-Whitney U-test and Spearman correlation analysis. The differences were statistically significant when P< 0.05.

RESULTSIn the severe symptom group, OSDI and SEEQ scores were significantly higher (P< 0.05) compared with the mild symptoms group. All other clinical sign examinations had no statistical difference in the two groups (P> 0.05). However, all the IVCM-observed data showed that patients with severe symptoms had more significant fibrosis in MG (acinar unit area 691.87 ± 182.01 μm2 for the severe, 992.17 ± 170.84 μm2 for the mild; P< 0.05) and severer decrease in the size of MG acinar units than those observed in patients with mild symptoms (MG acinar unit density [MGAUD] 70.08 ± 18.78 glands/mm2, MG acinar unit longest diameter [MGALD] 51.50 ± 15.51 μm, MG acinar unit shortest diameter [MGASD] 20.30 ± 11.85 μm for the severe, MGAUD 89.53 ± 39.88 glands/mm2, MGALD 81.57 ± 21.14 μm, MGASD 42.37 ± 14.55 μm for the mild;P< 0.05). Dry eye symptoms were negatively correlated with MG confocal microscopic parameters and positively correlated with conjunctival inflammatory cells and Langerhans cells (P< 0.05).

CONCLUSIONSIVCM application provides a strong support to differentiate dry eye patients with different symptoms: meibomian gland dysfunction (MGD) plays a pivotal role in dry eye aggravation, and using IVCM to observe MG fibrosis, changes in size and density of MG as well as status of inflammation cells can help not only correctly diagnose the type and severity of dry eye, but also possibly prognosticate in routine eye examination in the occurrence of MGD.

Adult ; Aged ; Dry Eye Syndromes ; diagnosis ; physiopathology ; Eyelid Diseases ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Meibomian Glands ; pathology ; physiopathology ; Microscopy, Confocal ; methods ; Middle Aged

PURPOSE: To investigate periorbital lipogranuloma cases that developed after autologous fat injection and to determine various treatment outcomes from these cases. METHODS: This retrospective study involved 27 patients who presented with periocular mass (final diagnosis of lipogranuloma) and had history of facial autologous fat injection. The collected data included information on patient sex, age, clinical presentation, number and site of fat injections, interval between injections, duration from injection to symptom onset, fat harvesting site, use of cryopreservation, and treatment outcome. RESULTS: The most common presenting symptom was palpable mass (92.6%), followed by blepharoptosis and eyelid edema. The mean time from injection to symptom onset was 13.6 +/- 29.2 months (range, 2 to 153 months). Patients were managed by intralesional triamcinolone injection (six patients) and surgical excision (three patients); 18 patients were followed without treatment. Among the six patients who underwent intralesional triamcinolone injection, five showed complete resolution, and one showed partial resolution. Among the 18 patients who were followed without management, three showed spontaneous resolution over a 5-month follow-up period. CONCLUSIONS: Lipogranuloma can develop in the eyelid after autologous fat injection into the face. Both surgical excision and intralesional triamcinolone injection yield relatively good outcomes. Simple observation can be a good option because spontaneous resolution can occur in a subset of patients.
Adipose Tissue/*transplantation ; Adult ; Autografts ; Cosmetic Techniques/*adverse effects ; Eyelid Diseases/diagnostic imaging/*etiology/therapy ; Female ; Granuloma, Foreign-Body/diagnostic imaging/*etiology/therapy ; Humans ; Injections ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Orbital Diseases/diagnostic imaging/*etiology/therapy ; Retrospective Studies ; Rhytidoplasty/*adverse effects ; Young Adult

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

PURPOSE: Single umbilical artery (SUA) is the most common malformation of the umbilical cord. However, there have been no studies on the ocular findings in SUA, except for one case report. This study aimed to investigate the ocular findings in children with SUA. METHODS: Fourteen children (eight boys and six girls) with SUA were evaluated retrospectively. All children underwent a complete ophthalmologic examination. RESULTS: The prevalence of abnormal ocular findings in children was up to 42.9%. Refractive errors are detected in four eyes (14.3%): myopia > or =-1.50 diopters (D) in one eye (3.6%) and hyperopia > or =+2.00 D in three eyes (10.7%). Epiblepharon was found in three children (21.4%), and strabismus was detected in one child (7.1%). CONCLUSIONS: Approximately half of the children with SUA showed abnormal ocular findings, therefore, our case series highlight the need for a comprehensive ocular examination and larger prospective research studies in young patients with SUA.
Child, Preschool ; Eyelid Diseases/*congenital/epidemiology ; Eyelids/*abnormalities ; Female ; Humans ; Hyperopia/diagnosis/*epidemiology ; Infant ; Male ; Myopia/diagnosis/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Single Umbilical Artery/*epidemiology ; Strabismus/*epidemiology ; Umbilical Arteries/*abnormalities

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

No abstract available.
Aged, 80 and over ; Antitubercular Agents/*therapeutic use ; Eyelid Diseases/drug therapy/*physiopathology ; Glucocorticoids/therapeutic use ; Humans ; Male ; Prednisolone/therapeutic use ; Tuberculosis, Ocular/drug therapy/*physiopathology