Effect of mannitol on globe and orbital volumes in humans.

Purpose: To determine the effect of intravenous mannitol on globe and orbital volumes.

Methods: Retrospective chart review of a consecutive series of Cleveland Clinic Neurosurgical Intensive Care Unit patients who underwent computed tomographic imaging before and after intravenous mannitol administration. Volume measurements were performed according to a previously described technique by averaging axial image areas.

Amyloid Pseudo-Dacryolith and Nasolacrimal Obstruction in a 67-Year-Old Male.

A 67-year-old male with a 35-year history of left-sided epiphora presented with a nonpainful, noninflamed, left medial canthal mass and complete left nasolacrimal obstruction. During routine dacryocystorhinostomy, a lesion was present within the lacrimal sac that mimicked a lacrimal stone in appearance but with a consistency concerning for malignancy. Histologically, the lesion displayed apple-green birefringence on polarized light microscopy and Congo red staining.

Frontalis Muscle Asymmetry and Lateral Landmarks.

Purpose: To investigate frontalis muscle asymmetry and characterize its lateral interdigitation with the orbicularis oculi muscle.

Methods: After making a mid-coronal incision and bluntly dissecting to the orbital rim, the frontalis muscle was exposed, marked, and photographed. The right and left muscle bellies were analyzed and compared in both pixels and cm ratios generated with NIH ImageJ software.

Rotational Flap Repair of Full Thickness Eyelid Defects without a Posterior Lamellar Graft or Flap.

Background: To determine the safety and effectiveness of full thickness eyelid reconstructions using a semicircular rotational flap without reconstructing the posterior lamella.

Methods: The charts of all patients undergoing semicircular flap closure of full thickness eyelid defects by one surgeon (JDP) at the Cole Eye Institute between March 2000 and October 2012 were reviewed. Charts were reviewed for patient demographic information, as well as for the size of the defect, the type of flap used, length of follow-up and complications.

Regional Variations in Orbicularis Oculi Histology.

Purpose: To investigate and compare the histologic compositions of the pretarsal, preseptal, and orbital orbicularis oculi muscle (OOM) using nonpreserved, fresh-frozen, human cadavers.

Methods: The OOM was exposed using sharp and blunt dissection. A metric ruler was used to measure and mark 0.

Nasolacrimal system aeration on computed tomographic imaging: effects of patient positioning and scan orientation.

Purpose: To determine the impact of patient positioning and scan orientation on the appearance of air in the nasolacrimal drainage system on computed tomography (CT) imaging, and the repeatability of the observations.

Methods: This was a retrospective analysis of CT images for 92 patients.

Results: Air was found to be present more fully in the upright-position group as compared with the supine-position group.

Nasolacrimal System Aeration on Computed Tomographic Imaging: Sex and Age Variation.

Purpose: To investigate variation in aeration of the nasolacrimal drainage system between age groups and genders, and to report the reliability of repeated aeration grading and nasolacrimal canal measurements on CT.

Methods: Retrospective review of CT images from 92 individuals, 60 female and 32 male, was conducted by 3 independent reviewers for the presence of air within the nasolacrimal drainage system. Diameter and area measurements were also obtained at the smallest identifiable portion of the nasolacrimal canal by 2 independent reviewers.

Anatomy and histology of the frontalis muscle.

Purpose: To determine the gross and histologic configurations of the medial and lateral frontalis muscle.

Methods: After making a midcoronal incision and bluntly dissecting to the orbital rim, the frontalis muscle was marked and measured. A protractor was used to measure the frontalis-orbicularis angle (FOA) and, when present, the angle of central bifurcation (AOB).

Small-incision frontalis muscle transposition flap for lateral eyebrow ptosis repair.

Purpose: To describe a novel technique to correct lateral eyebrow ptosis using a frontalis muscle transposition flap.

Methods: The charts of all patients undergoing eyebrow ptosis repair using a frontalis muscle transposition flap from December 2013 through April 2014 were reviewed to describe the surgical technique.

Results: Sixteen patients underwent eyebrow ptosis repair using a frontalis muscle pedicle flap during the study period.

Intralesional tetracycline injection for treatment of lower eyelid festoons: a preliminary report.

Purpose: To determine the safety and effectiveness of intralesional tetracycline 2% injection for the treatment of lower eyelid festoons.

Methods: The authors retrospectively reviewed the charts of all patients undergoing tetracycline 2% injection of lower eyelid festoons at the Cole Eye Institute from August 2008 to August 2013. Charts were reviewed for patient demographic data, dose and number of tetracycline injections, follow-up interval, the presence of preinjection and postinjection photographs, and complications.

Indocyanine green-guided sentinel lymph node biopsy for periocular tumors.

Purpose: To compare the accuracy of indocyanine green (ICG)-guided sentinel lymph node biopsy to sentinel lymph node biopsy performed with technetium-99m in eyelid and in conjunctival malignancies.

Methods: Review of a consecutive series of adult patients undergoing sentinel lymph node biopsy for eyelid and conjunctival malignancies between 2009 and 2013. Only patients undergoing both ICG-guided and technetium-99m-guided sentinel lymph node biopsies were included.

Safety of onabotulinum toxin a injection to the central upper eyelid and eyebrow regions.

Purpose: To evaluate the safety of onabotulinum toxin A injected into the central upper eyelid and eyebrow regions.

Methods: The authors retrospectively reviewed the charts of all patients undergoing onabotulinum toxin A injection to the central upper eyelid and eyebrow between February, 2012, and November, 2012. Age, gender, indication, injection sites, number of central units, total number of units, and occurrence of adverse events were all recorded.

Dimensions and anatomic variations of the orbicularis oculi muscle in nonpreserved, fresh-frozen human cadavers.

Purpose: To determine average dimensions of the orbicularis oculi muscle (OOM) from the orbital rim and to investigate polymorphic variations through anatomical dissection of nonpreserved, fresh-frozen human cadavers.

Methods: The OOM was exposed using sharp and blunt dissection until its distal borders were identified. A metric ruler was used to measure the superior (S line), inferior (I line), and lateral (L line) dimensions of the OOM from the orbital rim.

Severe neutropenia presenting with Candida albicans eyelid abscess in a 1-year-old child.

A previously healthy 1-year-old boy presented with a right lower eyelid abscess. Oral and topical antibiotics were initiated, and the lesion was drained and explored. Despite medical and surgical treatment, the abscess failed to resolve completely and formed again 1 month later.

Orbital and intraocular myofibroblastoma.

A 66-year-old woman presented with a blind, painful, hypertensive, and proptotic left eye. Computed tomographic imaging revealed a well-circumscribed mass involving the left orbit and globe. Metastatic work-up failed to reveal extraorbital lesions and the tumor was removed in toto via an evisceration approach orbitotomy.

Intraoperative sub-tenon injection increases optic nerve length transection during enucleation.

Purpose: To determine the effect of sub-Tenon injection on the length of optic nerve resected during enucleation.

Methods: Case-control laboratory study on 22 orbits of 11 unpreserved, fresh-frozen human cadavers. Each cadaver underwent a conventional enucleation technique on one side and an otherwise identical technique on the contralateral side that included sub-Tenon injection of 2.

Corneal biomechanical properties affect Goldmann applanation tonometry in primary open-angle glaucoma.

Purpose: To study differences in corneal biomechanical properties between primary open-angle glaucoma (POAG) and central corneal thickness (CCT)-matched control subjects and their effect on intraocular pressure (IOP) measurement.

Methods: Thirteen eyes of 13 POAG subjects and 15 eyes of 15 normal subjects underwent corneal topography; IOP using Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), and corneal compensated IOP (IOPcc) using the Reichert ocular response analyzer (ORA); corneal hysteresis; and CCT. Results from POAG and control eyes were then compared using t tests.