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Results for “Tenon Capsule”

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At least 253 records · Page 14Linked to original sources

PubMed1992

Congenital unilateral fibrosis, blepharoptosis, and enophthalmos syndrome.

The authors report four cases of the rarest form of the congenital fibrosis syndrome. This disorder is exhibited in infancy as unilateral blepharoptosis, strabismus, limited ductions, globe displacement (enophthalmos and blepharoptosis), and decreased vision, usually due to amblyopia. Forced ductions are positive and surgical exploration confirms anomalous muscle structure. Computed tomography and magnetic resonance imaging studies in these four patients were diagnostically beneficial, showing extraocular muscle and tendinous insertion involvement, and poorly defined intraconal and extraconal masses that had the appearance of scar or inflammatory tissue. All patients had globe displacement. The opposite eye and intracranial contents were normal in all of our patients. Results of histopathologic examination obtained at surgery in three of these patients show replacement of affected structures by fibrous tissue and included the extraocular muscles, orbital fat, Tenon's capsule, and conjunctiva.

Adult↗

PubMed1999

Augmentation of filtering blebs with perfluoropropane gas bubble: an experimental and pilot clinical study.

OBJECTIVE: To evaluate the use of perfluoropropane (C3F8) gas bubble in the augmentation of glaucoma-filtering blebs. DESIGN: Experimental animal study and a pilot clinical study. PARTICIPANTS: Twenty rabbits in the animal study and 20 humans in the pilot study participated. INTERVENTION: Twenty patients underwent trabeculectomy for medically uncontrolled glaucoma. Surgical techniques were similar to those used in standard limbus-based trabeculectomies. The Tenon's capsule and conjunctival wound were closed separately using continuous sutures. Before the final knots were tied, 0.1 to 0.2 ml of 15%:85%-C3F8:air mixture gas bubble was introduced into the subconjunctival space with a silicone tube attached to a 27-gauge Rycrof cannula. The sutures were immediately knotted on withdrawal of the tube. The patients were reviewed after surgery for the appearance, size, and location of the gas bubble. The bleb morphology and intraocular pressures were also monitored. MAIN OUTCOME MEASURES: The parameters measured were intraocular pressure control, Snellen visual acuity, appearance of the bleb in relation to its elevation and degree of inflammation of the subconjunctival tissue, and characteristics of the gas bubble (e.g., size, number, and position). RESULTS: The gas bubbles stayed in the conjunctival bleb for an average duration of 17 days (range, 13-27 days). In all cases, the gas bubbles helped to maintain the filtering bleb until their complete resolution. No excessive inflammation was noted in the filtering blebs. The mean preoperative intraocular pressure was 27.3 +/- 5.5 millimeters of mercury (mmHg), and the mean postoperative intraocular pressure was 14.5 +/- 2.3 mmHg, with only two patients requiring supplementary topical medication. All cases resulted in good filtering blebs with satisfactory intraocular pressures after 16 months of follow-up. CONCLUSIONS: Subconjunctival C3F8 gas bubbles, via a "spacer" effect, aid the maintenance of filtering blebs in the early postoperative period. This technique may be useful in augmenting or salvaging blebs at risk of failure.

Adult↗

PubMed1998

Sub-Tenon's anesthesia with a retained catheter in ocular surgery of longer duration.

A sub-Tenon's anesthesia technique was developed that is suitable for surgical procedures of longer duration. After application of a small amount of anesthetic agent in the standard manner, a thin polyethylene catheter is introduced under Tenon's capsule and fixated. The catheter is used to inject more anesthetic agent during the procedure. This anesthesia regimen provides unlimited time for surgery without the risks of losing anesthetic effect and without using a potentially toxic, long-term local anesthetic agent.

Anesthesia, Local↗

PubMed2006

Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants.

PURPOSE: To evaluate bovine pericardium (Tutopatch) as a wrapping material for hydroxyapatite implants in patients undergoing enucleation for uveal melanoma. METHOD: Prospective cohort study of patients who had enucleation for uveal melanoma between January 2003 and August 2003 were included in the study. Any patient with less than 3 months follow-up was excluded. Enucleation was performed under general anaesthesia followed by insertion of hydroxyapatite implants wrapped in bovine pericardium (Tutopatch). The recti muscles were sutured directly to the wrap. The tenon's capsule and conjunctiva were closed in two layers. A conformer was inserted at 1 week and artificial eye at 2-3 months. The patients were followed up regularly and were assessed for cosmetic result, exposure of implant, and the need for any further surgical procedures. RESULTS: A total of 19 patients (seven male and 12 female) were included in the study. Median age at diagnosis was 63 years (range 38-80 years). Median follow-up was 26 months (range 22-30 months). No patient developed postoperative complications of wound dehiscence. The overall cosmetic result was excellent in all the patients. The rate of postoperative complications compared favourably with published data using other wrapping materials/implants. CONCLUSION: Tutopatch is a safe wrapping material for hydroxyapatite orbital implants in patients undergoing enucleation for uveal melanoma.

Adult↗

PubMed2003

Mitomycin C eliminates the short-term intraocular pressure rise found following Molteno tube implantation.

PURPOSE: Molteno implants remain popular for treating recalcitrant glaucomas. This study aimed to assess the effect of mitomycin C (MMC) use with Molteno tube implantation upon intraocular pressure (IOP) control and complication rates. In particular, the study aimed to assess any change that MMC might have upon the postoperative hypertensive phase. METHODS: A retrospective case record study was conducted of all patients undergoing double plate Molteno implant surgery by one surgeon over 5 years. Eyes with recalcitrant glaucoma unresponsive to previous surgery, or deemed unlikely to succeed with trabeculectomy, underwent double plate Molteno tube implantation. Eyes that had MMC (0.3 mg/mL, 3 min) applied to Tenon's capsule over the secondary plate were compared with eyes that underwent surgery without adjunctive MMC application. RESULTS: Twenty-seven eyes received MMC and were similar to 26 eyes not receiving MMC in terms of glaucoma subtype, age, sex, previous surgery, preoperative IOP and postoperative IOP lowering agents. Those not receiving MMC had raised IOP 31-90 days post implantation compared with MMC treated eyes (P < 0.01) and more often received oral antifibrosis medication (P < 0.05). Complications were no more common with MMC except for initial overdrainage. Significant systemic complications from the use of oral antifibrosis medication were common. CONCLUSIONS: The findings suggest a useful role for MMC. Caution is advised in case selection for MMC use. Mitomycin C treatment over the secondary plate alone permits removal of this plate if MMC-related complications occur without requiring removal of the whole implant.

Adult↗

PubMedDate not supplied

Ultrastructural changes during contraction of collagen lattices by ocular fibroblasts.

Contraction and scarring of the cornea and conjunctiva following disease or injury are major causes of visual morbidity. The aim of this study was to identify any specific ultrastructural features of ocular fibroblast behavior in different collagen lattices in order to understand some of the mechanisms of cell-mediated contraction. Normal human Tenon's capsule fibroblasts were cultured within both restrained and floating collagen lattices for periods of up to 13 days and then analyzed using transmission electron microscopy. The contractile force of these fibroblasts was also tested using the culture force monitor, an instrument capable of measuring the minute forces exerted by cells within a collagen lattice. The results showed differences in the behavior of fibroblasts cultured in the two gel models. The features seen in restrained gels suggest that fibroblasts were actively migrating across and through the lattice. These migratory features were not seen to the same extent in untethered gels, which lack the inherent tension and support of the tethered model. We hypothesize that contraction of the collagen matrix in tethered lattices is due to cellular migration and that this fact cannot be ascertained from untethered gels. Both lattice models have experimental value, but it is important to appreciate what mechanical signals cells receive from the matrix in order to understand cellular behavior.

Cell Movement↗

PubMed1999

[Wound healing after glaucoma filtering surgery--a review].

Wound healing after glaucoma filtering surgery is characterized by a complex sequence of molecular and cellular events. Results of recent investigations have shown that the activation, migration, proliferation and differentiation of Tenon's capsule fibroblasts represents the central element of the wound healing response. An exaggerated wound healing will result in the closure of the artificial fistula between the anterior chamber and the subconjunctival space, leading to an increase in intraocular pressure. The present review summarizes the current knowledge regarding the most important cellular and molecular mechanisms, which regulate the postsurgical wound healing response in the subconjunctival space. Special emphasis will be put on the specific role of cytokines during the wound healing response. An extensive understanding of these mechanisms appears pivotal for the development of specific therapeutic strategies to inhibit the events which lead to fibrogenesis and scarring in the wound region after glaucoma filtration surgery. The databank was Medline.

Animals↗

PubMed1996

[Dermal fat transplant as autologous orbital implant].

BACKGROUND: The use of orbital implants after an enucleation is the pre-condition for an adequate fitting of the prosthesis and gives the best functional and cosmetic results. The autogenous dermofat graft is an alternative to the widely used alloplastic orbital implants. It can be used as a primary implant or as a secondary implant for the correction of a contracted socket or a post enucleation socket syndrome. METHOD: Deepithelialized skin with subcutaneous fat is implanted into the socket. The rectus muscles, Tenon's capsule and conjunctive are fixed to the transplant separately. Surgical technique, possible complications and their therapy are presented. CONCLUSIONS: Disadvantages of the method are the more extensive surgery, some minor complications and the possible shrinkage of the transplant. Advantageous is the fact, that typical complications of all alloplastic implants, like migration and extrusion, can be avoided, heterologous materials like donor sclera are unnecessary and the functional and cosmetic results are very good.

Adipose Tissue↗

PubMed1985

[Vital staining of the conjunctiva for prevention of epithelial implantation cysts].

Selective vital staining with 1% toluidine blue makes short-term intraoperative differentiation of the conjunctiva from Tenon's capsule possible. It is used with advantage in operations where the anatomical situation is unclear to avoid displacement of conjunctival epithelium into deeper tissues and subsequent growth of cysts. Examples of its application are reoperations with excessive scars after squint or detachment surgery, wound dehiscence after enucleations, lacerated wounds after accidents, and as an aid for beginners in ophthalmic surgery.

Animals↗

PubMed2003

Pars plana vitrectomy for refractory diabetic macular edema.

OBJECTIVE: The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME). METHODS: Review of the relevant peer-reviewed scientific literature identified using Medline. MAIN OUTCOME MEASURES: The anatomical and functional outcome of surgery. RESULTS: Vitrectomy with or without internal limiting membrane (ILM) peeling can be beneficial for the treatment of DME that is resistant to laser photocoagulation or sub-Tenon's steroid injection. Visual improvement has been reported in approximately 40-90% of patients, with approximately 85-100% experiencing either improvement or stabilization of vision. Retinal edema decreases or resolves in approximately 70-100% of patients. Complications range in severity with approximately 5-20% of patients developing peripheral retinal breaks, approximately 1-2% developing retinal detachment, approximately 2% developing macular hole, and approximately 10-60% developing cataract. Severe complications such as rubeosis iridis and the fibrinoid syndrome have also been reported. CONCLUSION: Pars plana vitrectomy can be an effective treatment for diabetic macular edema refractory to laser therapy and/or sub-Tenon's capsule steroid injection.

Diabetic Retinopathy↗

PubMed2002

Suspension of the eyelid to the check ligament of the superior fornix for congenital blepharoptosis.

A new surgical procedure for the treatment of all types of congenital blepharoptosis is described: suspension of the eyelid to the check ligament of the superior fornix. This is a dynamic suspension technique by which the check ligament, which is an extension of Tenon's capsule and normally inserts into the superior conjunctival fornix, is brought forward and sutured to the tarsus, which raises the eyelid. This technique does not sacrifice or add any tissue and is simple to repeat if necessary. Sixty-two patients were operated on using the technique and followed up for a mean of 23 months (range 3 months to 9.6 years). In a group of patients not operated on before for ptosis, 50 eyelids were raised with 74% normalisation, 22% improvement, and one eyelid each that showed only slight change or overcorrection. In a group of patients with 27 eyelids operated on before using other techniques, 67% of the eyelids were normalised, 30% were improved, and only one eyelid showed no change. In conclusion, this new technique has proved to be quite successful in raising the level of the upper eyelid in congenital blepharoptosis, with results at least comparable to those of most other techniques. The advantages with the check ligament over other techniques are the minimal trauma of the surgery, its simplicity, and its repeatability.

Adolescent↗

PubMed2002

Anatomical study of the structures at the roof of the orbit with special reference to the check ligament of the superior fornix.

In an attempt to clarify the topography of the structures at the roof of the orbit we dissected the anterior cranial fossas of seven cadavers. Structures such as the periorbita, levator muscle of the upper eyelid and its aponeurosis, as well as Tenon's capsule with its continuation into the check ligament of the superior fornix were identified. The technique for correction of congenital blepharoptosis by suspension of the check ligament of the superior fornix to the tarsus was mimicked and its function clarified.

Blepharoplasty↗

PubMed2004

Effects of intraoperative sponge mitomycin C and 5-fluorouracil on scar formation following strabismus surgery in rabbits.

PURPOSE: To investigate the influence of 5-fluorouracil (5-FU) and mitomycin C (MMC) on the postoperative adhesions following strabismus surgery in rabbits. METHODS: Twenty-one New Zealand white rabbits were used in this prospective, masked, controlled trial. Both eyes of 20 animals underwent 3-mm recession of the superior rectus muscle (SRM). In group I (io animals), one eye of each animal received topical application of MMC (0.2 mg/ml) for 5 minutes and the other eye (control eye) was treated with balanced salt solution (BSS) using an intraoperative sponge. In group II (10 animals), a randomly chosen eye of each animal was treated with 5-FU soaked sponges (50 mg/ml) for 5 minutes and the fellow eye (control eye) with BSS. Two eyes of a rabbit were included as unoperated controls. Four weeks after the surgery, conjunctival vascularity and postoperative adhesions between the SRM Tenon's capsule (TC) and SRM sclera (scl) were assessed. Additionally, eyes were enucleated and evaluated histopathologically for evidence of scarring, granuloma formation, and muscle tissue changes under a light microscope. RESULTS: MMC-treated eyes had a higher rate of avascular conjunctiva compared to both controls and 5-FU-treated eyes. Mean adhesion scores, particularly between the SRM-scl, were lower in eyes treated with antiproliferative agents compared to controls. The difference was statistically significant in MMC-treated eyes for the adhesions between SRM-scl (p = 0.03). Histopathological examination revealed less scarring and granuloma formation in MMC- and 5-FU-treated eyes compared to their control eyes. CONCLUSIONS: MMC, and to a lesser extent 5-FU, are shown to be effective in reducing postoperative scarring following strabismus surgery in rabbits. It seems reasonable to suggest that antimetabolites should be used for cases having an increased risk of postoperative adhesions.

Animals↗

PubMed1998

Transconjunctival herniation of orbital fat.

The authors present 3 patients with subconjunctival fat prolapse treated at their oculoplastic unit. Albeit rare, orbital fat is a well-recognized entity, and is described in the literature as being associated with trauma and surgery. The 3 patients reported herein, however, presented with no history of trauma or surgery. This condition is produced by herniation of the intraconal fat between the conjunctiva and the sclera, presumably due to dehiscence of the Tenon's capsule. Differential diagnosis should be made with lacrimal gland ptosis, lacrimal gland tumors, and lymphoid tumors.

Adipose Tissue↗

PubMed1985

Avoiding complications following primary dermis-fat orbital implantation.

Primary dermis-fat orbital implantation can be performed successfully in cases without preexisting systemic vascular disease or orbital burns. Meticulous handling of the graft (using a Goeller trephine and Tenon's traction sutures), filleting Tenon's capsule and avoiding cautery of the graft bed may minimize graft necrosis and atrophy. Conjunctival granuloma formation and hair growing within the socket are easily managed. Keratinization of the socket, graft wound dehiscence, and donor wound hematomas are avoided with careful surgical technique.

Adipose Tissue↗

PubMed1985

Update on enucleation and evisceration surgery.

The best operative results with fewest complications after enucleation surgery can be achieved by following basic principles, some of which are those of conservative tissue excision, using spherical implants placed behind Tenon's capsule into the muscle cone and avoiding surgical techniques that overlap the extraocular muscles (especially the superior rectus) over the front of the implant. The presence of an intraocular tumor demands that an enucleation be done. When the possible development of sympathetic ophthalmia is not present, the surgeon should consider doing an evisceration because of the cosmetic and motility advantages. Mention is made of some developments in enucleation surgery, such as the scleral cap reinforcement, the "baseball" implant technique using donor sclera, the use of liquid nitrogen to freeze intraocular tumors before removal of the eye, the dermis-fat orbital graft, and the use of two spherical orbital implants instead of one.

Eye Enucleation↗

PubMed1987

Subconjunctival orbital fat prolapse.

Subconjunctival orbital fat prolapse is a benign entity in which fat herniates through Tenon's capsule. It is often confused with other lesions such as lacrimal gland tumors, lymphoid tumors and lipodermoids. The clinical and computed tomographic findings in a series of 15 patients are presented, and the features that are helpful in the differential diagnosis are discussed.

Adipose Tissue↗

PubMed2004

Bleb revision for hypotony maculopathy after trabeculectomy.

PURPOSE: To assess the efficacy of a bleb revision technique with regard to improvement in intraocular pressure (IOP) and visual acuity after hypotony maculopathy and to evaluate the influence of duration of hypotony on visual outcome. PATIENTS AND METHOD: : Retrospective review of a series of patients who underwent bleb revision for hypotony maculopathy (IOP less than 6 mm Hg and loss of two or more lines of central vision) following trabeculectomy. Bleb revision included excision of avascular bleb tissue, dissection posteriorly between conjunctiva and Tenon's capsule, and advancement and suturing of the conjunctiva at the limbus. RESULTS: Fourteen patients were included in the study. The average age was 49.8 years (range 18-85) and eight were female. Before trabeculectomy, the mean IOP was 23.2 +/- 11.8 mm Hg, and the visual acuity was 20/30-2 or better in 13 patients and 20/80 in one patient. The mean IOP before bleb revision was 1.07 +/- 0.73 mm Hg, and 12 patients had lost an average of 4.33 +/- 2.96 lines of visual acuity from baseline, while one had count fingers and another had hand motion vision. The final mean IOP after bleb revision was 11.07 +/- 3.08 mm Hg. Compared with visual acuity just prior to bleb revision, 12 patients regained an average best corrected vision of 3.08 +/- 2.67 lines, with seven returning to the pre-trabeculectomy vision level. The duration of hypotony prior to bleb revision was 1 to 24 months (average 8.36 months) with no correlation (correlation coefficient -0.13) between duration and visual outcome. CONCLUSION: Bleb revision for hypotony maculopathy following trabeculectomy is an effective technique for raising IOP and limiting visual loss, which is not influenced by duration of hypotony within the time frame of the study.

Adolescent↗