ABSTRACT
PURPOSE: To describe a bilateral involutional lower eyelid ectropion in a patient with cutis laxa, a paraneoplastic process in multiple myeloma. DESIGN: Case report. RESULTS: A 60-year-old male presented with a marked involutional left lower eyelid ectropion. Systemic history included cutis laxa, a paraneoplastic feature of multiple myeloma. After surgical treatment, the ectropion recurred; furthermore, a right lower eyelid ectropion developed. In addition, a distinct dermatochalasis of both upper eyelids was present. CONCLUSIONS: This case is the first description of a marked bilateral involutional ectropion in cutis laxa acquisita.
Subject(s)
Cutis Laxa/complications , Ectropion/etiology , Eyelids/pathology , Multiple Myeloma/complications , Paraneoplastic Syndromes, Ocular/complications , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cutis Laxa/surgery , Ectropion/surgery , Eyelids/surgery , Humans , Male , Middle Aged , Multiple Myeloma/drug therapy , Multiple Myeloma/pathology , Ophthalmologic Surgical Procedures , Paraneoplastic Syndromes, Ocular/pathology , RecurrenceABSTRACT
AIM: To report the efficacy of the Wies procedure (transverse blepharotomy and marginal rotation) in the management of trichiasis or cicatricial entropion of the upper or lower eyelid. METHODS: A retrospective chart review was performed of all cases of Wies eyelid rotations supervised or performed by one surgeon for cicatricial entropion or trichiasis of the upper or lower eyelids over a 16-year period to assess the indications, success rate and complications of the procedure. Where follow-up was less than 6 months, telephone interviews were conducted to assess patient satisfaction with the surgery. Patients not meeting these criteria were excluded from the final analysis. Success was defined as no recurrence of the entropion or trichiasis and/or patient satisfaction at least 6 months postoperatively. Statistical analysis was performed using a chi(2) test. RESULTS: 126 eyelids (77 upper lids, 49 lower lids) were identified in 89 patients (53 single eyelid, 33 multiple eyelids) who underwent a Wies procedure with a minimum follow-up period of 6 months. The mean follow-up period was 67 months (range 6-188 months). The overall success rate was 85%. 13 eyelids (10%) developed complications. 18 eyelids (14%) developed recurrences that required a second procedure. 10 of these second procedures were repeat Wies procedures, one of which was followed by electrolysis. All of these second Wies procedures were successful. CONCLUSIONS: The Wies procedure (transverse blepharotomy and marginal rotation) is reasonably successful in managing trichiasis and cicatricial entropion of either upper or lower eyelids.
Subject(s)
Blepharoplasty/methods , Eyelashes , Eyelid Diseases/surgery , Hair Diseases/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cicatrix/etiology , Cicatrix/surgery , Entropion/etiology , Entropion/surgery , Eyelid Diseases/etiology , Female , Hair Diseases/etiology , Humans , Male , Middle Aged , Retrospective Studies , Suture Techniques , Treatment Outcome , Young AdultABSTRACT
We report on two patients, each with an atrophic blind eye who underwent strabismus correction as an alternative treatment of artificial eye prosthesis intolerance. Both patients had acquired intolerance of their prostheses, which could not be adjusted by the ocularist. The intolerance was assumed to result from focal corneal pressure by the prosthesis, related to progressive exotropia and hypertropia. This led to irritation and pain in both patients, and to focal corneal staining in one. Both patients underwent retropositioning of the external and superior rectus muscles of the left eye. At 4 weeks and 13 months postoperatively, they were free of symptoms while wearing the original artificial eye prosthesis.
Subject(s)
Esotropia/surgery , Eye, Artificial , Postoperative Complications/surgery , Adult , Eye Enucleation , Eye Evisceration , Eye Injuries, Penetrating/surgery , Female , Humans , Oculomotor Muscles/surgery , Prosthesis Failure , ReoperationABSTRACT
PURPOSE: To assess the effectiveness of bicanalicular silicone intubation (SI) in acquired partial nasolacrimal duct (NLD) obstruction. DESIGN: Retrospective nonrandomized case series METHODS: 72 tear ducts from 53 patients with severe epiphora due to acquired partial NLD obstruction underwent bicanalicular SI. Mean age at intubation was 55.9 years. The silicone tubes were removed after, on average, 10.4 weeks. Mean follow up period was 29.3 months (range 6 to 66 months). The results were assessed using the Munk score: 0-1: complete success, 2: partial success and 3-4: failure. RESULTS: Complete success was reported in 47% (31/66). Partial success was reported in 3% (2/66), and no improvement in 50% (33/66). 12% (8/66) was subsequently treated with dacryocystorhinostomy (DCR). CONCLUSION: In patients with acquired partial NLD obstruction, we noted a low success-rate for bicanalicular SI. Although it may be considered in patients who refuse DCR surgery, the relatively poor outcome compared to DCR does not justify its systematic use for this indication.
Subject(s)
Intubation/methods , Lacrimal Duct Obstruction/therapy , Biocompatible Materials , Female , Humans , Male , Middle Aged , Nasolacrimal Duct , Silicones , Treatment OutcomeABSTRACT
In this case report we present a preterm born baby with bilateral hazy corneas and initially normal intraocular pressures. After birth, the corneal opacification increased and a progressive buphthalmos became evident in the right eye. A trabeculectomy was performed in the right eye. Our final diagnosis was sclerocornea in combination with Peters' anomaly.
