PubMed Health⌕ Search

Biomedical subjects

R B Wilkins

Publications and source records attributed to R B Wilkins.

At least 19 recordsLinked to original sources
PubMed1991

Involutional entropion: a retrospective analysis of the Wies procedure alone or combined with a horizontal shortening procedure.

The surgical management of 95 cases of involutional entropion were reviewed to form this retrospective study. The 66 cases treated with the Wies procedure alone had a recurrence rate of 11%. The 29 cases treated with a combined procedure consisting of a Wies procedure with a lateral canthal horizontal shortening had no recurrences. All patients had a minimum of 6 months postoperative follow-up. The etiologic factors as they relate to the appropriate surgical procedures are discussed.

Aged↗
PubMed1987

Heterotopic brain tissue in the orbit.

A 3-month-old female infant with Turner's syndrome was noted to have progressive swelling of the left upper lid at the age of 1 month. A computed tomogram demonstrated a well-circumscribed, low-density, homogeneous orbital mass. Initially, the main clinical differential diagnosis included dermoid cyst, hemangioma, and encephalocele. Medial orbitotomy followed by histopathologic examination disclosed a cystic choristomatous malformation containing brain tissue. No choroid plexuses within the mass were demonstrated on microscopic examination. Aspiration of fluid from the cystic mass and subsequent biochemical studies unequivocally demonstrated that the mass was filled with cerebrospinal fluid. Despite five surgical procedures, including two frontal craniotomies, and specialized roentgenographic studies, no communication could be demonstrated between the orbital mass and the central nervous system. We postulate that the cerebrospinal fluid was produced within the orbital mass, which represented ectopic brain tissue. Problems in diagnosis and management of this unusual orbital malformation are discussed.

Brain↗
PubMed1987

Effectiveness of botulinum toxin therapy for essential blepharospasm.

The effectiveness of Botulinum toxin (Oculinum) therapy in 76 patients with the diagnosis of essential blepharospasm was analyzed. Botulinum offers relief to almost all patients suffering from essential blepharospasm, however, this relief is usually temporary. The response time for repeated treatments tended to be longer than the first treatment. Patients with mild blepharospasm responded significantly longer to Botulinum injection, than those with severe spasms. The response to Botulinum was not significantly different in patients with Meige syndrome than in patients with only essential blepharospasm. Patients previously treated surgically for essential blepharospasm did not respond differently than those patients with no previous surgical therapy. The authors believe that Botulinum toxin injection is an effective, although temporary, mode of therapy for the signs and symptoms of this focal dystonia. The authors recognize that there may be psychologic factors affecting the response.

Blepharospasm↗
PubMed1986

Intraconal dermoid cyst. A case report.

We report an unusual dermoid cyst that was located entirely within the muscle cone. The delineation of the tumor was enhanced preoperatively by using an MRI scan in conjunction with the CT scan and ultrasonography.

Adult↗
PubMed1985

Complications of blepharoplasty.

To avert complications of blepharoplasties the surgeon must first communicate with the patient. Once a rapport is established, a thorough preoperative evaluation is performed. It is imperative to determine the expectations of the patient and to communicate the realistic results that can be achieved from surgery. Strict adherence to proper surgical technique is paramount for good postoperative results. If complications occur, correct diagnosis of the etiology of the problem usually leads to a satisfactory resolution.

Eyelids↗
PubMed1984

Vertical tarsal buckling as a complication of levator aponeurosis repair for acquired blepharoptosis.

In two patients (a 60-year-old man and a 69-year-old woman) vertical buckling of the superior tarsus followed surgery to correct levator aponeurosis disinsertions for the management of acquired upper eyelid blepharoptosis. The superior tarsus rotated posteriorly and folded on itself because the sutures reattaching the levator aponeurosis to the tarsus were placed too low on the anterior tarsal plate. This complication can be prevented by placing the tarsal sutures above the vertical midpoint of the tarsus. If this complication develops, early correction is possible by revising the suture heights and keeping the tarsus flat with a symblepharon ring. This led to a satisfactory outcome in one of our cases. Late correction of vertical tarsal buckling requires excision of the buckled tarsus and repositioning the levator aponeurosis sutures. In one of our patients, an entropion developed as a result of insufficient vertical tarsal height that caused instability of the upper eyelid. The outcome was otherwise satisfactory.

Aged↗
PubMed1984

Acquired ptosis in patients undergoing upper eyelid blepharoplasty.

Involutional or senile ptosis may be present in patients undergoing upper eyelid blepharoplasties. Several patients have been seen who have requested removal of excess upper eyelid skin when they actually required ptosis surgery. Other patients have undergone blepharoplasties and recognized the presence of ptosis following their cosmetic surgery. The ptosis was either present but unrecognized prior to surgery or developed following their blepharoplasties. Finally, some patients have required combined ptosis repair and upper eyelid blepharoplasties. This article aims to make the surgeon performing eyelid surgery aware of the potential presence of ptosis in patients undergoing blepharoplasties and assist in appropriate workup and management of these patients.

Adolescent↗
PubMed1983

A useful alternative to silicone intubation in congenital nasolacrimal duct obstructions.

Initial treatment of congenital nasolacrimal duct obstructions, by a variety of methods, is highly successful. However, a small percentage of obstructions either are not cleared or recur. Silicone intubation has been reported highly successful in treatment of these obstructions. This paper describes our experience with infracturing the inferior turbinate (described originally by Jones and Wobig) as being at least as highly successful, safe, and easy to perform.

Child, Preschool↗
PubMed1982

Current treatment of blow-out fractures.

Blow-out fracture repair and its timing have been controversial. Originally all x-ray proven fractures were repaired regardless of size or symptoms. Later a controversial report of a large series of cases indicated repair to be unnecessary. Today, x-ray proven fractures with enophthalmos justify surgery, but double vision alone is insufficient. Observation of improving diplopia for several days is suggested. Evaluation of x-rays, enophthalmos, diplopia with restriction, and facial anesthesia are recommended before surgery. Recognition of diagnostic signs and symptoms, as well as potential severe cosmetic and functional complications, have aided the approach to the decision for or against fracture repair.

Diplopia↗
PubMed1982

The recognition of acquired ptosis in patients considered for upper-eyelid blepharoplasty.

Involutional or senile ptosis commonly occurs simultaneously with dermatochalasis. Levator aponeurosis dehiscence or disinsertion is the most common etiology of acquired involutional ptosis in our practice. The presence of ptosis should be ascertained prior to performing an upper-lid blepharoplasty. The surgical repair of a levator dehiscence or disinsertion can be performed simultaneously with a blepharoplasty or may be the indicated procedure rather than a blepharoplasty. The recognition and appropriate management of acquired ptosis will provide better cosmetic and functional surgical results in patients undergoing upper-eyelid surgery.

Adult↗
PubMed1982

Surgical management of congenital eyelid coloboma.

Congenital eyelid colobomas are a partial or total absence of eyelid structures. The degree of severity determines the surgical techniques employed for repairing the eyelid. We feel that early surgical treatment reduces the risk of ocular scarring with satisfactory results. We present four cases of congenital upper eyelid colobomas of differing severity and discuss surgical approaches to these lid abnormalities.

Child, Preschool↗
PubMed1982

Ectropion.

Explore the source record for details and available documents.

Cicatrix↗
PubMed1981

Spontaneous enophthalmos associated with chronic maxillary sinusitis.

Enophthalmos and ptosis of the globe is usually a consequence of orbital trauma resulting in a blowout fracture of the orbital floor. Surgical exploration reveals a loss of inferior support due to a disruption of the bony orbital floor. We document five patients with a syndrome of spontaneous enophthalmos and ptosis of the globe unassociated with orbital trauma. The apparent dissolution of the orbital floor causes the loss of inferior support. There is a strong association with ipsilateral chronic maxillary sinus disease.

Adult↗
PubMed1980

Display hook injuries to the eye.

Display hook injuries are more common than previously believed. These injuries occur typically in young children and involve the canalicular system of the upper lid. These hooks could be modified to eliminate the dangerous shape to their tip and thereby prevent this type of injury.

Adolescent↗