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Common problems in ophthalmic plastic surgery.

Many ophthalmic plastic surgical problems are ignored because the patient seems to be ""getting along." Frequently physicians are only vaguely aware of the constant daily discomfort their patients experience from seemingly minor problems such as endocrine exophthalmos, an ill-fitting prosthesis or baggy eyelids. As a result, too often the patient is unaware of the treatment possibilities that are available to relieve and often eliminate his problem. These conditions are often first seen by the family physician.

Adult↗

[Clinical and morphological bases of inferior exterior tarsopexy].

Involution processes caused by elongation of the lower eyelid are associated with loss of elastic fibers, destruction of collagen fibers, and fibrous degeneration of the distal fragment of the tarsal plate. The authors present a morphological validation of resection of the lower pedicle of the external ligament of the eyelid and shortening of the lateral part of the tarsal plate. Modified suture fixation to the orbital external wall periosteum and external retinaculum is proposed, ensuring adequate tension of the lower eyelid. High functional efficiency of the operation is analyzed on 66 clinical cases; the incidence of complications was low and good cosmetic results were attained (period of observation 3-52 months).

Aged↗

[Surgical treatment of upper lid trichiasis with partial tarsal rotation: a new procedure].

The authors' report a new surgical technique for partial isolated upper lid trichiasis. This ten minutes' time consuming procedure is easy to perform. It allows a fair cosmetic appearance of the operated eyelid and permits a reliable uneventful outcome. The technique consists to severe the lid margin and the tarsal plate on a distance of 3 to 4mm, at each part of it's trichiased area, in order to allow the pathological part of the eyelid to rotate like a shutter. The rotation of the ill eyelid segment is strengthen by a partial resection of the anterior lamella localizated here and there of the lid crease above the trichiased part of the eyelid, which allows to place everting sutures between the superior part of the tarsus and the two edges of the anterior lamella incision.

Adult↗

Oculocutaneous manifestations of the erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum.

Although they were once believed to be distinct diseases, many observers currently consider erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis to represent a mild-to-severe continuum of the same process. Each shares certain clinical, histologic, and etiologic characteristics; among the latter two are frequent ocular involvement. Because long-term ophthalmic sequelae may be catastrophic, early recognition and therapy of this acute oculocutaneous disease spectrum are critically important.

Conjunctivitis↗

Overcorrections of the Wies procedure.

The Wies procedure may be complicated by an overcorrection, which is in effect a cicatricial ectropion. Four cases of such a complication are presented. The mechanism of an overcorrection is related to the level of the incision in the lid and to the suture placement. Correction of this complication primarily involves lysing cicatricial bands maintaining the overcorrection. Placement of sutures maintains the lid in a normal position.

Adult↗

Ocular findings in a patient with deletion short arm chromosome 5 (cri du chat) and ring chromosome 14.

The general and ocular signs in patients with deletion of the short arm of chromosome 5 (cri du chat) and ring chromosome 14 have been reported previously in the literature. Ophthalmic changes recorded in the latter anomaly are scanty. We describe a patient with the combined chromosomal anomaly--a deletion of part of the short arm of chromosome 5 and a ring chromosome 14 which hitherto has not been reported.

Child↗