Numerical Aberrations of the Extraocular Muscles and the Levator Palpebrae Superioris: An Anatomical and Clinical Insight.

Purpose: To comprehensively review the literature about numerical aberrations of the orbital muscles of ocular motility (here referred to as extraocular muscles [EOMs]) and the levator palpebrae superioris (LPS).

Methods: The authors summarize the embryologic bases and the possible etiopathogenetic causes of numerical aberrations of the EOMs and the LPS and organize these lesions into several broad categories. The clinical and radiologic diagnostic challenges are discussed.

A major review on punctal stenosis: Part II: Updated therapeutic interventions, complications, and outcomes.

We continue our review of on punctal stenosis by providing a detailed discussion of management modalities, their complications, and outcomes. There is a significant change in the understanding of punctal and peripunctal anatomy, puncto-canalicular junction, and the lacrimal pump mechanisms. While the snip punctoplasty procedures are still practiced, there is an increasing trend toward nonincisional procedures.

A major review of punctal stenosis: Updated anatomy, epidemiology, etiology, and clinical presentation.

We aim to provide a detailed and updated literature review on the epidemiology, etiology, clinical presentations, histopathology, and ultrastructural features of punctal stenosis. There are inconsistencies in the definition and staging of punctal stenosis. While advanced optical coherence tomography imaging techniques have revolutionized the way the punctum and vertical canaliculi are assessed or monitored following treatment, the planes of measurement to characterize punctum anatomy need to evolve further.

Debunking the Puzzle of Eyelid Apraxia: The Muscle of Riolan Hypothesis.

Purpose: Apraxia of eyelid opening (AEO) has been defined by the presence of an intermittent nonparalytic bilateral loss of the volitional ability to open the eyes or to maintain the eyelids in a sustained elevated position. It is not known whether the condition represents an apraxia, a dystonia, or a freezing phenomenon, and several different nomenclatorial terms have been suggested for this condition including the so-called AEO (scAEO), blepahrocolysis, focal eyelid dystonia, and so on. The primary goal of this review is to attempt to clarify the pathogenetic mechanisms underlying scAEO as a clinical phenomenon.

Orbital Vascular Anomalies: A Nomenclatorial, Etiological, and Nosologic Conundrum.

Purpose: Vascular anomalies are a heterogeneous group of disorders that frequently present in the periorbital region. They encompass 2 broad entities: vascular tumors, which possess a proliferative endothelium, and vascular malformations, which are basically localized defects of vascular morphogenesis. The primary goal of this review was to address inaccurate or controversial terminology in the oculoplastic literature concerning orbital and periorbital vascular anomalies and to categorize these lesions in an abridged and simplified hierarchical list that adheres as much as possible to the most recent (2018) iteration for the classification of vascular lesions proposed by the International Society for the Study of Vascular Anomalies (ISSVA).

Embryologic and Fetal Development of the Human Orbit.

Purpose: To review the recent data about orbital development and sort out the controversies from the very early stages during embryonic life till final maturation of the orbit late in fetal life, and to appreciate the morphogenesis of all the definitive structures in the orbit in a methodical and timely fashion.

Methods: The authors extensively review major studies detailing every aspect of human embryologic and fetal orbital morphogenesis including the development of extraocular muscles, orbital fat, vessels, nerves, and the supportive connective tissue framework as well as bone. These interdisciplinary studies span almost a century and a half, and include some significant controversial opposing points of view which the authors hopefully sort out.

Embryologic and Fetal Development of the Human Eyelid.

Purpose: To review the recent data about eyelid morphogenesis, and outline a timeline for eyelid development from the very early stages during embryonic life till final maturation of the eyelid late in fetal life.

Methods: The authors extensively review major studies detailing human embryologic and fetal eyelid morphogenesis. These studies span almost a century and include some more recent cadaver studies.

Dual-sided electrosurgery handpiece for simultaneous tissue cutting and coagulation: first report on a conceptual design validated by an animal experiment.

Objective: To introduce and evaluate the safety of a novel dual-sided electrosurgery handpiece design for simultaneous tissue cutting and coagulation.

Methods: We designed a prototype double-sided handpiece allowing automatic switching between two electrodes with a simple handpiece flip. The concept of the system as a surgical instrument was assessed by an animal experiment.

Revisiting the Role of the Myofibroblast in Socket Surgery: An Immunohistochemical Study.

Purpose: To determine the impact of a single injection of various anti-inflammatory, antimitotic, and antiangiogenic agents on the cell count of myofibroblasts in an eviscerated socket.

Methods: One eye from 15 skeletally mature New Zealand white rabbits was eviscerated, and the rabbits were divided into 5 groups. Each group of 3 rabbits received a 0.

Sevoflurane versus propofol sedation during periocular anesthetic injections in oculoplastic procedures: An open-label randomized comparison.

Purpose: The purpose of the current investigation was to make an objective controlled comparison of pain tolerance, patient satisfaction and potential complications during the injection of local anesthesia in oculoplastic procedures under short-term sedation using inhalational versus parenteral sedatives.

Methods: This was an open-label, randomized clinical trial where patients were randomized to 3 groups. Group I: Sedation with intravenous propofol.

Congenital upper eyelid coloboma: embryologic, nomenclatorial, nosologic, etiologic, pathogenetic, epidemiologic, clinical, and management perspectives.

Purpose: To review the recent literature and describe the authors' experience with congenital upper eyelid coloboma.

Methods: In this review, we will summarize the embryologic and etiopathogenetic bases of congenital upper eyelid coloboma, and study the published clinical reports. We will also attempt to briefly shed some light on the rarer syndromic curiosities associated with upper eyelid coloboma.

Simplified local anesthesia technique for external dacryocystorhinostomy without nasal packing: a new technique and pilot study outcome.

Background: The purpose of this paper is to describe a simplified local anesthesia technique for external dacryocystorhinostomy (EXT-DCR).

Methods: In this pilot, retrospective, noncomparative, interventional case series, 448 patients (480 eyes) underwent EXT-DCR using a simplified local anesthesia technique. Nasal mucosal anesthesia was achieved using combined application of 6 mL of oxymetazoline 0.