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Biomedical subjects

J R Collin

Publications and source records attributed to J R Collin.

At least 19 recordsLinked to original sources
PubMed1992

The use of Q-switched Nd:Yag laser for removal of permanent eyeliner tattoo.

We present the results of a pilot study of the use of Nd:Yag laser in the removal of permanent eyeliner tattoos. Fourteen eyelids were treated, and in all cases a reduction in pigmentation was achieved although responses were variable. The advantages of such therapy over existing techniques are described. The technique offers a useful reduction of permanent eyeliner pigmentation and is particularly suited to treatment of localized areas of imperfect application or pigment migration.

Cosmetics↗
PubMed1992

Micrographically controlled excision (Mohs' surgery) of basal cell carcinoma around the eye. Combined dermatological surgical clearance and oculoplastic surgical repair.

Periorbital infiltrative basal cell carcinomas are notoriously difficult to treat, particularly those around the medial canthus. Micrographically controlled excision with horizontal frozen sections (Mohs' surgery) allows for clearance of the tumour with minimal loss of normal tissue. Once the tumour has been completely removed, the defect can be repaired by the oculoplastic surgeon for the best functional and cosmetic result. This is the ideal treatment for tumours with a contiguous growth pattern that are liable to be seriously over or under treated by other modalities. The technique requires special training for both the operator and the Medical Laboratory Scientific Officer (MLSO). It is costly in time and manpower but in selected cases, where recurrent tumour is most dangerous and where tissue conservation is paramount, it may be invaluable. Close collaboration between dermatological and oculoplastic surgeons in such cases probably offers the patient the best treatment and outcome.

Basal Cell Carcinoma↗
PubMed1991

Eyelid surgery in facial palsy.

Paralysis of the orbicularis oculi muscle is by far the most serious consequences of loss of function of the facial nerve. The severity of the resultant ocular problems is related to the degree and duration of this paralysis. The primary goal of the ophthalmologist in managing the patient with orbicularis oculi paralysis is to protect the cornea. The alleviation of epiphora, correction of paralytic ectropion, and amelioration of the resultant cosmetic deformities are secondary goals. The major factor in determining the most appropriate therapeutic approach in the management of the patient with a facial paralysis is whether the paralysis is temporary or permanent. In temporary paralysis, conservative methods of treatment are usually adequate and are well documented. In permanent orbicularis paralysis, the development of lid abnormalities is inevitable, and corrective lid procedures are required. The procedures required depend on the resultant dysfunction and degree of deformity. This study reviews 65 patients who underwent surgical treatment for the ophthalmic consequences of established and permanent facial palsy in order to evaluate the efficacy of their treatment.

Adult↗
PubMed1991

Blepharochalasis. A review of 30 cases.

This paper presents the findings in a series of 30 patients with blepharochalasis, including the age of onset, sex, predisposing factors, symptoms and signs, frequency and duration of attacks, and length of the history. There were 16 bilateral and 14 unilateral cases. The condition can be divided into an active (early) and a quiescent (late) stage. The active stage is further subdivided into intumescent (hypertrophic) and atrophic forms. The sequelae included excess thin skin, fat herniation, lacrimal gland prolapse, ptosis, blepharophimosis, pseudoepicanthic fold, proptosis, conjunctival injection and cysts, entropion, and ectorpion. Surgery primarily involved blepharoplasty, ptosis correction, and lateral canthal reattachment alone or in combination. The pathology showed a variable picture of epithelial atrophy, vasculitis, and loss of elastic fibers, which did not greatly help to differentiate blepharochalasis from angioedema, lymphedema, dermatochalasis, tumors and infiltrations, and floppy lid syndromes. Blepharochalasis is probably a localized angioedema. The diagnosis depends on the clinical features of intermittent attacks of localized swelling affecting one or more eyelids associated with thinning of the skin giving either an intumescent (hypertrophic) or atrophic appearance in the active stage of the condition and progressing to atrophic changes in the quiescent (late) stage.

Adolescent↗
PubMed1991

Visual development in the blepharophimosis syndrome.

One hundred and one cases of the blepharophimosis syndrome presenting over a decade are reviewed with particular attention to the factors influencing their visual development. Three distinct clinical patterns emerge--severe bilateral ptosis, moderate bilateral ptosis, and asymmetric ptosis--and their differing incidence of amblyopia and strabismus is discussed. The risk of amblyopia is much higher than previously believed (56.4% in our series) and preventive management is discussed.

Amblyopia↗
PubMed1991

Medical canthal resection: an effective long-term cure for medial ectropion.

The results of 37 medial canthal resection procedures performed for the correction of severe paralytic or involutional medial ectropion are presented with an average follow-up of 5.4 years. Epiphora was improved in 33 out of the 37 cases and all but one patient had an anatomically improved lid-globe apposition, medial canthal angle, and posterofixation of the medial canthus. These results confirmed the long-term value of the operation.

Aged↗
PubMed1991

Capillary haemangiomas: an approach to their management.

Twenty-five children with eyelid haemangiomas were reviewed. Fifteen patients with enlarging lesions thought to be at risk of causing amblyopia were treated with intralesional steroids as soon after presentation as possible. This appeared to reduce significantly the incidence of amblyopia. Surgery was reserved for older children in whom no further involution of the lesion was expected.

Amblyopia↗
PubMed1991

Surgical management of essential blepharospasm.

We have reviewed the surgical management of essential blepharospasm over the last 15 years, comparing the results from facial nerve avulsion with those from orbicularis muscle stripping. After facial nerve avulsion 50% of patients remained free of troublesome spasm for 15 months after surgery, but only 25% remained so for more than two years. Following orbicularis oculi myectomy 50% of patients were free of troublesome spasms for 30 months after surgery and 55% of patients had relief from spasm for more than two years. Secondary effects of the two procedures are compared and are found to be fewer after orbicularis myectomy. There were no major complications after either form of surgery. Botulinum toxin is the treatment of first choice for this condition. If this becomes ineffective or inconvenient, surgical treatment is warranted and should not be deferred for fear of severe side effects of treatment, since these are rare. Protractor myectomy gives longer relief from blepharospasm than facial nerve avulsion and has fewer complications. However, it is technically difficult, time consuming, and has greater peroperative morbidity. Facial nerve avulsion may therefore still have a role in selected patients.

Adult↗
PubMed1990

The Mersilene mesh ptosis sling.

A variety of materials are currently available for use in brow suspension ptosis surgery when an alternative to autogenous fascia lata is indicated. We describe the use of a Mersilene mesh sling, developed to overcome the problems of failure and extrusion commonly associated with substitute suspensory materials. The results and follow up in 23 cases of blepharoptosis are presented. Our findings suggest that the Mersilene mesh sling has a definite place in ptosis management; we currently use this sling for all cases in which autogenous fascia lata is considered inappropriate.

Adolescent↗
PubMed1979

Terminal course of nerve supply to Müller's muscle in the rhesus monkey and its clinical significance.

Electron microscopic, histochemical fluorescence, and pharmacologic evidence suggested that, in the rhesus monkey, Müller's muscle was not totally denervated either by cutting the levator palpebrae superioris muscle or by a Fasanella-Servat procedure. We examined the terminal course of the sympathetic nerve supply and the potential for preserving Müller's muscle in blepharoptosis surgery.

Adrenergic Fibers↗
PubMed1979

Blepharochalasis.

The condition of blepharochalasis and its treatment are discussed. Four cases are presented which show a physical sign that may help in its diagnosis.

Adolescent↗
PubMed1979

A ptosis repair of aponeurotic defects by the posterior approach.

A simple posterior approach operation for correcting ptosis due to a disinsertion of the aponeurosis of the levator palpebrae superioris muscle is presented. Müller's muscle is restored to its normal length. Pull-out sutures are used which give some postoperative control of eyelid level and allow the procedure to be done under general anaesthesia if required.

Blepharoptosis↗
PubMed1979

Cyclic oculomotor palsy.

This rare condition, an oculomotor palsy which is interrupted by spastic contractions of the levator muscle and the pupillary sphincter at fairly regular intervals, had been reported in 54 patients up to 1975. Two patients presented to the authors with apparently complete unilateral ptosis but abnormal pupillary reactions prompted closer examination. Once the diagnosis has been considered only 5 minutes of careful clinical examination are necessary to confirm or reject it. During the past 4 years the authors have found nine new cases of the condition and it is clear that the diagnosis must often be missed. Details of the patients are shown and discussed in the light of Loewenfeld and Thompson's theory of the pathology. The place of surgical treatment is considered.

Adult↗
PubMed1978

Involutional entropion. A review with evaluation of a procedure.

The pathophysiologic changes that lead to involutional entropion are discussed. The Quickert entropion operation gives good results because it rectifies the effect of enophthalmos; it restricts the upward movement of the preseptal muscle; it repairs the relaxation or disinsertion of the lower eyelid retractors; and it corrects the buckling of the upper tarsal border. Using this procedure, the recurrence rate of 3.7% is comparable with that of other procedures.

Adolescent↗
PubMed1978

Experimental and clinical data on the insertion of the levator palpebrae superioris muscle.

Radiographic and electron microscopic evidence showed that the upper eyelid skin crease is formed by the insertion of the levator palpebrae superioris muscle into the septa between the orbicularis muscle into the septa between the orbicularis muscle bundles and not into the skin itself. Experiments on monkeys showed that the insertions of the aponeurosis and of Müller's muscle both contribute to normal eyelid elevation. No histologic evidence was found for a disinsertion of Müller's muscle in 20 cases of blepharoptosis. This, with other evidence discussed, supports the functional importance of the human aponeurotic insertions in eyelid elevation.

Adolescent↗
PubMed1978

Cryosurgery for trichiasis.

A series of 41 cases of trichiasis was treated with cryosurgery using a standard retinal cryoprobe. The failure rate was approximately 50 per cent. The results should be improved by using properly designed equipment capable of cooling the lash follicles to -20 degrees C, and ensuring that this temperature is achieved by using a tissue thermocouple. A double freeze-thaw cycle should be used and a long-acting local anaesthetic containing adrenaline. The main complication is depigmentation which is a problem only with heavily pigmented patients. Cryosurgery does have potential for the treatment of trichiasis.

Adolescent↗