Subject(s)
Eye, Artificial , Orbital Implants , Ceramics , Hydroxyapatites , Prostheses and Implants , Sodium FluorideABSTRACT
BACKGROUND: Coralline hydroxyapatite has been used since 1983 as volume replacement. Through 2001, a total of 200 hydroxyapatite implants were used in our department. OBJECTIVE: This prospective study was undertaken to measure the subjective and objective long-term tolerance of this implant. MATERIALS AND METHODS: In 2012, a total of 20 patients were examined, who were enucleated or eviscerated between 1993 and 2001 (average follow-up 16.2 years) and had an hydroxyapatite implant placed with a scleral sheath. We evaluated the subjective tolerance and measured the motility, the prominence of the globe, lid positions, changes of the conjunctiva and postoperative complications. RESULTS: The subjective long-term tolerance was reported to be good. All patients had a ptosis; an ectropion was found in 50% of patients. In 40% of the patients additional surgery was performed. The motility was better in primary than in secondary placed implants. Volume replacement was successful in 10 patients, 9 patients had a retraction and 1 patient a prominent prosthesis. DISCUSSION: Hydroxyapatite implants with sclera sheathing were well tolerated and showed good motility on long-term follow-up over more than 16 years. Lid malpositions such as ptosis or ectropion are common but might be due to mechanical stress through the prosthesis and atrophy of the orbital fat.
Subject(s)
Orbital Implants , Ceramics , Eye Enucleation , Humans , Hydroxyapatites , Prospective Studies , Prostheses and ImplantsABSTRACT
Blepharoplasty is one of the most frequently performed plastic cosmetic interventions. For this purpose the CO2 laser is an instrument that can be used as a laser scalpel to cut as well as in its ablative function to remove skin irregularities, such as scars and tumors and also to treat changes of the skin due to aging. Fractionated laser irradiation reduces the duration of skin redness and the postoperative rehabilitation time after a resurfacing. The advantages of the CO2 laser are a gentle intraoperative preparation and less postoperative swelling due to an additional cauterization of blood vessels. Disadvantages are an increased occurrence of wound dehiscence and the high cost of instrumentation. Before performing a blepharoplasty an exact analysis of changes of the eyelid and also the wishes of the patients are necessary to establish the most suitable surgical procedure and the correct dosage. In addition to skin and fat resection, depending on the original situation it is possible to tighten slack skin with a resurfacing, to shift the fat compartments, to change the position of the eyebrows, to correct a ptosis and also to modulate the tension of the lid. The frequency of complications can be reduced by good planning of the surgical intervention. In the case of occurrence of complications, suitable treatment strategies should be available.
Subject(s)
Blepharoplasty , Laser Therapy , Eyebrows , Eyelids , Humans , Postoperative ComplicationsSubject(s)
Blepharoplasty/methods , Eyelid Diseases/surgery , Eyelids/abnormalities , Eyelids/surgery , Minimally Invasive Surgical Procedures/methods , Patient Satisfaction , Combined Modality Therapy/methods , Evidence-Based Medicine , Eyelid Diseases/pathology , Eyelids/pathology , Humans , Rhytidoplasty/methods , Treatment OutcomeABSTRACT
BACKGROUND: Orbital and periorbital complications due to acute paranasal sinusitis can be treated surgically or conservatively. In many cases the type of treatment depends on the ophthalmological findings. In the context of this clinical analysis we explored whether a conservative rather than an surgical therapy should be chosen for specific otorhinolaryngological or ophthalmological findings. METHODS: 32 patients were treated conservatively, whereas 4 patients had to be operated. Before therapy and after completion of the treatment otorhinolaryngologistical and ophthalmological findings were recorded and these findings as well as the two therapy options were compared with each other. RESULTS: In the cases of the 32 conservatively treated patients plus the 4 patients, who were treated surgically, a complete restitutio ad integrum could be observed at the end of the treatment period. DISCUSSION: A conservative therapy is obsolete in cases with specific ophthalmological findings such as reduction of vision, significant increase of exophthalmos, extreme limitation of motility. In all other cases, a conservative attempt can be made first, because the results of this therapy are as good as the results of surgical intervention but with less exposure for the patient. So the choice of therapy depends the ophthalmological findings.
