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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen years after a partial maxillectomy and radiation therapy for left antral carcinoma, a 53-year-old woman presented to the Eye Plastics and Orbit Service of the Massachusetts Eye and Ear Infirmary, Boston, with phthisis and a large, black corneal lesion in the left eye. She had been treated for unilateral glaucoma in the left eye for more than 10 years with topically administered epinephrine borate, timolol maleate, and pilocarpine hydrochloride. Clinically, the lesion was smooth, black, and homogeneous, and was thought to represent uveal prolapse covered by a thin layer of epithelium. An eyelid-sparing anterior exenteration was performed. Histopathologic examination revealed an acellular, homogeneous substance that stained positively with the Fontana Masson stain for melanin and bleached with potassium permanganate, findings consistent with corneal adrenochrome deposition. Since adrenochrome can be easily dissected free from the cornea, this case illustrates that misdiagnosing adrenochrome deposition may lead to unnecessary surgery.
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PMID:'Black cornea' after long-term epinephrine use. 152 Jan 15

The authors place autosomal dominant oculopharyngeal muscular dystrophy in a historical perspective, look at the genealogy involved, and review the genetic studies. In addition to summarizing what happens at the histopathological level, they examine the clinical characteristics of this late-onset dystrophy. Based on this knowledge, they try to present their rationale for the surgical treatment of the eyelid ptosis, taking into account that this disease is progressive and that treatment should be planned for the lifetime of the patient. Three representative cases are illustrated.
Orbit 2001 Dec
PMID:Oculopharyngeal muscular dystrophy: What's new? 1204 2

The authors describe a new device for oculoplastic surgery, a so-called ptosis forceps with a protected lock, which greatly facilitates dissection of the levator muscle in ptosis operations as well as in levator recession procedures. The instrument consists of an inferior part, including two grooved atraumatic flat jaws, and a superior part, including a bulging rough area and a smooth tapered tip. The original feature of this new device is its hidden lock mechanism, located between the two bulging parts of the forceps, in such a way as to free the instrument(1)s outer surface, thus making grasping and release of the levator muscle easier during surgery.
Orbit 2001 Jun
PMID:Ptosis forceps with a protected lock: A new device in oculoplastic surgery. 1204 20

This prospective study highlights the result of a new technique for correction of recurrent lower lid entropion. The technique was designed to address the aetiological factors involved based on the pre- and per-operative findings. MATERIAL AND METHODS. 37 eyelids of 31 consecutive patients with recurrent entropion were enrolled. Under local anaesthesia, a horizontal incision was made at the lower border of the tarsus, involving the total width of the lower eyelid. Anterior lamellar (skin and orbicularis oculi muscle - OOM) inferior to the incision was dissected towards the orbital rim. An ellipse of the excess overriding OOM and overlying skin inferior to the incision was excised. The OOM was fixed to the lower border of the tarsus with three to four 6/0 Vicryl subcutaneous sutures. Skin was repaired with 6/0 silk sutures, which were removed five days post-operatively. Five cases underwent horizontal lid shortening and 15 had preaponeurosis fat sculpting in addition. RESULTS. 37 procedures were performed on 31 patients (23 M & 8 F). The mean age was 76.5 yrs. (range 63-90). The patients had had one to four (mean = 1.7) previous surgeries. All patients had OOM override. Fifteen had significant preaponeurosis fat prolapse. Lower lid laxity was not identified in all cases, in some due to previous lid surgery. There was no evidence of lower lid retractor laxity in the majority of cases. After a mean follow-up time of 18 months (5-36) there were three recurrences. One underwent further tarsal fixation and the other two had horizontal lid shortening with a favourable outcome. CONCLUSIONS. Excision of overriding OOM and tarsal fixation for recurrent entropion is simple and effective. Its success is due to direct tackling of the aetiological factors.
Orbit 2001 Jun
PMID:Orbicularis oculi muscle stripping and tarsal fixation for recurrent entropion. 1204 22

From 1994 to 1999, 1121 operations for blepharoptosis were performed in our department on 987 patients. In 44 cases we found a moderate to severe congenital ptosis with a levator function of less than 2 mm. Until today, in such cases, it is recommended to use a frontalis suspension in order to elevate the upper eyelid. Unsatisfactory cosmetic results in facial expression and lack of skin-fold are only a few of the disadvantages of this technique. In 1994, therefore, we decided to perform a maximal levator resection in the treatment of unilateral congenital ptosis with poor levator function. All children included in our study were younger than six years of age. The ptosis was moderate (2-4 mm) in 36/44 and severe (>4 mm) in 8/44 cases. The levator function was less than 2 mm. Complete transsection of the medial and lateral horn of the levator aponeurosis under preservation of the Whitnall ligament is the most important surgical step in mobilizing the levator muscle. A satisfactory eyelid elevation (generally considered to be a difference of less than 1 mm between both eyelid fissures) was achieved in 36/44 cases. Our results indicate that, in contrast to established practice, maximal levator resection is the treatment of choice for congenital ptosis with poor levator function.
Orbit 2001 Jun
PMID:Maximal levator resection in the treatment of unilateral congenital ptosis with poor levator function. 1204 25

This study was designed to determine the incidence of lagophthalmos following aponeurotic ptosis repair, and to establish any predictive factors for its development. Data from a prospective, interventional, non-comparative case series was reviewed. Of these 164 eyelids with acquired involutional ptosis, 134 eyelids of 75 patients had both preoperative and postoperative photographs of the eyelids in the primary and gently closed positions, and were therefore analyzed for this study. Lagophthalmos was present in 23/38 (60%) of eyelids on the first postoperative day; in 27/81 (33%) one week after surgery; and persisted in 12/134 (9%) eyelids and 8/75 (11%) patients six to twenty weeks after surgery (mean 11 weeks). The lagophthalmos of these twelve eyelids ranged from 0.5 to 1.5 mm with a mean of 0.6 mm. Both the pre-existing lower scleral show and the final height of the eyelid following surgery were significant predictors of postoperative lagophthalmos. Neither eyelid excursion nor the degree of change in eyelid height from pre- to post-surgery was significantly associated with eyelid closure.
Orbit 2000 Jun
PMID:Incidence of lagophthalmos after aponeurotic ptosis repair. 1204 49

Oculomotor palsy with cyclic spasms is a rare, non-progressive disorder in which the muscles innervated by the third cranial nerve undergo alternating rhythmic spasm and paralysis. An 18-year-old male was referred with left upper eyelid ptosis present since birth. On examination we noted cyclic movements of the left eyelid and pupil. The cycle consisted of periods of ptosis and mydriasis alternating with eyelid retraction with miosis. The interpalpebral fissure measured 2 mm in the paralytic phase and 11 mm in the spastic phase. The pupil diameter varied from 3 mm to 6 mm. Six cycles were observed in 5 minutes. The patient had no voluntary control over his left eyelid, nor over the other muscles innervated by the third nerve. The affected eye was deeply amblyopic and exotropic. Systemic evaluation and cranial MRI gave normal results. A therapeutic trial with oral baclofen (30 mg/day), a central muscle relaxant drug, was ineffective in suppressing the cyclic movements.
Orbit 2000 Jun
PMID:Oculomotor palsy with cyclic spasms: a case report. 1204 57

Involutional entropion is the commonest cause of entropion in the elderly population. Many surgical procedures have been described to correct it. The everting suture technique is simple and quick and can be undertaken in the clinic or even away from a medical setting. However, it has been regarded as a temporary cure, especially in the presence of horizontal lower lid laxity. We reviewed the results of everting sutures in 55 lids of 50 patients. The minimum follow-up was 18 months. 78% of patients had no recurrence of their entropion. Our results suggest that horizontal eyelid laxity may not be the only major factor in recurrent entropion following everting sutures. Dermatochalasis with orbital fat prolapse may also contribute.
Orbit 1999 Sep
PMID:Everting sutures in involutional entropion. 1204 82

A case of extra-abdominal fibromatosis (EF) of the orbit is described in a 35-year-old man presenting with progressive exophthalmos, right ptosis and diplopia. MRI showed an orbital mass of intermediate signal in T1-weighted images (WI) and low signal in T2WI, which enhanced non-homogeneously after contrast injection. The histological diagnosis of EF was made and the lesion was surgically removed. No recurrence occurred in 40 months of follow-up.
Orbit 1999 Sep
PMID:Orbital (desmoid type) fibromatosis. 1204 86

Congenital cutis laxa is a rare generalized inherited elastosis, characterized by the appearance of premature aging and skin laxity with mild to severe systemic anomalies. Ocular manifestations include excess skin in the eyelids, ptosis and lower lid ectropion. Of the hyperelasticity syndromes - Ehlers Danlos, Pseudoxanthoma elasticum and cutis laxa - only cutis laxa has normal skin wound healing. The diagnosis must therefore be established before surgical options for treatment are considered. We report an unusual case of a 5-month-old male child with cutis laxa who presented with upper lid entropion secondary to severe redundant upper eyelid skin. An anterior lamellar repositioning procedure successfully corrected the lid margin malposition with complete relief of symptoms.
Orbit 1999 Mar
PMID:Surgical correction of entropion and excess upper eyelid skin in congenital cutis laxa: a case report. 1204 99


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