ABSTRACT
Background. Obtaining symmetry is one of the most critical challenges of bilateral blepharoplasty surgery. Current techniques rely on caliper measurements and the "eye" of the surgeon. This is time-consuming and prone to error. There is a need for a precise and cost-effective surgical guide. Objective. The purpose of this experimental study was to design a device to improve the accuracy of markings in blepharoplasty. Methods. The device, a combination of a camera and pico-projector, creates a mirror image of the marked eye that is projected onto the second eye with a light beam. This allows the reference features in the captured image to be overlaid precisely on the respective features in the second eye. The device concept was tested initially on a mannequin and then on eleven human volunteer subjects. No actual surgeries were performed. The accuracy of the markings was assessed by comparing optical images of one eye to another via a specifically designed computer analysis. Results. The results of this study revealed that the accuracy of guided blepharoplasty markings was superior to that of unguided markings. Conclusion. The proposed device has a potential to improve precision of symmetrical surgical marking in blepharoplasty surgery, greatly reduce surgeon's time and effort, and ultimately contribute to successful patient outcomes and satisfaction. Additional modifications are forthcoming to prepare the device for clinical use.
Subject(s)
Blepharoplasty , Optical Devices , Eyelids/surgery , HumansABSTRACT
PURPOSE: To evaluate the expression of inflammatory mediators in xanthelasma palpebrarum. METHODS: In this retrospective histopathologic case-control study, xanthelasma specimens obtained from the private practice and pathology archives of 1 author (R.Z.S.) were analyzed and compared with the blepharoplasty tissues from age- and sex-matched controls. Paraffin-embedded tissue sections were stained with hematoxylin-eosin and CD3, CD20, CD163, cyclooxygenase-1, inducible nitric oxide synthase, matrix metallopeptidase-9, and myeloperoxidase antibodies. Immunostaining was quantified by light microscopy and with a computerized image analysis system of scanned images. RESULTS: Hematoxylin-eosin-stained preparations of xanthelasma specimens demonstrated significantly more intense chronic lymphocytic infiltrate when compared with the control blepharoplasty tissues (p < 0.001). Immunohistochemical studies revealed more intense CD3+ T cell and CD163+ histiocytic infiltrate (11% vs. 5%; p = 0.02 and 28% vs. 5%; p = 0.003, respectively) and increased expression of cyclooxygenase-1 (44% vs. 20% expressing cells; p < 0.001 and 21% vs. 9% strongly expressing cells; p = 0.008) and inducible nitric oxide synthase (43% vs. 26% expressing cells; p = 0.03 and 42% vs. 25% strongly expressing cells; p = 0.02) in xanthelasma specimens compared with control tissues. CONCLUSIONS: The inflammatory milieu in xanthelasma appears to be analogous to descriptions of the early stages of cardiac atherosclerotic plaque formation. These findings may contribute to the understanding of xanthelasma pathogenesis and to the development of potential targeted therapies.
