A new concept of the orbital fascia and rectus muscle sheaths and its surgical implications.
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A new method for the treatment of trichiasis is presented. A retinal cryoprobe is used in a freeze-thaw-freeze (double freeze) of the lid. The method is highly successful with no major complications occurring thus far when used on nonpalsied lids.
In cases of senile entropium we prefer an operation method, which attempts to exclude the aetiologic factors of these senile alterations. The tension of the tarsus must be increased and the muscle of the orbicularis at the palpebral margin must be reduced and retightened over the convex margin of the tarsus. It is not of less importance to correct the reduced elasticity of the fascia tarsoorbitalis. These corrections are achieved by a perforating rhomboid excision of the lower eyelid. The operation is performed with the use of a Chalazion forceps (Desmarres) which steps all bleeding. The method of operation was successful in all 34 cases and achieved good functional and cosmetic results. Recurrences were not observed.
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Tubuloreticular structures (TRS) were observed in the orbicularis oculi muscle of two patients operated on senile inversion of the lower eyelid. The structures formed occasionally loose or solid networks similar as those observed in endothelial cells, blood lymphocytes, fibroblasts and muscle cells in association with viral infections, autoimmune diseases, tumors and other tissue destructions and muscle diseases. The tubuloreticular derive form the plasma membrane by the formation of multiple cavities. Their appearance is interpreted as a specific cellular response.
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