The Effect of Intravenous Tranexamic Acid on Postoperative Ecchymoses after Upper Blepharoplasty.

Background: Tranexamic acid has been increasingly used in facial plastic surgery to improve perioperative hemostasis. While subcutaneous tranexamic acid has been found to not significantly decrease postoperative ecchymoses following upper blepharoplasty, systemic administration has not previously been studied.

Methods: A total of 325 patients undergoing upper blepharoplasty were randomly assigned to either receive intravenous tranexamic acid or serve as a control.

Use of oxymetazoline hydrochloride ophthalmic solution, 0.1% for improved lid symmetry in Graves' disease.

Purpose: The purpose of this study is to evaluate the usage of oxymetazoline hydrochloride ophthalmic solution, 0.1% in the treatment of Graves' disease to improve lid symmetry.

Methods: Fourteen patients were identified with unilateral upper eyelid retraction, secondary to Graves' disease.

Surgical treatment of a spontaneous intraorbital arteriovenous fistula with direct embolization via transconjunctival orbitotomy.

Spontaneous arteriovenous fistula is a rare orbital lesion that may cause proptosis, ptosis, chemosis, and visual disturbances. The widely practiced treatment is a transvenous embolization approach accessed from the femoral or petrosal sinus. In this case report, we present a surgical approach via transconjunctival orbitotomy for direct access to achieve complete fistula embolization.

Correction of severe medial ectropion using a novel osseous fixation technique.

Purpose: To study the feasibility of osseous medial canthal fixation for severe medial ectropion.

Methods: Retrospective analysis over a period of 3 years identified 10 patients who had undergone the modified medial canthoplasty. Outcome measures were based on the presence of complications and cosmetic/functional results.

Sebaceous Carcinoma Masquerading As Orbital Cellulitis.

Sebaceous cell carcinoma is an uncommonly encountered cutaneous malignancy. Often considered a great masquerader, sebaceous cell carcinoma arises from meibomian glands and can have a poor prognosis if not diagnosed early. In this case report, we present a patient with sebaceous cell carcinoma who presented to our emergency department with a clinical presentation that was concerning for orbital cellulitis.

Metastatic neuroendocrine carcinoma presenting with left lateral rectus enlargement and orbital cellulitis.

Neuroendocrine tumors (NETs) of the orbit are a rare but increasingly recognized clinical phenomenon. The vast majority of orbital NETs are metastatic, and most metastasize from the gastrointestinal system to the extraocular muscles. While orbital metastasis typically occurs in the setting of a known primary neoplasm, some cases represent the initial manifestation of disease and can precede detection of the primary tumor by many months.

Eyelid margin Kaposi sarcoma leading to AIDS diagnosis.

A wide variety of eyelid lesions are routinely encountered in standard medical practice. Most commonly, these lesions are benign; however, malignant etiologies may present on the eyelid and require further attention. In this case, we present a 51-year-old man with no known medical history who presented to an ophthalmologist for treatment of a lesion on the left lower eyelid, which was presumed to be an inflamed chalazion.

Histologic Evaluation of Nonvisual Afferent Sensory Upper Eyelid Proprioception.

Purpose: Recent research has suggested a possible role for proprioception in ipsilateral frontalis activation in the setting of ptosis; however, there has not been any robust histologic or anatomic evidence to support this theory. To further elucidate proprioceptive structures in the eyelid, this investigation uses validated histologic techniques to explore the presence of proprioceptive structures or afferent neural networks in the Levator Palpebrae Superioris (LPS) and Müller muscle.

Methods: Müller muscle and LPS samples were evaluated by a laboratory with extensive experience with the histology of extraocular muscle proprioception.

Orbitozygomatic approach for bullet retrieval from the temporal fossa.

Gunshot wounds involving the periorbital region pose numerous challenges due to the high morbidity related to direct and collateral ophthalmic injury. Additionally, the critical structures of the orbit are often injured, resulting in a variety of serious sequelae. The technique for bullet retrieval is also a special concern, given the limited space in the orbit and presence of critical structures.

Multicentric Mucinous Adenocarcinoma in the Periorbital Region.

Primary mucinous adenocarcinoma of the skin is an uncommon malignancy in clinical practice, but multicentric presentation of the malignancy is considered even more rare. In this case report, the authors present a 70-year-old woman with multicentric primary mucinous adenocarcinoma of the skin manifesting with 2 separate lesions located on the right eyelid and cheek. Lesion removal and immunohistochemical staining ruled out mucinous adenocarcinoma of the skin secondary to lung or thyroid carcinoma, however, was inconclusive for breast carcinoma.

Rapid and complete vision loss due to idiopathic orbital inflammation with partial recovery following orbital decompression.

We present a case of a 36-year-old man who developed rapid onset of proptosis and orbital compartment syndrome resulting in no light perception vision. He was treated with surgery and subsequent rituximab therapy with some recovery of vision and motility. Though the range of presentations of idiopathic orbital inflammation is broad, such rapid evolution of proptosis with complete vision loss is very uncommon.

Natural killer/T-cell lymphoma invading the orbit and globe.

Natural killer/T-cell lymphomas are extremely rare and carry high mortality rates. Epidemiologically, these cancers tend to affect mainly Asian and South American patients and are associated with Epstein-Barr virus seropositivity. This report details a 78-year-old Vietnamese woman who presented initially with vitritis of unknown cause, but later developed proptosis and conjunctival involvement as her disease spread.

Self-inflicted enucleations: Clinical features of seven cases.

We report the clinical presentation, radiography, and management outcomes of autoenucleations (AE). Charts of 7 patients evaluated at 4 institutions with AE were reviewed. Four males and three females had a mean age of 50 years (range 26-72 years).

Operating room fires in periocular surgery.

Aim: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery.

Methods: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons.

Volumization of the Brow at the Time of Blepharoplasty: Treating the Eyebrow Fat Pad as an Independent Unit.

Purpose: Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit.

Dilated Superior Ophthalmic Vein: Clinical and Radiographic Features of 113 Cases.

Purpose: Dilated superior ophthalmic vein (SOV) is an uncommon radiographic finding. The authors review the presentation, etiology, radiography, and visual implications of 113 patients with dilated SOV.

Methods: An observational case series and multicenter retrospective chart review were conducted.

Evaluating the growth of eyelid lesions: comparison of clinical evaluation and a software-based model.

Purpose: To evaluate the accuracy of clinicians in evaluating the growth of eyelid lesions and to compare the measurements of experienced ophthalmologists to a novel computerized measurement method.

Design: Prospective, single center, observational study.

Methods: Six experienced ophthalmologists were asked to measure 3 simulated eyelid lesions using a slit lamp.

Wingtip Flap for Reconstruction of Full-Thickness Upper and Lower Eyelid Defects.

Purpose: Pentagonal wedge resection is a technique used to address a wide variety of eyelid pathology. This procedure frequently results in excess skin at the apex of the wound, commonly known as a "dog ear." A variety of methods have been described to address the cutaneous redundancy, the most classic of which is the Burow's triangle repair.