Essential Subtleties on the Silver Sea(《银海精微》)is a well-known ophthalmology work of traditional Chinese medicine(TCM).There are many discourses on eyelids diseases.This paper analyzed the classification of relat...Essential Subtleties on the Silver Sea(《银海精微》)is a well-known ophthalmology work of traditional Chinese medicine(TCM).There are many discourses on eyelids diseases.This paper analyzed the classification of related diseases and their treatment methods and intends to sort out the pathogenesis of eyelids diseases related to the spleen and stomach function in TCM,thus inspiring new treatment ideas and guiding clinical treatment.Through the sorting out,it is found that the eyelids diseases are closely related to the function of the spleen and stomach such as the Qi(气)and blood generation and transformation,the blood circulation,and the Yin(阴)-Yang(阳)harmony.The corresponding treatments are various,including expelling the pathogen,moving Qi(气)and invigorating blood,warming and activating the spleen Yang(阳).展开更多
·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids....·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids.·METHODS:This was a retrospective analysis of 140 eyes of 87 patients(mean age 52.29±16.45 y;22 males,65 females)with upper eyelid ptosis.Totally 88.6%had aponeurotic and 11.4%had congenital ptosis.For the evaluation of the responses of the upper and lower eyelids to topical 2.5%phenylephrine,the scleral show height,the marginal reflex distance(MRD)between the inferior margin of the upper eyelid and pupillary light reflex(MRD1),and between the central portion of the lower eyelid and pupillary light reflex(MRD2)were measured at the 2^(nd),5^(th),and15^(th)minutes.The changes of MRD1 and MRD2 with time(ΔMRD1 andΔMRD2)were evaluated.·RESULTS:The mean MRD1,MRD2.and scleral show heights increased within 5 min after testing,remaining largely stable between the 5^(th)-15^(th)minutes.The percentage of eyes with a greater response in MRD1 increased with increased severity of ptosis(P<0.05).Eyes with aponeurotic ptosis were more responsive to phenylephrine testing than congenital ptosis.The mild ptosis group had lower scleral show measurements and higherΔMRD2 values.TheΔMRD1 andΔMRD2 values were poorly correlated in all measurement times.·CONCLUSION:Performing the phenylephrine test 5 min after instilling the reagent is adequate to assess the maximum response of the upper and lower eyelids.The upper and lower eyelid responses in phenylephrine testing are poorly correlated.However,theΔMRD2 is related with baseline scleral show degree that may be a postoperative predictive factor.Further studies are necessary to determine the relationship between the responses of the lower eyelids to phenylephrine testing.展开更多
Objective:To explore the clinical efficacy of plastic surgery of asymmetric double eyelid.Methods:The clinical data of 70 patients with asymmetrical double eyelid who underwent plastic surgery in our hospital from Apr...Objective:To explore the clinical efficacy of plastic surgery of asymmetric double eyelid.Methods:The clinical data of 70 patients with asymmetrical double eyelid who underwent plastic surgery in our hospital from April 2018 to December 2019 were retrospectively analyzed.The patients were divided into different groups based on different plastic surgery procedures.The control group(n=35 cases)were the patients who underwent double eyelid incision method,and the patients who used embedding double eyelid method were included in the observation group(n=35 cases).The operation time,intraoperative blood loss,incision size,healing time of incision,satisfaction of p1astic surgery and occurrence of complications were compared between the two groups.Results:The operation time and incision healing time of the observation group were shorter than those of the control group.The intraoperative blood 1oss and incision were less than those of the control group,and the satisfaction was higher than that of the control group.The difference was statistically significant(P<0.05).The incidence of complications in the observation group was slightly lower than the control group,but the difference was not statistically significant(P>0.05).Conclusion:For asymmetric double eyelid,it should undergo embedding double eyelid plastic surgery,because the operation time and incision healing time are shorter.And intraoperative blood 1oss and incision size are smal1er,which can improve patient satisfaction and reduce the incidence of complications.展开更多
AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological s...AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological survey was conducted on 3038 individuals over the age of 50,all of whom were evaluated at the community health center.Each participant underwent routine ophthalmic examinations and eyelid morphology evaluations by an ophthalmologist.Eyelid disorders and morphology were assessed through slit-lamp examination and direct visual inspection.The study analyzed the characteristics of common eyelid disorders,including blepharoptosis,dermatochalasis,eyelid tumors,entropion,lower eyelid retraction(LER)and ectropion,as well as eyelid morphologies such as sunken and bulging eyelids.Descriptive statistics were used for demographic data,Chi-square test analyzed gender distribution differences,and logistic regression calculated odds ratios for blepharoptosis(P<0.05 considered significant).RESULTS:The study revealed that eyelid disorders were present in 1250(41%)individuals,with blepharoptosis being the most common disorder(25%),followed by severe dermatochalasis(16%),eyelid tumors(9.3%),LER and ectropion(11%),and entropion(1.2%).Sunken eyelids were more prevalent in men(26%)than in women(17%).The study found significant associations between the presence of blepharoptosis and sunken upper eyelids[P=0.01,odds ratio(OR)=1.33],as well as male gender(P=0.038,OR=1.22).Additionally,the prevalence of blepharoptosis increased with age.CONCLUSION:Eyelid disorders are highly prevalent in older people and increase steeply with age.This study highlights the need for increased awareness of eyelid health among older individuals at risk for eyelid disorders and the importance of ophthalmic examination for early diagnosis and management of these disorders.展开更多
BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches....BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.展开更多
Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulc...Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions.展开更多
Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting i...Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting interest in biocompatible alternatives,such as biodegradable diplene membranes.This study introduces a novel modification to the standard protocol: the use of diplene membranes enriched with Solcoseryl,a metabolically active agent that enhances angiogenesis,reduces inflammation,and accelerates epithelialization.Methods: Twenty-seven patients(mean age,68.96 ± 8.09 years) with histologically confirmed malignant lowereyelid tumors underwent reconstruction using diplene membranes combined with Solcoseryl.The outcomes were compared with those of a previously reported cohort treated with Diplene alone.The follow-up period ranged from 3 to 12 months.Results: All patients achieved successful restoration of eyelid support with high aesthetic satisfaction.The Solcoseryl group demonstrated significantly faster epithelialization(mean 9.8 ± 1.2 days),improved microcirculatory parameters,and no serious complications.Minor hematomas occurred in two cases(7.4%).Conclusion: The modified Diplene–Solcoseryl membrane enhanced wound healing and biocompatibility during lower-eyelid reconstruction by transforming the membrane into a bioactive scaffold.This innovation offers superior functional and aesthetic outcomes compared to standard diplene use and represents a significant advancement in oculoplastic and oncological reconstructive surgery.展开更多
Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely c...Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely complex.Excess excisions may cause detrimental effects to eyelid function and undesirable aesthetic outcomes.Conversely,adequate resection must occur to prevent further disease progression.Mohs micrographic surgery(MMS),a technique offering high remission rates,is often employed for periocular BCC.This method allows for precise cancer removal while preserving as much healthy tissue as possible,balancing the need for both effective treatment and aesthetic and functional preservation.Following Mohs surgery of periocular BCC,reconstruction methods vary and can be tailored based on the size of the resection and the functional requirements of the affected tissue.Amongst these methods,primary closure with and without secondary intentions,direct margin repair,local flap closure and advance flap,Tenzel flap,tarso-conjunctival flap,periocular skin grafting,and structural grafting are commonly utilized and each has its advantages and limitations.In the future,advancements in synthetic flaps and stabilizing glues in the periocular region may provide additional tools for post-Mohs reconstruction.However,these emerging techniques require further research to establish efficacy and safety,especially in more complex and sensitive regions like the periocular tissues.The primary purpose of this review is to provide a comprehensive analysis of periocular reconstructive techniques following Mohs surgery,comparing their efficacy,functional outcomes,and aesthetic considerations while addressing recent advancements such as synthetic flaps and stabilizing glues to guide clinical decision-making.展开更多
The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures world...The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.展开更多
AIM: To report various ocular lesions caused by accidental instillation of superglue. METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instilla...AIM: To report various ocular lesions caused by accidental instillation of superglue. METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye. RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye. CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.展开更多
Upper lid blepharoplasty is a surgical procedure that requires meticulous planning and execution.It is not a standalone procedure but can be combined with ptosis correction surgery.Prior to surgery,thorough lid examin...Upper lid blepharoplasty is a surgical procedure that requires meticulous planning and execution.It is not a standalone procedure but can be combined with ptosis correction surgery.Prior to surgery,thorough lid examinations are essential to determine the appropriate approaches.Skin markings for incision sites should be drawn before anesthesia injection to avoid distortion of lid wrinkles and creases.The design of the lid crease is crucial,with a nasal tapered crease serving as a guide for subsequent parallel crease drawings.Incisions should be made with care to avoid excessive bleeding,particularly from the orbicularis muscles.It is important to control bleeding promptly to prevent secondary ptosis during the early post-operative period.When releasing the orbital septum,care should be taken to avoid injury to surrounding structures,particularly the trochlea nasally and the lacrimal gland laterally.Moist cotton tip applicators can be used to safely separate fat from the underlying aponeurosis.展开更多
We report a case of ocular myasthenia gravis(MG)accompanied by anosmia. A 76-year-old man had idiopathic anosmia of 2-year duration. Four months before consultation, he began to have drooping in the right upper eyelid...We report a case of ocular myasthenia gravis(MG)accompanied by anosmia. A 76-year-old man had idiopathic anosmia of 2-year duration. Four months before consultation, he began to have drooping in the right upper eyelid along with muscle soreness,distension, and pain in the nape. His tongue was dark-red with a thin and white coating; his pulse was wiry and slippery. According to Traditional Chinese Medicine, eyelid drooping and anosmia are the main signs of liver constraint and spleen deficiency. In Western Medicine, the diagnosis was ocular MG and idiopathic anosmia. Our patient, along with the literature, suggests that anosmia may be an early symptom before MG. MG accompanied by anosmia could be a special subtype of MG according to antibody production and symptoms.展开更多
目的为解决疲劳驾驶检测中人眼状态识别的难点,提出一种基于眼白分割的疲劳检测方法。方法首先对获取图像进行人脸检测,利用眼白在Cb-Cr上良好的聚类性,基于YCb Cr颜色空间建立高斯眼白分割模型;然后在人脸区域图像内做眼白分割,计算眼...目的为解决疲劳驾驶检测中人眼状态识别的难点,提出一种基于眼白分割的疲劳检测方法。方法首先对获取图像进行人脸检测,利用眼白在Cb-Cr上良好的聚类性,基于YCb Cr颜色空间建立高斯眼白分割模型;然后在人脸区域图像内做眼白分割,计算眼白面积;最后将眼白面积作为人眼开度指标,结合PERCLOS(percentage of eyelid closure over the pupil over time)判定人的疲劳状态。结果选取10个短视频进行采帧分析,实验结果表明,高斯眼白分割模型能有效分离眼白,并识别人眼开合状态,准确率可达96.77%。结论在良好光线条件下,本文方法能取得不错的分割效果;本文所提出的以眼白面积作为判定人眼开度的指标,能准确地判定人的疲劳状态。实验结果证明了该方法的有效性,值得今后做更深入的研究。展开更多
Objective: To evaluate the safety and effectiveness of eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye. Methods: This was a prospective, randomized...Objective: To evaluate the safety and effectiveness of eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye. Methods: This was a prospective, randomized, open-label, investigator-masked, and self-controlled study. We randomly assigned one eye of patients with meibomian gland dysfunction-associated dry eye to the treatment group, and the other eye to the control group. Both groups received artificial tears and lid warming;the treatment group received an additional one-time in-office eyelid margin cleaning using Deep Cleaning Device. Non-invasive tear break-up time(NITBUT) and tear meniscus height(TMH) of each eye, and Standard Patient Evaluation for Eye Dryness II(SPEED II) score of each patient were evaluated before and at one week after treatment. Results: Thirty eyes of 15 patients were enrolled. No adverse effects occurred during the treatment. Compared with the baseline values, the SPEED score decreased significantly at one week after treatment(mean±95% confidence interval, 11.00±0.99 vs. 5.67±1.67, P<0.0001), the NITBUT-first in the treatment group increased significantly at one week after treatment((4.74±1.27) s vs.(7.49±2.22) s, P=0.01). The NITBUT-first was significantly longer in the treatment group((7.49±2.22) s) than in the control group((5.17±0.91) s) at one week after treatment(P=0.042). No significant differences were found in other tear film parameters between the two groups. Conclusions: Eyelid margin cleaning using the novel Deep Cleaning Device is a convenient, effective, and safe treatment for patients with meibomian gland dysfunction-associated dry eye.展开更多
AIM：To evaluate the functional and aesthetic outcomes of upper eyelid cicatricial entropion（UCE） correction using anterior lamellar recession（ALR） with addressing the associated conditions including dermatochalas...AIM：To evaluate the functional and aesthetic outcomes of upper eyelid cicatricial entropion（UCE） correction using anterior lamellar recession（ALR） with addressing the associated conditions including dermatochalasis,brow ptosis,blepharoptosis,and lid retraction.METHODS：Chart review of patients with upper lid cicatricial entropion who had undergone ALR from 2013 to 2016 was reviewed.Success was defi ned as the lack of any lash in contact with the globe,no need for a second procedure,and acceptable cosmesis at the fi nal follow up.RESULTS：Sixty eight patients（97 eyelids） were operated by ALR with simultaneous correction of associated lid problems in each case when necessary.The mean followup time was 17.8 mo（range,6.0-24.0 mo）.Concomitantly,levator tucking was performed in 19 eyelids（19.6%）,upper lid retractor recession in 18 eyelids（18.6%）,and internal browpexy in 31 eyelids（32.0%）.In 95.8% of patients（95%CI：0.85-0.96）,satisfactory functional and cosmetic outcome was achieved with a single surgical procedure.CONCLUSION：Based on the principles of lamellar recession and concurrently addressing the associated lid problems,this approach is an effective and safe treatment of UCE.展开更多
Objective To explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cata...Objective To explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction.Methods In this study,61 patients(97 eyes)with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected,and randomly grouped.In the experimental group,the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery.In the control group,levofloxacin eye drops alone were applied for three consecutive days.Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures,respectively.Results In the experimental group,the positive rates of the two bacteria samples were 100%(50/50)and 40%(20/50)before and 10%(5/50)and 0%(0/50)after the treatment.In the control group,the positive rates of the two bacteria samples were 97.9%(46/47)and 29.8%(14/47)before and 40.4%(19/47)and 10.6%(5/47)after the treatment.The positive rates between the two groups were not significantly different before taking antimicrobial measures(P=0.485 and 0.395),while they were significantly different after taking antimicrobial measures(P=0.001 and 0.024).Conclusion Combined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.展开更多
AIM： To report the long-term outcomes of a large cohort of upper lid retraction patients treated with subconjunctival triamcinolone acetonide injections.METHODS： This retrospective clinical study was conducted from ...AIM： To report the long-term outcomes of a large cohort of upper lid retraction patients treated with subconjunctival triamcinolone acetonide injections.METHODS： This retrospective clinical study was conducted from 2009 to 2016. The documents of 97 patients（126 eyes） were reviewed. The patients were treated with subconjunctival triamcinolone acetonide injections monthly and evaluated pre-and post-treatment by taking measurements of the upper margin reflex distance（MRD1, the distance between the upper-lid margin and the pupil center）, lid aperture, lagophthalmos and proptosis. The patients were divided into the cured group, the improved group and the ineffective group based on the final treatment effectiveness. The improved group and the ineffective group were combined into non-cured group.RESULTS： The follow-up time was 23.45±14.86 mo. Of the patients, 63（64.9%） were assigned to the cured group, 22（22.7%） in the improved group, 12（12.4%） in the ineffective group. Injection times for cured group was 4.66±1.74, and for non-cured group was 5.17±2.08（P≤0.05）. The MRD1 was significantly reduced between baseline and 1 mo after the initiation of treatment in the cured and improved groups（P〈0.001）. The values did not change significantly after 4 mo for the improved group, while they continued to decrease in the cured group. In the ineffective group, the MRD1 did not significantly change after treatment. A statistically significant difference was observed between the baseline and post-treatment values of the mean muscle thickness（2.95±0.99 mm vs 2.04±0.63 mm, P〈0.05） and surface area（27.27±10.5 mm2 vs 18.3±7.04 mm2,P〈0.05） of the levator superioris with magnetic resonance imaging examination. Twelve patients（12.4%） relapsed after treatment and required additional subconjunctival injections. The main side effects included menstrual cycle disturbances（32%） and elevations of intra-ocular pressure（18.6%）. CONCLUSION： A repeated subconjunctival injection of triamcinolone is an effective and relatively safe treatment for upper lid retraction due to thyroid-associated ophthalmopathy. This is related to the anti-inflammation effect of the medicine and the levator thickness can become thinner. Patients must be monitored regularly for recurrences and side effects.展开更多
AIM： To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS： In this retrospective study, a total of 2228 cases of eyelid tumors with patho...AIM： To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS： In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin： epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS： Most eyelid tumors were epidermal in origin（1080, 48.5%）, followed by miscellaneous（885, 39.7%） and adnexal tumors（263, 11.8%）. Among all the tumors, 292（13.1%） were malignant lesions, 1910（85.7%） benign and 26（1.1%） premalignant lesions. Most malignant tumors originated from epidermal cells（60.0%）, followed by adnexal cells（34.6%）. The most common malignant tumors were basal cell carcinomas（56.5%） followed by sebaceous carcinoma（34.6%）, squamous cell carcinomas（3.8%） and lymphoma/plasmocytoma（1.7%）. The benign and premalignant eyelid lesions mostly originated from epidermal cells（46.4%） followed by miscellaneous cell sources（45.2%）, including melanocytic nevus（33.8%）, seborrheic keratosis（13.7%）, squamous cell papilloma（13.0%） and epidermal cysts（11.5%）. CONCLUSION： Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.展开更多
· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved ...· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.展开更多
Simultaneous co-firing of the levator palpebrae （LP） and pterygoid muscles were recorded in Marcus Gann Syndrome （MGS） patients in early clinical studies. ＂Release hypothesis＂ proposed an intrinsic masticatory o...Simultaneous co-firing of the levator palpebrae （LP） and pterygoid muscles were recorded in Marcus Gann Syndrome （MGS） patients in early clinical studies. ＂Release hypothesis＂ proposed an intrinsic masticatory oculo- motor neural circuit and this kind circuit, which, however, has been observed only in amphibian. On the other hand, congenital miswiring hypothesis has overwhelmed other interpretations. However, the same phenomenon visualized in MGS cases was unveiled in human subjects without any sign of congenital oculomotor disorder. To further study co-firing of the upper eyelid and jaw muscles, we applied non-invasive EMG recording of the upper eyelid and ipsilateral masseter muscle belly in nine healthy volunteers. LP activity was determined initially by looking upward and active retraction of upper eyelid with head fixed. Then, dual channel inputs from upper eyelid and masseter muscle was recorded during tooth occlusion motivated by isometric masseter muscle contraction without jaw and face moving. The EMG recorded from upper eyelid when the subjects retracted eyelid with head fixed exhibited the same pattern as that collected during tooth occlusion, but the pattern was completely different from EMG of active eye closure. This reflects tooth occlusion evoked LP activity. Then, simultaneous co-firing of the LP and masseter muscle was recorded simultaneously during tooth occlusion without jaw movement. Finally, the aforemen- tioned co-firing was recorded when the subjects conducted rhythmic occlusion and synchronous EMG from both muscles was acquired. In conclusions, humans may also have an intrinsic masticatory oculomotor circuit and release hypothesis may apply, at least, to some cases of MGS.展开更多
基金Young Teacher Project of Beijing University of Chinese Medicine(2018-JYBZZ-JS186):Clinical Study on the Treatment of Children's Meibomian Cysts by Iontophoresis with Traditional Chinese Medicine.
文摘Essential Subtleties on the Silver Sea(《银海精微》)is a well-known ophthalmology work of traditional Chinese medicine(TCM).There are many discourses on eyelids diseases.This paper analyzed the classification of related diseases and their treatment methods and intends to sort out the pathogenesis of eyelids diseases related to the spleen and stomach function in TCM,thus inspiring new treatment ideas and guiding clinical treatment.Through the sorting out,it is found that the eyelids diseases are closely related to the function of the spleen and stomach such as the Qi(气)and blood generation and transformation,the blood circulation,and the Yin(阴)-Yang(阳)harmony.The corresponding treatments are various,including expelling the pathogen,moving Qi(气)and invigorating blood,warming and activating the spleen Yang(阳).
文摘·AIM:To characterize the phenylephrine test in aponeurotic and congenital eyelid ptosis,to determine the appropriate timing of the phenylephrine test,and to assess the responses of the upper and lower eyelids.·METHODS:This was a retrospective analysis of 140 eyes of 87 patients(mean age 52.29±16.45 y;22 males,65 females)with upper eyelid ptosis.Totally 88.6%had aponeurotic and 11.4%had congenital ptosis.For the evaluation of the responses of the upper and lower eyelids to topical 2.5%phenylephrine,the scleral show height,the marginal reflex distance(MRD)between the inferior margin of the upper eyelid and pupillary light reflex(MRD1),and between the central portion of the lower eyelid and pupillary light reflex(MRD2)were measured at the 2^(nd),5^(th),and15^(th)minutes.The changes of MRD1 and MRD2 with time(ΔMRD1 andΔMRD2)were evaluated.·RESULTS:The mean MRD1,MRD2.and scleral show heights increased within 5 min after testing,remaining largely stable between the 5^(th)-15^(th)minutes.The percentage of eyes with a greater response in MRD1 increased with increased severity of ptosis(P<0.05).Eyes with aponeurotic ptosis were more responsive to phenylephrine testing than congenital ptosis.The mild ptosis group had lower scleral show measurements and higherΔMRD2 values.TheΔMRD1 andΔMRD2 values were poorly correlated in all measurement times.·CONCLUSION:Performing the phenylephrine test 5 min after instilling the reagent is adequate to assess the maximum response of the upper and lower eyelids.The upper and lower eyelid responses in phenylephrine testing are poorly correlated.However,theΔMRD2 is related with baseline scleral show degree that may be a postoperative predictive factor.Further studies are necessary to determine the relationship between the responses of the lower eyelids to phenylephrine testing.
文摘Objective:To explore the clinical efficacy of plastic surgery of asymmetric double eyelid.Methods:The clinical data of 70 patients with asymmetrical double eyelid who underwent plastic surgery in our hospital from April 2018 to December 2019 were retrospectively analyzed.The patients were divided into different groups based on different plastic surgery procedures.The control group(n=35 cases)were the patients who underwent double eyelid incision method,and the patients who used embedding double eyelid method were included in the observation group(n=35 cases).The operation time,intraoperative blood loss,incision size,healing time of incision,satisfaction of p1astic surgery and occurrence of complications were compared between the two groups.Results:The operation time and incision healing time of the observation group were shorter than those of the control group.The intraoperative blood 1oss and incision were less than those of the control group,and the satisfaction was higher than that of the control group.The difference was statistically significant(P<0.05).The incidence of complications in the observation group was slightly lower than the control group,but the difference was not statistically significant(P>0.05).Conclusion:For asymmetric double eyelid,it should undergo embedding double eyelid plastic surgery,because the operation time and incision healing time are shorter.And intraoperative blood 1oss and incision size are smal1er,which can improve patient satisfaction and reduce the incidence of complications.
基金Supported by the National Natural Science Foundation of China(No.82101176)Natural Science Foundation of Zhejiang Province(No.LTGD23H120002).
文摘AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological survey was conducted on 3038 individuals over the age of 50,all of whom were evaluated at the community health center.Each participant underwent routine ophthalmic examinations and eyelid morphology evaluations by an ophthalmologist.Eyelid disorders and morphology were assessed through slit-lamp examination and direct visual inspection.The study analyzed the characteristics of common eyelid disorders,including blepharoptosis,dermatochalasis,eyelid tumors,entropion,lower eyelid retraction(LER)and ectropion,as well as eyelid morphologies such as sunken and bulging eyelids.Descriptive statistics were used for demographic data,Chi-square test analyzed gender distribution differences,and logistic regression calculated odds ratios for blepharoptosis(P<0.05 considered significant).RESULTS:The study revealed that eyelid disorders were present in 1250(41%)individuals,with blepharoptosis being the most common disorder(25%),followed by severe dermatochalasis(16%),eyelid tumors(9.3%),LER and ectropion(11%),and entropion(1.2%).Sunken eyelids were more prevalent in men(26%)than in women(17%).The study found significant associations between the presence of blepharoptosis and sunken upper eyelids[P=0.01,odds ratio(OR)=1.33],as well as male gender(P=0.038,OR=1.22).Additionally,the prevalence of blepharoptosis increased with age.CONCLUSION:Eyelid disorders are highly prevalent in older people and increase steeply with age.This study highlights the need for increased awareness of eyelid health among older individuals at risk for eyelid disorders and the importance of ophthalmic examination for early diagnosis and management of these disorders.
文摘BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.
文摘Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions.
文摘Background: The full-thickness excision of malignant lower-eyelid tumors,particularly those with posterior lamellar involvement,presents a reconstructive challenge.Traditional grafts often have limitations,prompting interest in biocompatible alternatives,such as biodegradable diplene membranes.This study introduces a novel modification to the standard protocol: the use of diplene membranes enriched with Solcoseryl,a metabolically active agent that enhances angiogenesis,reduces inflammation,and accelerates epithelialization.Methods: Twenty-seven patients(mean age,68.96 ± 8.09 years) with histologically confirmed malignant lowereyelid tumors underwent reconstruction using diplene membranes combined with Solcoseryl.The outcomes were compared with those of a previously reported cohort treated with Diplene alone.The follow-up period ranged from 3 to 12 months.Results: All patients achieved successful restoration of eyelid support with high aesthetic satisfaction.The Solcoseryl group demonstrated significantly faster epithelialization(mean 9.8 ± 1.2 days),improved microcirculatory parameters,and no serious complications.Minor hematomas occurred in two cases(7.4%).Conclusion: The modified Diplene–Solcoseryl membrane enhanced wound healing and biocompatibility during lower-eyelid reconstruction by transforming the membrane into a bioactive scaffold.This innovation offers superior functional and aesthetic outcomes compared to standard diplene use and represents a significant advancement in oculoplastic and oncological reconstructive surgery.
文摘Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely complex.Excess excisions may cause detrimental effects to eyelid function and undesirable aesthetic outcomes.Conversely,adequate resection must occur to prevent further disease progression.Mohs micrographic surgery(MMS),a technique offering high remission rates,is often employed for periocular BCC.This method allows for precise cancer removal while preserving as much healthy tissue as possible,balancing the need for both effective treatment and aesthetic and functional preservation.Following Mohs surgery of periocular BCC,reconstruction methods vary and can be tailored based on the size of the resection and the functional requirements of the affected tissue.Amongst these methods,primary closure with and without secondary intentions,direct margin repair,local flap closure and advance flap,Tenzel flap,tarso-conjunctival flap,periocular skin grafting,and structural grafting are commonly utilized and each has its advantages and limitations.In the future,advancements in synthetic flaps and stabilizing glues in the periocular region may provide additional tools for post-Mohs reconstruction.However,these emerging techniques require further research to establish efficacy and safety,especially in more complex and sensitive regions like the periocular tissues.The primary purpose of this review is to provide a comprehensive analysis of periocular reconstructive techniques following Mohs surgery,comparing their efficacy,functional outcomes,and aesthetic considerations while addressing recent advancements such as synthetic flaps and stabilizing glues to guide clinical decision-making.
文摘The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.
文摘AIM: To report various ocular lesions caused by accidental instillation of superglue. METHODS: Three cases of ocular injuries are described in children aged 6 years, 3 years and 8 months, following accidental instillation of superglue in the eye. RESULTS: In the first case there was sticking of eyelashes in the medial 1/3 of eyelids in both eyes. In the second case sticking of eye lashes was present in the lateral 1/3 of eyelids in the left eye. In the third case, superglue was present on the right cheek, above the right ear and sticking of eyelids in medial 1/3 in right eye. The eyelids were separated by pulling the lid margins with fingers in the first case and later on superglue was removed by trimming the eyelashes; and by direct trimming the eyelashes in second and third cases. There was no injury to other structures of anterior segment in the first two cases. However, removal of the superglue on the cornea resulted in corneal abrasion in the third case which healed with medical treatment and patching of the right eye. CONCLUSION: Accidental instillation of superglue is possible because of the appearance of the tube like eye ointment tube. Immediate medical aid will prevent ocular morbidity.
文摘Upper lid blepharoplasty is a surgical procedure that requires meticulous planning and execution.It is not a standalone procedure but can be combined with ptosis correction surgery.Prior to surgery,thorough lid examinations are essential to determine the appropriate approaches.Skin markings for incision sites should be drawn before anesthesia injection to avoid distortion of lid wrinkles and creases.The design of the lid crease is crucial,with a nasal tapered crease serving as a guide for subsequent parallel crease drawings.Incisions should be made with care to avoid excessive bleeding,particularly from the orbicularis muscles.It is important to control bleeding promptly to prevent secondary ptosis during the early post-operative period.When releasing the orbital septum,care should be taken to avoid injury to surrounding structures,particularly the trochlea nasally and the lacrimal gland laterally.Moist cotton tip applicators can be used to safely separate fat from the underlying aponeurosis.
文摘We report a case of ocular myasthenia gravis(MG)accompanied by anosmia. A 76-year-old man had idiopathic anosmia of 2-year duration. Four months before consultation, he began to have drooping in the right upper eyelid along with muscle soreness,distension, and pain in the nape. His tongue was dark-red with a thin and white coating; his pulse was wiry and slippery. According to Traditional Chinese Medicine, eyelid drooping and anosmia are the main signs of liver constraint and spleen deficiency. In Western Medicine, the diagnosis was ocular MG and idiopathic anosmia. Our patient, along with the literature, suggests that anosmia may be an early symptom before MG. MG accompanied by anosmia could be a special subtype of MG according to antibody production and symptoms.
文摘目的为解决疲劳驾驶检测中人眼状态识别的难点,提出一种基于眼白分割的疲劳检测方法。方法首先对获取图像进行人脸检测,利用眼白在Cb-Cr上良好的聚类性,基于YCb Cr颜色空间建立高斯眼白分割模型;然后在人脸区域图像内做眼白分割,计算眼白面积;最后将眼白面积作为人眼开度指标,结合PERCLOS(percentage of eyelid closure over the pupil over time)判定人的疲劳状态。结果选取10个短视频进行采帧分析,实验结果表明,高斯眼白分割模型能有效分离眼白,并识别人眼开合状态,准确率可达96.77%。结论在良好光线条件下,本文方法能取得不错的分割效果;本文所提出的以眼白面积作为判定人眼开度的指标,能准确地判定人的疲劳状态。实验结果证明了该方法的有效性,值得今后做更深入的研究。
基金Project supported by the Key Research&Development Projects of Zhejiang Province(No.2018C03082)the Health Commission of Zhejiang Province(Nos.WKJ-ZJ-1905 and 2018ZD007),China
文摘Objective: To evaluate the safety and effectiveness of eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye. Methods: This was a prospective, randomized, open-label, investigator-masked, and self-controlled study. We randomly assigned one eye of patients with meibomian gland dysfunction-associated dry eye to the treatment group, and the other eye to the control group. Both groups received artificial tears and lid warming;the treatment group received an additional one-time in-office eyelid margin cleaning using Deep Cleaning Device. Non-invasive tear break-up time(NITBUT) and tear meniscus height(TMH) of each eye, and Standard Patient Evaluation for Eye Dryness II(SPEED II) score of each patient were evaluated before and at one week after treatment. Results: Thirty eyes of 15 patients were enrolled. No adverse effects occurred during the treatment. Compared with the baseline values, the SPEED score decreased significantly at one week after treatment(mean±95% confidence interval, 11.00±0.99 vs. 5.67±1.67, P<0.0001), the NITBUT-first in the treatment group increased significantly at one week after treatment((4.74±1.27) s vs.(7.49±2.22) s, P=0.01). The NITBUT-first was significantly longer in the treatment group((7.49±2.22) s) than in the control group((5.17±0.91) s) at one week after treatment(P=0.042). No significant differences were found in other tear film parameters between the two groups. Conclusions: Eyelid margin cleaning using the novel Deep Cleaning Device is a convenient, effective, and safe treatment for patients with meibomian gland dysfunction-associated dry eye.
文摘AIM：To evaluate the functional and aesthetic outcomes of upper eyelid cicatricial entropion（UCE） correction using anterior lamellar recession（ALR） with addressing the associated conditions including dermatochalasis,brow ptosis,blepharoptosis,and lid retraction.METHODS：Chart review of patients with upper lid cicatricial entropion who had undergone ALR from 2013 to 2016 was reviewed.Success was defi ned as the lack of any lash in contact with the globe,no need for a second procedure,and acceptable cosmesis at the fi nal follow up.RESULTS：Sixty eight patients（97 eyelids） were operated by ALR with simultaneous correction of associated lid problems in each case when necessary.The mean followup time was 17.8 mo（range,6.0-24.0 mo）.Concomitantly,levator tucking was performed in 19 eyelids（19.6%）,upper lid retractor recession in 18 eyelids（18.6%）,and internal browpexy in 31 eyelids（32.0%）.In 95.8% of patients（95%CI：0.85-0.96）,satisfactory functional and cosmetic outcome was achieved with a single surgical procedure.CONCLUSION：Based on the principles of lamellar recession and concurrently addressing the associated lid problems,this approach is an effective and safe treatment of UCE.
基金supported by the National Natural Science Foundation of China(81970768).
文摘Objective To explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction.Methods In this study,61 patients(97 eyes)with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected,and randomly grouped.In the experimental group,the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery.In the control group,levofloxacin eye drops alone were applied for three consecutive days.Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures,respectively.Results In the experimental group,the positive rates of the two bacteria samples were 100%(50/50)and 40%(20/50)before and 10%(5/50)and 0%(0/50)after the treatment.In the control group,the positive rates of the two bacteria samples were 97.9%(46/47)and 29.8%(14/47)before and 40.4%(19/47)and 10.6%(5/47)after the treatment.The positive rates between the two groups were not significantly different before taking antimicrobial measures(P=0.485 and 0.395),while they were significantly different after taking antimicrobial measures(P=0.001 and 0.024).Conclusion Combined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.
基金Supported by the National Natural Science Foundation of China (No.81271043)
文摘AIM： To report the long-term outcomes of a large cohort of upper lid retraction patients treated with subconjunctival triamcinolone acetonide injections.METHODS： This retrospective clinical study was conducted from 2009 to 2016. The documents of 97 patients（126 eyes） were reviewed. The patients were treated with subconjunctival triamcinolone acetonide injections monthly and evaluated pre-and post-treatment by taking measurements of the upper margin reflex distance（MRD1, the distance between the upper-lid margin and the pupil center）, lid aperture, lagophthalmos and proptosis. The patients were divided into the cured group, the improved group and the ineffective group based on the final treatment effectiveness. The improved group and the ineffective group were combined into non-cured group.RESULTS： The follow-up time was 23.45±14.86 mo. Of the patients, 63（64.9%） were assigned to the cured group, 22（22.7%） in the improved group, 12（12.4%） in the ineffective group. Injection times for cured group was 4.66±1.74, and for non-cured group was 5.17±2.08（P≤0.05）. The MRD1 was significantly reduced between baseline and 1 mo after the initiation of treatment in the cured and improved groups（P〈0.001）. The values did not change significantly after 4 mo for the improved group, while they continued to decrease in the cured group. In the ineffective group, the MRD1 did not significantly change after treatment. A statistically significant difference was observed between the baseline and post-treatment values of the mean muscle thickness（2.95±0.99 mm vs 2.04±0.63 mm, P〈0.05） and surface area（27.27±10.5 mm2 vs 18.3±7.04 mm2,P〈0.05） of the levator superioris with magnetic resonance imaging examination. Twelve patients（12.4%） relapsed after treatment and required additional subconjunctival injections. The main side effects included menstrual cycle disturbances（32%） and elevations of intra-ocular pressure（18.6%）. CONCLUSION： A repeated subconjunctival injection of triamcinolone is an effective and relatively safe treatment for upper lid retraction due to thyroid-associated ophthalmopathy. This is related to the anti-inflammation effect of the medicine and the levator thickness can become thinner. Patients must be monitored regularly for recurrences and side effects.
文摘AIM： To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS： In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin： epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS： Most eyelid tumors were epidermal in origin（1080, 48.5%）, followed by miscellaneous（885, 39.7%） and adnexal tumors（263, 11.8%）. Among all the tumors, 292（13.1%） were malignant lesions, 1910（85.7%） benign and 26（1.1%） premalignant lesions. Most malignant tumors originated from epidermal cells（60.0%）, followed by adnexal cells（34.6%）. The most common malignant tumors were basal cell carcinomas（56.5%） followed by sebaceous carcinoma（34.6%）, squamous cell carcinomas（3.8%） and lymphoma/plasmocytoma（1.7%）. The benign and premalignant eyelid lesions mostly originated from epidermal cells（46.4%） followed by miscellaneous cell sources（45.2%）, including melanocytic nevus（33.8%）, seborrheic keratosis（13.7%）, squamous cell papilloma（13.0%） and epidermal cysts（11.5%）. CONCLUSION： Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.
基金Supported by Jilin Province Science and Techology Development Plan Project(No.20150414032GH)
文摘· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.
基金partially supported by Natural Sciences Research Funding 2006C225 and 2009K01-74 from Shaanxi Province
文摘Simultaneous co-firing of the levator palpebrae （LP） and pterygoid muscles were recorded in Marcus Gann Syndrome （MGS） patients in early clinical studies. ＂Release hypothesis＂ proposed an intrinsic masticatory oculo- motor neural circuit and this kind circuit, which, however, has been observed only in amphibian. On the other hand, congenital miswiring hypothesis has overwhelmed other interpretations. However, the same phenomenon visualized in MGS cases was unveiled in human subjects without any sign of congenital oculomotor disorder. To further study co-firing of the upper eyelid and jaw muscles, we applied non-invasive EMG recording of the upper eyelid and ipsilateral masseter muscle belly in nine healthy volunteers. LP activity was determined initially by looking upward and active retraction of upper eyelid with head fixed. Then, dual channel inputs from upper eyelid and masseter muscle was recorded during tooth occlusion motivated by isometric masseter muscle contraction without jaw and face moving. The EMG recorded from upper eyelid when the subjects retracted eyelid with head fixed exhibited the same pattern as that collected during tooth occlusion, but the pattern was completely different from EMG of active eye closure. This reflects tooth occlusion evoked LP activity. Then, simultaneous co-firing of the LP and masseter muscle was recorded simultaneously during tooth occlusion without jaw movement. Finally, the aforemen- tioned co-firing was recorded when the subjects conducted rhythmic occlusion and synchronous EMG from both muscles was acquired. In conclusions, humans may also have an intrinsic masticatory oculomotor circuit and release hypothesis may apply, at least, to some cases of MGS.
