OBJECTIVETo discuss the operation method and characteristic of correcting upper eyelid depression by transposition of orbital septum fat.

METHODSDuring the double eyelid surgery, we set.the lateral orbital septum fat completely free, while the bottom is still connected with the middle orbital septum fat. We separate a tunnel from the middle to the inner side in orbital septum, and the separated orbital septum fat is transposed to the inner side of orbital septum by the tunnel with suturing fixation.

RESULTSFrom March 2008 to October 2013, 51 cases with upper eyelid depression were treated successfully. Patients were followed up for 3 months to 3 years (average, 7. 5 months) with sustained aesthetic results.

CONCLUSIONSOrbital septum fat transposition can successfully correct the upper eyelid depression. It should become a regular procedure in blepharoplasty.

Adipose Tissue ; transplantation ; Blepharoplasty ; methods ; Esthetics ; Eyelids ; abnormalities ; surgery ; Humans ; Orbit

OBJECTIVE: To report a case series of Tessier 3, 4, 7 and combined 4,7 craniofacial clefts, their clinical presentations, surgical approaches and outcomes in light of the current literature.
METHODS:
Design: Case series
Setting: Tertiary Government Hospital
Subjects: Five patients
RESULTS: Five  patients aged 3 to 14-years-old with Tessier 3, 4 (2  cases), 7  and combined 4,7 were included in this study: Tessier 3 - medial orbitomaxillary cleft extending through the bony skeleton traversing obliquely across the lacrimal groove, Tessier 4 - median orbitomaxillary cleft traversing  vertically  through  the  inferior  eyelid,  infraorbital rim and  orbital  floor extending  to the lip between the philtral crest and the oral commissure  (2 cases), Tessier 7 - macrostomia and cleft oral commissure and combined Tessier 4 and 7, combining features described above. Four underwent 2- or 3-stage surgeries while one declined.
CONCLUSION: Five  craniofacial  clefts  were  presented.  Because  of  the  varying  patterns of craniofacial  deformities,  a  series of surgical  procedures,  tailor-made  for  each  individual  were performed  on  four. Otolaryngologists who perform maxillofacial and cosmetic surgery  should have good background knowledge about craniofacial defects and be familiar with the  surgical approaches at their disposal to yield favorable results that are appropriate to their local contexts.

Human ; Male ; Adolescent ; Child ; Child Preschool ; General Surgery ; Macrostomia ; Surgery, Plastic ; Lip ; Otolaryngologists ; Craniofacial Abnormalities ; Eyelids ; Orbit

PURPOSE: To assess outcomes of levator resection for the surgical correction of congenital and acquired upper lid ptosis in patients with fair to good levator function and evaluation of the relationship between demographic data and success of this operation. METHODS: In a retrospective study, medical records of patients with blepharoptosis who had undergone levator resection over a 10-year period and were followed for at least 3 months were reviewed. RESULTS: Overall, 136 patients including 60 (44.1%) male and 76 (55.9%) female subjects with a mean age of 20 +/- 13.8 years (range, 2 to 80 years) were evaluated, of whom 120 cases (88.2%) had congenital ptosis and the rest had acquired ptosis. The overall success rate after the first operation was 78.7%. The most common complication after the first operation was undercorrection in 26 cases (19.1%), which was more prevalent among young patients (p = 0.06). Lid fissure and margin reflex distance (MRD1) also increased after levator resection (p < 0.001). Age, sex, type of ptosis, amblyopia, levator function, MRD1, lid fissure and spherical equivalent were not predictive of surgical outcomes of levator resection. CONCLUSIONS: Levator resection has a high rate of success and few complications in the surgical treatment of congenital and acquired upper lid ptosis with fair to good levator function. Reoperation can be effective in most cases in which levator resection has been performed.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blepharoplasty/methods ; Blepharoptosis/*congenital/*surgery ; Chi-Square Distribution ; Child ; Child, Preschool ; Eyelids/*abnormalities/*surgery ; Female ; Humans ; Infant ; Iran ; Logistic Models ; Male ; Middle Aged ; Oculomotor Muscles/*abnormalities/*surgery ; Retrospective Studies ; Treatment Outcome

PURPOSE: To evaluate the effect of epiblepharon surgery on visual acuity and with-the-rule astigmatism in children compared to patients without surgical treatment. METHODS: We undertook a retrospective case control study and reviewed the charts of 202 eyes treated with epiblepharon surgery and of 142 eyes without surgery. The surgical procedure for epiblepharon correction used rotating suture techniques. Data regarding age, best corrected visual acuity, and degree of astigmatism were recorded. Baseline and 1-, 3-, 6-, and 12-month postoperative data were collected. The chi-square test, Student's t-test and general linear model analysis for repeated measures were applied. RESULTS: The mean astigmatism in the surgical group decreased from 1.10 +/- 1.02 diopter (D) preoperatively to 0.84 +/- 1.05 D at 3 months after surgery (p < 0.05). However, there was no statistically significant difference compared to the non-surgical group during the first year. The general linear model analysis comparing the mean astigmatism between the two groups over time showed a significant group-time interaction (p < 0.05). Within the surgical group, the higher baseline astigmatic subgroup and the 5- to 8-year-old group demonstrated greater cylinder reduction over time. The change in mean visual acuity was not significant in either group. CONCLUSIONS: Significant astigmatic reduction was found after surgical correction in epiblepharon patients. Patients with higher baseline astigmatism exhibited greater astigmatic reduction after epiblepharon surgery. These results suggest that, in order to reduce astigmatism, an epiblepharon operation should be considered in patients with a high level of astigmatism.
Astigmatism/*etiology/*physiopathology ; Case-Control Studies ; Child ; Child, Preschool ; Eye Abnormalities/*complications/*surgery ; Eyelashes/pathology ; Eyelids/*abnormalities/pathology/surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; *Visual Acuity

PURPOSE: To describe a series of patients with lower eyelid epiblepharon associated with lower eyelid retraction. METHODS: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid retraction, epiblepharon, or thyroid-associated ophthalmopathy (TAO) between October 1999 and March 2007. Patients with both lower eyelid retraction and epiblepharon on preoperative examination were included in this study. RESULTS: Twenty-seven eyelids of 20 patients with both lower eyelid retraction and epiblepharon were enrolled. The underlying causes of lower eyelid retraction included congenital retraction (seven eyelids), congenital fibrosis of the extraocular muscles (CFEOM; seven eyelids), TAO (seven eyelids), post-operative cicatricial retraction (five eyelids), and facial nerve palsy (one eyelid). Eight of 27 eyelids were successfully corrected after the repair of retraction without the repair of epiblepharon, regardless of the cause of lower eyelid retraction. Another four eyelids with epiblepharon associated with TAO resolved after only orbital decompression. Cilia-everting sutures were additionally applied for epiblepharon in another 14 eyelids, 12 of which did not require the excision of a skin fold or the orbicularis muscles. Only one eyelid with mild retraction and epiblepharon underwent simple epiblepharon repair. Recurrence of retraction or epiblepharon developed in three eyelids during follow-up. CONCLUSIONS: In cases with both lower eyelid retraction and epiblepharon, the retraction should be repaired first, and then the epiblepharon can be corrected selectively according to the severity of the case.
Adolescent ; Adult ; Child ; Child, Preschool ; Eye Abnormalities/*complications/surgery ; Eyelid Diseases/*complications/surgery ; Eyelids/*abnormalities/surgery ; Graves Ophthalmopathy/surgery ; Humans ; Middle Aged ; Ophthalmologic Surgical Procedures/*methods ; Retrospective Studies ; Young Adult

PURPOSE: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. METHODS: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. RESULTS: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. CONCLUSION: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.
Adolescent ; Ambulatory Care Facilities ; Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Eyelids ; Forehead ; Humans ; Nevus ; Parents ; Skin ; Surgery, Plastic ; Transplants

OBJECTIVETo evaluate the application of temporal fascia flaps in the correction of severe depression deformities at lower eyelids.

METHODSSevere depression deformities at lower eyelid were corrected with temporal fascia flaps pedicled with superficial temporal artery in 9 cases.

RESULTSAll flaps survived with good appearance. All patients were followed up for 6-12 months with good long-term results. The donor sites had no obvious scalp scar.

CONCLUSIONSTemporal fascia flap is an optimal choice for correction of the severe depression deformities at lower eyelid. It is easily performed with good result and less donor site morbidity.

Adolescent ; Adult ; Blepharoplasty ; methods ; Eyelids ; abnormalities ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVEAdhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities.

METHODWe shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap.

RESULTWe had treated 32 case in past two years. The results were satisfying.

CONCLUSIONThe method are acted easy and gained fine result, so behaving to extend application.

Adipose Tissue ; transplantation ; Adult ; Blepharoplasty ; methods ; Eye Abnormalities ; etiology ; surgery ; Eyelids ; abnormalities ; pathology ; Female ; Humans ; Oculomotor Muscles ; surgery ; Postoperative Complications ; surgery ; Tissue Adhesions ; Young Adult

OBJECTIVETo investigate the application of forward and reversal flow axial island flap in the orbital skin defects.

METHODSAccording to the distribution of superficial temporal artery as well as the anastomoses with the branches of supraorbital artery and supratrochlear artery, etc, the frontal, scalp, preauricular and postauricular island flaps were designed. The flaps were displaced through subcutaneous tunnel to cover all kinds of orbital skin defects.

RESULTS13 cases of forward flow flap and 9 of reversal flow flap out of 22 cases in all were observed. One postauricular reversal flow axial island flap showed the obstruction of venous refluence in early postoperative stage, however, after active treatment, mere the distal epidermal necrosis was revealed. There were six re-operations on the postoperative flap hypertrophy. The others were in good shape and functional state.

CONCLUSIONSThe superficial temporal artery is one of most vital blood supply in the upper face. It has wide anastomoses with the supraorbital artery and supratrochlear artery. As the colors and the nature of the frontal, preauricular and post auricular skin are close to orbital skin, the application of forward and reversal flow axial island flap based on the superficial temporal artery can be used in the reconstruction of all kinds of orbital skin defects.

Adolescent ; Adult ; Child ; Eyelids ; abnormalities ; surgery ; Female ; Humans ; Male ; Orbit ; abnormalities ; surgery ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Temporal Arteries ; surgery ; Young Adult

OBJECTIVETo study the reason and the management of the sunken upper eyelid after implanting a hydroxyapatite platform.

METHODSFrom 1998, we developed a method of subperiosteal implantation at the orbital floor to repair the introcession of the upper eyelid after hydroxyapatite platform implantation. 11 cases of the sunken upper eyelid were treated with this method. The implants included Medpor in 2 cases, hydroxyapatite plates in 7 cases and acellular dermal matrix in 2 cases.

RESULTSPostoperatively, all the patients obtained satisfactory results. Follow-up for 1 to 4 years showed no complications of extrusion or infection of the implants. Re-operation was needless in all of them.

CONCLUSIONSubperiosteal implantation to correct the sunken upper eyelid is a safe and effective method.

Adult ; Durapatite ; therapeutic use ; Eyelids ; abnormalities ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Care ; Postoperative Complications ; etiology ; surgery ; Prosthesis Implantation ; adverse effects ; methods ; Treatment Outcome