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PubMed1976

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↗
PubMed1977

Repair of ptosis using frontalis muscle and fascia lata: a 20-year review.

The results of an analysis of the surgery ("Repair of Ptosis using Frontalis Muscle and Fascia Lata") carried out on 316 lids is presented. The main indication for this operation is a large congenital ptosis with minimal levator function. Conclusions from the study indicate that autogenous fascia is an ideal tissue for lid suspension, and is better than stored fascia. Stored fascia does present some problems but is useful in small children or when the patient does not want a scar on the leg. Bilateral repair for unilateral ptosis is recommended for symmetrical results. The best ages for surgery is between 3-1/2 and 6 years of age, as these young corneas rapidly adapt to the exposure problems. It is very important to check the corneal sensation before carrying out the surgery. When this operation is done on older patients with acquired ptosis, e.g. ptosis associated with myasthenia gravis, corneal exposure problems frequently result.

Blepharoptosis↗
PubMed1997

Cornea and iris changes in congenital ectropion uvea after trabeculotomy.

This article details a previously undescribed complication of trabeculotomy occurring in a patient with congenital ectropion uvea and discusses its possible association with an anterior chamber membrane. A 6-year-old boy with congenital ectropion uvea underwent trabeculotomy. After the trabeculotome was swept into the anterior chamber, multiple ovoid and round endothelial and posterior stromal opacities developed in the cornea, and new areas of iris surface irregularities appeared. This is the first reported case of corneal endothelial and iris changes occurring in a patient with congenital ectropion uvea after trabeculotomy without direct endothelial or iris contact from the trabeculotome. The exact cause of these changes is unknown.

Child↗
PubMed1997

Lower eyelid tightening: a comparative study.

Tightening of the lower eyelid is often performed as an adjunct to various lower lid procedures, and many techniques are available. Herein the author describes a simple and effective surgical technique and compares its failure rate with that of full-thickness pentagonal lid resection and lateral tarsal strip technique. Over a 7-year period, the author has used this procedure on 121 patients (153 eyelids) requiring horizontal tightening of the lower eyelid. The average follow-up period is 19 months and the results have been excellent. Complications included three overcorrections, one undercorrection, three suture abscesses, two exposed sutures, and two suture breakages. The most common complication was a transient point tenderness over the orbital rim lasting 2 to 4 weeks. Comparison of these results with those obtained in 44 other patients (54 eyelids) whose lower eyelids were tightened with either the pentagonal lid resection or the lateral tarsal strip technique showed this procedure to be just as effective and versatile yet much easier to perform.

Aged↗
PubMedDate not supplied

Socket reconstruction: what really happens.

Reconstruction of contracted sockets can be extremely difficult and may result in a number of complications. Adherence to certain contraindications in attempting socket reformation can avoid some of these problems. Complications of socket reconstruction as discussed previously are (1) infection and (2) recurrent socket contracture, manifested either by extrusion of the acrylic plate placed in the orbit or by eyelid retraction.

Acrylates↗
PubMed1998

Surgery of the eyelids.

This article reviews the most common pediatric oculoplastic conditions and addresses clinical evaluation as well as medical and surgical management. The complex issues of amblyopia and special considerations for eyelid surgery in children are discussed. A step-by-step approach is used in the treatment of many common pediatric oculoplastic conditions, including congenital blepharoptosis and lid margin defects. Surgical options are explored and clinical examples are provided.

Amblyopia↗