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

Pachydermoperiostosis (PDP) is a multisystem disorder of mesenchymal origin. It is a form of hypertrophic osteoarthropathy. The typical clinical features include pachydermia, cutis verticus gyrata, digital clubbing, and periostosis. Patients present with mechanical ptosis resulting from markedly thickened eye lids. Floppy eye lids have rarely been reported in association with PDP. We describe a rare case of PDP associated with ptosis and floppy eye lids in an adult male. Meibomian gland dysfunction was documented by meibography. The patient underwent bilateral upper lid wedge resection, lateral tarsal strip, tarsectomy and external levator advancement with good cosmetic outcome following surgery.
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PMID:A rare case of pachydermoperiostosis associated with blepharoptosis and floppy eyelids. 2811 40

Background: Facial nerve palsy (FNP) is known to worsen Meibomian gland dysfunction on the affected side. Chronic Meibomian gland dysfunction leads to a variant of upper eyelid marginal entropion associated with excessive tarsal curling, termed Meibomian gland inversion (MGI). Surgical correction with grey line split, tarsoplasty and anterior lamellar repositioning (GLS surgery) appears to further improve the ocular surface in these patients who have previously undergone upper eyelid loading.Methods: Retrospective, 3 year, non-comparative, single-centre study of patients with FNP identified as having MGI and treated by GLS surgery under the supervision of a single surgeon. We present specific examination findings and a useful test (cotton tip test) to determine suitability for GLS surgery. We assessed changes in symptoms and CADS (Cornea, static Asymmetry, Dynamic function and Synkinesis) score, along with cosmetic grading of lash loss and contour and report complications.Results: 23 patients with acquired FNP underwent GLS surgery for MGI with or without lash ptosis. 17 out of the 23 patients (74%) demonstrated an improvement in their CADS score after GLS surgery. Seven patients had insufficient records with scores missing and no conclusion could be reached for this group. Improvement of corneal staining, static and dynamic symmetry were all statistically significant. No patient worsened. The cosmetic outcome including lashes, lid contour and lid margin appearance is acceptable. Whilst it is possible to achieve minimal difference between the operated and unoperated eyelids, many patients will have a small difference.Conclusion: We report outcomes of MGI treatment and useful diagnostic features.
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PMID:Recognising meibomian gland inversion in patients with facial palsy to improve the ocular surface. 3189 55