Ophthalmic plastic and reconstructive surgery
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Ophthal Plast Reconstr Surg · Jul 2007
Case ReportsIntraorbital arteriovenous fistula secondary to penetrating injury.
: To describe the clinical and radiologic features and management of an intraorbital arteriovenous fistula secondary to penetrating injury. ⋯ : Penetrating injury of the orbital apex may lead to the formation of an arteriovenous fistula, transvenous embolization of which may be complicated by thrombosis of the SOV. In our case, this unintentional result facilitated the resolution of the fistula.
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Ophthal Plast Reconstr Surg · Mar 2007
Case ReportsTraumatic subluxation of the globe into the maxillary sinus.
Fractures of the orbit most commonly involve the orbital floor, and enophthalmos is a common sign of orbital fractures. Complete globe dislocation in the maxillary sinus, however, has rarely been reported. Herein we report on an 18-year-old man referred to us 1 week following a car accident. ⋯ CT revealed a large orbital floor fracture with globe dislocation in the right maxillary sinus. The patient underwent repair of the fracture using a Medpor implant together with repositioning of the globe. Preoperative vision was no light perception, which remained unchanged during follow-up.
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Ophthal Plast Reconstr Surg · Mar 2007
Comparative StudyEfficacy of skin cooling and EMLA cream application for pain relief of periocular botulinum toxin injection.
To investigate the efficacy of EMLA cream and local dry cold application for pain relief before periocular botulinum toxin injection, and to compare these two methods. ⋯ Skin cooling and EMLA applications significantly decrease the pain associated with periocular botulinum toxin injections. Clinically or statistically significant difference in pain scores between the two methods was not noted. Patients had a slight preference for EMLA cream over skin cooling.
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Ophthal Plast Reconstr Surg · Mar 2007
Case ReportsPerilimbal needle manipulation of conjunctival chemosis after cosmetic lower eyelid blepharoplasty.
We report an effective treatment procedure for postoperative conjunctival chemosis following cosmetic lower eyelid blepharoplasty. A minimally invasive procedure was used to treat three patients who presented with chronic conjunctival chemosis following lower eyelid blepharoplasty. ⋯ Two months following the procedure, reduction of the chemosis was observed in all three patients. Our cases indicate that perilimbal manipulation with a 27-gauge needle is a viable treatment for this surgical complication.
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Ophthal Plast Reconstr Surg · Jan 2007
Case ReportsNewly recognized ocular side effects of erlotinib.
An 85-year-old man had a bilateral periorbital rash and conjunctivitis leading to lower eyelid ectropion and epiphora within 6 weeks of treatment with erlotinib (Tarceva, Genentech, Inc., San Francisco, CA, and OSI Pharmaceuticals, Melville, NY), a second-line antineoplastic agent. The treatment was discontinued secondary to toxicity, and the periorbital rash completely resolved within 6 weeks of cessation of the drug. To our knowledge, the periorbital rash resulting in bilateral lower eyelid ectropion associated with epiphora is a newly recognized side effect of erlotinib that is completely reversible with discontinuation of the drug. The rash and ectropion should be treated palliatively, and surgical intervention should be avoided unless the patient cannot be removed from treatment.