A novel technique for small-incision fascia lata harvesting without a fasciatome for the frontalis suspension procedure

Aim: To introduce a small-incision technique for fascia lata (FL) harvesting for the frontalis suspension blepharoptosis procedure. Technique and Methods: A skin incision was made along a line between the lateral condyle of the tibia and the anterior superior iliac crest, starting 4-5 cm above the knee and extending upward 2-2.5 cm. Approximately 8 cm superior to the first incision, a second skin incision was made with the same length. The FL was dissected from the subcutaneous tissue from 1 cm above the superior border of the upper incision to 1 cm below the inferior border of the lower incision. A 15 mm � 5-10 mm strip of FL was excised. The fascial defect was left open. Subcutaneous and deep layers were closed with three 4-0 plain catgut sutures and the skin was closed with subcuticular 5-0 prolene sutures. Results: The technique was used in 22 patients from 4 to 47 years of age (mean: 18.29) for 34 frontalis sling procedures. Mean follow-up time was 6.17 (3-16) months. Wound hematoma (1/22, 4.5), wound discharge (2/22, 9), pain at rest (100, for up to 4 days), pain on walking (20/ 22, 90; for up to 3 weeks), and limping (13/22, 59.1; for up to 7 days) were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Conclusion: The small-incision FL harvesting procedure is a good alternative method when the FL stripper is not available. Copyright © 2007 Informa Healthcare USA, Inc

Association of fibroblast growth factor (FGF-21) as a screening biomarker for chronic progressive external ophthalmoplesia

Purpose: To investigate whether or not fibroblast growth factor (FGF-21) can be used as a screening biomarker in chronic progressive external ophthalmoplesia (CPEO) patients. Methods: FGF-21 concentration was measured in the serum of 24 patients with CEPO phenotype and 24 control samples by enzyme-linked immunosorbent assay (ELISA) and determined the deletion of mitochondrial genome by multiplex polymerase chain reaction (PCR). Results: FGF-21 concentration in 50% of CPEO patients showed notable differences from that in control subjects. FGF-21 concentration ratio in patient group, 2 disorder control groups (mitochondrial and non-mitochondrial) and normal group, respectively, was 294.87 ± 42.10 (p 50 years age group who show acute symptoms. © Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights reserved

Anterior lamellar recession, blepharoplasty, and supratarsal fixation for cicatricial upper eyelid entropion without lagophthalmos

PurposeTo assess the results of anterior lamellar recession, blepharoplasty, and supratarsal fixation procedure in patients with upper eyelid cicatricial entropion without lagophthalmos.MethodsIn a prospective interventional case series, 52 eyelids (32 patients) were included (April 2009-December 2010). Excluded were patients with previous eyelid surgeries, lagophthalmos, and <12 months of follow-up. Using a microscope, after recessing anterior lamella 3-4 mm above the eyelid margin, it was fixed with 4-5 interrupted 6-0 vicryl sutures. Excess anterior lamella was then excised (blepharoplasty), supratarsal fixation sutures (6-0 vicryl) were put and the skin was closed with 6-0 nylon sutures. Success and failure defined based upon eyelash-globe touch on the last follow-up visit (at least 12 months), respectively.ResultsThere were 21 females (65.6) and 11 males (34.4) with a mean age of 69.7 years (SD=6.9) and mean follow-up of 21.06 months (SD=8.26). Success was observed in 39 (75) and failure in 13 (25). Mean time of failure was 4.5 months (SD=3). Although re-treatment with radio-frequency electrolysis (eight eyelids) and re-anterior lamellar recession (two eyelids) resulted in success in 12 eyelids with failure, two patients (three eyelids) declined further procedure. Except for thickened eyelid margin, no complications were observed.ConclusionAnterior lamellar recession, blepharoplasty, and supratarsal fixation procedure is an effective and safe technique for the treatment of the upper eyelid cicatricial entropion without lagophthalmos. © 2016 Macmillan Publishers Limited All rights reserved

Multiple cavernous hemangiomas presenting as orbital apex syndrome

A 41-year-old man presented with a 7-year history of gradually increasing right proptosis and a 2-year history of decreased vision and limited eye movements. Right proptosis (11 mm), limitation of movement in all gazes, anisocoria, and visual impairment implied orbital apex compression. Computed tomography showed several distinct lesions with mild delayed enhancement extending to the orbital apex. Through a lateral orbitotomy, 10 discrete hemangiomas were removed uneventfully. Histopathologic findings were consistent with cavernous hemangioma in all tumors removed. Proptosis resolved after surgery at 3 to 4 weeks. Visual acuity was unchanged (20/25), and eye movement significantly improved at last follow-up, 15 months after surgery. ©2005 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc

Monocanalicular versus bicanalicular silicone intubation for nasolacrimal duct stenosis in adults

Purpose: To compare the success rate of monocanalicular versus bicanalicular silicone intubation of incomplete nasolacrimal duct obstruction (nasolacrimal duct stenosis) in adults. Methods: In a retrospective, nonrandomized comparative case series, 48 eyes of 44 adult patients with nasolacrimal duct stenosis underwent endoscopic probing and either bicanalicular (BCI; n = 22 eyes) or monocanalicular (MCI; n = 26 eyes) nasolacrimal duct intubation under general anesthesia. "Complete success" was defined as complete disappearance of the symptoms, "partial success" as improvement with some residual symptoms, and "failure" as absence of improvement or worsening of symptoms at last follow-up. The last follow-up examination included diagnostic probing and irrigation if there was not complete success. Results: Patient ages ranged from 31 to 90 years (mean, 69; SD, 11.5). Forty-five tubes were removed 6 to 17 weeks (mean, 9.1; SD, 3) after surgery. Premature tube dislocation and removal occurred in one eye with BCI and in two eyes with MCI. Follow-up ranged from 6 to 52 months (mean, 14.9; SD, 8.4). The complete success rate was nearly the same in eyes with MCI (16/26, 61.53) and BCI (13/22, 59.09). Partial success (MCI: 8/26, 30.76; BCI: 1/22, 4.54) and failure (MCI: 2/26, 7.69; BCI: 8/22, 36.36) were, however, significantly different (p = 0.010). Complications included 3 slit puncta with BCI and 4 temporary superficial punctuate keratopathy after MCI. Conclusions: MCI had virtually the same complete success rate as BCI, a higher partial success rate than BCI, and a lower failure rate than BCI in treatment of nasolacrimal duct stenosis in adults. ©2005 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc

Techniques of Eyebrow Lifting: A Narrative Review

None of brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity, and potential complications. The aim of this study was to provide a comprehensive review of the literature on the pros and cons of the most popular techniques in brow and forehead lift. Relevant original articles in the PubMed database (English language) were sought using the search terms �eyebrow lift�, �forehead lift�,�periorbital rejuvenation�,�eyebrow ptosis�,�blepharoplasty and eyebrow change�,�surgical eyebrow lift�, and�non-surgical eyebrow lift�, No date limitation was considered. Titles and abstracts were scanned to include the most pertinent articles. Subsequently, full texts of included articles (111 articles) were skimmed and finally 56 references were selected for the review. A narrative synthesis of data was finally undertaken with particular attention to the indications, techniques, and common complications of the eyebrow lift procedures. Ten popular techniques including two nonsurgical methods (Botulinum toxin A and soft tissue fillers) were reviewed in this article. In general, non-surgical methods of forehead/brow lift are temporary, need less experience and correction would be easier should any complication occur. Surgical methods are divided into three categories: trans-blepharoplasty eyebrow lift, direct eyebrow lift, and trans-forehead eyebrow/forehead lift. Currently, the most popular method is the endoscopic forehead lift approach even though its longevity is limited. Direct brow-lift is particularly useful in patients with facial palsy and those who are more likely to be accepting of the scar (male gender, high forehead hair line). © 2020 JOURNAL OF OPHTHALMIC AND VISION RESEARC